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November 9, 2011
Our High-Tech Health-Care Future
By FRANK MOSS
Cambridge, Mass.
WHY can’t Americans tap into the ingenuity that put men on the moon, created the Internet and sequenced the human genome to revitalize our economy?
I’m convinced we can. We are in the early phases of the next big technology-driven revolution, which I call “consumer health.” When fully unleashed, it could radically cut health care costs and become a huge global growth market.
Over the past few years, innovations like electronic health records and the use of mobile computing devices in hospitals have begun to improve medical care delivery. Consumer health information Web sites and online disease support groups have made millions of people active participants in their own health care.
But imagine a far more extreme transformation, in which advances in information technology, biology and engineering allow us to move much of health care out of hospitals, clinics and doctors’ offices, and into our everyday lives.
Here’s a picture — inspired by ideas and innovations emerging from university research labs, clinical innovation centers, start-ups and large companies — of how it could work.
It would begin with a “digital nervous system”: inconspicuous wireless sensors worn on your body and placed in your home would continuously monitor your vital signs and track the daily activities that affect your health, counting the number of steps you take and the quantity and quality of food you eat. Wristbands would measure your levels of arousal, attention and anxiety. Bandages would monitor cuts for infection. Your bathroom mirror would calculate your heart rate, blood pressure and oxygen level.
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Annual 1-50 Ranking of States Based on E-Prescribing Use
Shows Nationwide Growth of E-Prescribing
Safe-Rx Awards Salute Top E-Prescribing States, Detail Progress Across All
ARLINGTON, Va. - Nov. 9, 2011 - Surescripts today announced that over 52 percent of office-based doctors now use e-prescribing. The announcement was made over Twitter as part of a nationwide online event featuring healthcare leaders and providers from across the U.S. who gathered to celebrate the sixth annual Safe-Rx Awards, given each year to the top 10 states based on e-prescribing use. To view and participate in the post-event discussion, go to www.surescripts.com/safe-rx where visitors can also find adoption and use statistics for all states and share in the experiences of the individuals and organizations driving the use of e-prescribing across the nation.
"Congratulations to this year's Safe-Rx Award winners and to all the states for taking action to improve one of the most fundamental parts of our nation's health care system," said Harry Totonis, president and CEO of Surescripts. "In three short years, the nation has moved from less than 10 percent to more than 50 percent of physicians e-prescribing. This represents one of the most significant milestones achieved to date in the nationwide effort to adopt and achieve meaningful use of health information technology."
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iPad in Healthcare: Not So Fast
– Tom Kaneshige, CIO
November 07, 2011
A handful of clinicians at Seattle Children's Hospital gave iPads a test run, using them to tap into the corporate network and run critical apps in a virtual desktop environment. The results weren't good: iPads came back with a poor bill of health.
"Every one of the clinicians returned the iPad, saying that it wasn't going to work for day-to-day clinical work," says CTO Wes Wright. "The EMR (electronic medical record) apps are unwieldy on the iPad."
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By Joseph Conn
Where healthcare IT could be improved: Japan (really)
Yesterday, we were talking about health information technology in New Zealand with Dr. John Halamka.
Today, let's go with him to Japan.
The Boston IT maven authored a report for the Center for Strategic and International Studies comparing the U.S. experience in healthcare IT, in particular after Hurricane Katrina, with the needs of Japan in the wake of the triple disasters of an earthquake, a tsunami and the resultant meltdown of a nuclear power plant.
The U.S. seems to be well ahead of Japan on the health IT adoption curve, Halamka reports.
Physicians in Japan, outside of those practicing in academic settings, have not widely adopted electronic health records that include e-prescribing, clinical documentation and electronic laboratory work flow, Halamka wrote. Meanwhile, hospitals there, "have not widely adopted best practices such as computerized provider order entry, decision support systems or healthcare information exchange."
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Electronic medical records rarely encrypted: expert
Wed, Nov 9 2011
WASHINGTON (Reuters) - Electronic medical records, which the Obama administration would like to see widely used, are rarely encrypted so a data breach could be triggered by the simple theft of a laptop or misplaced thumb drive, a privacy expert told lawmakers on Wednesday.
Regulations require healthcare providers to report data breaches unless the data lost had been encrypted.
"We know from the statistics on breaches that have occurred since the notification provisions went into effect in 2009 that the healthcare industry appears to be rarely encrypting data," according to written testimony by Deven McGraw, of the Center for Democracy and Technology.
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November 9, 2011
Province Invests In Electronic Tools To Improve Patient Care: Oswald
Manitoba is launching innovative electronic tools that make the health-care system work better for patients and health-care providers, Health Minister Theresa Oswald announced today.
“Putting better technology in the hands of our health-care providers gives them another way to help patients faster and more effectively,” said Oswald. “The entire health-care system benefits when we find new solutions and opportunities to improve patient care.”
The province has received $1 million from Canada Health Infoway to create eReferral, a tool to help primary-care providers refer their patients to an appropriate specialist and share necessary information through the patient’s electronic medical records. This project is the next step in Manitoba’s successful Bridging General and Specialist Care referral program, which continues to be available to primary-care providers who are not yet using electronic medical records, said Oswald.
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By Joseph Conn
Kiwi IT fruit might be food for U.S. healthcare thought
Here in Chicago, we're familiar with Daniel Burnham's admonition to "Make no little plans."
So, imagine a little Kiwi bird swallowing not a worm, but a python.
Enter Malcolm Pollock, the director of the National Institute for Health Innovation at the University of Auckland in New Zealand.
If New Zealand were a U.S. state, it would rank 25th in population (ahead of Kentucky) at not quite 4.3 million people.
Still, in his recent 38-page white paper, "Modest Costs, Excellent Quality: Information Technology Shapes New Zealand's Healthcare," (PDF) Pollack asks U.S. healthcare IT buyers to consider the IT vendors from way, way down under.
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EHI Intelligence 2011 Market Forecast Report - English NHS IT Market
09 Nov 2011
The EHI Intelligence 2011 Market Forecast Report provides in-depth analysis of the main trends shaping the NHS IT market, focusing on acute and mental health trusts.
In spite of negative comment about the abandoned National Programme for IT in the NHS and general gloom in the public sector, England’s hospitals are set to increase their spend on IT over the next three years.
The Market Forecast Report calculates that local NHS trust spending on information technology is set to rise by 3.7% CAGR (compound annual growth rate) over the next three years. This will take the total size of the locally-determined English NHS hospital and mental health trust IT market to £883m by 2014-15.
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Provider hesitation, confusion key to slow EHR market growth
November 10, 2011 — 8:05am ET | By Marla Durben Hirsch - Contributing Editor
Perhaps not unexpectedly, the market for electronic health record software is strong and is expected to stay that way for several years. According to a new study released this week by Millennium Research Group, the market will enjoy more than 12 percent growth per year, and is expected to reach more than $8.3 billion by 2016. The report comes on the heels of a Frost & Sullivan report that predicts that market revenues for EHR systems will peak at $6.5 billion in 2012 for new licensing and upgrades.
The big drivers of this growth are the government's EHR incentive programs, which provide bonuses to those who adopt EHRs and meet the Meaningful Use requirements, and impose penalties on those who don't starting in 2015.
But the story is a bit more complicated, according to Mickel Phung, a market research analyst and author of the study, who was fairly surprised by the results. "I expected higher growth," he tells FierceEMR. "Early reports from 2008 and 2009 indicated 20 percent growth. That didn't happen."
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Thursday, November 10, 2011
Spotlight on New PHR Model Privacy Notice
Personal health records can help consumers play a more active role in their health care by enabling them to coordinate and manage their health information. However, PHR adoption is subject to a number of obstacles, including consumer privacy concerns.
Recognizing this, the Office of the National Coordinator for Health IT recently released a new PHR Model Privacy Notice (Model Notice) to help providers of Web-based PHRs alert consumers to their data sharing and privacy and security policies. The goal of the Model Notice is to help consumers make more informed decisions when choosing a PHR.
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EHR Vendors Endorse Medical Error Reporting System
As the spotlight shines on electronic health record-related adverse events, vendor group embraces voluntary, anonymous reporting system.
By Neil Versel, InformationWeek
November 07, 2011
Recognizing that electronic health records (EHRs) can and do cause medical errors, a group of EHR vendors has agreed to support a patient-safety organization's online system for reporting adverse events.
The HIMSS EHR Association, an affiliate of the Healthcare Information and Management Systems Society (HIMSS) that represents 44 EHR vendors, announced Monday that it is promoting the use of EHRevent, a year-old reporting system developed by the iHealth Alliance. The iHealth Alliance is a patient-safety organization convened by major U.S. medical societies, medical malpractice insurers, other patient-safety advocates, and liaisons from the U.S. Food and Drug Administration (FDA).
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10 IT challenges for physician practices in 2012
November 08, 2011 | Michelle McNickle, Web Content Producer
By now, we know physician practices have slightly different rules when it comes to their IT, and just as their technology is different, so are the challenges they’ll face in the upcoming year.
Whether it’s meaningful use or simply finding the right personnel, 2012 promises to be chock-full of tricky IT issues for physician practices. Bob Dean, vice president of technology at ChartLogic, gives us the top 10 challenges for physician practices in the new year.
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Carestream gets FDA OK for iPad medical image viewer
November 08, 2011
by Brendon Nafziger, DOTmed News Associate Editor
Carestream Health said Tuesday it received Food and Drug Administration clearance to market a Web-based radiology image viewer for the iPad and other portable devices, so doctors can instantly access imaging data anywhere they are.
The Vue Motion lets referring physicians and other doctors check out MRI scans or other images by logging onto a website. As it's all Web-based and doesn't require storage on the viewing device, it can work with tablets and other mobile devices, as well as laptops, desktops and workstations, Rochester, N.Y.-based Carestream said. It's also compatible with other companies' PACS and can be embedded in an electronic health record.
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Do-It-Yourself IT Solutions
Greg Freeman for HealthLeaders Media , November 8, 2011
Healthcare providers are spending billions to implement EMRs, but progress toward meaningful use is being stymied by a severe shortage of tech professionals who are qualified to set up and maintain these complex systems—and to support the clinicians and staff who use them.
Several efforts are under way to address the shortage for the entire industry, but most of those will not yield benefits any time soon.
In April, HHS awarded $144 million to colleges and universities to create training programs, but some in the industry are skeptical that the programs—some of which can be completed in six months or less—will produce highly skilled workers. Even the better-quality programs won’t turn out techs soon enough to avoid meaningful use delays for most providers.
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Do-It-Yourself IT Solutions
Greg Freeman for HealthLeaders Media , November 8, 2011
Healthcare providers are spending billions to implement EMRs, but progress toward meaningful use is being stymied by a severe shortage of tech professionals who are qualified to set up and maintain these complex systems—and to support the clinicians and staff who use them.
Several efforts are under way to address the shortage for the entire industry, but most of those will not yield benefits any time soon.
In April, HHS awarded $144 million to colleges and universities to create training programs, but some in the industry are skeptical that the programs—some of which can be completed in six months or less—will produce highly skilled workers. Even the better-quality programs won’t turn out techs soon enough to avoid meaningful use delays for most providers.
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A Difficult Balancing Act
Health Data Management Magazine, 11/01/2011
Earlier this year, Janet Spangler got an object lesson in the tension between data access and security. A new patient at Family Medical Associates of Raleigh (N.C.) toted his own laptop into the exam room, recalls Spangler, administrator at the five-physician group practice. When the physician arrived, the patient-a computer technician-turned his laptop around, revealing he had just gained access into the group's ostensibly secure wireless network, then admonishing the physician about the need to improve access controls. "We have since modified our wireless system," Spangler says. "But the experience left us uneasy."
No sensitive information was exposed during the interlude, but the episode gives insight into why Family Medical Associates takes what Spangler describes as "a conservative approach" to data access. Not only did the group bolster its firewall against unwarranted outside intrusion, it put limits on what its own staff can see on the EHR, an ambulatory system from Greenway Medical Technologies that has been in place for five years. The practice even takes the extraordinary step of maintaining any employee medical records on paper-in a locked cabinet-and not on the EHR. "We can restrict access to our online charts, but you don't want records inappropriately accessed by other staff," she explains. "We are all for access if it results in better care. But we are quick to limit access if there's a risk of a security breach."
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Agreement reached on interoperability specs
Posted: November 8, 2011 - 11:15 am ET
A multistate collaboration with multiple health information technology vendors has produced a pair of interoperability specifications to facilitate health information exchange based on the Health Level 7 Continuity of Care Document, a work group that developed the specifications has announced.
The first specification relates to Statewide Send and Receive Patient Record Exchange, which enables encrypted information exchange over the Internet. A second specification is for the Statewide Patient Data Inquiry, which allows a provider to query a health information exchange for records on a specific patient.
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Trusts urged to embrace portals
8 November 2011 Shanna Crispin
NHS trusts have been urged to consider using clinical portals as a way of overcoming restrictions with committing to best of breed systems.
A session on the 'rise of the clinical portal' at EHI Live 2011 looked at how providers in both Scotland and Wales have worked to implement portals, both to give staff access to systems and to encourage data sharing between organisations.
Martin Murphy, the clinical director of the NHS Wales Informatics Service, said implementing a portal was a significant challenge because providers had to break down some initial barriers.
“It’s a long hard slog because you suddenly come across all the technology lock-ins, and you are actually confronting the problems that people have been confronting for the last 20 years, which are ‘how do we get out of these systems?'" he said.
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CEO: How to Integrate IT Staff and Mission
Gienna Shaw, for HealthLeaders Media , November 8, 2011
In last week's column, I wrote that healthcare information technology professionals who identify themselves as healthcare workers?as opposed to HIT workers might be happier and more effective in their jobs.
This week I have a Q&A with Sheila Currans, CEO of the 61-bed Harrison Memorial Hospital in East Cynthiana, KY. Currans talks about the CIO's role in the C-suite, and how IT professionals can better communicate with others in the hospital, contribute to their organization's mission and strategy, and improve patient care.
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IBM aims to prevent readmissions with Watson-based analytics solution
November 1, 2011 — 1:26pm ET | By Ken Terry
In its latest foray into healthcare, IBM has produced a solution that uses its natural language processing (NLP) technology to improve the quality of care and reduce costs. The NLP approach is the same as the one that the IBM Watson supercomputer used to defeat human contestants on the "Jeopardy" TV game show.
Austin, Texas-based Seton Healthcare Family, a healthcare system that is part of Ascension Health, will be the first provider organization to employ IBM's new Content and Predictive Analytics for Healthcare. In combination with other health IT products, Seton will use the Big Blue application--which converts unstructured data into structured data--to focus on the root causes of readmissions and how to ultimately prevent them.
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Meaningful Use about better care, not just better technology
November 5, 2011 — 4:41pm ET | By Ken Terry
About a quarter of hospitals are qualified to meet the Stage 1 Meaningful Use criteria, according to a recent CHIME survey. Many institutions are still finding it difficult to implement the necessary software and reengineer their operations to meet requirements in such areas as computerized physician order entry, quality reporting, and health information exchange.
It's likely that the Centers for Medicare & Medicaid Services (CMS) will push back the starting data for Stage 2 of Meaningful Use from fiscal 2013 to 2014. Yet there already is talk that Stage 2 may be pointless, because few hospitals will be able to achieve the government's goals.
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Louisiana launches health info exchange
Posted: November 7, 2011 - 12:00 pm ET
Louisiana's statewide health information exchange, known as LaHIE, was launched last week by the Louisiana Health Care Quality Forum during the state conference of the Louisiana chapter of the Healthcare Information and Management Systems Society.
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EHR group, iHealth Alliance collaborate on health IT incident reporting
Posted: November 7, 2011 - 4:30 pm ET
The Electronic Health Records Association, an affiliate of the Chicago-based Healthcare Information and Management Systems Society, will team up with the iHealth Alliance, a not-for-profit coalition of medical societies and medical malpractice insurers, to "work collaboratively to support efforts to develop practical, effective and optimized reporting tools to collect information on medical incidents that may be related to the use of health information technology."
The two IT organizations announced in a news release Monday that they had reached a collaborative agreement.
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DH and Intellect draft 'vibrant' plan
7 November 2011 Daloni Carlisle
Intellect and the Department of Health Informatics Directorate have published a draft plan to develop a “healthy and vibrant” NHS IT marketplace.
The draft sets out ideas for how the two bodies will work together. It also sets out ideas for the issues they should explore.
The DH / Intellect collaboration was announced in September when the government announced an "accelerated" dismantling of the National Programme for IT in the NHS, at the end of various Parliamentary and departmental reviews.
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Monday, November 07, 2011
Are There Privacy Impediments to Payers and Providers Joining Forces?
In recent months, the line between health care providers and payers has become more and more gray. With rising frequency, health plans purchase physician groups, physician groups increasingly bear risk and, under the banner of accountable care organizations, a growing spectrum of delivery systems with insurance licenses begins to take shape.
Some have posited that as we consider option after option for a coordinated, high-quality, efficient health care system, the answer may already exist. Can an integrated system where health care providers and payers join forces to increase quality of care and reduce health care costs be the way, or at least one possible way, to successfully reform the system?
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Enjoy!
David.
