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Standardization effort aims to make patient health data in EHRs easier for public health agencies to access, so they can respond more quickly to infectious disease outbreaks.
By Nicole Lewis, InformationWeek
August 23, 2012
August 23, 2012
Preliminary results of a pilot project testing standardized reporting of public health information from electronic health records (EHRs) reveals that by using templates for clinical data, public health officials can improve the quality and coordination of care as they try to contain problems such as West Nile Virus, or outbreaks of whooping cough or flu.
"This was the first pilot implementation of clinical document architecture for the purposes of public health reporting from clinical care providers specifically in the area of communicable diseases," Dr. Nikolay Lipskiy, health IT standards and interoperability lead for the Centers for Disease Control and Prevention (CDC), said in an interview with InformationWeek Healthcare.
Study finds better outcomes as hospitals achieve Stage 1 Meaningful Use, but gains recede in the rush to move beyond those standards.
By Neil Versel, InformationWeek
August 23, 2012
August 23, 2012
Meeting Stage 1 standards for Meaningful Use of electronic health records (EHRs) can help hospitals achieve measurable gains in quality of care, but higher levels of functionality might actually lead to worse clinical outcomes, a new study from Dartmouth College suggests.
Research published in the journal Health Services Research found a small but measurable increase of quality in treatment of inpatients with acute myocardial infarction, heart failure, and pneumonia at hospitals transitioning to EHRs in line with Stage 1 Meaningful Use requirements. But facilities saw a decrease of 0.9 to 1 percentage point for those conditions when moving beyond the 2011 requirements for Stage 1. The changes are more noticeable at hospitals with baseline quality scores in the lowest quartile.
Margaret Dick Tocknell and Scott Mace , August 24, 2012
The final rule for Meaningful Use Stage 2 was released late Thursday afternoon by the Department of Health and Human Services. In a step sure to please many stakeholders, HHS will delay the onset of MU Stage 2 criteria until 2014 to allow time for vendors to develop the necessary certified electronic health record technology.
The 672-page rule specifies the criteria that eligible professionals, hospitals, and critical access hospitals must meet to qualify for Medicare and/or Medicaid electronic health record incentive payments. It also specifies the Medicare payment adjustments that will be made for failing to demonstrate meaningful use of certified EHR technology.
Scott Mace, for HealthLeaders Media , August 14, 2012
This article appears in the August 2012 issue of HealthLeaders magazine.
The debate continues to rage: Are meaningful use requirements too specific or too vague? On target or wide of the mark? It still depends on who you ask.
"If these guidelines remain this rigid, this inflexible, this one-size-fits-all, there may well be a number of physicians who try in good faith and fail," says Steven J. Stack, MD, chair of the board of trustees of the American Medical Association and an emergency physician with Lexington, Ky.–based Saint Joseph Health System.
"It actually ends up creating a lot of unnecessary overhead to offer options," counters John D. Halamka, MD, MS, the CIO of the Beth Israel Deaconess Medical Center in Boston.
Posted: August 23, 2012 - 4:15 pm ET
President Barack Obama named three Presidential Innovation Fellows who will be charged with promoting wider use of the Blue Button, a health information technology service implemented in the Veterans Affairs Department to allow patients and their families to more easily download medical and health records.
Those named to tackle the Blue Button project are: Matt McCall, an information systems expert from Baltimore; Ryan Panchadsaram, founder of Pipette, San Francisco; and Dr. Henry Wei, a physician and information systems expert. The three were introduced as part of a broader announcement of 18 new fellows working on a total of five projects.
August 23, 2012 | By Marla Durben Hirsch
The Centers for Medicare & Medicaid Services has published the final rule outlining the requirements for Stage 2 of the Meaningful Use incentive program, adopting many, but not all of the provisions they proposed in March.
CMS's 672-page rule delays the Stage 2 requirements to 2014, giving providers more time to meet the Stage 2 criteria. No provider will have to follow the Stage 2 requirements before then. Stage 2 originally was slated to begin in 2013
August 24, 2012 | By Dan Bowman
Reaction from healthcare providers and associations alike has been pouring in following the publication of the final rule for Stage 2 of Meaningful Use by the Centers for Medicare & Medicaid Services. While hospital executives like Drex DeFord, CIO of Boston-based Steward Health Care, haven't had even 24 hours to digest the massive, 672-page document, initial responses, thus far, have been mostly positive.
DeFord told FierceHealthIT in an email that after the release of the proposed rule in February, he had particular interest about the timing of the rules and the 365-day attestation requirement. "I felt it was impossible for, not only providers, but [also] vendors, given what was a significantly compressed timeline," DeFord said. "The good news is, my initial read is that they listened, and we've got some breathing room to make the transition to Stage 2 code, giving us more time to plan and do the work better."
August 24, 2012 | By Dan Bowman
The Centers for Medicare & Medicaid Services have officially pushed back the timeline for healthcare organizations to convert to the ICD-10 coding system to Oct. 1, 2014. According to an announcement, which comes on the heels of CMS's unveiling of the final rule for Stage 2 of Meaningful Use, CMS also will establish a unique health plan identifier.
August 22, 2012 By David Raths
In June, the board of the nonprofit Health Information Partnership for Tennessee (HIP TN) announced plans to wind down its operations. The group was created three years ago to help Tennessee create a statewide clinical health information exchange. Officials at HIP TN said the state decided to pursue a simpler strategy that relies on secure email transmission of health information among providers.
And Tennessee may not be the only state changing direction. With limited grant funding and tight time frames, others also are re-evaluating ambitious goals of creating an infrastructure that would allow searching for patient records across hospitals and doctors’ offices statewide. Instead, states are downshifting to more incremental plans that start with enabling email connections between providers or that focus on supporting state Medicaid organizations. (HIEs — health information exchanges — are not to be confused with health insurance exchanges, which are being set up to allow consumers to comparison-shop for health plans.)
By Erin McCann, Contributing Editor
Officials at the West Virginia Health Information Network (WVHIN) announced on Wednesday the launch of two new pilots for its statewide health information exchange (HIE) system.
Wheeling Hospitals and West Virginia University Healthcare are the first to go live with this new part of the statewide WVHIN HIE, a public/private partnership created in 2006 aiming to create a secure electronic health information system for the exchange of patient data among physicians, hospitals, diagnostic laboratories, other care providers and stakeholders.
August 22, 2012 | By Marla Durben Hirsch
Providers need to ensure that their electronic health record systems are in compliance with documentation and coding guidelines to avoid problems during a government or payer audit, according to a recent PhysiciansPractice.com article.
August 22, 2012 | By Marla Durben Hirsch
For anyone out there that doubted whether the Meaningful Use incentive program has influenced the adoption of electronic health records, here's proof, according to a study published this week in the Journal of the American Medical Informatics Association.
The researchers wanted to quantify whether health IT certification and Meaningful Use were making a quantifiable impact on supply and demand in the EHR market. Their study analyzed a cohort of 3,447 hospitals from 2006-2010.
They found that the government programs encouraging the adoption of EHRs were creating substantial changes in the structure of the EHR market, creating a trend toward EHRs and away from paper records. The study also found that there were more vendors in the market, and more competition among those vendors.
August 23, 2012 | By Julie Bird
Data-breach analysis shows portable electronic devices and other easy-to-carry, easy-to-lose items such as CDs and thumb drives pose a growing risk for breaches of personal health information. One consulting group is advising healthcare organizations to avoid storing PHI on those items.
Portable devices, CDs, backup tapes and even X-ray films "may soon pose the greatest risk to [electronic] PHI because they are more prone to loss and theft," the Florida-based accounting and consulting firm Kaufman Rossin & Co. says in a new white paper.
22 August 2012 Rebecca Todd
The Department of Health is re-procuring Choose and Book and wants to remove the use of Cerner Millennium so it owns the intellectual property for the system’s functionality.
The current e-booking service is built on an implementation of Cerner’s Millennium product, using the person and scheduling modules.
A Department of Health market engagement exercise document, seen by eHealth Insider, says it is looking to remove dependencies on commercial-off-the-shelf products - specifically Cerner Millennium - for the provision of business functionality and data access.
Thursday, August 23, 2012
This is an exciting time in health care. Not long ago, the Supreme Court voted to uphold the Affordable Care Act -- historic legislation that has the potential to increase the accessibility of health care coverage, lower health care costs, increase consumer protections and improve the quality of care.
At the Asian & Pacific Islander American Health Forum, we understand that recent investments and reforms like the ACA are critically important; however, the road to health equity is a long one, and more must be done to remove barriers to care and to improve the health of Asian American, Native Hawaiian and Pacific Islander (AA and NHPI) communities. For example, language barriers, communication difficulties and cultural differences are common and frequently obstruct access to health care for many AAs and NHPIs.
Innovative approach to medical data analysis can yield new treatment options at a lower cost.
By Paul Cerrato, InformationWeek
August 21, 2012
August 21, 2012
Healthcare providers are being pushed to deliver more cost effective medical care and to improve the health of not just individual patients but large populations. One key to carrying out both mandates is finding more clinically effective treatment options.
Many academic medical thought leaders insist that the best way to find those treatment protocols is to test them in randomized controlled trials. Such RCTs require a large group of control subjects to receive either a placebo or conventional therapy and a large group to receive the experimental treatment in question. The problem is RCTs are outrageously expensive. In today's cost conscious healthcare system, that's a problem.
Enter comparative effectiveness research. CER compares two or more accepted treatments to determine which are most effective. Medical informatics comes into the picture because it's now possible to get these projects off the ground by analyzing huge patient databases. And much of that patient data can now be gleaned from electronic health record systems.
By Erin McCann, Associate Editor
DEERFIELD, IL – Walgreens, the nation’s largest drugstore chain, announced Wednesday the company is poised to expand its electronic health record (EHR) solution to some 8,000 locations by the end of summer 2013.
Officials say expanding the EHR solution – currently deployed in upwards of 200 stores nationwide – is an effort to integrate the drugstore’s healthcare services further, specifically for immunizations and health testing.
Walgreens tapped Greenway Medical Technologies for the drugstore’s WellHealth EHR, a component of the Walgreens HealthCloud initiative that supports the transformation of its traditional drugstores to health and daily living destinations.
Bill Aylward’s experience as a “frustrated medical director” at Moorfields Eye Hospital NHS Foundation Trust led to him taking on an open source electronic patient record project. Rebecca Todd reports.
21 August 2012
In the cafeteria of Moorfields Eye Hospital, Bill Aylward flicks through an online patient record on his laptop and books the imaginary patient in for cataract surgery.
This functionality is the first phase of the trust’s open source electronic patient record project - Open Eyes - which has been live at the hospital since January.
The patient administration and booking system has been well received, he says, and he is looking forward to the addition of clinical modules in September. His goal is to turn the tables on the disparity between personal and work IT.
He no longer wants to hear clinicians in the café complaining about the IT in their surgeries while happily playing Angry Birds on their iPhones. Rather, he wants to hear them singing the praises of the technology available on the job.
22 August 2012
New research from EHI Intelligence has concluded that English acute trusts are looking at spending £2.7 billion on electronic patient records over the next six years.
The report – ‘Electronic patient records: the £2.7 billion opportunity’ – focuses on how NHS trusts will pick up the pieces from the long wind-down of the National Programme for IT in the NHS, which largely failed in its key task of delivering detailed care records to hospitals.
It concludes that trusts will be taking three approaches; buying new systems from a single supplier, looking to adopt a ‘best of breed’ approach by building on the IT systems that they have, and trying to undertake their own development.
By Patricia Sengstack DNP, RN-BC, CPHIMS, Deputy CIO and Chief of Clinical Informatics at NIH Clinical Center and Marcy Stoots, MS, RN-BC, Principal at CIC Advisory
microscope and a focus for healthcare organizations. The government has studied and reported on it, professional organizations have acknowledged and weighed in on it, private sector institutions have implemented various levels of it, but a standard approach that is evidence based remains elusive.
The November 2011 IOM report, IT and Patient Safety: Building Safer Systems for Better Care, offers 10 recommendations for improvement that rely on both public and private entities stepping up efforts to make reporting of errors an acceptable practice without repercussions. It calls for expanded funding by AHRQ, ONC and the National Library of Medicine for further research, training, and education of safe practices for the design, implementation and usability of EHRs. More importantly, it calls for more research in the area of patient safety as it relates to the use of clinical systems. And while the published data clearly indicates we don’t yet have a handle on the severity, types and volume of the various safety issues that currently exist, there is clear evidence that there are serious unintended consequences that occur as a result of poor system design, implementation and adoption.
21 August 2012 Rebecca Todd
PRIMIS has launched a commercial product and has more than 1,000 practices signed up for it, after losing central funding for its services.
PRIMIS is based at the University of Nottingham and provides health informatics tools, education and training to primary care providers.
The service was centrally funded for 12 years, most recently by the Health and Social Care Information Centre.
Scotland has been quietly surging ahead with its e-health strategy in primary care. Reporter Rebecca Todd went to see what has been achieved.
17 August 2012
Direct from a meeting with consultants in Glasgow, Dr Bill Martin and Dr Bruce Thomson arrive promptly for an interview in Kirklands House, South Lanarkshire.
Their previous meeting, to discuss the electronic discharge summaries sent from Glasgow hospitals to GPs, is just one of many get-togethers they attend on a regular basis.
In fact, when they are asked to list the committees on which they sit, Dr Thomson needs a pen and paper to write them all down.
20 August 2012 Rebecca Todd
All Scottish GP practices have migrated to either EMIS or INPS clinical systems and the country’s General Practice Administration System has been formally shut down.
Scottish health boards decided in 2008 to discontinue support for GPASS after a series of problems and critical reports, and to purchase a commercial product.
Both EMIS and INPS were selected to be on the framework agreement for a replacement system and each board held a mini-competition to decide which to deploy.
Published: August 19, 2012
Before long, your doctor may be telling you to download two apps and call her in the morning.
Smartphone apps already fill the roles of television remotes, bike speedometers and flashlights. Soon they may also act as medical devices, helping patients monitor their heart rate or manage their diabetes, and be paid for by insurance.
The idea of medically prescribed apps excites some people in the health care industry, who see them as a starting point for even more sophisticated applications that might otherwise never be built. But first, a range of issues — around vetting, paying for and monitoring the proper use of such apps — needs to be worked out.
Scott Mace, for HealthLeaders Media , August 21, 2012
"Patient safety is impaired by the failure to quickly fix technology when it becomes counterproductive, especially because unsolved problems engender dangerous workarounds."
Those words might have been spoken at last week's Contra Costa County Board of Supervisors meeting in Martinez, CA, where two nurses went public with concerns about the safety of their county health system's July 1 Epic EMR implementation.
In fact, those words were published in 2008 by the Joint Commission. What healthcare leaders have to ask this week is, how seriously have these problems been addressed, since they are still occurring in 2012?
Scott Mace, for HealthLeaders Media , August 16, 2012
A multimillion-dollar "go-live" implementation of the EpicCare EMR from Epic Systems Corp. came under intense scrutiny Tuesday when two nurses approached the governing body of a California hospital with patient safety concerns.
Those concerns stem from an incident at a Contra Costa County hospital clinic at the West County Detention Facility in Richmond, CA, where one nurse says the Epic system's recommended dosage of a heart medication "could have killed the patient."
"We're unable to document our medication administration correctly," said an emotional Lee Ann Fagan, speaking to the Contra Costa County Board of Supervisors in Martinez, CA.
By Bernie Monegain, Editor
KUALA LUMPUR, MALAYSIA – Rising wealth, aging and growing populations, demand for quality healthcare and an increase in the number of hospitals are driving growth for the healthcare information technology markets in Indonesia and Vietnam, according to new analysis from Frost & Sullivan.
Overall, the total revenue of Indonesia and Vietnam healthcare market will move from $8.20 billion in 2011 to $12.01 billion in 2015, and the compound annual growth rate (CAGR) for the period is 10 percent, Frost & Sullivan notes.
Healthcare spending has increased significantly in the past decade in these emerging economies, helping the industry expand, according to the study, and governments in both countries are also encouraging private sector investment.
By Anthony Brino, Contributing Editor
TOPEKA, KA – Kansas' two largest health systems are now sharing data on a provider-based health information exchange. That's been achieved just as the state's quasi-governmental HIE board is considering dissolving itself, and some significant regulatory debates are waiting to be settled.
Wesley Medical Center and Via Christi Health announced earlier this week that the two systems have started sharing clinical data through the Wichita Health Information Exchange (WHIE), a project using Informatics Corporation of America’s CareAlign platform that links diffuse electronic medical records systems at clinics and hospitals throughout the two networks.
15 August 2012 Chris Thorne
Clinicians from NHS Western Isles are using a mixture of iPods, iPads and PCs for patient handovers following the implementation of Cambric’s Cortix patient safety system.
More than 20 users, including consultants, junior doctors and clinical nurses, are using the wireless system, which has replaced traditional handovers based on daily meetings and sharing of paper notes.
Cortix takes feeds detailing basic patient demographic information from the health board’s Topas patient administration system, which is also supplied by Cambric.
August 20, 2012 | By Susan D. Hall
With the coming Meaningful Use Stage 3 requirements to require greater use of clinical decision support systems, a review of such systems and their use outside healthcare seems particularly apt for looking at lessons learned.
The results are published at BMC Medical Informatics and Decision Making. The researchers were looking for insights that could be generalized to healthcare provider decisions.
August 20, 2012 | By Gienna Shaw
Even the most common functions of the average patient portal are pretty impressive. Patients can check test results, request prescription refills and make appointments without actually having to talk to a human being. It's not hard to see how those functions can improve patient satisfaction and make life a little easier--not only for patients but also for front-line staff.
The technology is not exactly commonplace--in one recent survey, only 30 percent of physicians said they use patient portals. But as the number of providers that do offer patient portals rises, so too will consumers' expectations of them. I've been using my provider's patient portal for at least a couple years now. And I'm getting a little bored--even frustrated--with what once seemed innovative.
By Erin McCann, Associate Editor
MOUNTAIN VIEW, CA – The adoption of advanced health data analytics will continue to increase significantly over the next five years, according to the U.S. Hospital Health Data Analytics Market research analysis.
The analysis, conducted by research firm Frost & Sullivan, projects the usage of advanced health data analytics solutions in hospitals will increase from 10 percent adoption in 2011 to 50 percent adoption by 2016, representing a 37.9 percent compound annual growth rate and a 400 percent uptick in baseline.
Officials say growth will be driven by a combination of changes brought on by the increased use of EHRs.
Kathleen Roney| August 17, 2012
Ninety-one percent of physicians are interested in accessing electronic health records via mobile devices, according to an "EHR Solutions and Mobile Technologies Study" by Vitera Healthcare Solutions, a Tampa, Fla.-based healthcare information technology provider.
Physicians, executives and practice managers were surveyed on how they currently use mobile technologies and how they intend to use them in the future.
Monday, August 20, 2012
A year-and-a-half after the Direct secure clinical messaging protocol emerged upon the scene, it's suddenly attracting a lot of attention across the country.
More than 40 statewide health information exchange entities have implemented or are in the process of implementing Direct, and many of them are contracting with health information service providers to give health care providers the ability to exchange Direct messages. Others are setting up marketplaces for HISPs.
In all, at least 7,000 providers already have signed up with these HISPs. A number of regional HIEs that are not part of the federally funded statewide HIEs also are using Direct in various ways.
Meanwhile, some health IT regional extension centers are encouraging their client practices to adopt Direct, partly as a way to meet the meaningful use criteria for receiving government electronic health record incentives. And there are signs that some health care organizations are starting to use Direct to communicate across their enterprises and even across accountable care organizations.