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Expert Panel: OpenMRS Implementers: Experiences and Lessons Learned, May 14th to 18th 2012.
Many clinical organizations are working to implement an electronic medical record (EMR) or electronic health record (EHR) to digitize their work and improve the care they can provide. However, many have questions about how to choose an EMR and how to implement these programs.
To answer these questions, we have been fortunate to obtain access to the knowledge resources of four experts in the field of e-health and OpenMRS implementation. OpenMRS is an open source EMR with a community of hundreds of implementers and developers, that have implemented this system in over 130 sites in 50 countries (http://openmrs.org/about/locations/), including the US, South Africa, Germany, the Philippines, and Chile. Further, both the Rwandan and Kenyan governments have chosen OpenMRS for the implementation of their national eHealth infrastructure.
To answer these questions, we have been fortunate to obtain access to the knowledge resources of four experts in the field of e-health and OpenMRS implementation. OpenMRS is an open source EMR with a community of hundreds of implementers and developers, that have implemented this system in over 130 sites in 50 countries (http://openmrs.org/about/locations/), including the US, South Africa, Germany, the Philippines, and Chile. Further, both the Rwandan and Kenyan governments have chosen OpenMRS for the implementation of their national eHealth infrastructure.
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Telemonitoring helps to lower blood pressure rates
By danb
Created May 11 2012 - 11:59am
With an estimated one in three adults in the U.S. suffering from high-blood pressure [1]--which, when combined with stroke, costs the U.S. healthcare system $156 billion annually--it is imperative that better methods of caring for the condition emerge. Telemonitoring research unveiled this week [2] at the American Heart Association's Quality of Care and Outcomes Research Scientific Sessions 2012 in Atlanta provided a glimmer of hope for such patients.
Patients who received telemonitoring help and regular follow-up support from a pharmacist were more likely to have lowered their blood pressure than patients receiving traditional care, according to researchers, led by Karen Margolis, M.D., of Bloomington, Minn.-based HealthPartners Research Foundation.
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Public vs. private HIEs: Room for both?
By danb
Created May 11 2012 - 1:25pm
While private health information exchanges are non-reliant on government handouts and thus, slightly more self-sustaining, according to an article [1] published in this month's Journal of AHIMA, they also, according to some, undermine efforts of public HIEs, which aim to connect providers for the greater good, rather than for greater profits. So the question remains: Is there room for both?
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ONC Seeks Input on NwHIN Governance
MAY 11, 2012 12:05pm ET
The Office of the National Coordinator for HIT has issued a request for information on establishing a governance mechanism for the emerging Nationwide Health Information Network.
The mechanism will include common rules expressing technical, privacy and security, and business practice requirements to create a consistent trust baseline for stakeholders, according to a PowerPoint presentation from ONC. “In the absence of national guidance, states and other private sector stakeholders/consortiums are beginning to develop state/consortium-unique and potentially conflicting governance approaches to electronic health information exchange.”
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5 reasons data inaccuracies occur in EMRs
By Michelle McNickle, Web Content Producer
Created 05/10/2012
Studies have shown in recent years that the quality of data in many electronic medical records is often not very good. According to Peter Witonsky, president and chief sales officer at iSirona, this is largely due to simple inaccuracies that occur more often than we think.
"A lot of these fall into the same category, in my mind, but it's different ways of getting to that category," said said Witonsky. "That latency of data is terrible. We have customers, prior to us, with eight to 10 hours in latency of data, and that's not uncommon. It's not the end of the world, but there are tons and tons of examples of what latency of data will do to decision making on the other side."
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Doctor Fights Back Against Online Complaints
Joe Cantlupe, for HealthLeaders Media , May 10, 2012
On neighborhood Internet community bulletin boards, like the ones I frequent, people write their joys, concerns, and gripes about everyday life, whether it's about a house painter, or the local school system. They also rave about doctors they are crazy about, and occasionally nix those they definitely wouldn't recommend.
But the physician talk is only sporadic, and generally not too specific. There seems to be an understanding that the physician probably lives nearby and might see the negative comments.
Wednesday, May 9, 2012
Health Information Technology in the United States:Driving Toward Delivery System Change, 2012
From the abstract: "Health information technology (HIT) has become central to health care reform policy-making due to its potential to improve efficiency and increase the quality of health care in the United States. Adoption of these technologies has remained a priority of the federal government as evidenced by incentive programs enacted through legislation, including the American Recovery and Reinvestment Act of 2009 and the Patient Protection and Affordable Care Act.
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Friday, May 11, 2012
ONC Must Go Further To Achieve Flexibility in its 2014 Edition
Of the three tenets of meaningful use -- adopt certified electronic health record technology, demonstrate core and menu set requirements, and report on clinical quality measures -- adopting certified EHRs has proven more complicated than most providers anticipated. In an iHealthBeat Perspective last year, we discussed some of the specific challenges that health care providers -- in this context, both eligible hospitals and eligible professionals -- have faced in adopting certified technology. One of the most significant challenges was the Office of the National Coordinator for Health IT's December 2010 clarification that required providers to possess each of the certified EHR's capabilities, not just those that they intended to use to demonstrate meaningful use.
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California Providers Reach Out For EHR Help
Unusually large number of Californian docs ask state's regional extension center, CalHIPSO, for help meeting Meaningful Use regulations, but few have actually achieved MU so far.
May 11, 2012
More than 7,700 healthcare providers have enrolled in the California Health Information Partnership and Services Organization (CalHIPSO), the largest health IT regional extension center (REC) in the nation. This is significantly more than the 6,200 providers who were expected to participate when CalHIPSO started two years ago with $33.2 million in federal grants.
The target population for RECs includes rural and safety net providers, as well as primary care doctors in practices of 10 or fewer physicians. Currently, CalHIPSO's membership is divided about evenly among small private practices, community health centers, and public hospitals and rural providers, said CalHIPSO CEO Speranza Avram in an interview with InformationWeek Healthcare. 
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Experts: Use patients to reduce errors in electronic records
By mdhirsch
Created May 10 2012 - 10:07am
Giving patients better access to their electronic health records is not only part of Stage 2 of Meaningful Use. It's also an effective way to improve the quality of the data, according to a panel of experts who spoke on a recent webinar [1] hosted by the National e-health Collaborative [2], a public-private partnership established by a grant from the Office of the National Coordinator for Health IT (ONC) to foster national health information exchange (HIE).
"You can't proofread your own stuff. You have to have a second pair of eyes," said speaker Dave deBronkart, co-chair of the Society for Participatory Medicine.
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Despite challenges, disruption, experts sunny on HIE market
By gshaw
Created May 10 2012 - 12:08pm
In spite of turmoil, the health information exchange (HIE) market grew more than 40 percent in 2011, according to a Chilmark Research report [1].
"In little over a year we have seen several vendors exit the market, several others enter and the acquisitions of Carefx by Harris and MobileMD by Siemens. We also saw Microsoft pull completely out of the clinical market by turning over all its HIT assets (except HealthVault) to the new joint venture with GE, Caradigm," Chilmark notes in a post [2] about the report.
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New ONC dashboard tracks nationwide HITECH progress
By Mike Miliard, Managing Editor
Created 05/09/2012
WASHINGTON – The Office of the National Coordinator for Health Information Technology (ONC) has launched its new Health IT Dashboard, offering an interactive trove of data related to grants programs, regional extension centers and other measures of health IT adoption.
Chock full of maps, charts and graphs, the dashboard presents comprehensive information about ONC innovation grant programs, and it offers detailed presentations of performance data for programs such as the Health IT Regional Extension Centers and Community College Consortia to Educate Health IT Professionals.
"The release of the Health IT Dashboard is a significant milestone and we are glad to welcome the website as a tool for delivering key data to ONC's stakeholders and the interested public," said Victor Lazzaro, ONC's performance officer and director for the Health IT Dashboard projects.
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Telemental Health Dramatically Cuts Psychiatric Hospitalization Rates
Caroline Cassels
May 9, 2012 (Philadelphia, Pennsylvania) — Providing telemental health (TMH) services to patients living in rural and remote areas dramatically reduces psychiatric hospitalization rates, new research shows.
The first large-scale assessment of TMH outcomes showed that patients' psychiatric hospitalization utilization decreased by about 25%.
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6 keys to the future of analytics and big data in healthcare
By Michelle McNickle, Web Content Producer
Created 05/08/2012
A recently released report by Ewing Marion Kauffman Foundation proves the value of big data is certainly something to take seriously. And as more organizations create plans to make better use of and leverage their big data, Joe Petro, senior vice president of healthcare research and development at Nuance Communications, believes the industry is on the brink of seeing some pretty remarkable things as a result.
Petro outlines six keys to the future of analytics and big data in healthcare.
1. Organizations are "drowning in information, but dying of thirst" at the same time. According to Petro, one CMIO at Nuance sums up the current state of big data eloquently: "When you're in the institution and you're trying to figure out what's going on and how to report on something, he says you're dying of thirst in a sea of information," he said. "And what he means by that is, there's a tremendous amount of information but a big data problem, and the issue is how do we tap into that to make sense of what's going on?" This question applies not only to the patient, Petro continued, but also to the government's plans in regard to disease and population management. "The issue is it isn't organized," he said. "It's a mixture of structured and unstructured data, and what's going to happen over the course of next several years is the government is imposing a tremendous amount of information for folks to report."
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ONC privacy and security guide offers 10 steps for MU
By Mike Miliard, Managing Editor
Created 05/09/2012
WASHINGTON – ONC's Office of the Chief Privacy Officer (OCPO) has published a "Guide to Privacy and Security of Health Information," which aims to help physicians, nurses and IT staff better understand how the safety of patient data is essential to meaningful use of electronic health records and mobile devices.
Earlier this spring Healthcare IT News reported the results of a study from HIMSS Analytics and Kroll that showed security breaches are still widespread in healthcare – despite increased attention paid to patient privacy.
The "HIMSS Analytics Report: Security of Patient Data," suggested that, despite increasingly stringent regulatory activity with regard to reporting and auditing procedures, most providers were prioritizing compliance with the rules over actually bolstering their own organizations' security protocols.
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NHS IT has chance to be a world leader
4 May 2012 Chris Thorne
Katie Davis, the current head of IT for the NHS, has given the NHS an 'eight, possibly' score of confidence in the NHS becoming a world leader in healthcare IT within ten years’ time.
Speaking in a question time panel at the end of the 2012 Health Informatics Congress in London yesterday, the managing director of NHS Informatics at the Department of Health, was asked how likely it was that the UK could gain such a position.
“That’s a tough question, it would be unrealistic to say we will definitely have a world beating IT system in ten years because we are in a period of huge change,” Davis told journalist Nick Ross, who moderated the event. “
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HIPAA changes likely to put onus on vendors to protect data
By danb
Created May 9 2012 - 11:04am
Health IT companies that deal with patient data are more likely to be on the hook for data breaches when highly anticipated changes to the Health Insurance Portability and Accountability Act are announced within the next few months, according to an article posted to Mass High Tech.
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KLAS: Providers Have Big Plans For BI Solutions
05/04/2012 By Kate Gamble Leave a Comment
CIOs Are Looking for More from BI Solutions
Slightly more than half of healthcare providers are planning to buy or replace their business intelligence (BI) solution in the next three years, according to a new KLAS report, which found that those who are in the market are seeking a robust solution.
The report — Business Intelligence Perception 2012: A Wave is Coming — found that providers are looking beyond clinical and financial data needs and targeting solutions that offer predictive analytics, data modeling, forecasting, trending, and other functionalities that will help them get meet regulatory requirements and position their organizations for participating in HIEs and ACOs.
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JAMIA: PHR med review tool reduces discrepancies
Concordance between documented and patient-reported medication regimens and reduction in potentially harmful medication discrepancies can be improved with a PHR medication review tool linked to the provider's medical record, according to a Journal of the American Medical Informatics Association article published online May 3.
Medication-related morbidity and mortality is estimated to result in $76 billion in total costs annually, and adverse drug events are estimated to occur in one-quarter of ambulatory patients. Of these, 11 percent are considered preventable.
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Computer-Based Screening May Reduce Teen Substance Abuse
Last Updated: May 07, 2012.
A computer-facilitated screening and provider brief advice system for primary care can increase adolescent receipt of substance use screening across a variety of practice settings, according to a study published online May 7 in Pediatrics.
MONDAY, May 7 (HealthDay News) -- A computer-facilitated screening and provider brief advice (cSBA) system for primary care can increase adolescent receipt of substance use screening across a variety of practice settings, according to a study published online May 7 in Pediatrics.
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Help! My Shrink Tried To Friend Me
Doctors with bad social media etiquette.
Back in college, a friend of mine was seeing a therapist. It was a small school, and the therapist was always in the commons drinking coffee and smoking with the students, including my friend. It was a little sketchy even back then, but she was sure it would end after college. It hasn’t: More than 20 years later, the shrink is all over Facebook. She’s “liked” my friend’s business Facebook page, she frequently comments on the alumni page, and she’s become Facebook friends with other classmates. My friend is not happy that this ex-therapist—someone with whom she shared deeply personal issues from a difficult time in her life—has taken advantage of easy online access to her, even if it’s virtual. Old classmates you never liked all that much lurking on your page are one thing, but a medical professional who knows your inner secrets is a whole other level of invasion. In my friend’s words: It’s creepy.
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AMA seeks to remedy 'cumbersome' Stage 2 rules
By Mike Miliard, Managing Editor
Created 05/08/2012
CHICAGO – Arguing that changes "are necessary to ensure that the meaningful use program lives up to its intended purpose," the American Medical Association on Monday submitted its comments on proposed Stage 2 criteria to Centers for Medicare and Medicaid Services Acting Administrator Marilyn Tavenner.
Joined by 98 state and specialty medical societies, the AMA sought more flexibility in its formal comments on the proposed rules for Stage 2 of the Medicare and Medicaid electronic health record incentive programs.
Citing the "technological and other challenges" many doctors are experiencing as they work to meet meaningful use, AMA officials offered suggestions for "synchronizing the multiple health IT and quality programs currently underway" in a bid to drive up physician participation.
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mHealth poised to explode, expert says
By Diana Manos, Senior Editor
Created 05/07/2012
MORTON, IL – Mobile health, or mHealth, is poised to explode over the next decade, says Chad Udell, managing director of Float Mobile Learning, a mobile learning consulting, strategy and research firm based in Morton, Illinois.
“Wellness programs and at-home health monitoring are just exploding right now,” Udell says. “So much of this is due to the fact that people like mobile. Mobile is with us all the time. It has facilitated so much bi-directional communication, and it gives us constant connectivity in a very and meaningful way.”
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Report Posits that Decentralized Data Analysis Increases Privacy Safeguards
MAY 7, 2012 4:46pm ET
A recent report from the Center for Democracy and Technology examines decentralizing analysis of health data to better protect privacy.
“As the digitization of health records makes it easier and more cost effective to share and analyze health data, policymakers and businesses are increasingly looking to use health data for secondary purposes--uses beyond that for which the health data were originally collected,” according to the report.
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Politicians block state drug tracking database bill to protect privacy
By danb
Created May 8 2012 - 1:58pm
Despite calls for a drug tracking databases to help curb prescription medication abuse, not everyone is convinced that such databases are the right way to go. For instance, Missouri state Sen. Rob Schaaf helped to block a bill [1] pushing for the creation of a drug tracking database, calling it an invasion of privacy.
"This bill causes every citizen to be forced against their will to give up their ... personal information about the controlled substances they are prescribed by their doctor," he said, according to [2] the Associated Press. Schaaf, who is also a family physicians, was part of an eight-hour filibuster against the bill.
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Somerset plans 4,000 telehealth users
4 May 2012 Lyn Whitfield
NHS Somerset is planning to monitor the symptoms of 4,000 people living with long-term conditions over the next three years, using technology from Safe Patient Systems.
The programme will be one of the largest roll-outs of telehealth monitoring outside the national whole system demonstrator project, and will focus on people with chronic obstructive pulmonary disease, congestive heart disease, and diabetes.
The Safe Mobile care System, which was developed by a consultant surgeon, David Morgan, works by providing patients with a touch-screen mobile phone-style device, which is programmed with personalised care plans from its web-based application software.
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GP prescribing 'could be improved by IT'
2 May 2012 Fiona Barr
Better use of computer systems in general practice could reduce errors in GP prescribing, which are currently found in one in 20 prescriptions, a major study has recommended.
An investigation of prescribing in general practice commissioned by the General Medical Council, found most errors were classified as mild or moderate, but one in 550 was judged to be serious.
It recommends a greater role for pharmacists in supporting GPs, more effective use of IT in general practice, and extra emphasis on prescribing in GP training to address the issue.
Professor Sir Peter Rubin, chair of the GMC, said GPs were typically very busy so it was important to make sure that prescribing was given the priority it needed.
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Climbing the Meaningful Use Mountain
Scott Mace, for HealthLeaders Media , May 8, 2012
Not long before I joined HealthLeaders, I found myself engrossed in a subject that involved technology and medicine, but took place far from the operating room.
The subject was mountain climbing. And the parallels to health system leadership are many. I'll explain. Scaling one of the world's tallest peaks remains an expensive endeavor. Not all calamities can be foreseen. Risks are high. Public exposure is great. (These days, many mountaineers tweet their way to the top.)
In each endeavor, technology continues to make great strides, but often requires a leap of faith, and months, if not years, of preparation. And yet, the best expeditions are guided by seasoned veterans who've often learned the hard way, through failure.
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E-prescribing up by 75% in 2011, Surescripts says
More than half of office-based physicians prescribing electronically
May 4, 2012 | By Alaric DeArment
ARLINGTON, Va. — More than one-third of prescriptions were sent electronically in 2011, the country's largest e-prescribing network said.
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Will Regina Holliday Become Health Care's Rosa Parks?
The protest organized by Regina Holliday over a patient’s right to access their medical information is not quite the same magnitude as agitating for integration in 1950s-era Alabama. Yet there are intriguing similarities between the crusade Rosa Parks launched then and what Holliday is attempting today. Both involve a refusal to accept second-class status and a resolve to push back against entrenched institutions.
Parks’ story is well known. Her refusal to surrender her seat to a white male passenger on a Montgomery city bus in December, 1955, prompted her arrest and a sustained bus boycott by outraged black residents. That boycott’s success propelled a young Martin Luther King, Jr. to the forefront of the fight against segregation. Parks eventually came to be known as the “mother of the modern day civil rights movement.”
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Virtual doctor’s visits catch on with insurers, employers
By Phil Galewitz, Kaiser Health News
Tired of feeling "like the walking dead" but worried about the cost of a doctor's visit, Amber Young sat on her bed near tears one recent Friday night in Woodbury, Minn.
By Todd A. Buchanan, for USA TODAY
Amber Young at home with her husband Bill and sons Cameron, 6, and Brody, 8, as she prepares dinner.
That's when she logged onto an Internet site, run by NowClinic online care, a subsidiary of UnitedHealth Group (parent of health insurer UnitedHealthcare), and "met" with a doctor in Texas.
After talking with the physician via instant messaging and then by telephone, Young was diagnosed with an upper respiratory illness and prescribed an antibiotic that her husband picked up at a local pharmacy. The doctor's "visit" cost $45.
"I was as suspicious as anyone about getting treated over the computer," said Young, 34, who was uninsured then. "But I could not have been happier with the service."
NowClinic, which started in 2010 and has expanded into 22 states, is part of the explosion of Web- and telephone-based medical services that experts say are transforming the delivery of primary health care, giving consumers access to inexpensive, round-the-clock care for routine problems — often without having to leave home or work.
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Markle Foundation releases new policy guide for health IT
By Diana Manos, Senior Editor
Created 05/07/2012
NEW YORK – The Markle Foundation has issued a new resource to help organizations implementing health IT navigate governance, individual consent, procurement and other areas related to secure information sharing.
The May 3rd release of the new Policies in Practice updates a similar resource, the Common Framework, released by Markle in 2006. Since then, the health IT landscape has dramatically transformed, Markle officials said. The passage of the HiTECH Act, new waves of regulation and increased investment in and adoption of health IT have brought both challenges and opportunities.
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IHI puts the spotlight on innovators pursuing better care
By Bernie Monegain, Editor
Created 05/07/2012
CAMBRIDGE, MA – Hospitals, physician practices and health plans across the country are boosting care – and saving millions – by employing quality measures, information technology and plenty of innovation. A new book tells the stories behind the successes.
Maureen Bisognano, president and CEO of the independent, nonprofit Institute for Healthcare Improvement, and Charles Kenney, a healthcare journalist put the spotlight on seven of these organizations in a new book, “Pursuing the Triple Aim.”
The triple aim they refer to is better care, better health and lower costs.
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Digging into docs' love-hate relationship with EHRs
By gshaw
Created May 7 2012 - 11:41am
If you ask a doctor what she hates about electronic health records, you're liable to get an earful. But it turns out that docs have something to say when it comes to what they love about EHRs, too.
Interviews [1] with a number of practitioners in American Medical News reveal some themes.
Docs hate that there's no guaranteed increase in productivity, that EHRs often add extra steps to their workflow and send them hunting for difficult-to-find data, for example.
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Physicians and social media: Follow the money
By kterry
Created May 5 2012 - 1:03pm
Physicians would not be well advised to use social media to connect with patients [1], said family physician Dike Drummond in a recent commentary posted to KevinMD.com--one of the top social media sites for doctors. His view is evidently similar to that of the majority of his colleagues: while 84 percent of physicians [2] use social media for personal reasons and 67 percent for professional purposes, few of them communicate with patients on Facebook, Twitter, or other social sites.
Some experts say that physicians are reluctant to use Facebook or Twitter for patient contact because of privacy or malpractice issues [3]--and that's undoubtedly true in many cases. But Drummond observed that physicians are not paid for going on social media sites with patients unless they have concierge practices. Furthermore, he pointed out, studies show that a third of physicians feel burned out on any given work day. So the extra time and effort required to interact with patients on social media might be the straw that breaks the camel's back, he argued.
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Monday, May 07, 2012
EHR Vendor Contract Controversy Persists
Like many industries that evolve in a somewhat unregulated marketplace, health IT has enjoyed a bit of a Wild West existence, albeit within a highly competitive environment. The scene is changing. Products' merits and their pivotal position within the care delivery system -- particularly with regard to patient safety -- face increasing scrutiny, as quality improvement advocates, policymakers and even the health IT community press for more transparency and, potentially, regulation.
One hot-button issue is electronic health record vendor contract language that some claim impedes safety improvement. Two types of clauses have landed in the limelight:
- "Hold harmless" clauses that require purchasers to indemnify vendors for errors, injuries or malpractice claims arising from use of the product; and
- Clauses that prohibit users' open disclosure of identified product defects, glitches or hazards.
The American Medical Informatics Association, in a November 2010 position paper, and the Institute of Medicine, in its November 2011 health IT safety report, called for eradication of such clauses on the grounds that they run counter to public policy and safety-improvement interests.
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GOODBYE, PAPER
Electronic health records are being used in hospitals and doctors’ offices. So how are they doing? Do the E-records protect and promote patient safety?
Globe Staff / April 30, 2012
The patient who had come to see Dr. Eduardo Haddad had complicated problems — he was obese and diabetic with pulmonary hypertension. As Haddad reviewed the 50-year-old man’s medications, reading from a long list saved in the patient’s electronic health record, a window popped up on Haddad’s laptop. Two of the drugs, when taken together, could make the patient drowsy, it warned.
Haddad, an independent nephrologist in a two-doctor office in Lawrence, calls himself “old-fashioned.” He still keeps a bank of paper records in the receptionist’s office, but the electronic records system he uses each day is advanced. There are tools to screen for adverse drug interactions like this one and prompts to help him make choices about tests and treatments.
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Enjoy!
David.