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HL7 to Explain CDA and CCD Standards in Stage 2
JUL 11, 2012 5:34pm ET
Standards development organization Health Level Seven International on July 13 will host a free Web seminar on the Clinical Documentation Architect Release 2.0 (CDA) and the Continuity of Care Document (CCD).
Both standards are proposed for use in Stage 2 of the electronic health records meaningful use program. CDA is HL7’s standard for exchanging clinical documents, such as discharge summaries, imaging reports, admission and physical forms, and pathology reports, among others.
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Thursday, July 12, 2012
Supreme Court Decision: What We've Learned and Where We're Headed
On June 28, the Supreme Court ruled 5-4 to uphold most of the Patient Protection and Affordable Care Act, President Obama's health care reform law. The opinion upheld the individual mandate requiring most U.S. residents to have health insurance, while striking down the government's threat of withholding existing Medicaid payments to states that choose not to participate in the expanded Medicaid program called for by the ACA. The decision is a landmark one, and now with a final ruling that the law is constitutional, the health care sector can move forward with more clarity.
I've been thinking about the ACA and how it will affect health IT. Although the ruling did not directly touch on IT, it will define the health care landscape and the amount of money spent on improving it in the future. With that backdrop, I've identified key takeaways from the decision and where I see health IT moving forward post-Supreme Court decision.
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Health technology and patient-centered principles shown to improve care
A review of studies suggests the two strategies may be mutually dependent.
Using both patient-centered care principles and health information technology improves care, according to the bulk of evidence published during the last 14 years.
Researchers at the Johns Hopkins University Evidence-Based Practice Center reviewed 327 published articles examining results of health IT tools used in implementing patient-centered care. The studies looked at health outcomes for patients with a range of health conditions, including diabetes, heart disease, depression and cancer. The review was limited to research published in 1998 or later.
“Substantial evidence exists confirming that health IT applications with patient-centered care-related components have a positive effect on health care outcomes,” researchers wrote in a report published June 14 by the Agency for Healthcare Research and Quality.
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New technology could reduce intensive care mortality rates
By PAM ADAMS
Posted Jul 11, 2012 @ 09:39 PM
Last update Jul 11, 2012 @ 10:58 PM
PEORIA —
For now, the basement of OSF Healthcare's corporate headquarters is home to the newest technology in intensive care units, not just for OSF Saint Francis Medical Center, but for OSF Healthcare hospitals in four other cities.
From the ground floor remote location, two nurses - or as one physician referred to them, eRNs, for electronic registered nurses - monitor dozens of ICU patients as if they were just a few steps away.
One of the six computer screens shows patients' electronic medical records. Another monitors vital signs alerting nurses and doctors to potential crises. A third allows the nurses to do virtual rounds on as many as 40 patients. Still another is a virtual ICU version of Skype, allowing two-way audio visual communication between nurses and doctors in ICUs and nurses and doctors in the cramped, ground floor eICU a block from St. Francis.
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Florida Retirement Community Adopts Telehealth as Linchpin of ACO
July 12, 2012 by Jennifer Prestigiacomo
Online care to extend healthcare into the homes of retirees to improve chronic disease management, decrease hospitalizations
“Picture it: Florida, 2012. An elderly diabetic woman turns on her computer and has an online visit with her doctor to check on her blood glucose readings.” Sophia Petrillo, Estelle Getty’s character on Golden Girls, probably would have never fathomed telling this story; however, this story, unlike many of her native Sicilian tall tales, will be coming true. The Villages, the country’s largest senior residential community in the U.S., in partnership with University of South Florida (USF) Health and Boston, Mass.-based American Well, have launched an e-visit telehealth platform to begin its journey toward accountable and patient-centered care.
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Montefiore Hospital Tackles Worrisome Computer Physician Order Entries
Researchers devise tool to track CPOE snafus, such as prescribing drugs for the wrong patient, and suggest ways to reduce potentially life-threatening mistakes.
By Ken Terry, InformationWeek
July 11, 2012
URL: http://www.informationweek.com//news/healthcare/CPOE/240003533
July 11, 2012
URL: http://www.informationweek.com//news/healthcare/CPOE/240003533
Amid growing national concern over the errors that health IT systems may cause, a recent study in the Journal of the American Medical Informatics Association shows how to measure and reduce a marker for a common type of error in computerized physician order entry (CPOE).
The researchers at Montefiore Medical Center in New York wanted to find a way to detect wrong-patient orders in their CPOE system. Since clinician reports were unreliable, they looked at a marker for these errors: the retraction of orders within 10 minutes of placement, followed by reorders 10 minutes later. 
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Personal Tech-Wielding Docs Challenge IT Leaders
Scott Mace, for HealthLeaders Media , July 12, 2012
Healthcare leaders are facing the challenge—and opportunity—presented by physicians and clinicians bringing ever more of their own technology with them to work.
Two years after the iPad's debut, the devices are making inroads in all aspects of society, and healthcare is no exception.
Those who are benefiting now had a virtual desktop strategy already in place. Tablets and other larger-screen devices are often able to fit into the IT picture with relatively little work.
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9 ways future EHRs need to support ACOs
By Michelle McNickle, New Media Producer
Created 07/11/2012
Just a few years ago, the industry saw most vendors touting their support for meaningful use. Today, that focus is slowly shifting to the "ready for ACO" mentality. But unlike meaningful use, said Shahid Shah, software analyst and author of the blog, The Health IT Guy, the technology required for ACOs isn't as well defined, leaving most vendors' claims "untestable."
"Don’t be fooled into buying health IT applications that promote an 'ACO in a box' solution," said Shah. "There is no such technology, and there really can’t be. ACOs are not a technology problem; they are a business model problem first, and until the business side has decided how it will identify savings – and share those savings – any purchase will likely be useless.
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Living with Imperfect Data
By Jim Ericson
JUL 11, 2012 10:49am ET
In a keynote at our MDM & Data Governance conference in Toronto a couple weeks ago, an executive from a large analytical software company said something interesting that stuck with me. I am paraphrasing from memory, but it was very much to the effect of, “Sometimes it’s better to have everyone agreeing on numbers that aren’t entirely accurate than having everyone off doing their own numbers.”
Let that sink in for a moment.
After I did, the very idea of this comment struck me at a few levels. It might have the same effect on you.
In one sense, admitting there is an acceptable level of shared inaccuracy is anathema to the way we like to describe data governance. It was especially so at a MDM-centric conference where people are pretty single-minded about what constitutes “truth.”
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Clinical decision support cuts down antibiotics misuse
July 11, 2012 | By Marla Durben Hirsch
Using an electronic health record's clinical decision support (CDS) system can "substantially" affect the prescribing patterns of antibiotics by primary care practices, according to a new study published in the Journal of the American Medical Informatics Association.
The researchers, from the Medical University of South Carolina, studied 70 adult and pediatric primary care practices in nine states, all using the same EHR system. Nine of the practices were intervention practices using the CDS system; the remaining 61 were control practices. The purpose of the study was to determine if the initiation and daily use of a CDS system for the diagnosis and management of acute respiratory tract infections, which would incorporate diagnosis and treatment information as well as delayed prescription strategies for these infections, would have an impact on the prescribing of antibiotics for these conditions.
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Alignment of e-prescribing incentive programs a step in the right direction
July 11, 2012 | By Marla Durben Hirsch
Well, it isn't perfect, but the Centers for Medicare & Medicaid Services' proposed 2013 fee schedule--set to be published in the Federal Register July 30--does provide some relief for physicians trying to avoid the penalties in the electronic-prescribing (eRx) incentive program by creating two additional hardship exemptions for prescribers also participating in the Medicare and Medicaid EHR Incentive programs.
The eRx incentive program, which began in 2008, uses a combination of incentive payments and payment adjustments to encourage electronic prescribing by eligible professionals. It allows CMS to pay incentives for using e-prescribing systems to prescribe for Medicare patients. The incentives began at 2 percent of allowed charges in 2009 and 2010, dropped to 1 percent in 2011 and 2012, and dropped again to 0.5 percent in 2013.
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EHRs improve hand offs, care coordination in post-acute settings
July 12, 2012 | By Marla Durben Hirsch
Although long term and post acute providers are not part of the Meaningful Use program, their use of electronic health records help improve care transitions of patients, according to health IT expert Bill Russell, M.D., as reported in McKnight's Long Term Care News.
Russell, in a release reflecting on a presentation he gave at the American Health Information Management Association's annual Long Term Care and Post Acute Providers Health IT Summit in Baltimore, noted that EHRs can help acute and post acute providers work together and coordinate care.
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http://www.healthdatamanagement.com/news/hie-health-information-exchange-direct-project-44721-1.html
AAFP: ‘Worry Free’ Direct Protocols Key to Data Exchange
JUL 10, 2012 4:48pm ET
Use of the Direct Project protocols for secure messaging of protected health information in a ubiquitous and “worry free” environment would represent a major breakthrough for interoperable health data exchange, according to the American Academy of Family Physicians.
AAFP recently sent a comment letter to the Office of the National Coordinator for Health Information Technology in response to a request for information on governance of the Nationwide Health Information Network.
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Federal Regulation of HIT Embedded in New Law
JUL 11, 2012 12:06pm ET
President Obama has signed the Food and Drug Administration Safety and Innovation Act, which includes language to establish federal regulation of the safety and functionality of health information technology applications, including mobile apps. The bill now is Public Law 112-144.
The new law has many changes for the FDA, including updated user fees that pay for regulatory programs, new policies to better manage drug shortages, and mandated establishment of unique medical device identifiers.
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Interactive record systems boost preventive screening rates
July 11, 2012 | By Susan D. Hall
Patients who used an interactive personal health record (IPHR) were twice as likely to be up to date on preventive screenings such as mammograms and colonoscopy as those who did not, according to research from Virginia Commonwealth University.
The study, published in the Annals of Family Medicine, involved eight primary care practices and 4,500 patients. The research came out of the university's Cancer Prevention and Control program at Massey Cancer Center.
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Researchers develop secure protocol for linking data registries
July 11, 2012 | By Dan Bowman
Researchers studying the effectiveness of HPV vaccinations have developed a practical and secure protocol for linking data registries from different organizations, according to a study published this week in the peer-reviewed science journal PLoS ONE. The protocol, which allows for continuous monitoring of vaccine effectiveness, can be applied for examination of other similar efforts, including disease surveillance.
The researchers, based at the Children's Hospital of Eastern Ontario Research Institute in Canada, used cryptographic techniques that enable exact matching of records between different registries via identifiers like health card numbers or birth dates, while maintaining privacy. The computation time for scanning through records for as many as 100,000 patients was at worst, just under 4 hours and at best, slightly less than 3 hours.
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http://www.fiercehealthit.com/story/simulated-training-improves-surgical-residents-skills/2012-07-11
Simulated training improves surgical residents' skills
July 11, 2012 | By Susan D. Hall
Simulated training so improved surgical residents' performance that St. Michael's Hospital in Toronto implemented it before the organization published the results of its pilot program in the July issue of the Annals of Surgery.
In the study from the University of Toronto, 25 surgical residents underwent either conventional residency training for laparoscopic colorectal surgery (removing a tumor from the colon) or followed a new curriculum that included a virtual reality simulator, cognitive training (when and how to operate, how to work as a team) and practice on cadavers.
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DataMotion files patent that could simplify Direct exchange
By Jeff Rowe, Editor, EHRWatch
Roughly speaking, Moore’s Law famously holds that the number of transistors on a chip will double approximately every two years, thereby bolstering processing speeds accordingly.
A recent announcement from DataMotion, which specializes in cloud-based data delivery services, makes us wonder if perhaps someone should take a crack at a similar prediction when it comes to health IT.
The announcement revolves around a provisional patent the company recently filed for a new technology that aims to simplify and expedite email communications of personal health data. According to a company release, the new technology, dubbed the "Method and Apparatus for Securely Communicating Using Public/Private Keys," will simplify the process used by the federal Direct Project to create the digital certificates needed for the secure transfer of health information via email.
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4 strategies to combat healthcare fraud
By Craig Miller, Vice president of health strategy and innovation, General Dynamics Information Technology
The healthcare industry continues to face fraud, and much of it goes unexamined every year.
The GAO estimates that in 2010 more than $70 billion in improper payments were made by the federal government within the Medicare and Medicaid programs alone. According to the National Healthcare Antifraud and Abuse Association, between three and ten percent of all healthcare spending is lost to fraud.
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Stroke Telemedicine: An interview with Séamus Watson
By April Cashin-Garbutt, BA Hons (Cantab)
Stroke is the third largest cause of death in England. (1) It is a condition that requires rapid assessment and treatment to reduce deaths, disability and the risk of having another stroke. (2)
Over recent years, medical and technological advances have transformed our understanding of the brain and given the ability to help patients recover from stroke. In order to capitalise on these advances it is important that the symptoms of stroke are swiftly recognised and the patient is brought straight to A&E in order to be treated by a senior stroke specialist.(3)
I recently spoke with Seamus Watson, Head of Public Health Programmes & Public Health Workforce NHS South of England, regarding the use of Telemedicine in the treatment of Stroke patients. Here is what he said.
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'Most Wired' hospitals named for 2012
By Mike Miliard, Managing Editor
Created 07/10/2012
CHICAGO – The 2012 installment of the "Health Care’s Most Wired" survey finds hospitals nationwide leveraging health information technology in new and envelope-pushing ways.
As they deploy IT to improve care and address inefficiencies, hospitals are also concerned with protecting patient data, optimizing patient flow and improving staff communications, according to Hospitals & Health Networks, which polled some 1,570 hospitals for the survey, conducted in partnership with McKesson, the College of Healthcare Information Management Executives (CHIME) and the American Hospital Association.
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3 truths of health data exchange
By Andrew Fitzpatrick, CEO of WPC
In healthcare, the government mandates data structure for certain types of electronic exchange. Despite overwhelming evidence to the contrary, a mentality persists that standardizing and sharing data entails a difficult process to implement. People are often misguided and intimidated by the perceived complexities of structured data along with the technical obstacles of securely exchanging it with other healthcare entities.
Moreover, prior to more recent legislation, there has been little apparent economic incentive to focus on widespread interoperability unless these entities, largely represented by providers and insurers, agree to collaborate and define a clear strategy to achieve productive data exchange. With the introduction of the Nationwide Health Information Network (NwHIN), followed by the Direct Project and CONNECT software, there is hope that important technical obstacles to expanding the secure exchange of health information have been overcome, making it available to all that can benefit by its use.
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E-referral almost complete in Wales
10 July 2012 Chris Thorne
NHS Wales is approaching the completion of the roll-out of its e-referral system, with more than 90% of GP practices now using it.
The Welsh Clinical Communications Gateway was first implemented 18 months ago and allows clinical messages to be sent securely in an electronic format from the GP to the hospital, replacing patient referral letters.
Dr Martin Murphy, clinical director at NHS Wales Informatics service, told EHI Primary Care that the idea stemmed from work by NHS Scotland, which has implemented the Scottish Care Information Gateway, which is used by over 95% of GPs.
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End game for Davis and CfH announced
9 July 2012 Lyn Whitfield
Katie Davis will step down as managing director for NHS Informatics by 1 September, according to an internal memo circulated to NHS Connecting for Health staff at the end of last week.
The memo, seen by eHealth Insider, says the director responsible for the day to day delivery of NHS programmes and services, Tim Donohoe, will take-over Davis’ role until CfH itself shuts at the end of March 2013.
Davis took over from Christine Connelly, the Department of Health’s director general of informatics and the NHS’ first - and possibly last - chief information officer, when Connelly stepped down in June last year.
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NCQA Preps Specialists for Patient-Centered Medical Homes
Scott Mace, for HealthLeaders Media , July 10, 2012
Public comment wraps up this week on a major effort to extend the patient-centered medical home into specialty practices.
The National Committee for Quality Assurance (NCQA) is accepting public comments on its proposal until this Friday, July 13.
The Specialty Practice Recognition (SPR) 2013 standard will be published next March, but first, NCQA will consider all public comments on the proposal, and conduct pilot testing of the standard at 14 or 15 specialty physician practices, according to Johann Chanin, NCQA director of product development.
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Global OR solutions market to hit $3.1 billion in 2018
July 10, 2012 | By Julie Bird
The global market for integrating more technology into surgical suites is expected to grow to $3.1 billion in 2018, up from $1.86 billion in 2011, according to a market study from GlobalData.
The efficiencies gained by operating-room solutions allow hospitals to schedule more surgeries, thereby increasing revenue, according to a GlobalData announcement, "Operating Room Solutions Market - An Overview." The report says hospitals also save money by trimming OR support staffing.
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Tenn. winds down state health info exchange in favor of Direct
Posted: July 9, 2012 - 2:15 pm ET
The Health Information Partnership for Tennessee, the state's federally funded, statewide health information exchange organization, has started "winding down" its operations, a state official confirmed.
Instead of running a statewide exchange, Tennessee will focus its efforts on promoting the use of the federally developed Direct exchange protocol for peer-to-peer messaging, according to Will Rice, executive director of the Office of eHealth Initiatives, the state agency that coordinated the formation of the not-for-profit HIP TN in 2009.
The new state aim, Rice said, is to ensure that Tennessee providers meet expected information-exchange goals of the Stage 2 meaningful-use criteria of the electronic health-record incentive payment program funded by the American Recovery and Reinvestment Act of 2009.
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PA Pushes Direct Messaging For Health Data Exchanges
Pennsylvania eHealth Collaborative launches grant program that encourages doctors to use secure emails instead of paper and fax to share patient information.
By Nicole Lewis, InformationWeek
July 09, 2012
URL: http://www.informationweek.com//news/healthcare/interoperability/240003323
July 09, 2012
URL: http://www.informationweek.com//news/healthcare/interoperability/240003323
The Pennsylvania eHealth Collaborative has launched a grant program that encourages healthcare providers to use direct messaging to electronically exchange health information over the Internet. The program takes particular aim at providers who lack the resources or technical capacity to purchase advanced technology.
Direct messaging is based on the Direct Project program, begun two years ago to specify a secure, scalable, standards-based way for healthcare participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. Overseen by The Office of the National Coordinator for Health Information Technology, this one-way exchange allows any licensed, certified, or regulated healthcare provider to share patient information.
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EHR Implementation Still Costs Too Much
Even with the federal government's EHR incentives, many hospitals continue to fret about costs, according to recent KPMG poll.
By Nicole Lewis, InformationWeek
July 09, 2012
URL: http://www.informationweek.com//news/healthcare/EMR/240003310
July 09, 2012
URL: http://www.informationweek.com//news/healthcare/EMR/240003310
Hospitals have always had problems securing the initial down payment for electronic health record (EHR) implementation; a recently released poll from KPMG suggests that financing such projects remains an ongoing concern that promises to last throughout the implementation phase and beyond.
The recently released results of a May poll that surveyed more than 220 hospital and health system administrators found that while 49% of respondents are more than halfway to completing full EHR implementation, 48% of those polled said they are only somewhat comfortable with the level of budgeting their organization planned for EHR deployment. Nine percent said they weren't comfortable at all with their budget plans, while 18% said they were unsure. On the positive side, 25% said they were very comfortable with the funding they had for their EHR implementation project.
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Tennessee Dissolves its State HIE
JUL 9, 2012 12:01pm ET
Health Information Partnership for Tennessee, the entity responsible for building a statewide health information exchange, is shutting down after the state cancelled its contract in June.
The Tennessee Office of eHealth Initiatives has decided to forgo the HIE and encourage use of the federally developed Direct Project protocols for secure messaging of health information, says Keith Cox, CEO of Health Information Partnership. The Office of eHealth received $11 million in federal stimulus funds for a state HIE and distributed money to the partnership.
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How are you? is very well with award win
9 July 2012 Chris Thorne
Cambridge Healthcare has won HealthInvestor’s Innovation Award for its smartphone enabled web portal that gives patients control of their personal medical records.
'How are you?' was set-up by Dawson King in his attic in April 2011 and has been developed in partnership with the NHS Midlands and East, NHS Connecting for Health and NHS Choices.
The portal has 343 health professionals and 7,432 patients registered across eight regions and is also available in the form of an iPhone application available on iTunes. An Android version is in development.
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Microsoft releases Health Choices app
2 July 2012 Chris Thorne
Health Choices, a smartphone app that provides health guidance and information about NHS services has been released by Microsoft for use on Apple and Android devices.
The app, which was originally released by the company in collaboration with NHS Choices for its Windows Phone last month, gives users access to choice and treatment information from the government’s flagship health website and to Microsoft’s HealthVault platform.
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Mobile health security policies must weigh legal risks as well as privacy
July 9, 2012 | By Susan D. Hall - Contributing Writer
The proliferation of mobile devices in healthcare requires organizations to not only consider the security and privacy issues related to their use, but also the legal risk associated with information contained on them that becomes part of patients' health records, according to an article published this month in the Journal of the American Health Information Management Association.
Author Lydia Washington, director of practice leadership with AHIMA, pointed out that several federal agencies, like the U.S. Food and Drug Administration, have been involved in monitoring use of healthcare mobile devices, so far. Other groups Washington mentioned were the Federal Communications Commission, the Federal Trade Commission, the Office for Civil Rights and the National Institute of Standards and Technology.
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ONC must go slow on NwHIN governance
July 10, 2012 | By Ken Terry
The healthcare and health IT associations that recently slammed the Office of the National Coordinator for IT's plan to devise a governance structure and rules of the road for the Nationwide Health Information Network (NwHIN) have a point: It does look like the heavy hand of federal regulation coming down on a sector that's still trying to find its footing.
Moreover, the stakeholders should be better represented in this initiative than they would be under ONC's plan. Because health information exchange (HIE) is so important to healthcare providers, both public and private entities should have a lot of input into the governance mechanism and the specifications for data exchange.
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Nearly one-fifth of hospitals plan to replace their LIS
By Mike Miliard, Managing Editor
Created 07/06/2012
BURLINGTON, VT – A new report from CapSite finds that 19 percent of hospitals are dissatisfied with their laboratory information systems (LIS) and are planning to replace them. EHR integration and improved efficiency are atop their wish lists.
The 2012 U.S. Laboratory Information System (LIS) Study is the latest in a series of studies evaluating the HITECH Act's impact on EHR adoption, HIE growth and other health IT usage. The report polled 290 hospitals on the market opportunity, vendor mind share and vendor market share across the U.S.
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Monday, July 09, 2012
Hospitals Face Medical Device Security Challenge
Hospitals patrolling their IT systems for security flaws have another group of assets to consider: medical devices that increasingly use wireless technology.
Concerns over medical device vulnerability have grown as machines such as infusion pumps land on hospital networks. Devices that communicate wirelessly add to worries that critical health systems could be breached.
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Enjoy!
David.