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Patient data outage exposes risks of electronic medical records
'Human error' is blamed for a five-hour computer outage last week. It highlights the risks of a nationwide switch to electronic medical records.
By Chad Terhune, Los Angeles Times
August 3, 2012
Dozens of hospitals across the country lost access to crucial electronic medical records for about five hours during a major computer outage last week, raising fresh concerns about whether poorly designed technology can compromise patient care.
Cerner Corp., a leading supplier of electronic health records to hospitals and doctors, said "human error" caused the outage July 23 that it said affected an unspecified number of hospitals that rely on the Kansas City, Mo., company to remotely store their medical information.
Doctors and nurses use these complex computer systems for nearly every task within a hospital, such as recording patient notes, ordering medical tests and drugs, and communicating with one another about lab results and changes in a patient's condition. Adventist Health, which runs White Memorial Medical Center in Los Angeles and 18 other hospitals, and St. Jude Children's Research Hospital were among those affected by the outage.
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July 31, 2012 9:51 pm
Crowdsourcing as catalyst for change
Crowdsourcing has changed from a buzzword to a business model. In simple terms, it means taking a job traditionally done by one person and outsourcing it to a large, undefined group. Think Threadless, where consumers vote on T-shirt designs to be produced. Mob4Hire has a global crowd 45,000 strong that beta tests mobile products. It’s easy to see how crowdsourcing helps solve problems and drive profits in digital and high-tech companies.
But I would argue crowdsourcing’s next frontier should be a less obvious one - the complex, rapidly changing American healthcare system.
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Joe’s view: of NHS IT leadership
As Katie Davis gets ready to leave NHS Informatics, Joe McDonald reflects on previous NHS IT leaders and their legacy.
25 July 2012
I didn’t have a great deal to do with Katie Davis during the short time we coincided at the Department of Health Informatics Directorate.
Since I was “let go” during her tenure, I might be forgiven for feeling some bitterness towards a regime that is nearly over - it has been announced that Davis will leave by 1 September.
I don’t, but I see from the EHI newsfeed that some have been quick to criticise her contribution and point out that her legacy is NHS informatics hopelessly split up across three organisations.
In the future, the Department of Health is meant to do IT policy, the NHS Commissioning Board is meant to commission systems and standards, and the Health and Care Information Centre is supposed to manage and monitor them.
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Stage 3 list for meaningful use coming soon
By Mary Mosquera, Contributing Editor
Created 08/02/2012
WASHINGTON – There’s a new checklist coming to town – and it won’t be easy. That would be Stage 3 of meaningful use.
Indeed, the cadre of tasks, from CDS and care coordination, to quality and safety, patient engagement, and population health, promises to go a long way toward industry improvements in care delivery. Simply put: Physicians and hospitals will need to integrate more clinical decision support (CDS) into their practices and coordinate care more extensively to meet meaningful use measures in 2016.
To make that happen, electronic health records will have to be able to perform more complex functions, such as being able to include external medication lists for drug-drug interactions and be able to catch “never” combinations.
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Portal harmony
Northern Ireland is planning to roll-out an Orion Health portal to give clinicians access to a range of systems, including its Emergency Care Summary. Chris Thorne visited Belfast to see the system in action.
1 August 2012
“For as long as I have been in the IT service, people have wanted to go to one place and log-on and see all the relevant information about a patient,” says Des O’Loan, the electronic care record project lead for Health and Social Care Northern Ireland.
O’Loan’s words could have been uttered by more or less any IT lead or clinician in any health organisation across the UK; and the majority are still searching for a solution.
However, IT directors and senior clinicians in Northern Ireland really seem to believe that they are getting close with an Orion Health web-based portal that gives them access to an electronic care record built out of feeds from existing systems.
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FDA approves electronic pills to track med adherence
August 2, 2012 | By Susan D. Hall
If patients have the stomach for it, doctors can take medication adherence to a whole new depth.
The U.S. Food and Drug Administration has approved tiny digestible microchips that can be added to pills, allowing providers to monitor whether they take their medicine, Medical Xpress reports. The microchips previously had been allowed only in placebos to determine whether they worked and posed no danger. Redwood City, Calif.-based Proteus Digital Health plans to market the chips to drug manufacturers.
The chips, about the size of a grain of sand, are made of copper, magnesium and silicon. They react with stomach juices, then send a signal to a skin patch, which then relays it to a smartphone, then on to the doctor's office. Afterward, the chip dissolves and passes through the digestive system normally.
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Natural-language processing effective for de-identifying clinical health data
August 2, 2012 | By Julie Bird
Using natural-language processing programs to quickly scrub clinical narrative text of personal health information for trend analysis is just as effective as time-consuming record annotation by humans, a new study finds.
Electronic health records contain huge stores of information that researchers can use to analyze who gets sick and why and how treatment regimes affect outcomes. They also can be used to predict emerging health problems among large populations or smaller demographic subsets, or to analyze business practices. But before it can be analyzed, HIPAA privacy rules require either that personal health information is removed, or patients give their consent to the use of their records.
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GAO: Data privacy protection must keep up with technology
August 2, 2012 | By Dan Bowman
Data privacy protection laws should be updated with the ever-changing technology landscape, according to a statement written by Government Accountability Office Director of Information Security Issues Gregory C. Wilshusen presented to a senate subcommittee on homeland security this week.
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AHIMA calls for HIM professionals to be more active in HIEs
August 3, 2012 | By Dan Bowman
Accurate patient identification is crucial to the success of health information exchange efforts, which is why health information management professionals must actively pursue leadership roles within their local HIEs, according to a new white paper published by the American Health Information Management Association.
Such professionals, the paper's authors say, provide added peace of mind with regard to the delivery of quality data. "Ideally, the health data in an electronic record should be accurate, up-to-date and complete; but unfortunately the real world is far from ideal," they say. "High-quality data requires us to have a very clear understanding of the meaning, context, and intent of the data--unambiguous and, ideally, standardized computable definitions of data that can form the basis for future safe decision making."
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AHIMA White Paper Tackles HIE Data Integrity Issues
AUG 2, 2012 5:10pm ET
Health information management professionals should get involved with their local health information exchange because they have expertise to guide data integrity issues, the American Health Information Management Association advises in a new white paper.
The involvement should be at a leadership level, such as on the board or executive committee, or on a specialty committee, such as HIM, finance or audit/compliance, among others, “that develop policy and procedures that ensure health data are accurate, complete, relevant and up to date.”
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Ford shifts gears to mHealth
By Erin McCann, Associate Editor
Created 08/02/2012
DEARBORN, MI – The automotive industry has taken health IT out for a spin, and is liking the way the technology handles.
Officials at Ford Motor Company announced Thursday the advent of its new voice-activated mobile health application, which allows drivers to monitor external allergy, flu and UV conditions.
Company officials say the Allergy Alert app enables allergy sufferers to safely monitor outdoor conditions that may cause symptoms such as scratchy eyes, sore throat and nasal congestion.
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GAO: New tech calls for privacy-law changes
Posted: August 1, 2012 - 2:15 pm ET
Radical changes in information-gathering methods and information-sharing technologies have created loopholes that can render key federal data privacy protection laws ineffective, according to a Government Accountability Office security expert.
That assessment was contained in the written testimony of Gregory Wilshusen, the GAO's information security issues director, before a subcommittee of the Senate Committee of Homeland Security and Government Affairs.
The 22-page GAO statement "Federal Law Should Be Updated to Address Changing Technology Landscape" (PDF) focused on the government's data-handling systems across all agencies and specifically mentioned the 2006 breach of 26.5 million veterans' records by the Veterans Affairs Department as an example of security problems involving personally identifiable data.
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iPhone app checks medication mix for potential interactions
August 1, 2012 3:00 am by Grove, Jennifer Van | 0 Comments
Mango Health is a stealthy startup lifting the veil today on an iPhone app that could save your life.
The beta application allows users to easily enter their medications and supplements by snapping a picture — or by entering text, of course. The app will then determine the potential interactions between medications and nutritional supplements to provide the pill-popper with necessary warnings.
Founded in February, the San Francisco-based startup aims to build health-focused mobile apps that consumers actually want to use.
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Cameron hails plan to utilise patient data
A world-leading initiative to spur medical breakthroughs by making all NHS patient data available for research was announced by the prime minister on Wednesday.
Addressing the inaugural Global Health Policy Summit at London’s Guildhall, David Cameron said the government would consult on changing the NHS constitution to make use of patients’ data for research the “default setting”, requiring people actively to opt out if they did not wish their information to be used.
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Clinical analytics 'next big thing' for health IT
By Erin McCann, Associate Editor
Created 08/01/2012
CLEARWATER, FL – Clinical analytics and business intelligence tools have emerged as a top priority for hospital IT leaders who are moving towards accountable care adoption, according to a Black Book Rankings survey released on Wednesday.
According to survey findings, more than 1,340 hospital IT leaders nationwide indicated clinical analytics to be their highest prioritized system to acquire over the next year. Clinical analytics or clinical decision support (CDS) is the rapidly developing field that harnesses real-time medical data to inference programs in order to generate fact-based diagnostic and therapeutic decisions, capture revenues and save costs.
Black Book officials say all 87 developing accountable care organizations (ACOs) participating in the survey confirmed the need for thoughtful adoption and proper use of evidence-based clinical decision support systems within a certain time frame before their respective ACO operations initiate.
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Patients uneasy about EHR security
By Bernie Monegain, Editor
Created 08/01/2012
ROCHESTER, NY – More needs to be done to assure patients that their personal medical information will be safe and secure as the nation switches to electronic health records, according to a new survey that shows only 26 percent of Americans want digital health records.
The findings come from the third annual Electronic Health Records (EHR) online survey of 2,147 U.S. adults, conducted for Xerox by Harris Interactive in May 2012.
According to the survey, 40 percent of respondents believe digital records will deliver better, more efficient care. That response fell 2 percent from last year's survey, and matches the response reported in 2010. Overall, 85 percent of respondents this year expressed concern about digital medical records.
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New EHR from Lippincott Targeted for Nursing Curricula
AUG 1, 2012 11:58am ET
The Lippincott Williams & Wilkins unit of Wolters Kluwer Health has introduced an educational electronic health records system for use in nursing schools.
The University of Tennessee-Knoxville helped develop the Web-based EHR. “Relying on the limited exposure to EHR technology that nursing students get during their clinical experiences is just not enough,” Tami Wyatt, R.N., associate nursing professor, notes in a statement.
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Twitter helps to predict flu trends in New York
August 1, 2012 | By Dan Bowman
Researchers from the University of Rochester in New York used Twitter to predict flu trends among individuals up to eight days before symptoms became present, according to a recent article in New Scientist.
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Clinical decision support tools top hospital IT leaders' wish lists
August 1, 2012 | By Dan Bowman
Clinical decision support (CDS) will be the highest priority for hospital IT leaders--particularly those in developing accountable care organizations--over the next 12 months, according to the results of a new survey by Black Book Rankings. Just 16 percent of hospital leader respondents said their facilities have the CDS tools they need for accountable care.
Smaller community hospitals with less than 200 beds will comprise the biggest market for CDS vendors in the next 12 months, Douglas Brown, a senior partner who helped with the survey, said in an announcement. According to the survey, more than four-fifths of provider organizations lacking CDS systems plan to acquire at least one clinical analytics tool in that time span.
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Cost benefit unclear on eICU systems
August 1, 2012 | By Susan D. Hall
Remote ICU monitoring can cost hospitals $50,000 to $100,000 per bed, but it's not clear whether the tactic improves outcomes or can show a return on investment, according to a study published in the journal CHEST.
The study, lead by Gaurav Kumar, a fellow at the University of Iowa who is also affiliated with the Veterans Administration Medical Center in Iowa City, involved a review of eight studies, covering 29 ICUs and 26 hospitals.
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CONNECT urges use of patch for better performance
By Tom Sullivan, Government Health IT
Created 07/31/2012
WASHINGTON – The folks behind CONNECT, based on feedback from community members going through ONC onboarding, have made version 3.3.1 available.
CONNECT essentially uses National Health Information Exchange (NwHIN) standards and protocols for secure health information exchange. ONC issued the latest full release, that being 3.3, on March 16 of this year, with improved performance, usability, and higher exchange volume features.
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PE Coach App Aims to Help Veterans Overcome PTSD
July 31st, 2012 by Molly Klinefelter, LAPTOP Editorial Assistant
An interesting new iOS and Android app aims to help veterans overcome post-traumatic stress disorder. The free app, coined PE Coach (for prolonged exposure), was designed by the Departments of Defense and Veterans Affairs to facilitate treatment between therapy sessions.
Prolonged exposure therapy involves a patient revisiting a trauma memory with his or her therapist to emotionally process the event. The theory is that once the memory is processed, anxiety can then decrease and a patient can attempt to begin moving past it.
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Could Liability Concerns Derail Clinical Decision Support?
July 6, 2012
The Institute of Medicine's landmark 1999 report on patient safety, To Err is Human (PDF), estimated that medical errors may be responsible for as many as 98,000 deaths in the United States each year and may cost the health care system up to $29 billion. A substantial number of these errors are medication errors. When prescribed inappropriately, medications can cause serious harm—including drug-drug interactions that can be lethal.
Computerized clinical decision support (CDS) systems have been developed to enhance physician decision-making and to reduce the incidence of avoidable medical errors. Drug-drug interaction warnings are a mainstay of clinical decision support systems, but they give rise to a fundamental problem that has limited much of the utility of those systems to date.
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Top 3 issues facing patient privacy
By Rick Kam, President and co-founder ID Experts
You have greater privacy rights regarding the size of a shirt you purchased online than you do about information in your mental health records under the Consumer Privacy Bill of Rights, issued by the White House in February 2012. At least that’s the position of James C. Pyles, an attorney specializing in patient privacy rights. He authored the forthcoming Health Information Privacy Bill of Rights, an initiative to provide at least the same level of rights to patients as are offered to consumers under the Consumer Privacy Bill of Rights.
The Health Information Privacy Bill of Rights, developed with the American Psychoanalytic Association, comes at a critical time when, with the nationwide implementation of Electronic Health Records (EHRs) and Health Information Exchanges (HIEs), the issue of patient privacy is more important than ever. With the advent of electronic records, Mr. Pyles and others point out that it’s possible to improperly disclose identifiable electronic health information of millions of patients almost instantly.
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5 critical technologies health systems should require
By Michelle McNickle, New Media Producer
Created 07/30/2012
The need for tools that help provide coordinated care is growing. And according to Sai Subramaniam, business head for Life Sciences & Healthcare at Persistent Systems, health IT professionals need to start thinking beyond traditional models of building and running applications, which tend to be "complex and expensive."
"Taking a platform as a service approach (PaaS)… healthcare IT professionals can now focus on building integrated care management applications and providing real
value to physicians and patients," he said.
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5 technologies every hospital should be using
By Michelle McNickle, New Media Producer
Created 09/20/2011
With new health IT products springing up left and right, you may find yourself swimming in a sea of apps, updates, frameworks and systems.
Shahid Shah, enterprise software analyst and owner of the blog The Healthcare IT Guy, breaks it down to the five technologies every hospital should be using.
1. Single Sign-On (SSO) and common identity management with CCOW integration. "Start to phase out all applications that cannot meet common identity or SSO requirements," said Shah. The benefits of SSO are many, and include end-to-end user audit sessions to improve security reporting and auditing as well as significant password help desk cost savings. Likewise, Clinical Context Object Workgroup (CCOW) was designed to allow information sharing between clinical and health IT applications, Shah wrote on his blog, adding that "if a hospital can get their labs, <a href="/directory/electronic-medical-record-emr" target="_blank" class="directory-item-link">EMR, and CPOE vendors to become CCOW compliant, they can share patient context instead of the user having to log in and out of each application separately."
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New CMS Office to Manage Troves of Data
JUL 30, 2012 5:07pm ET
The Centers for Medicare and Medicaid Services recently launched a new Office of Information Products and Data Analysis as it seeks to become more transparent with the data it holds.
The new office will assume responsibility for the following databases and services:
Chronic Condition Warehouse, with data files linked by a unique beneficiary identifier across the continuum of care from 1999 to the present;
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Healthcare Supply Chain Technology Powers Vital Feedback Loop
Scott Mace, for HealthLeaders Media , July 31, 2012
If they ever reboot the old television series, Marcus Welby, MD, there's at least one episode title that could be recycled for the high-tech age: "Feedback."
Doctors today get a lot more feedback than they used to. The public rates them on the Web. Payers scrutinize their charges and make controversial adjustments in reimbursement. And power software evaluates their performance through a vast array of analytical algorithms.
The good news for doctors is that they're not the only targets of all this feedback. Now the very technologies and products they use are being analyzed as never before.
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National IT transfer plans unveiled
31 July 2012 Lyn Whitfield
Staff working for NHS Connecting for Health, its strategic health authority delivery arms, and the Health and Social Care Information Centre face a long period of disruption as a ‘new’ HSCIC is formed.
An ‘informatics functions transfer document’ sent to staff last week says that with just a few exceptions, all CfH, SHA informatics delivery and HSCIC staff will be transferred to the new HSCIC, which will be set up as an executive non-departmental body on 1 April next year.
However, it says that SHA staff may have to transfer to CfH before they can be transferred on again.
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Access to Personal Health Records boost patient loyalty
July 31, 2012 | By Julie Bird
Patients who engage regularly with a personal health record are significantly more likely to remain members of a health plan, a three-year study of Kaiser Permanente patient retention suggests.
The study of 394,214 Kaiser Permanente Northwest members, published online in the July issue of the American Journal of Managed Care, found that members who used Kaiser's personal health record were 2.6 times more likely to stay with Kaiser. PHR use was the third strongest predictor of retention, following membership tenure and illness burden, and was especially noticeable among newer plan members.
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Mount Sinai algorithm predicts drug side effects
July 31, 2012 | By Dan Bowman
A new algorithm developed by researchers at New York-based Mount Sinai School of Medicine aims to help scientists to better understand why different drugs have certain side effects on patients, the school announced. The algorithm assists researchers in building networks from data found in medical records by helping them to better understand interactions like gene-gene, protein-protein and drug side effects.
The researchers, led by Avi Ma'ayan, Ph.D., created 15 types of gene-gene networks using the algorithm. They also found unreported side effects of drugs through a network built via analysis of 1 million patient medical records consisting of common co-prescribed drugs, common side effects and relationships between side effects and drug combinations.
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A Database of All Medical Knowledge: Why Not?
By
Physicians won't become obsolete any time soon, but the comprehensive integration of everything we know about well-being could revolutionize medical care.
Hannibal Hanschke/Reuters
The progress of modern applied science has been defined by a series of outrageously ambitious projects, from the effort to build the first atomic bomb to the race to sequence the human genome.
For scientists and engineers today, perhaps the greatest challenge is the structure and assembly of a unified health database, a "big data" project that would collect in one searchable repository all of the parameters that measure or could conceivably reflect human well-being. This database would be "coherent," meaning that the association between individuals and their data is preserved and maintained. A recent Institute of Medicine (IOM) report described the goal as a "Knowledge Network of Disease," a "unifying framework within which basic biology, clinical research, and patient care could co-evolve."
The information contained in this database - expected to get denser and richer over time -- would encompass every conceivable domain, covering patients (DNA, microbiome, demographics, clinical history, treatments including therapies prescribed and estimated adherence, lab tests including molecular pathology and biomarkers, info from mobile devices, even app use), providers (prescribing patterns, treatment recommendations, referral patterns, influence maps, resource utilization), medical product companies (clinical trial data), payors (claims data), diagnostics companies, electronic medical record companies, academic researchers, citizen scientists, quantified selfers, patient communities - and this just starts to scratch the surface.
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Top 5 health conditions for telemedicine treatment
By Steff Deschenes, New Media Producer
Created 07/27/2012
Providers of cellular and satellite networking services for connecting telehealth and other non-phone wireless devices are approached every day with new use case scenarios about how telemedicine can provide novel value. Those applications are growing rapidly in the market.
Healthcare IT News spoke with Alex Brisbourne, president and COO of KORE Telematics, a wireless network provider focused on the M2M communications market, regarding these evolving telemedicine opportunities. Brisbourne presented the top five health conditions ripe for treatment -- or already being treated -- via telemedicine.
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Device could improve anaemia detection in developing regions
A team of Johns Hopkins biomedical engineering undergraduates has developed a non-invasive way to identify women with anaemia in developing nations.
Dubbed HemoGlobe, the device is designed to convert the existing mobile phones of community health workers into so-called ‘prick-free’ systems for detecting and reporting anaemia, which is said to contribute to 100,000 maternal deaths and 600,000 newborn deaths annually.
In places where medical care is easily accessible, doctors routinely test pregnant women for anaemia and prescribe treatment, including routine iron supplementation.
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Health IT 'young bloods' report highlights under-35 stars
July 30, 2012 | By Gienna Shaw
A bevy of "young bloods" in health IT are taking on more responsibility and making more enterprise-level decisions, Health Data Management notes in a special report recognizing five under-35 clinicians, administrators and IT staff.
Among them, 29-year-old Michael Dozier, regional information officer at Southeast Health in Cape Girardeau, Mo., tells the publication he's "constantly battling the age thing."
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Goals of mHealth: Better relationships and ROI
By Eric Wicklund, Contributing Editor
BOSTON – The burgeoning mHealth field offers healthcare a wealth of opportunities to engage with patients and provide a satisfactory return on investment. But if mobile medical apps are going to stand any chance of survival – with physicians as well as consumers – they'll have to be able to integrate.
They'll need to integrate with other devices and healthcare platforms, with electronic medical records and personal health records, to give physicians meaningful data with which to improve clinical outcomes. And they'll need to integrate with the consumer's "pleasure points," providing compelling reasons to use them that go beyond those "not-so-sexy" health benefits.
That was the general theme of several sessions at Thursday's mHealth World Congress, in its second day of a three-day stint at the Collonade Hotel in Boston.
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Monday, July 30, 2012
A Look at the Newly Released HIPAA Audit Program Protocols
On June 26, HHS' Office for Civil Rights released the protocol it is using to audit compliance with various requirements under HIPAA. OCR is performing the audits as part of a pilot program designed to inform a larger, ongoing audit program mandated by the Health Information Technology for Economic and Clinical Health Act.
The protocol, which has been highly anticipated, offers a breakdown of the performance measures against which covered entities (i.e., health plans, health care clearinghouses or health care providers that transmit health information in electronic form in connection with certain transactions) are evaluated during an audit. Thus, it can help covered entities prepare for a HIPAA audit and/or simply self-evaluate their own HIPAA compliance efforts.
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Enjoy!
David.