Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
-----
For ACOs, IT Startup Costs Top $1 Million
Smaller accountable care organizations must pony up $1 million, larger ones $4 million, to get to the starting line, says Black Book report.
By Ken Terry, InformationWeek
September 27, 2012
URL: http://www.informationweek.com/healthcare/clinical-systems/for-acos-it-startup-costs-top-1-million/240008087
September 27, 2012
URL: http://www.informationweek.com/healthcare/clinical-systems/for-acos-it-startup-costs-top-1-million/240008087
The data requirements for launching an accountable care organization will cost smaller ACOs more than $1 million and large ones up to $4 million before they start operations, according to a Black Book survey that included 300 developing and established ACOs.
The survey also reveals that 39% of ACO respondents plan to make most or all of their technology purchasing decisions before the third quarter of 2013. 
-----
An X Prize for Health Care
SEP 27, 2012 5:27pm ET
By now pretty much everyone that is a practicing physician, or has seen the doctor lately, has figured out that doctors in the new era of electronic health records and meaningful use are spending way too much time in the computer (physically and mentally) and not enough time diagnosing and treating patients.
Health care is the ONLY industry on earth that has gone into mass adoption of technology that LOWERS productivity. Nothing wrong with properly digitized health information, but the technology given to doctors is a scandal. And anyone with more than a few years in I.T., or who uses email, knows that manual input of information by humans into computers is extremely error prone (garbage in - garbage out).
-----
FDA must focus on protecting implantable medical devices from hacking
September 28, 2012 | By Julie Bird
The Food and Drug Administration needs to pay more attention to the information security risks for implantable electronic medical devices such as heart defibrillators and insulin pumps, the GAO says, including the threat of hacking and sabotage.
Although the FDA previously has considered information security risks from unintentional threats in select pre-market reviews, the new element highlighted by the General Accountability Office report are intentional threats.
-----
EHR redesign required to better integrate research, practice
September 26, 2012 | By Susan D. Hall
The clinical informatics community must be involved in a redesign of electronic health record systems to encourage data-sharing between healthcare research and clinical practices, writes Keith Marsolo of the biomedical informatics division of Cincinnati Children's Hospital Medical Center in an article published this week in the Journal of the American Informatics Association.
Marsolo cites frustrating examples in which EHRs make it difficult or impossible to use clinical data in research or vice versa. Current systems that in effect offer just an electronic version of a paper chart create "walled gardens" of information that further the disconnect between analyzing information collected and instituting improvements at the point of care, he says. Marsolo calls for a lobbying of EHR vendors to open their systems and design new architectures that allow for the integration of external applications and services.
-----
Docs down on EHRs, healthcare's future
September 25, 2012 | By Marla Durben Hirsch
Physicians are not happy with electronic health records and other aspects of their practices, according to a new study released by the Physicians' Foundation.
The study, which analyzed responses from 13,575, physicians found that while 69.5 percent of respondents have implemented EHRs, only 15.9 percent felt "very positive" about the products; almost the same number, 14.9 percent, were "very negative" about the technology. More than 47 percent were "significantly concerned" that EHRs posed a risk to patient privacy and almost 10 percent found that EHR implementation was one of the least satisfying aspects of operating their practice.
-----
IT staff deficits have CIOs strapped
By Erin McCann, Associate Editor
Created 09/26/2012
ANN ARBOR, MI – Chief information officers (CIOs) at healthcare organizations nationwide are confronted with growing challenges as they continue to see IT staff shortages, according to the findings of a CHIME survey released Thursday.
Officials say the survey highlights the urgent need for IT professionals in the industry, as more than two-thirds (67 percent) of industry CIOs reported deficits on their IT staffs, up from 59 percent in 2010.
As in 2010, respondents said they are in need of specialists capable of implementing and supporting clinical applications, such as electronic health records (EHRs) and computerized provider order entry. Some 74 percent of respondents to the CHIME survey indicated they most need clinical software implementation and support staff, similar to the 70 percent who said they needed clinical implementation and support staff in the 2010 survey.
-----
CSC axes GP software line-up
21 September 2012 Rebecca Todd
CSC has confirmed it is withdrawing Synergy, Premiere and Ganymede from the primary care market, but will support the products for at least another year.
EHealth Insider reported this week that the company had decided to pull its former iSoft products from the NHS GP IT market, but the company said the suggestion was “speculation”.
However, the company sent out an announcement to customers at noon today confirming the decision.
-----
Hospital CIOs: The biggest challenge in 2013 will be ...
September 27, 2012 | By Dan Bowman
Healthcare technology professionals have had their fill of challenges in 2012, from working to meet Stage 1 of Meaningful Use, to preparing for other government initiatives, such as the switch to ICD-10 coding--which has been pushed back by a year. As the year begins to wind down, we wanted to know what looming challenges will be top-of-mind for such hospital CIOs entering 2013.
Not surprisingly, Meaningful Use and ICD-10 remain in the forefront for some professionals. Stephen Stewart, CIO at Henry County Health Center in Mount Pleasant, Iowa, said the collision of both initiatives will be his organization's most pressing challenge.
-----
Health IT improves hospital quality, research finds
September 27, 2012 | By Julie Bird
Health IT appears to help hospitals focus on quality improvement, reduce mortality rates and improve patient satisfaction, new provisional research published this week by BMC Medical Informatics and Decision Making finds, but hospital quality managers were more likely to see improvement than doctors and nurses.
Previous studies have shown little health IT impact on quality, the researchers at Boston University said, but often evaluated a single technology. The Boston University study considered the combined impact of electronic health records, computerized provider order entry systems, medication management systems, picture archival and communication systems, bar coding and radio frequency identification technology.
-----
Thursday, September 27, 2012
Establishing Trust and Interoperability in the Post-NwHIN Governance Era
At the September meeting of the Health IT Policy Committee, National Coordinator for Health IT Farzad Mostashari announced that the Office of the National Coordinator for Health IT was dropping its plans to issue regulations setting voluntary "rules of the road" for participation in the Nationwide Health Information Network (NwHIN). This action removes one potential tool for advancing a framework of standards and policies to enable digital health information exchange among providers and patients.
With Stage 2 of meaningful use requiring more exchange of digital health information, the need to establish and implement such a framework has never been more urgent. HHS should more actively use its existing authorities to build a virtual network that facilitates the efficient sharing of health information in a way that health care providers and patients trust.
-----
Entirely Predictable Failures
Summary
Poul-Henning Kamp considers that if developers are not getting better, we are going to repeat many of the major IT project failures. He exemplifies with major Denmark project failures.
Poul-Henning Kamp considers that if developers are not getting better, we are going to repeat many of the major IT project failures. He exemplifies with major Denmark project failures.
-----
Feds Want Wider Use Of Health Records Applet
'Blue Button' web applet that provides personal health records has been popular with U.S. veterans; White House now promoting use by private sector insurers.
By J. Nicholas Hoover, InformationWeek
September 25, 2012
URL: http://www.informationweek.com/government/enterprise-applications/feds-want-wider-use-of-health-records-ap/240007937
September 25, 2012
URL: http://www.informationweek.com/government/enterprise-applications/feds-want-wider-use-of-health-records-ap/240007937
Millions more Americans soon will be able to download their personal health records by clicking on a simple "blue button" on the websites of their healthcare providers and insurance companies. The extent to which they do will be a gauge of consumer readiness for a Web application developed and first used by the federal government, an application that last month saw a milestone as its millionth user downloaded his health records using the technology.
-----
Utah health information database failing to deliver
Consumer help » Vendor hired to analyze data goes out of business, and the state lacks the resources to step in.
First Published Sep 24 2012 04:26 pm • Last Updated Sep 25 2012 05:20 pm
It was a data treasure trove promising answers to a question asked by health consumers everywhere: Which doctors, clinics and hospitals deliver the best care for the best price?
But Utah’s All-Payer Claims Database, a repository of all medical and pharmacy insurance claims filed statewide, has failed to deliver.
-----
Report Guides Preparing for Interstate HIE Before a Disaster
SEP 25, 2012 4:05pm ET
A new report from a consortium representing six Gulf States lays out how to make health information exchange among states part of disaster preparedness and response.
The effort, begun in late 2010 and supported by the Office of the National Coordinator for HIT, included representatives from Alabama, Arkansas, Florida, Georgia, Louisiana and Texas. Recommendations in the report pertain to other states, as well. A major goal of the initiative is to incorporate disaster planning earlier in health information exchange projects, according to a new ONC blog posting.
-----
http://www.fiercehealthit.com/story/it-staff-shortages-still-reality-most-healthcare-cios/2012-09-26
IT staff shortages still a reality for most healthcare CIOs
September 26, 2012 | By Dan Bowman
More healthcare organization executives are reporting shortages of IT staff today than two years ago, according to a new survey from the College of Healthcare Information Management Executives. Of 163 CIOs who responded to the survey, more than two-thirds said they're experiencing shortages, up from 59 percent in 2010. The bulk of responses came either from a community hospital (35 percent) or a multi-hospital (32 percent) setting.
-----
Accountable Care: IT Gets Us Only Halfway There
Accountable care organizations rely on software tools to deliver cost-effective care. But ACOs may be built on a shaky foundation.
By Paul Cerrato, InformationWeek
September 24, 2012
URL: http://www.informationweek.com/healthcare/clinical-systems/accountable-care-it-gets-us-only-halfway/240007867
September 24, 2012
URL: http://www.informationweek.com/healthcare/clinical-systems/accountable-care-it-gets-us-only-halfway/240007867
It's hard to imagine a successful accountable care organization (ACO) that doesn't rely heavily on IT. ACOs require that clinicians meet a long list of quality measures to prove that they're acting in an accountable way to reduce costs without reducing the quality of medical services. And most of those metrics are best tracked with software.
But the very foundation upon which ACOs are built could be shaky, making software tools only so effective. Let me explain.
-----
Commentary: Will health IT increase fraud and abuse?
By John Casillas, HIMSS senior vice president, business-centered systems
A September 15 article in the Washington Post examines an area of increasing focus in healthcare -- fraudulent and abusive Medicare billing practices.
The article, Doctors, Others Billing Medicare at Higher Rates, by Fred Schulte, Joe Eaton and David Donald, of the Center for Public Integrity, discusses how, over the past decade, a noted increase has appeared in the amount care providers are billing Medicare. The article goes on to say that “the aggressive push to electronic medical records is likely fueling the trend toward higher codes ..."
By definition, "fraudulent" implies intent to steal or cheat, whereas "abusive" implies theft without prior intent. Nevertheless, abuse results in over-charging for medical treatments.
-----
Onward and upward: ONC to automate Blue Button
By Mary Mosquera, Contributing Editor
Created 09/25/2012
WASHINGTON – Developers in an ONC voluntary community are beginning to drill down into what will be required to automate the Blue Button feature to exchange patient health information at the consumer’s request under different scenarios.
The Blue Button enables patients to view and download their information in simple text format and is currently available to veterans, military service members and Medicare beneficiaries. A few private sector health organizations have begun to make it available to their members.
The ONC’s Standards & Interoperability Framework community has created three panels to identify standards and tools to push personal data to a specific location, such as using Direct secure messaging protocols and the Consolidated Clinical Document Architecture (CDA), and allowing a third-party application to access personal health data on demand, in a pull transmission, according to Doug Fridsma, MD, director of ONC’s Office of Standards and Interoperability and acting chief scientist.
-----
AHA Fires Back at Feds on EHR Billing Controversy
SEP 25, 2012 12:26pm ET
The American Hospital Association has responded to a Sept. 24 letter that the Department of Health and Human Services and Attorney General sent to five hospital associations warning about the use of electronic health records to “game” the billing system and commit fraud. Following is AHA President and CEO Rich Umbdenstock’s response letter on Sept. 24 to the federal agencies:
“America’s hospitals take seriously their obligation to properly bill for the services they provide to Medicare and Medicaid beneficiaries. Hospitals have a longstanding commitment to compliance, establishing programs and committing resources to ensure that they receive only the payment to which they are entitled. We agree that the alleged practices described in your letter, such as the so-called ‘cloning’ of medical records and ‘upcoding’ of the intensity of care, should not be tolerated.
-----
HHS and AG to Hospitals: Stop Using EHRs to Game the Billing System
SEP 25, 2012 12:31pm ET
Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder have sent a letter to five hospital associations warning them against using electronic health records to “game” the billing system. First reported in the New York Times, what follows is the letter to the American Hospital Association, Federation of American Hospitals, Association of Academic Health Centers, Association of American Medical Colleges and National Association of Public Hospitals and Health Systems:
“As leaders in the health care system, our nation’s hospitals have been at the forefront of adopting electronic health records for use in coordinating care, improving quality, reducing paperwork, and eliminating duplicative tests. Over 55 percent of hospitals have already qualified for incentive payments authorized by Congress to encourage health care providers to adopt and meaningfully use this technology. Used appropriately, electronic health records have the potential to save money and save lives.
-----
Put another record on
Rebecca Todd speaks to Dr Charles Gutteridge, the national clinical director for informatics at the Department of Health, about progress on the Summary Care Record project.
20 September 2012
After a slow, then steady, then stop, then start again beginning, the Summary Care Record programme is on track to reach 40m people by early 2014 and the whole population soon after.
More than one third of the population now has an SCR, which contains basic demographic details about them along with allergies, current medications and adverse reactions.
The record is uploaded and automatically updated from a GP practice system to the national data Spine, and the summary information is available at any site with the application needed to view the records.
-----
40m SCRs by 2014
21 September 2012 Rebecca Todd
The Summary Care Record programme is on track to reach 40m people by early 2014.
National clinical director for informatics at the Department of Health Dr Charles Gutteridge told eHealth Insider there is a detailed plan to reach 40.4m records by March 2014 and 42m later that year.
The programme will ultimately reach the entire eligible English population as the SCR team moves to focus on areas that “have not quite got there for whatever reason,” he said.
-----
Healthcare a Seedbed for Analytics Research
Scott Mace, for HealthLeaders Media , September 20, 2012
The healthcare industry, which has long trailed other industries in its use of analytics, is developing into a seedbed for research on advanced analytics, including topics such as natural language processing, artificial intelligence, and genomics.
The healthcare analytics world last year took particular note of IBM's Watson project, a supercomputer able to answer questions posed in natural language that defeated human competitors on the TV quiz show Jeopardy! IBM then announced it was working with Columbia University and others to commercialize Watson for clinical analytics and decision support.
-----
-----
Healthcare IT Leadership Requires a Thick Skin
Scott Mace, for HealthLeaders Media , September 25, 2012
Healthcare is in crisis, and I'm here to report that IT is no panacea.
In fact, if you're in a healthcare IT leadership position, doing your job may feel a bit like running the gauntlet. In this ancient, barbaric practice practiced by both Europeans and Native Americans, prisoners or wrongdoers were forced to run between rows of soldiers or warriors who administered beatings.
Contrast the bright, shiny promises of healthcare IT vendors with the brutal, unforgiving punishment of making wrong choices in IT program selection, training, budgeting, and deployment and you get the picture.
-----
Healthcare claims database at a standstill after vendor goes belly-up
September 25, 2012 | By Susan D. Hall
Utah's statewide repository of medical and pharmacy insurance claims so far hasn't delivered on its promises. On top of that, the state Department of Health employees building it have moved on to other jobs and its data-mining vendor, New Jersey-based Care Advantage, went out of business. As a result, reports comparing the quality at various health centers have not materialized.
Barry Nangle, the interim director of the health department's Office of Health Care Statistics, however, told the Salt Lake Tribune that there is some good news. "The database wasn't satisfying all the users who emerged since we started collecting the data," he said. "Now we're engaging stakeholders in a broader development process than was dictated by the Legislature."
-----
Panel urges FCC role in leading push for wireless healthcare
Posted: September 24, 2012 - 5:15 pm ET
A task force assembled by the Federal Communications Commission said wireless health technologies should become a routine best practice for medical care within the next five years.
The FCC's mHealth task force issued a report (PDF) today that offers five wide-reaching recommendations that aim to spur adoption and implementation of mobile health, wireless health and e-care technologies in the U.S. healthcare system.
-----
IOM: Physicians play key role in stopping health system waste
The institute, which concludes that 30 cents of every health care dollar is wasted, seeks payment incentives and health IT adoption to improve patient outcomes.
Washington To cut down on what it says is a massive amount of waste and inefficiency in health care, an Institute of Medicine report is recommending that physicians and other health professionals become part of a “learning” system that uses new clinical support tools and payment models linking performance to patient outcomes, as well as a team approach to care management.
A panel convened by the institute to look at the challenges facing the U.S. health system found that unnecessary services, fraud and excessive administrative costs accounted for about 30%, or $750 billion, of total health spending in 2009. Wasted resources have human consequences, according to the report, “Best Care at Lower Cost: The Path to Continuously Learning Health Care in America.” According to one outside estimate, 75,000 deaths may have been prevented in 2005 if the quality of care in all of the states had risen to the level of care of the highest-performing state in the nation.
-----
September 22, 2012
New System for Patients to Report Medical Mistakes
By ROBERT PEAR
WASHINGTON — The Obama administration wants consumers to report medical mistakes and unsafe practices by doctors, hospitals, pharmacists and others who provide treatment.
Hospitals say they are receptive to the idea, despite concerns about malpractice liability and possible financial penalties for poor performance.
In a flier drafted for the project, the government asks: “Have you recently experienced a medical mistake? Do you have concerns about the safety of your health care?” And it urges patients to contact a new “consumer reporting system for patient safety.” The government says it will use information submitted by patients to make health care safer.
-----
Consumers embrace health IT, docs lag behind
By Erin McCann, Associate Editor
Created 09/24/2012
EDEN PRAIRIE, MN – When it comes to willingness to interact and engage with health information technology, consumers far surpass their physicians, according to the findings of Thursday’s Optum Institute and Harris Interactive national survey.
Officials say the survey – which includes responses from 4,270 physicians, consumers and hospital executives – provides new insights into U.S. consumers’ willingness to go online to view their medical records and engage with care providers.
-----
4 reasons to welcome the advent of meaningful use Stage 2
By Diana Manos, Senior Editor
Created 09/24/2012
RESTON, VA – With debate still swirling around the Aug. 23rd release of the final rules for meaningful use Stage 2, one CIO offers four reasons to celebrate it.
CIOs should be happy that the final government at last released the final rules for meaningful use Stage 2, says Dave Riley, the chief of informatics at Reston, Va.-based Harris Healthcare Solutions, a commercial and government vendor specializing in business intelligence, meaningful use, workflow management, EHRs and patient portals.
“In doing so we now have a clear target of what needs to be met with respect to compliance for meaningful use Stage 2,” he says. “It is impossible to implement to a moving target and do it well. By coming to closure we now have a known target whether we like it not it is something we can measure our progress against in moving forward and this is good.”
-----
Many mHealth programs lack focus, direction
September 24, 2012 | By Gienna Shaw
Healthcare organizations are forging ahead with mobile health initiatives, but they don't necessarily have a clear game plan for the programs.
In a recent survey, health IT consulting firm Medullan asked more than 100 healthcare provider professionals to name the top driver for their organization's mHealth initiative. The top answer? "No driver."
Nearly a quarter are pursuing an mHealth initiative without a specific driver.
-----
HIMSS asks Congress for national data-matching for HIEs and harmonized privacy regs
September 24, 2012 | By Julie Bird
A leading professional group for health IT executives is urging Congress to remove some of the hurdles complicating the exchange of health information that, in some cases, endanger patient safety.
In documents released this month, the Healthcare Information and Management Systems Society (HIMSS) recommends that Congress:
- Order a study of issues related to matching patient data to the correct records, including suggestions for developing a national patient data-matching strategy.
- Harmonize the hodgepodge of federal and state privacy laws and regulations, which make it a challenge to share information across state lines.
-----
iPhone App From WebMD Helps People Manage Chronic Pain
WebMD has introduced an iPhone app called Pain Coach to help people suffering from chronic pain manage their condition and live a healthier lifestyle.
Just days after Apple announced the iPhone 5, WebMD has introduced an application for the popular smartphone to help people manage chronic pain.
Called WebMD Pain Coach, the free app allows people suffering from chronic back pain to track their symptoms and set goals on how to manage their conditions. They can also share data with physicians on their progress.
-----
Survey: Patients Eager to Use Online Health Tools, Provider Systems Lag
September 21, 2012
According to a recent survey from health analytics and services firm, the Eden Prairie, Minn.-based Optum Institute, consumers are eager to use online healthcare tools, but physician systems aren’t yet up to par. While 70 percent of physicians surveyed said they have basic Electronic Medical Record (EMR) capabilities, only 40 percent of physicians have the capability to engage with patients via email or provide patients with access to their health records.
-----
HIMSS revisits national patient identifier
Posted: September 21, 2012 - 1:45 pm ET
The Healthcare Information and Management Systems Society is asking Congress to study patient identification issues, hinting at the need for another look at the controversial national patient identifier while not specifically asking that an identifier be part of the study.
HIMSS also asked Congress to review and "harmonize" federal and state health information privacy laws.
The request on patient identification was part of the Chicago-based health information technology trade group's legislative agenda, developed for its 2012 policy summit during Health IT Week in Washington this month.
-----
Monday, September 24, 2012
Guarding the Portal: Data Security Needs Rise With Patient Access
Health care providers, already grappling with information security, could see their responsibilities expand as demand grows for patient data access.
Federal policies require physicians and hospitals to make health care data available to patients. And with the increasing use of electronic health records, that handoff increasingly will take place online. A certain degree of electronic access already is required under Stage 1 of the federal government's meaningful use EHR incentive program; that impetus will expand under Stage 2.
Industry executives expect that much of the patient data dissemination will take place through Web-based portals. For many health care providers, this will represent new ground. Hospital and medical practice websites traditionally have been informational, rather than access-oriented. Providers, accordingly, will need to step up their information security and privacy measures.
-----
Enjoy!
David.