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Big Data Brings Big Privacy Concerns
– Kenneth Corbin, CIO
January 24, 2013
WASHINGTON -- When CIOs think of big data, they might envision the technical challenges and opportunities posed by the vast reservoirs of information their companies are collecting and analyzing. But when some policy makers contemplate the same situation, their concerns turn to questions of privacy, and what steps data-rich companies are taking to safeguard consumers' personal information.
Consumer Privacy
In recent years, lawmakers and regulators have voiced mounting concerns about the volume of data that businesses are collecting, how that information is then used and if it is sold, and whether consumers are given meaningful notice about those companies' practices.
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HL7 sharpens focus on clinical quality
By Bernie Monegain, Editor
Created 01/25/2013
Standards group Health Level Seven International (HL7) has formed the Clinical Quality Information Work Group. HL7 plans to offer more education to providers and the new work group will offer leadership in the development of standards artifacts and educational content to all stakeholders involved in quality measurement efforts.
“We are pleased to launch the Clinical Quality Information Work Group, which will provide an organizational infrastructure to collaborate, educate and foster greater communication and coordination with external quality, healthcare delivery and management, professional and government stakeholder organizations, as well as across HL7’s work groups,” Charles Jaffe, MD, CEO of HL7, said in a news release.
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Becoming Your Own Doctor In The Brave New World Of Personalized Medicine
Lately there’s been a lot of talk about personalized medicine. There’s a bold idea going around that people should take control of their own healthcare and manage the flood of new data stemming from a whole bunch of new technologies, including, but hardly limited to, personal genomes, biomarkers, wireless sensors, and iPhone ECGs.
It is unclear how much any of this is ready for prime time in actual medical practice. Although the science and technology advance every day, and there is no question that these will one day play an important role in medical care, there are still very few actual instances where personalized medicine has been shown to benefit patients, and no reason to think that widespread application in the general population would result in significant benefits.
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Attorney: HIPAA Rules Change Game for Cloud Companies
JAN 23, 2013 12:45pm ET
Provisions of the new HIPAA privacy and security rules could change the regulatory landscape for the cloud computing industry, says Robert Belfort, a partner in the health care practice at law firm Manatt, Phelps & Phillips.
Many cloud companies have taken the view that they are not business associates under HIPAA, but some of them now will be, Belfort asserts. The rules change the definition of a BA to include any entity that maintains protected health information. An Internet service provider, such as a cloud company, is not a BA if it does not maintain or at times access PHI, but acts as a conduit with data just passing through, he explains. “But a company that maintains data is a BA even if it doesn’t access the data. I think that will have implications for the cloud industry.”
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#Flu: Researchers analyze Twitter timelines to track outbreaks in real time
January 25, 2013 | By Ashley Gold
While scrolling through one's Twitter timeline, it might sometimes seem like everyone is tweeting about fear of contracting the flu, actually having the flu or just talking about their flu-ridden friends. From a research standpoint, such tweets can be hard to sift through when trying to determine how many people actually were infected with the flu in a given season.
To that end, Johns Hopkins University computer scientists in the School of Medicine recently developed a new Twitter screening method for delivering real-time data on flu cases that determines which publicly available tweets are linked to actual infection, according to a report in HUB, Johns Hopkins' medical research blog. The researchers said that their methods, based on analysis of 5,000 public tweets per minute, are more accurate than other tools and align more closely with government disease data.
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VA Blue Button adds patient summary document tool
By Mary Mosquera
The Veterans Affairs Department has added a new tool through its Blue Button feature so veterans may more easily download a summary of their essential health information. The enhancement is the VA Continuity of Care Document (VA CCD) in xml file format.
The VA CCD uses recognized standards that support the exchange of information between healthcare systems and providers for coordinated and continued care of the patient. VA started Blue Button as an unstructured ASCII text document, a simple download mechanism.
VA has expanded its Blue Button feature with other capabilities, including demographics, active problem list, discharge summaries, progress notes, expanded laboratory results, vitals and readings, pathology reports, radiology reports and electrocardiogram (EKG) list of studies.
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EHR Adoption Pitfalls, Strategies to Overcome Problems Are Focus of White Paper
Posted: 1/23/2013, 5:15 p.m. -- The ability of primary care practices to successfully adopt and use electronic health records (EHRs) is driven, in large part, by how well they integrate EHRs into six major practice areas. That's according to a white paper (15-page PDF; About PDFs) recently issued by Qualis Health, a nonprofit health care consulting company that manages the Washington and Idaho Regional Extension Center (WIREC).
WIREC is one of as many as 70 organizations funded through the Health Information Technology for Economic and Clinical Health Act and charged with helping physicians choose, implement and achieve meaningful use of electronic health records.
Qualis Health uses the experiences of nearly 700 primary care practices that participate in WIREC as the basis for the white paper. It draws on the experiences of the practices to identify common mistakes and pitfalls, as well as specific strategies that could help primary care practices minimize the risk of practice disruption and associated costs.
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Meaningful Use Slowly Increases EHR Use In Hospitals
Expense and resistance to change are among reasons 75% of hospitals still aren't in advanced stages of MU, says Health Information Management and Systems Society.
By Ken Terry, InformationWeek
January 24, 2013
URL: http://www.informationweek.com/healthcare/electronic-medical-records/meaningful-use-slowly-increases-ehr-use/240146903
January 24, 2013
URL: http://www.informationweek.com/healthcare/electronic-medical-records/meaningful-use-slowly-increases-ehr-use/240146903
The advanced use of electronic health records is starting to accelerate in hospitals, mainly because of the government's EHR incentive program, concludes a new analysis of HIMSS Analytics' Electronic Medical Record Adoption Model (EMRAM) scale. The EMRAM scale is an eight-stage model that indicates where hospitals stand on the EHR adoption curve.
A survey by HIMSS Analytics, the research arm of the Health Information Management and Systems Society, indicates that during the five quarters ended in September 2012, the number of U.S. acute care hospitals achieving EMRAM stage 5 or 6 increased by more than 80%; the number of facilities in stage 7 rose 63%. 
Nevertheless, the percentages of hospitals that are actually in these stages show that the majority of facilities have a long way to go before they realize the full potential of their EHRs. In the fourth quarter of 2012, HIMSS Analytics figures show, just 1.9% of hospitals had reached stage 7; 8.2%, stage 6, and 14%, stage 5. Three-quarters of the hospitals were not yet in stage 5.
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Providers: Assess the pros, cons of multifactor authentication for data protection
January 23, 2013 | By Marla Durben Hirsch
Healthcare providers should consider multifactor authentication to better protect their data, according to speakers participating on a recent webinar hosted by HealthcareInfoSecurity.com. The message is particularly relevant in light of a recommendation by the Office of the National Coordinator for Health IT's HIT Policy Committee calling for multifactor authentication as a requirement in Stage 3 of Meaningful Use.
Most entities at present use one form of authentication, such as a password. But authentication also can be something you have, such as a smartcard, or something you are, such as a fingerprint, many of the webinar's speakers stressed.
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Wales leads on dose monitoring
21 January 2013 Becky McCall
NHS Wales is implementing a facility for automated radiation dose monitoring as part of its picture archive and communication system renewal.
Information on radiation doses received from x-ray sources, including computed tomography scanners, across the regions of Wales will be collated and sent to a central database in mid-Wales.
The database will enable various comparisons related to radiation exposure to be made. For example, radiation exposure levels between institutions running equivalent examinations and between old and new equipment.
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Hospitals to have e-records by 2014
22 January 2013 Jon Hoeksma
NHS hospitals will need to have operational electronic patient records working by April 2014 to meet the data flow requirements set by the NHS Commissioning Board and as a milestone towards making the NHS paperless by 2018.
Tim Kelsey, the NHS Commissioning Board’s mercurial director of patients and information, told eHealth Insider: “We’ve said that by April 2014 we are expecting a flow of data out of hospital electronic records, and this clearly implies trusts must have electronic records in place.”
Health secretary Jeremy Hunt announced last week that he wanted electronic records and communications in place across health and social care by 2018 in a speech to the Policy Exchange think-tank.
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Should cash-strapped small practices turn to ad-supported EHRs?
Author Name Jennifer Bresnick | Date January 22, 2013 |
Advertising is everywhere. From your smartphone apps to your radio station to this very article, ads pay the bills for your favorite news outlets, entertainment destinations, and websites. Sometimes they’re annoying, and sometimes they alert you to a useful product or service you might not otherwise find. But should they be integrated into your EHR? With implementation costs soaring into the tens of thousands and no immediate return on such a massive investment, many physicians are saying yes.
The market for EHR advertising revolves around cloud-based services, since advertisers need an internet connection to push ads into their product. With 41% of physicians using cloud services, the market is robust and growing. “Advertising is a natural fit in the healthcare sector,” Bill Jennings, CEO of Good Health Media told Practice Fusion, one of the leading ad-based EHRs. “Doctors get it; they’re comfortable with discreet advertising inside their medical practice. The advertising programs give a small medical practice the chance to add a time-saving, life-saving technology solution – for free. It’s a benefit for the advertiser, the doctor and the patient.”
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Thursday, January 24, 2013
Public Policy for Telehealth in 2013: It's Time for Government To Lead or Get Out of the Way
After 40-plus years of development, telemedicine has finally come of age. Whether you call it telehealth, mHealth or remote monitoring, the deployment of telemedicine is galloping. No longer relegated to a demonstration grants or experimental research, mainstream medicine has joined up with Silicon Valley, private payers and consumer groups to make use of telecommunications technology to transform the delivery of care. Consider these facts:
- More than five million Americans had their medical images read remotely last year;
- Approximately 10% of all the intensive care unit beds in the U.S. use telemedicine;
- According to MobiHealthNews, there are more than 13,000 consumer health applications for the iPhone;
- One million Americans benefit from remote cardiac monitoring for implantable devices or for checking on a suspected cardiac arrhythmia; and
- The American Telemedicine Association estimates that more than 10 million Americans have directly benefited from some sort of telemedicine service this past year, probably double from just three years ago.
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HIPAA Changes Could Create New Bureaucratic Burdens
Modifications to HIPAA may take the focus off patients and pile on administrative work.
By Michelle McNickle, InformationWeek
January 23, 2013
URL: http://www.informationweek.com/healthcare/policy/hipaa-changes-could-create-new-bureaucra/240146842
January 23, 2013
URL: http://www.informationweek.com/healthcare/policy/hipaa-changes-could-create-new-bureaucra/240146842
Changes coming to the HIPAA Privacy and Security Rule mean added administrative work, and they could mean additional reporting, said Lisa Sotto, head of Hunton & Williams' global privacy and data security practice in an interview with InformationWeek Healthcare.
The Department of Health and Human Services recently announced what Office of Civil Rights (OCR) director Leon Rodriguez called "sweeping changes" to HIPAA that will strengthen the OCR's ability to enforce HIPAA.
The changes, also known as the final omnibus rule, are broken down into four parts, HHS explained in a PDF document. Among the four parts are modifications to the HIPAA security rule first proposed in July 2010; changes to HIPAA enforcement to incorporate the tiered civil monetary penalty structure provided by the HITECH Act; a final rule on breach notification for unsecured protected health information under the HITECH Act; and a final rule modifying the HIPAA Privacy Rule as required by the Genetic Information Nondiscrimination Act (GINA) to prohibit health plans from using or disclosing genetic information for underwriting purposes.
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Project shows gains of coordinated care
By Bernie Monegain, Editor
Created 01/23/2013
New findings show that communities where hospitals, other healthcare providers, and community services work together to coordinate evidence-based hospital discharges and provide better support in the community, can see a 6 percent drop in hospitalizations and rehospitalizations, per 1,000 beneficiaries, in just the first two years.
The project relied upon Medicare’s Quality Improvement Organizations (QIOs) to anchor and guide the work, and the average community netted about $3 million in annual savings for Medicare.
The results were released Jan. 22 by the Journal of the American Medical Association (JAMA) in an article titled "Associations between quality improvement for care transitions in communities and rehospitalizations among Medicare beneficiaries."
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Mostashari: ONC more than just a 'cheerleader' for EHRs
January 23, 2013 | By Dan Bowman
National Coordinator for Health IT Farzad Mostashari, in his latest post to the Health IT Buzz blog, touts his office's efforts over the past year for increasing both awareness and implementation of healthcare information technology. Responding to an article published earlier this month in the Boston Globe that classifies the Office of the National Coordinator for Health IT's role primarily as a "cheerleader" for EHR implementation, Mostashari outlines several ways he says his agency goes beyond such a label.
For instance, he breaks down ONC's role into five categories: Meaningful Use, exchange and interoperability, the consumer space, patient safety and privacy and security. With regard to Meaningful Use, he points out how ONC serves as both a regulator that defines EHR policies and a support network for providers looking to successfully install and use such technology via Regional Extension Centers across the country.
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http://www.fiercehealthit.com/story/mayo-clinic-partnership-advance-personalized-medicine/2013-01-23
Mayo Clinic partnership to advance personalized medicine
January 23, 2013 | By Susan D. Hall
Mayo Clinic has announced a strategic partnership with diagnostics company Silicon Valley Biosystems (SV Bio) to advance personalized medicine through genomics.
The arrangement sounds similar to one planned by Children's Hospital Boston and gene-sequencing giant Life Technologies, in which the tech company will provide the platform and the healthcare organization will offer clinical and laboratory expertise.
SV Bio, which just emerged from stealth mode, will provide clinical genome interpretation services and clinical decision support interfaces, according to an announcement. The plan calls for whole genome diagnostics and interpretation at the Mayo Clinic Center for Individualized Medicine and Mayo Medical Laboratories. Financial terms of the deal were not release.
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Patient Safety and the Ethics of EMR Implementation
By Wes Fisher MD, FACC,
Published: January 22, 2013
The implementation of the electronic medical record (EMR) in American medicine gained a powerful foothold in medical care with the passage of the American Reinvestment and Recovery Act (ARRA) in 2009. With the passage of this act came the promise of improved efficiencies, safety and ultimately reduced cost delivery for health care. Also, some $18 billion in financial incentives were offered to physicians to offset costs to deploy these systems nationwide. To assure adoption, if the systems were not implemented by 2015, doctors and care providers will suffer payment penalties from the government. For physicians who care for Medicare patients, there was no alternative other than to deploy these systems.
In 2010 alone, the EMR market was pegged at $15.7 billion, a cost that is ultimately passed to all Americans. In addition, despite all of the changes that health care reform has brought to date, people in some states continue to see their insurance premiums mushroom over 20% in 2013 from the preceding year. Simply put, patients are finding healthcare anything but “affordable.”
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New era of health data security begins
By Mary Mosquera, Senior Editor
Created 01/22/2013
The enhanced set of protections finalized in the omnibus HIPAA privacy and security rule released Jan.17 now becomes the new baseline for anyone who handles health information. It doesn’t change meaningful use requirements, but combined, the two may drive more providers to protect patient data, according to privacy and security experts.
The clear and comprehensive view of privacy, security and enforcement that comprise the final rule today was missing at the dawn of the meaningful use program as physicians and hospitals began to adopt electronic health records (EHRs).
To make up for that, some privacy and security experts were inclined to believe the meaningful use rule should include additional protections, according to Deven McGraw, director of health privacy project at Center for Democracy and Technology and a member of the federal advisory Health IT Policy Committee.
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Scotland gets GP info service
22 January 2013 Rebecca Todd
Scotland is building a national information service for GP data, due to go-live in a year.
Scottish GP and director of the Dundee Health e-Research Centre Frank Sullivan said the plan is to create a national service for GP data to replace the Primary Care Clinical Information Unit, which is being run down.
The PCCIU extracts data from about 30% of practices, but it is hoped that 100% will sign up to the new service.
“That was sufficient for what they wanted to do, but the national information service want to have every practice involved if possible,” said Sullivan.
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Cybersecurity, information exchange top of mind for state CIOs
January 22, 2013 | By Dan Bowman
Information exchange, cybersecurity and building a public safety broadband network are primary concerns for state CIOs across the nation, according to recently released federal advocacy priorities from the National Association of State Chief Information Officers for 2013. Regarding cybersecurity, in particular, NASCIO officials said the nation lacks "the level of federal and state investment and leadership" necessary to reduce risk and ensure safety in areas like healthcare.
"Over the past few years, cybersecurity has evolved into the most significant asymmetrical threat to our national security," NASCIO officials said. "Nation-states, 'hacktivists,' and criminals are attempting to exploit state government networks for economic gain, political espionage, and to compromise critical infrastructure."
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Automatically generating forms for data exchange a difficult task, researchers say
January 22, 2013 | By Susan D. Hall
Significant improvements must be made before legacy electronic health record systems can be used to automatically generate forms for data that can be shared in a standardized way, according to a paper published this week in BMC Medical Informatics and Decision Making.
The research, from the Medical University of Vienna in Austria, focuses on integrating archetypes--computable definitions for a single clinical concept, such as body mass index--into legacy EHR systems to generate forms for data exchange. The researchers found the idea of plug-and-play integration far from reality.
Using an ArchiMed EHR system, the researchers were able to successfully integrate 15 archetypes from a test set of 27; the other 12 failed due to the complex structure required that was not supported in ArchiMed's data model.
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Report: Telehealth to reach 1.8 million globally by 2017
January 22, 2013 | By Susan D. Hall
An estimated 1.8 million patients will be treated through telehealth worldwide by 2017, according to a new report from market research firm InMedica.
InMedica estimated that in 2012, 308,000 patients were remotely monitored for congestive heart failure, chronic obstructive pulmonary disease (COPD), diabetes, hypertension and mental health conditions. Most of those were monitored after being in the hospital--a growing trend as hospitals seek to curb readmissions. In the U.S., 140,000 post-acute-care patients and 80,000 ambulatory patients were monitored last year, according to an announcement.
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Will Payers Lead Digital Health?
Scott Mace, for HealthLeaders Media , January 22, 2013
This year's International Consumer Electronics Show featured a healthy dose of healthcare, with United Healthcare one of the biggest exhibitors at CES's Digital Health Summit segment. I spoke with Reed Tuckson, MD, UnitedHealth group executive vice president and chief of medical affairs.
HealthLeaders Media: How disruptive is it for you to be here with this huge booth at CES when we're used to seeing you at something like HIMSS?
Tuckson: I can't tell you how excited I am to be here, because we've just finished releasing in early December the “America's Health Rankings” annual report, and yet again, it shows this really frightening increase in the risk factors that are leading to and also increasing documentation of preventable chronic illness, especially as we look at hypertension and diabetes. I am so tired of the same old tools, the same old strategies and approaches. We have got to bring innovation into this space where we're helping people make better choices and decisions, so being here makes all the sense in the world, because we really are trying to be a part of recruiting an army of innovation in this space.
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The NHS's troubled relationship with technology
BBC NEWS HEALTH
The public are used to having most aspects of their life just a click away. But in the NHS it is a different matter
When you think how technology has reshaped everything from the way we shop to how we communicate with friends, the lack of progress made by the NHS is astonishing.
While booking holidays and doing the weekly shop online has become routine for many, making appointments to see a GP in such as way has not.
And in an era when companies hold a host of personal information, the fact remains an ambulance can still respond to an emergency call, ferry a patient to hospital but doctors will still have little knowledge of their medical history.
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New infrastructure, systems to be top IT priority for NHS in 2013
By Jamie Thompson, Web Producer
Created 12/19/2012
A recent report from EHI Intelligence, titled "The View from the Shop Floor," reveals that nearly 70 percent of acute NHS trusts say their main IT priority for 2013 is to deliver new infrastructure. Pursuing more patient-centered investments in health IT, nearly 50 percent of respondents saying their trust is looking to implement an EHR or portal solution.
“The report shows increased optimism among respondents compared with last year," said Lindsay Bell, the report's author. "Although their trusts are still facing financial pressures, they expect these to be less severe than last year, with only 17 percent of those who responded to the 2012 survey expecting their overall trust budget to fall by more than 20 percent, compared to 37 percent last year."
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Working towards a single electronic health record for every citizen
Created 12/14/2012
The engineer Mariano Soratti is the head of the Sistema Integrado de Información Sanitaria Argentino (Argentinian Integrated Healthcare Information System, SISA) being developed by the National Health Ministry, Argentina. We interviewed him to find out how such an ambitious project is put together, bearing in mind that Argentina is a federal country in which each province has an autonomous government and its own regulations regarding healthcare.
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Health IT investments on rise in Europe, says Frost & Sullivan
By Mike Miliard, Managing Editor
Created 12/27/2012
The market for health IT professional services is on the rise in Europe, according to a new report from Frost & Sullivan, driven by providers trying to improve care delivery and lower costs. Still, adoption levels aren't what they could be, thanks to tight budgets.
Exploring changes across the pond such as consolidation and the adoption of inorganic growth models, Frost & Sullivan's "Analysis of the European Healthcare IT Professional Services Market" finds that the European market saw revenues of $1.58 billion in 2011 and should reach $1.93 billion by 2017.
"Hospitals are now increasingly dependent on IT solutions to support them day-to-day, reduce human errors, limit operational costs and stay ahead in terms of technology," said Frost & Sullivan Research Analyst Somsainathan C.K. "As the penetration of healthcare IT rises, hospitals are investing in professional services to optimize the use of these solutions."
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Telemedicine for all
By Eric Wicklund, Editor, mHIMSS
Created 01/21/2013
One of the enduring criticisms of telemedicine is the price tag, in that much of the technology is beyond the means of smaller and remote healthcare providers who would benefit most from it. A new connected health offering is aimed directly at that pain point.
Cisco last week unveiled its HealthPresence 2.5, a software-driven version of its telemedicine platform that enables providers to build their own network with the tools at hand. The new solution is designed to enable standards-based connectivity to third-party medical devices and videoconferencing services, as well as flexibility in choosing hardware and deployment resources.
"Cisco HealthPresence 2.5 offers our customers incredible flexibility to build the right solution for their telehealth initiatives," said David Plummer, global business leader for Cisco HealthPresence, in a press release. "By unbundling the solution and offering Cisco HealthPresence software as a stand-alone offering, Cisco now enables customers to build telehealth networks using the hardware that best suits their needs."
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ONC posts tech guide for Blue Button Plus
By Mary Mosquera
The Office of the National Coordinator for Health IT has made available technical descriptions and guidance for its more automated version of the Blue Button feature aimed at giving patients easier access and use of their health information.
ONC announced in a Jan. 16 webinar an initial draft implementation guide for Blue Button Plus (+), a rebranding of its Automated Blue Button Initiative, so vendors and others can begin to incorporate the feature in their health IT system updates.
Blue Button+ will help providers meet requirements for meaningful use stage 2 because it incorporates in their certified electronic health records (EHRs) the function for view, download and transmit information for patients, said Lygeia Ricciardi, acting director of ONC’s Office of Consumer Health.
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Enjoy!
David.