Report Watch – Week of 20 April, 2009

Just an occasional post when I come upon a few interesting reports that are worth a download. This week we have a few.

First we have:

Blumenthal says HITECH faces challenges

April 10, 2009 | Molly Merrill, Associate Editor

BOSTON – David Blumenthal, MD, the newly appointed National Coordinator for Health Information Technology, sees "major hurdles" for the HITECH Act, according to a New England Journal of Medicine article.

The HITECH Act, the portion of the American Recovery and Reinvestment Act of 2009 (ARRA) that deals with healthcare information technology, is set to help doctors adopt HIT, specifically electronic health records.

The law uses a "carrot and stick approach" where eligible doctors will receive incentive payments for the first five years for demonstrating "a meaningful use" of EHR technology and demonstrated performance during the reporting period for each payment year. If an eligible professional does not demonstrate meaningful use by 2015, his/her reimbursement payments under Medicare will begin to be reduced. No incentive payment will be made after 2016.

Blumethal says spurring the adoption of EHRs and other HIT will probably require more than financial carrots and sticks.

"Proponents of HIT expansion face substantial problems," he said. "Few U.S. doctors or hospitals – perhaps 17 percent and 10 percent, respectively – have even basic EHRs, and there are significant barriers to their adoption and use: their substantial cost, the perceived lack of financial return from investing in them, the technical and logistic challenges involved in installing, maintaining and updating them, and consumers' and physicians' concerns about the privacy and security of electronic health information."

More here:
http://www.healthcareitnews.com/news/blumenthal-says-hitech-faces-challenges

The original article is found here:

http://content.nejm.org/cgi/content/full/360/15/1477

This one sure is a biggie!

Second we have:

Rhode Island report first to measure statewide healthcare IT use

April 10, 2009 | Bernie Monegain, Editor

PROVIDENCE – The Rhode Island Department of Health (HEALTH) has released two reports that show how nearly 40 percent of its physicians use health information technology on a regular basis.

Rhode Island is the first state in the country to measure healthcare IT use and to publish the findings.

Nearly 40 percent of Rhode Island physicians report using electronic clinical information systems to help care for their patients, the report shows.

In addition, about 25 percent of physicians transmit their prescriptions electronically, or e-prescribe.

"One of the State's healthcare priorities is to use HIT to increase the efficient delivery of patient care," said HEALTH Public Reporting Program Director Samara Viner-Brown. "These data help us to see how many physicians are actually using HIT. Patients can see if their physician uses electronic medical records or can find a physician who uses electronic medical records."

The survey reflects a three-year collaboration to encourage physician reporting in Rhode Island. In 1998, a legislative mandate required HEALTH to publicly report healthcare quality for licensed providers. In 2006, the law was expanded to include reports from individual physicians.

HEALTH and public reporting partner Quality Partners of Rhode Island (Quality Partners) identified HIT adoption as a local priority and developed the survey to assess physicians' technology use.

More found here:

http://www.healthcareitnews.com/news/rhode-island-report-first-measure-statewide-healthcare-it-use

Reports are here:

View the 2009 Physician Report and 2009 Summary Report

Seems like a useful approach to me – especially for patients who are interested.

Third we have:

This page features research conducted by RAND Health research staff that has been published in a scholarly journal.

Crossed Wires: How Yesterday’s Privacy Rules Might Undercut Tomorrow’s Nationwide Health Information Network.

Greenberg MD, Ridgely MS, Hillestad RJ. Health Affairs, Vol. 28, No. 2, March/April 2009, pp. 450-452

More than a decade after passage of the Health Insurance Portability and Accountability Act (HIPAA), concerns about the privacy and security of personal health information remain a major policy issue. Now, the emergence of the Nationwide Health Information Network (NHIN) presents deeper underlying privacy challenges, which will require renewed attention from policymakers as federal and state privacy rules need to be revisited. This is necessary because the current framework of privacy laws is not well suited for regulating a transformed health care system, where computer networks supersede conventional communications media.

More here:

http://www.rand.org/cgi-bin/health/showab.cgi?year=2009&key=2009_65

The link is in the text for those who can access Health Affairs.

Fourth we have:

Government reaffirms faith in NPfIT 'potential'

Author: Tony Collins

Posted: 16:29 14 Apr 2009

The government has reaffirmed its faith in the "potential" of the Cerner Millennium and the Lorenzo patient administration systems to work effectively within the NHS's £12.7bn National Programme for IT [NPfIT].

It has also pledged to ensure that NHS staff and clinicians, who have generally been kept in the dark, are kept informed on the timing and content of forthcoming releases of Cerner and Lorenzo.

But it conceded that care should be taken to deploy systems only if they are fit for purpose. Several hospitals have run up millions of pounds in extra costs, and have had the care and treatment of their patients disrupted, after troubled NPfIT go-lives.

The government expressed its confidence in the potential of Cerner and Lorenzo in "Treasury Minutes", which are formal government responses to committee reports, in this case a report of the Public Accounts Committee on the NPfIT in January 2009.

The government accepted most of the committee's recommendations on the NPfIT. This contrasts with 2006 when the government rejected most of the committee's report on the NPfIT.

More here:

http://www.computerweekly.com/Articles/2009/04/14/235629/government-reaffirms-faith-in-npfit-potential.htm

The link to the report is in the text.

Fifth we have:

Hidden Malpractice Dangers in EMRs

Steven I. Kern, Esq.

Medscape Business of Medicine. 2009; ©2009 Medscape

Posted 04/09/2009

Author: Steven I. Kern is a principal in the healthcare law firm of Kern Augustine Conroy & Schoppmann, P.C., with offices in New Jersey, New York, Pennsylvania and affiliates in Florida and Illinois. He is a nationally recognized expert on healthcare law, a Member of the Editorial Board of New Jersey Lawyer, and former New Jersey Deputy Attorney General assigned to the State Board of Medical Examiners.

An estimated 85,000 medical lawsuits are filed annually, which include those against hospitals and individual physicians. One of the highly-touted benefits of electronic medical records (EMRs) is the potential to help prevent malpractice incidents and medical errors. By providing better documentation, automatically checking for medication errors and drug interactions, providing failsafe systems to track test results and follow-up with patients, EMRs can dramatically reduce the risk of malpractice.

While the benefits of EMRs are far greater than the cons, no road is without stumbling blocks. A physician who is not careful when using the EMR could increase his malpractice liability.

Some of the possible malpractice risks are shown below.

More here (Registration Required):

http://www.medscape.com/viewarticle/589724?src=mp&spon=17&uac=17738FT

A useful perspective. Well worth a browse.

Sixth we have:

Consumer demand for healthcare IT 'never stronger,' survey shows

April 14, 2009 | Bernie Monegain, Editor

CHICAGO – Consumer appetite for electronic health records, online tools and services continues to grow, according to the results of the 2009 Deloitte Survey of Health Care Consumers.

While only 9 percent of consumers surveyed have an electronic personal health record, 42 percent are interested in establishing PHRs connected online to their physicians.

Fifty-five percent want the ability to communicate with their doctor via e-mail to exchange health information and get answers to questions.

Fifty-seven percent reported they'd be interested in scheduling appointments, buying prescriptions and completing other transactions online if their information is protected.

More here:

http://www.healthcareitnews.com/news/consumer-demand-healthcare-it-never-stronger-survey-shows

Press release with links here:

http://news.prnewswire.com/DisplayReleaseContent.aspx?ACCT=104&STORY=/www/story/04-06-2009/0005001525&EDATE=

Useful information.

Seventh we have:

Using Social Media in a Public Health Emergency

Posted by Brian McDaniel Write a Comment Thursday, April 16th, 2009

You may download this White Paper as a PDF document here.

Introduction

Quickly publicizing public health information during an emergency is a critical deliverable for many emergency response coordinators. Traditional communications techniques, such as press releases or news conferences, can slow the distribution of life saving information. Social Media technology appears to be a promising supplemental technique that can close the gap between the time an agency releases information to when it becomes available for use by the public.

More here:

http://www.brianmcdaniel.org/2009/04/16/using-social-media-in-a-public-health-emergency/

There is a link to the report in the article.

Last we have:

Many Hospitals Still Falling Short in Reaching Patient Safety Goals

Janice Simmons, for HealthLeaders Media, April 16, 2009

While more hospitals are making progress in incorporating measures to prevent medical errors, they still have a long way to go to better ensure patient safety using tested methods, according to a new report released yesterday by The Leapfrog Group, the nonprofit organization representing major private and public purchasers of healthcare benefits.

"I guess the big word is going to have to be 'disappointing,'" said Leapfrog CEO Leah Binder. The report, based on 2008 survey results received from 1,282 acute care hospitals nationwide, does show that "hospitals are making great strides and great efforts" to address patient safety concerns, she added.

However, most of the final numbers in Leapfrog's survey "are simply not adequate for the most expensive healthcare system in the world—in what should the best healthcare system in the world," Binder said. Failure to make these changes nationwide means higher mortality rates, higher volumes of care, and higher healthcare costs in the future—factors that could receive closer scrutiny during the healthcare reform debate.

Lots more here with link to report etc.

http://www.healthleadersmedia.com/content/231615/topic/WS_HLM2_QUA/Many-Hospitals-Still-Falling-Short-in-Reaching-Patient-Safety-Goals.html

So much to read – so little time – have fun!

David.

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