Report and Resource Watch – Week of 24, August, 2009

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

First we have:

Does Telemonitoring Of Patients--The eICU--Improve Intensive Care?

Robert A. Berenson 1*, Joy M. Grossman 2, Elizabeth A. November 3

1 Bob Berenson is an institute fellow at the Urban Institute's Health Policy Center in Washington, D.C., and a senior consulting researcher at the Center for Studying Health System Change (HSC), also in Washington.

Joy Grossman is a senior health researcher at the Center for Studying Health System Change (HSC) in Washington, D.C.

Elizabeth November is a health research analyst at the Center for Studying Health System Change (HSC) in Washington, D.C.

*Corresponding author.

Abstract

Intensive care units are an essential and costly component in most U.S. hospitals. However, little is actually known about what staffing and work-process interventions produce the best balance of quality and costs. We explore the reasons hospitals chose to either adopt or reject an innovative telemedicine approach to supporting delivery of intensive care. Hospital clinical leaders hold strong views but have little objective information on which to judge the worthiness of this innovation. We argue that comparative effectiveness initiatives should emphasize delivery-system and work-process innovations, which are relatively understudied compared to specific drugs, devices, and services. [Health Aff (Millwood). 2009;28(5):w937-47 (published online 20 August 2009; 10.1377/hlthaff.28.5 .w937)]

Key Words: Access To Care, Business Of Health, Consumer Issues, Hospitals, Research And Technology

More here:

http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w937

Interesting stuff. The full paper is available for free download until early September, 2009.

Second we have:

HITrust offers security framework free to providers

By Andis Robeznieks / HITS staff writer

Posted: August 19, 2009 - 11:00 am EDT

The Health Information Trust Alliance announced that it is now offering the common security framework it developed in March free of charge.

The framework is designed to help vendors and providers implement security measures that protect electronic information. Formed in 2007, the Health Information Trust Alliance includes providers, insurers, device manufacturers and biotechnology companies.

“As more organizations participate in health information networks, the need to have a consistent and measurable level of how well organizations protect information is crucial to ensuring trust,” said Deb LaMarche, a program manager with the Utah Telehealth Network, in a news release.

More here (registration required):

http://www.modernhealthcare.com/article/20090819/REG/308199991

Seems like a useful resource to be able to access.

Third we have:

Does Health Care Have an Electronic Future?

by William J. Holstein

8/18/09

he Obama administration’s focus on digital patient records to minimize medical errors and improve efficiency has promise, but will face significant obstacles.

The Obama administration’s decision to spend an unprecedented US$19 billion over the next seven years to encourage the use of electronic medical records is triggering a scramble among government officials and health-care industry chiefs to define how such a system will work.

Hundreds of vendors, from small consulting firms to large systems integrators, from makers of software to all manner of hardware, are jockeying to take advantage of the new funding. Doctors, hospitals, and the dozens of entrenched subprofessions and interest groups are locking horns over which standards will prevail. It’s generally felt by health-care experts that President Obama’s goal of nearly universal use of electronic records is possible, but it could take several years — with some stutter steps in between — before it becomes clear what form electronic files will take and which companies will profit.

The U.S. health system is fragmented among hospitals, doctors, nurses, testing laboratories, and drug wholesalers and retailers. By and large, this eclectic roster depends on paper to collect, communicate, and share its most valuable information — patient files and prescriptions. A mere 17 percent of doctors have even basic electronic systems for patient records, and only 10 percent of hospitals do, according to David Blumenthal, the Harvard Medical School professor who has been named Department of Health and Human Services (HHS) national coordinator for health information technology.

Much more here:

http://www.strategy-business.com/li/leadingideas/li00138

This is the busy man’s summary of what is going on in the US. The sidebar provides some excellent resources. (From Booz and Company in the US)

Fourth we have:

August 17, 2009

Mission Mobility

By Alice Shepherd

For The Record

Vol. 21 No.16 P. 16

By employing wireless technologies, hospitals can give healthcare professionals the freedom to provide quality care from anywhere in the organization.

Healthcare organizations that are going high tech with EMR systems want equally progressive voice and data communications. Yet, while physicians are reachable on their cell phones 24/7, whether at home or on the golf course, critical cellular coverage is often absent where it is needed most: inside the hospital. And while EMRs supposedly make data available anytime, anywhere, their benefits cannot be maximized as long as computers and medical devices remain stationary rather than following physicians and clinicians to the point of care.

Three healthcare organizations recently enhanced their voice and data mobility by deploying wireless technologies. Their experiences can serve as best practices for planning and implementing such systems.

Florida Hospital in Orlando rolled out in-building wireless technology from MobileAccess to support a full range of wireless services and applications, as well as support the diverse needs of more than 16,000 staff, 2,000 physicians, and countless visitors. The result is a wireless infrastructure that delivers pervasive coverage for all major wireless operators and ensures support for cellular voice and data services for more than 1,500 BlackBerrys and visitor cell phones. The system complements the 802.11 wireless infrastructure the hospital had previously deployed.

Lots more here:

http://www.fortherecordmag.com/archives/081709p16.shtml

This is a useful review of the topic of wireless in hospitals.

Fifth we have:

KLAS: Tough EMR sales in 2008, future looks brighter – Epic leads the pack

Healthcare IT research firm KLAS has released its annual clinical market share report, which details the wins and losses of acute-care EMR vendors at large hospitals with more than 200 beds. The report found that in 2008, EMR vendors sold the fewest number of new contracts in the United States and Canada in the last seven years.

However, despite a tough economy, Epic Systems continued to make gains among large hospitals, capturing nearly 40 percent of the new business, according to the report. McKesson and Siemens Healthcare also scored some unusual wins, while Cerner saw no net growth in its clinical market share for the first time.

KLAS collected data from more than 1,600 hospitals with more than 200 beds in the United States and Canada. While acknowledging the seven-year low in EMR sales, the report also noted that the recent past does not appear to be an indication of the future.

“The advent of new meaningful use requirements, plus the ongoing debate around broader healthcare reform, has many organizations looking for a new clinical information system,” said report author Jason Hess, KLAS general manager of clinical research. In its investigation, KLAS identified “more than 400 large hospitals that either have no EMR or are using a legacy system; and we are already aware of purchasing activity that, if the rate continues, will far exceed 2008 sales,” Hess added.

Much more here:

http://www.healthimaging.com/index.php?option=com_articles&view=article&id=18423

Interesting summary – the full report will cost!

Sixth we have:

Citation: Catwell L, Sheikh A (2009)

Evaluating eHealth Interventions: The Need for Continuous Systemic Evaluation.

PLoS Med 6(8): e1000126. doi:10.1371/journal.pmed.1000126

Published: August 18, 2009

.....

Summary Points

· eHealth interventions will play a substantial role in shaping health care systems in the 21st century.

· Until eHealth interventions are “fit for purpose”, health care professionals are unlikely to adopt them and this risks implementation failure.

· eHealth developments should be viewed as interventions, and evaluated as new drugs or management programmes, recognising the challenges of evaluating complex interventions.

· We propose a means to evaluate eHealth interventions while they are being designed, developed, and deployed.

· We argue that continuous systematic evaluations of eHealth interventions are needed.

More detail here:

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000126

Obvious, but important and often not done.

Second last we have:

http://www.csc.com/health_services/insights/31098-us_health_care_in_the_year_2015

US Health Care in the Year 2015

Author:

Jordan Battani, Walt Zywiak

Summary:

The U.S. health care industry is at a crossroads in 2009, and the next five years promise to be a time of upheaval and transformation as the entire industry redefines itself to deliver health care that is safe, effective, and high quality to enough people at a sustainable cost. The magnitude of these changes will affect every sector of the U.S. health care economy and providers, hospitals, and payer organizations that anticipate, prepare for, and embrace these changes are the ones that will survive and succeed.

In this paper we examine the changes underway in U.S. health care, and make some predictions about what will happen with health care cost inflation, coverage, capacity constraints, changing expectations, and health information technology by the year 2015. Recognizing that these changes will affect stakeholders in profoundly different ways, we discuss the implications for purchasers, consumers, providers, and payers, and provide strategic and tactical guidance for organizations to navigate successfully through the industry transformation.

Download "US Healthcare in theYear 2015"

Lastly we have:

The Time is Now: 2009 Global Life Sciences & Health Care Security Study

A global perspective on cyber security, privacy and data protection

Publish date: Tuesday, 21 July 20092009-07-21 00:00:00.0

The global economic environment and the ever-changing regulatory landscape have impacted life sciences and health care (LSHC) organizations, regardless of sector, size and region. The changing environment has a profound effect on how organizations realize their security and privacy objectives. The lifeblood of any health care or life sciences organization is information, whether patient, intellectual property, or revenue. Organizations are dealing with the challenge of how to protect their information while facing increasingly sophisticated security threats and spiraling regulatory and legislative requirements—all against a backdrop of reduced spending, staff cuts and organizational changes

More here:

http://www.deloitte.com/view/en_US/us/Industries/Health-Care-Providers-Healthcare/article/0292959ebac92210VgnVCM100000ba42f00aRCRD.htm

Read the full report attached for additional information.

http://www.deloitte.com/assets/Dcom-UnitedStates/Local%20Assets/Documents/AERS%20(us_assur,%20us_risk)/us_risk_sp_2009_LSHC_Global_Security_Study_July09.pdf

Well worth a download.

Enough goodies for one week!

Enjoy!

David.

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