Weekly Overseas Health IT Links - 26 February, 2011.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. 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.



Study: Clinical trial privacy safeguards lacking

February 17, 2011 | Molly Merrill, Associate Editor

OTTAWA – Security practices for transferring and sharing sensitive files for patients who are participating in clinical trials are inadequate, according to a recent study.

The two-part study, titled "How Strong Are Passwords Used to Protect Personal Health Information in Clinical Trials?," was led by Khaled El-Emam, Canada research chair in Electronic Health Information at the Children's Hospital of Eastern Ontario (CHEO) Research Institute.

The study, which was published in the Journal of Medical Internet Research, showed that the majority of passwords used to protect files are poorly constructed and easily cracked using commercial password recovery tools.

Study coordinator interviews indicated that electronic information shared in the context of clinical trials may put personal health information at risk.



CHIME: Delay MU Stage 2

HDM Breaking News, February 18, 2011

The College of Healthcare Information Management Executives, an influential group comprising 1,400 CIOs and other I.T. leaders, is recommending a delay in Stage 2 electronic health records meaningful use compliance.

"CHIME believes that it would not be prudent to move to Stage 2 until about 30 percent of eligible hospitals and eligible providers have been able to demonstrate EHR MU under Stage 1," according to a comment letter sent to federal officials. "We believe this approach would strike a reasonable balance between the desire to push EHR adoption and MU as quickly as possible, and the recognition that unreasonable expectations could end up discouraging EHR adoption if providers conclude that it will be essentially impossible for them to qualify for incentives."



Medical Home Assessment Tool Available

HDM Breaking News, February 16, 2011

The Primary Care Development Corporation, a not-for-profit organization providing financing and services to expand access to care in underserved communities, has released an update of its free online Patient-Centered Medical Home Assessment Tool.

The update enables the assessment and measurement of a primary care practice's current operations against the National Committee for Quality Assurance's new 2011 standards for its Patient-Centered Medical Home program (see story).



Doctors' digital divide could widen health care disparities

Government and private entities are looking to ensure that health IT adoption doesn't leave out physicians who treat poor and minority patients.

By Pamela Lewis Dolan, amednews staff. Posted Feb. 14, 2011.

As the federal government strengthens its push for health information technology adoption among physicians, there is growing concern that the effort may increase health care disparities in minority communities by adding a digital divide to the mix.

Efforts are under way by the government and private and nonprofit sectors to help advance health IT adoption and funding in minority communities, which advocates say have been slower to take advantage of federal programs to bolster adoption of electronic medical record systems. If done right, experts say, disparities will not only be kept from widening, they have the potential to disappear.



The limits of anonymisation in NHS data systems

NHS data provided to researchers in an 'anonymous' form is often easy to link to the patients concerned

  • Dr Lindsey Brown, research associate, University of Bristol
  • Guardian Professional, Thursday 17 February 2011 09.00 GMT

Current debates around the use of medical records for research become heated, with various arguments forwarded by different groups. Medical researchers believe research benefits patients by increasing knowledge around disease and treatment. This belief is sufficiently strong that they suggest laws governing research and the need for consent threatens research and as such puts lives at risk.



Whitepaper Highlights Policy Considerations Surrounding Data Segmentation Of Health Information

16 Feb 2011

A new whitepaper recently released by the Office of the National Coordinator for Health Information Technology of the U.S. Department of Health and Human Services, authored by faculty and researchers at The George Washington University's Department of Health Policy and researchers at AcademyHealth, explores key components of data segmentation, circumstances for its use, associated benefits and challenges, various applied approaches, and the current legal environment surrounding data segmentation in the area of health information exchange.

Data segmentation can be defined as the process of sequestering from capture, access or view certain data elements that are perceived by a legal entity, institution, organization, or individual as being undesirable to share. In the case of health information, some patients may prefer to withhold or sequester certain elements of their medical record, often when it is deemed by them (or on their behalf) to be "sensitive," whereas others may feel strongly that all of their health information should be shared under any circumstance.



Selective patient data protection difficult in health IT data exchange

February 17, 2011 — 11:47am ET | By David Perera

Patients need to know that despite all the potentially highly sensitive personal information being collected in an electronic health record, their data will be contextually protected from inappropriate disclosure, says a paper prepared for the Office of National Coordinator for Health Information Technology.

The paper, dated Sept. 29 but only recently posted on the ONCHIT website, acknowledges difficulties with what it terms data segmentation, but says that absent the ability to block the uniform distribution of patient data, some patients would react by hiding information from doctors.



Intermountain opens informatics research center

By Joseph Conn

Posted: February 17, 2011 - 11:30 am ET

Intermountain Healthcare announced the opening of the Intermountain Homer Warner Center for Informatics Research in Salt Lake City, named for a pioneer in medical informatics.

The center, which opened Wednesday, initially will be home to 60 full-time IT employees. Intermountain expects to add 100 more informatics specialists within the next 10 years, according to a news release from the system.

Dr. Homer Warner, 88, is chairman emeritus of the University of Utah's medical informatics department.



U.S. patients trust docs, but not e-health records, survey shows

Many respondents don't even trust themselves with their own records

Lucas Mearian

February 17, 2011 (Computerworld)

While Americans trust their physicians to keep their healthcare information private, they don't extend that same trust to computerized records systems, according to a new survey from CDW.

Thirty-five percent of 1,000 survey respondents indicated they are worried that their health information will end up widely available on the Internet. And, half of the respondents believe that electronic health records (EHRs) will have a negative impact on the privacy of their health data. Surprisingly, 24% of respondents said they don't even trust themselves with access to their own records.


Healthcare Social Media Sites Neglect Privacy Protections

Analysis of diabetes sites indicates that many lack scientific accuracy and put users' personal information at risk.

By Nicole Lewis, InformationWeek
Feb. 14, 2011

As the Internet in general and social networking in particular are used as a point of reference for gathering and sharing health information, a study that examined 10 diabetes-focused social networking sites has found that the quality of clinical information, as well as privacy policies, significantly varied across these sites.

The study, "Social but safe? Quality and safety of diabetes-related online social networks," was conducted by researchers in the Children's Hospital Boston informatics program who performed an in-depth evaluation of the sites and found that only 50% presented content consistent with diabetes science and clinical practice.

The research, published in late January in the Journal of the American Medical Informatics Association, also revealed that sites lacked scientific accuracy and other safeguards such as personal health information privacy protection, effective internal and external review processes, and appropriate advertising.



Drugmakers Create Mobile Phone Apps to Track Diabetes, Cancer

By Tom Randall - Feb 15, 2011 4:01 PM ET

Drugmakers led by Merck & Co. and Novartis AG boosted investments in mobile phone applications and educational websites by 78 percent to get patients to take their drugs, eat right and exercise, an Ernst & Young report found.

Pharmaceutical companies initiated 97 projects last year aimed at using information technologies to improve patient health, according to the report by the New York-based consulting firm, which relied on analyst reports and press releases to reach its tally. That compares with 124 projects started in the four prior years combined. About 41 percent of the projects were smartphone applications, an increase from 11 percent since 2006.



Drugmakers Create Mobile Phone Apps to Track Diabetes, Cancer

By Tom Randall - Feb 15, 2011 4:01 PM ET

Drugmakers led by Merck & Co. and Novartis AG boosted investments in mobile phone applications and educational websites by 78 percent to get patients to take their drugs, eat right and exercise, an Ernst & Young report found.

Pharmaceutical companies initiated 97 projects last year aimed at using information technologies to improve patient health, according to the report by the New York-based consulting firm, which relied on analyst reports and press releases to reach its tally. That compares with 124 projects started in the four prior years combined. About 41 percent of the projects were smartphone applications, an increase from 11 percent since 2006.



Speech recognition market poised for growth

February 15, 2011 | Bernie Monegain, Editor

OREM, UT – Providers report a demonstrable return on their speech recognition dollars, according to a new report from KLAS. Participants of the study indicated benefits of speech recognition such as staff reductions, improved report turnaround times and increased physician satisfaction.

"The speech recognition market is ripe for healthy growth," said Ben Brown, author of the report. "Currently, less than one in four hospitals use the technology, however, in light of meaningful use and the benefits providers point out in this study, we expect it will assume a more prominent place in the role of clinical documentation."



HHS 2012 budget seeks increase in health IT funds

By Mary Mosquera

Tuesday, February 15, 2011

The administration has requested $57 million for the Office of the National Coordinator for Health IT in the proposed budget for fiscal 2012, a 37 percent increase on the amount it received in 2010.

ONC would also receive additional funds from other sources, such as reimbursements from the Public Health Service Act, for a total of $78.4 million in 2012 compared with $60.5 million in 2010, according to the Health & Human Services Department.



Monday, February 14, 2011

Detailed Clinical Models

As the PCAST Workgroup ponders the meaning of a Universal Exchange Language and Data Element Access Services (DEAS), it is exploring what it means to exchange data at the "atomic", "molecular", and document level. See Wes Rishel's excellent blog defining these terms. For a sample of my medical record using one definition of an atomic form, see this Microsoft Healthvault screenshot. It's clear to me that if we want to exchange structured data at a level of granularity less than an inpatient/outpatient/ED encounter, we need to think about detailed clinical models to specify the atoms.

As I've discussed previously, it would be great if EHRs and PHRs with different internal data models could use middleware to exchange a reasonably consistent representation of a concept like "allergy" over the wire. I think of an allergy as a substance, a precise reaction description, an onset date, a level of certainty, and an observer (a clinician saw you have a severe reaction verses your mother thought you were itchy). PHRs often have two fields - substance and a severe/minor indicator. Any EHR/PHR data exchange without an agreed upon detailed clinical model will lose information.



80% of Recalled Medical Devices Got Little FDA Scrutiny

Cheryl Clark, for HealthLeaders Media , February 15, 2011

Of 113 medical devices recalled by the FDA between 2005 and 2009 because they were dangerous, 81% had been cleared under a lenient process reserved for devices deemed "substantially equivalent" to others already approved, revealing "critical flaws" in the federal review system.

That's the conclusion of a report in Tuesday's Archives of Internal Medicine that evaluated each medical device. The researchers discovered that these recalled cardiac and other devices were approved without clinical trials or higher levels of scrutiny under 510(k) protocols in which they were deemed similar enough to an already approved device and a few were exempt from the approval process entirely.

"These devices did not undergo clinical testing or premarket inspections, nor were postmarket studies required to determine safety and efficacy," as they would have under the U.S. Food and Drug Administration's higher level "premarket approval" or PMA process that requires clinical testing and inspections, wrote Diana Zuckerman of the National Center for Women & Families.



Parks Associates forecasts U.S. Digital Health Industry to triple in total revenues by 2015

Mobile technologies motivate growth in digital health

U.S. revenues from digital health technology-enabled solutions and services will exceed $5.7 billion in 2015, fueled by chronic-care monitoring solutions, senior aging-in-place services, and connected wellness and fitness apps and programs, a new industry report from Parks Associates forecasts.

According to Delivering Quality Care to the Digital Home: 2010 Update, industry revenues in 2010 hit $1.7 billion, and the projected compound annual growth rate (CAGR) for the next five years will be 27%. Mobile broadband will be a key growth driver as many emerging health devices and services rely on high-speed connectivity to track vital signs or enable interactive features.



NQF converting to electronic quality measures

By Paul Barr

Posted: February 15, 2011 - 12:00 pm ET

The National Quality Forum has released 113 NQF-endorsed measures of healthcare performance in an electronic "eMeasure" format.

HHS requested the conversion of the measures to an electronic format from a paper-based format to ensure that they comply with the information technology provisions of the American Recovery and Reinvestment Act of 2009. The goal is to make the performance measures "more easily readable by electronic health-record systems," according to a news release from the Washington-based NQF.



Taking up a challenge

Joseph Conn Blog

In early December, the President's Council of Advisors on Science and Technology uncorked a 108-page report recommending some new wrinkles for the federal government's healthcare information technology program.

Thus far, the council's report, subtitled "The Path Forward," (PDF) has shown remarkable legs.

Whether it will have the entire healthcare industry trudging off in the council's newly recommended direction remains to be seen. We should know more after a two-day hearing beginning Tuesday before a first-of-its-kind joint hearing of the federally chartered Health IT Policy and Health IT Standards committees and the work group established specifically to review and address the PCAST report.



Providers offer ideas for PCAST exchange goals but balk at burden

By Mary Mosquera

Thursday, February 17, 2011

Providers could begin to share immunization data with a state registry as a way of demonstrating how health information exchange could work in the next iteration of meaningful use criteria, health IT experts suggested this week.

That would an example of how to begin to realize the goals set out in a December report from the President’s Council of Advisors on Science and Technology (PCAST) , in line with ideas the Office of the National Coordinator for Health IT is seeking to foster more complex data exchange.

ONC held a two-day hearing Feb. 15 and 16 to gather information for how to put the PCAST goals into practice.



PCAST report criticism abounds at hearing

By Joseph Conn

Posted: February 16, 2011 - 12:00 pm ET

Witnesses testifying at a daylong hearing in Washington on Monday protested that a proposed shift to a Web-based architecture for information exchange was simply too much change, too soon.

Hosting the hearing were three key federal advisory panels—the Health IT Policy Committee, its sister panel, the Health IT Standards Committee, and a work group they both constituted to study the recommendations that the President's Council of Advisors on Science and Technology made in a 108-page report (PDF) on the federal health IT promotional program.

PCAST recommended that the federal government push harder toward achieving advanced interoperability of electronic health-record systems by including requirements for information exchange in the Stage 2 criteria for meaningful use of EHR systems. Stage 2 criteria are set to take effect in 2013. The council also recommended applying federal pressure toward creating and adopting a common computer language for information exchange based on a to-be determined dialect of Web-oriented, extensible markup language, or XML.



Telemedicine: The Case for Acting Sooner Rather Than Later

Gienna Shaw, for HealthLeaders Media , February 15, 2011

For this month's HealthLeaders magazine cover story I interviewed a number of healthcare organizations that are using remote health technologies to improve efficiency, respond quickly to emergencies, and open up new streams of revenue. Many of those I interviewed said telemedicine isn't just as good as being there—it's better. And although the technology is hardly widespread, it does show signs of growth, according to HealthLeaders Media's annual industry survey. Nearly half (46%) of respondents said they have one or more telemedicine programs in place. Another 41% say they'll have one in place in one to five years.

Advancing technology—the availability of faster and more reliable networks, wireless devices, high-definition digital images and video, and the ubiquity of mobile devices—is creating a foundation for a system of virtual healthcare where neither patient nor caregiver need be in the same place—or even in a clinical setting at all.



Security breaches of personal health information widespread

February 11, 2011 — 4:59pm ET | By Ken Terry

Hackers and other malefactors steal a surprising amount of personal health information by breaching computer security. Between August 2009 and December 2010, the electronic health records of more than 6 million individuals were compromised, and 61 percent of those security breaches were the result of malicious intent, according to Redspin, a leading provider of HIPAA risk analysis and IT security assessment services.

The Redspin report focuses only on breaches involving more than 500 people, which must be reported to the Department of Health and Human Services under the breach notification provision of the HITECH Act. So it's likely that far more than 6 million people actually had their personal health information compromised, and that's just during the study period.



Public health IT still getting the short end of the stick

February 11, 2011 — 3:20pm ET | By Ken Terry

From the inception of the government's health IT program in 2004, one of its major goals has been to increase the country's emergency preparedness and the ability of public health agencies to monitor incipient epidemics. But this is one area where the reality has fallen far short of the vision.

The good news is that the Department of Health and Human Services has finally allocated $137 million for public health infrastructure, including new technology and staff training, as part of an overall investment of $750 million for disease prevention efforts.

But this overdue move follows years of federal and state neglect of public health agencies' IT capabilities. In fact, according to the Government Accountability Office, HHS still hasn't developed a strategic plan to build a national electronic network for public health emergencies, four years after Congress ordered it to do so.



Five ways health IT will reduce the cost of care

February 10, 2011 | Jamie Thompson, Web Editor

Health IT presents many opportunities to dramatically improve healthcare delivery in America, from changing the way healthcare is financed to enhancing efficiency. Jerry Buchanan, account director, healthcare technology and services at eMids Technologies, shares five ways that health IT can cut healthcare costs in the long term.

1. Improved standards of care

Analyzing data collected by electronic health records provides the best treatment methods, leading to a healthier population. "Whether this data is combined with financial data to analyze cost effectiveness or not... is tangential to the overall goal of knowing the best way to handle treatment for each individual patient," Buchanan noted.



Virtual Care

Gienna Shaw, for HealthLeaders Media , February 13, 2011

From the consumer’s point of view, the online clinic Virtuwell has a number of things going for it. Open around the clock, for $40 a patient can go online, answer a series of questions, and receive a diagnosis and treatment plan, including prescriptions as needed, for simple medical conditions. As a business model, it’s helping the Minneapolis–based HealthPartners keep patients with minor complaints out of its busy clinics, and build loyalty and boost more profitable in-person business by driving patients who need advanced care to physician offices.

The virtual clinic was a natural outcome of the EHR technology the organization has been using for the past 10 years, says Kevin Palattao, vice president of patient care systems at HealthPartners, an integrated system that includes a health plan, several clinics, and three hospitals. The organization’s first foray into online care was in 2005, when it began releasing test results to providers and patients simultaneously.



EHRs can help researchers track newborns treated for disorders

By Kathryn Foxhall

Friday, February 11, 2011

The child health center of the National Institutes of Health said it is critical to make available in electronic medical records information on testing and treatment of certain disorders in newborns.

All states require babies to have some level of “newborn screening,” the testing of blood drops taken from the babies’ heals, for multiple disorders for which early treatment can prevent death, disability or mental retardation.

Although states vary somewhat in the disorders for which they require testing, nearly all of them direct screening for over two dozen conditions.



Black Book poll names best EMRs

Written by Editorial Staff

February 11, 2011

Black Book Rankings shared results of a four-month user poll to determine the highest ranked EHR/EMR inpatient organizations for 2011.

Black Book Rankings surveyed more than 30,000 healthcare records professionals, physician practice administrators and hospital leaders. The New York-based technology market researcher employed 18 key performance indicators targeted at ensuring high product and service performance through comparing vendors from the customer experience.



Best EMRs named by Black Book Rankings

February 17, 2011 — 1:35pm ET | By Janice Simmons - Contributing Editor

Following a four-month survey of 30,000 healthcare records professionals, physician practice administrators, and hospital leaders in the information technology arenas, Black Book Rankings has compiled its findings evaluating the highest ranked electronic health and electronic medical records (EHRs/EMRs) for inpatient organizations in 2011.

The New York-based technology market researcher narrowed down its results to the top 20 EHR vendors in each of 10 categories from a field of over 400 qualified healthcare software firms. The company used 18 key performance indicators.



Rational versus rushed

Joseph Conn Blog

First come, first served isn't a bad way to go about handing out some stuff, sometimes.

It works just fine with pie at church picnics, for example.

But give HHS rulemakers some credit for both listening to their critics before issuing a final rule last week and pulling back on a decision to use first-come, first-served as a way to select a small but important cog in the federal health information technology promotional machinery.

Here’s what happening. HHS is setting up a permanent program to select organizations to test and certify electronic health records systems as capable of meeting the meaningful-use requirements of the American Recovery and Reinvestment Act. It also soon will anoint one, independent body to accredit those organizations—there are six now—offering meaningful use testing and certification services.



DoD Seeks Details from EHR Vendors

HDM Breaking News, February 10, 2011

The Department of Defense has kicked into high gear its effort to develop a new electronic heath records system for the Military Health System and is doing so on a fast track.

TRICARE, the DoD heath care program serving active service members, retirees and their families, has issued a request for information for a Web-based electronic health records system, with a submission deadline of 4 p.m. EST on Feb. 18.



Big Breach at NYC Hospitals

HDM Breaking News, February 14, 2011

New York City Health & Hospitals Corp. is notifying 1.7 million patients, staff, employees of vendors and others who received services at two hospitals and two clinics during the past 20 years that some of their protected health information has been breached.



Online healthcare projects planned

by Tran Quynh Hoa

HA NOI — Viet Nam is going to launch its first national e-health plans this year, the Ministry of Health has said.

Director of the Department of Medical Services Administration Luong Ngoc Khue told Viet Nam News that a national telemedicine service and a synchronous electronic medical records system would be set up in four years' time under the plans.

The telemedicine service was awaiting approval from the Minister of Health and the Prime Minister and the blueprints for the records system would be completed soon, he said.

The telemedicine project would connect all central hospitals and many provincial hospitals across the country using video conferencing technology.



Former commissioner: Countries have to take 'ownership' of e-health

Published: 14 February 2011

Across Europe, national and local governments are experimenting with e-health initiatives to help relieve demand for healthcare services. But many challenges remain, says David Byrne, who served as the EU's health commissioner from 1999-2004.

David Byrne was the EU's health commissioner from 1999 to 2004. He is currently a patron for Health First Europe, a non-profit alliance of the medical technology industry, healthcare workers, patient groups and experts.

He was in Brussels last week to meet with members of the European Parliament about patient access to e-health.

He was speaking to EurActiv's Noelle Knox.



Monday, February 14, 2011

Small Calif. Company Center Stage in Data Exchange

Will Ross speaks geek, but doesn't consider himself one.

"I'm bilingual. I understand conceptually enough of health IT to be able to be a translator. I can figure out how to get things done."

Ross is project manager for Redwood MedNet, a small company in rural Mendocino County, Calif., about to launch the state's first contribution to the national Direct Project for electronic health information exchange. Involved since the project began March 1, 2010, Ross said the Direct Project -- an updated, distilled version of the Nationwide Health Information Network -- offered his company a rare chance to participate with the big guys.



Does E-Health Stand a Remote Chance?

Gienna Shaw, for HealthLeaders Media , February 13, 2011

Kathleen Webster, MD, had her keys in her hand and was on her way out the door—about to make the 30-minute commute to the Loyola University Medical Center in Maywood, IL, where she is the director for pediatric critical care and the medical director for the pediatric ICU—when a nurse called to say one of her patients had arrested. “Get the cart and bring it into the room,” Webster said. The nurse was bemused—of course the code cart was already in the patient’s room.

“Not the code cart,” Webster said. “The telemedicine cart!”

Instead of racing to the hospital while talking to the care team on her cell phone, Webster opened up her laptop and was at the bedside—virtually—in minutes. “I can do everything but touch the patient,” she says. “I see a lot of the studies that say telemedicine is equivalent to being there. But I actually think there is a case for saying at times telemedicine is better than being there.” It’s faster and easier (and safer than driving and talking on the phone). And a high-definition monitor and digital stethoscope allow her to see and hear better than she could if she were in the room.





Post a Comment