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Medicine Jim, but not as we know it
12 January 2012 Shanna Crispin
Developers worldwide have been challenged to create their version of Star Trek’s medical tricorder in the hope that it will spark more innovation in health technology.
Three different versions of the tricorder featured on the show, but they all enabled doctors to diagnose diseases and collect bodily information about a patient by simply scanning them with a detachable hand-held scanner.
The Qualcomm Tricorder X Prize is offering $10m (£6.5m) to any developer that can create a similar device.
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Digital Health Revolution Long Awaited, Much Misunderstood
Jim Molpus, for HealthLeaders Media , January 17, 2012
First let's dispel one thing about revolutions: no one reading this column who works in healthcare is going to start one, except maybe in your respective capacities as consumers of healthcare. Revolutions come when a critical mass of people—18th-century French serfs or overtaxed colonists—decide there is a better way.
So if anything, the work being done by hospitals, health systems, physicians, and IT companies in creating electronic health records and smart devices is mere road-paving for a new way of practicing medicine that is hopefully not too far off—just in time to save healthcare from collapsing in its own inefficiency.
Eric Topol, MD, cardiologist and chief academic officer at Scripps Health, hopes that his new book, The Creative Destruction of Medicine, will help nudge consumers and a few other constituencies into seeing the true potential of digital health to flip the paradigm, as suggested by the book's subtitle, "How the Digital Revolution Will Create Better Health Care."
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Break down all barriers to health information exchange
January 17, 2012 — 12:05pm ET | By Ken Terry
Farzad Mostashari, National Coordinator for Health IT, discussed the obstacles to the interoperability of health information systems in a recent interview with HealthLeaders Media. To overcome these barriers, he said, the cost of HIEs must be reduced, their value must be increased, and the "preconditions for trust" among providers must be created.
The Office of the National Coordinator for Health IT (ONC), he noted, is developing standards that will lower the cost by making interfaces easier to build. At the same time, ONC is working with the states to ensure that all healthcare providers have access to HIEs, he said.
As for the value of HIE, Mostashari pointed out that public and private payers "are putting out new models for paying for care that rewards coordination [so] we're seeing the value proposition start to emerge for information exchange." He added that while trust among providers develops slowly, he believes it will begin in local networks and gradually spread.
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Despite $3.2B HIT spend in Europe, clinical IT investment lacking
January 17, 2012 — 2:40pm ET | By Dan Bowman
Health professionals in Europe are embracing integrated technology, but only to an extent, according to a recent report by the European Coordination Committee of the Radiological, Electromedical and Healthcare IT Industry (COCIR). The report found that hospitals in western Europe--the UK, Germany, France, Italy and Spain--spent roughly $3.2 billion on health IT in 2010, according to an article in Health Imaging, but most of that spend went toward administrative IT.
Additionally, the level of equipment utilized "varie[d] greatly" between different countries, the authors noted.
"More investment in clinical information is needed to move today's healthcare delivery models to the next level of efficiency and quality," the report's authors wrote. "Industry calls for more investment in order to move to integrated, more efficient, safer and patient-centered healthcare systems."
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5 keys to getting your HIE capabilities up and running
January 18, 2012 | Michelle McNickle, Web Content Producer
Health information exchange is an integral part of many HIT initiatives, including the meaningful use of health IT and healthcare reform. While still a relatively new capability, the idea of transferring sensitive information securely is enough to make organizations nationwide take note.
Sonal Patel, vice president of client services at Corepoint Health, suggests five keys to getting your HIE up and running.
1. Have a strategy in place. According to Patel, HIEs have become the center of attention these days, and she suggests organizations take baby steps in this arena while developing a strategy that’s their own. Whether it’s an acute care facility, a larger ambulatory care organization, or standalone centers that submit results to an HIE, all are in a situation where, “they need to ask themselves about the surrounding market, their environments, and what approach they want to take to the market,” she said. “Do they want to use this connection as a differentiating factor, or a capability to move forward? It’s a decision that’s made at a higher level as to where integration occurs.”
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Patient-specific, eye catching alerts less likely to be ignored
By mdhirsch
Created Jan 19 2012 - 9:29am
Want doctors to read the alerts they receive in their electronic health records systems? Then make them more patient-specific and interesting to read.
That's the skinny from a recent study published in the Journal of the American Medical Informatics Association. The study focused on the use of computerized drug alerts for psychotropic drugs prescribed to 5,628 senior citizens by 81 physicians. The researchers expected computerized alerts to reduce the number of falls by these seniors, which is a leading cause of injuries. However, physicians overrode most drug alerts because they believed that the benefit of the drugs outweigh the risks involved. Physicians also expressed a concern that too many drug alerts were "nuisance alerts" of little clinical value.
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Electronic alerting system improves documentation of patient problems
By mdhirsch
Created Jan 19 2012 - 9:23am
Using an automatic alert system in providers' EHR systems "significantly" increases the documentation of previously unknown patient problems, which could potentially facilitate quality improvement.
That's the conclusion of a recent study published by the Journal of the American Medical Informatics Association. According to the study, which involved 28 clinics affiliated with a large academic medical center, patient problems were about three times more likely to be documented when providers received an alert. "This increase is clinically important, since many of these problems are used for quality improvement and clinical decision support," the study's authors reported.
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American Docs Question Health IT's Benefits
U.S. physicians are more skeptical about the benefits of electronic health records and health information exchanges than their international counterparts, according to an Accenture study.
By Nicole Lewis, InformationWeek
January 18, 2012
U.S. physicians are less likely than doctors in other countries to think that healthcare IT can improve diagnostic decisions, according to a survey of 3,700 doctors in eight countries. Additionally, only 47% of U.S. doctors report that healthcare technology has helped improve the quality of treatment decisions, compared to 61% of the other physicians interviewed. Only 45% think that technology leads to improved health outcomes for patients, against a survey average of 59%.
"The survey of doctors shows that more needs to be done to bridge the disconnect in perception and impact of health IT benefits," Kaveh Safavi, Accenture's health practice lead in North America, told InformationWeek Healthcare. "However, despite the high-level skepticism of technology, U.S. physicians have made progress in implementing healthcare IT for practices relating to disease management."
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New Apps Let Facebook Record Your Personal History
The site can now provide summaries and stats that offer a window on your life months or years in the past.
Facebook won the loyalty of more than 800 million users largely by getting them into the habit of visiting again and again to see the latest updates, comments, and photos posted by friends. Now the site will also let outside apps provide even more content, and it will encourage people to spend time looking back over activity from months or even years ago. New features introduced at an event in San Francisco last night will enable users to automatically record their eating, reading, exercise, and other habits over time, share them with friends, and review their previous actions.
The key to the new features is an update to the Timeline page that Facebook founder Mark Zuckerberg introduced at his company's F8 event last September. Now, with a user's permission, third-party websites and mobile apps can record details of what the person is doing and automatically feed that information to the person's Timeline page through a "Timeline app" that sends the data to Facebook and provides the necessary permission and privacy settings.
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Report highlights promises, perils of social media for healthcare
Posted: January 19, 2012 - 6:00 pm ET
A report from the not-for-profit ECRI Institute, a patient-safety and quality-improvement organization, details social media's potential as a public-engagement tool for healthcare organizations but warns that risk management is necessary.
The 20-page report "Social Media in Healthcare" from the Plymouth Meeting, Pa.-based organization cites a 2011 National Research Corp. survey that found that 41% of roughly 23,000 respondents reported using social media to research healthcare decisions. Facebook and YouTube dominated their social-media selections.
So far, most hospitals use social media "as an extension of their existing marketing and public relations plans"; physicians use the sites also to market themselves and their practices while often mixing in personal information.
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SATURDAY JANUARY 21, 2012 Last modified: Wednesday, January 18, 2012 11:23 AM CST
Nurse terminated for unauthorized viewing of TRMC patient records
A privacy breach by a “curious” nurse at Titus Regional Medial Center has resulted in letters to 108 former patients warning of a slight risk of identity theft.
Hospital Administrator Ron Davis relayed Tuesday that internal auditing procedures uncovered the misconduct.
“The nurse said she was just ‘curious’ and looked at records she was not authorized to view,” Davis said. “She has sworn that she did not do anything with that information.”
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5 ways to make your EMR more user-friendly
January 19, 2012 | Michelle McNickle, Web Content Producer
By Michelle McNickle, Web Content Producer
Created 01/19/2012
One of the biggest objections to the adoption of an EMR is its usability (or lack thereof), which is no surprise considering the ease of its predecessor: paper. Thankfully, there are a few ways to make your system not only more bearable, but significantly easier to use.
“There are several guidelines that have been published, [and each] cover particular OS, whether it be Mac, Unix, or Windows,” said Bob Hunchberger, a clinical informaticist for a 500-bed hospital. “If your application will be deployed in the PC world, it’s important that you adhere to the standards that are implemented in the Windows world. Why? Because Microsoft has ‘trained’ its users for more than a decade what behaviors to expect from applications that run in that environment.”
Hunchberger suggests five practical ways to make your EMR more user friendly.
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5 Legal Issues Surrounding Electronic Medical Records
January 19, 2012
Though the technology has been around for roughly 30 years, physicians making the move from paper to electronic medical records may still face some challenges — particularly when it comes to understanding the legal implications of EMRs. In Nov. 2011, the Centers for Disease Control and Prevention reported that the percentage of physicians who've adopted basic EMRs in their practice doubled from 17 to 34 percent from 2008-2011. The percent of primary care physicians using EMRs grew even more, roughly doubling from 20 to 39 percent in that same time frame.
A large portion of EMR implementation revolves around a seamless transition for physicians, nurses and other caregivers, so as to not disrupt workflow or take excessive time out of their day. These systems, however, pose certain legal risks for physicians and healthcare systems that should not go unnoticed.
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Tuesday, January 17, 2012
The Role of the CMIO
Although my business cards and my CV list the title Chief Information Officer, I was given the title Chief Medical Information Officer (CMIO) when I was hired at BIDMC in 1998. Today, I serve three kinds of roles:
CIO - Responsible for strategy, structure, staffing, and processes for a 300 person IT organization
CTO - Responsible for the architecture of our applications and infrastructure, ensuring reliability, security, and affordability
CMIO - Responsible for the adoption of the applications by clinicians, optimizing quality, safety, and efficiency in their workflows
Although I've been able to balance these three roles because of the extraordinary IS staff at BIDMC, good governance, and a supportive CEO, it's challenging for one person to perform all these tasks. Many hospitals and health systems are expanding their management team to include a CMIO.
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Friday, January 20, 2012
Q4 2011 Saw Surge of Federal Health IT Activity
During the last quarter of 2011, the federal government continued to implement the HITECH Act, enacted as part of the American Recovery and Reinvestment Act. Below is a summary of key developments and milestones achieved between Oct. 1, 2011, and Dec. 31, 2011.
Q4 2011 Health IT Highlights
The fourth quarter of 2011 saw a number of important developments, including the following.
- IOM Publishes Report on Patient Safety and Health IT.
On Nov. 8, 2011, the Institute of Medicine released a series of recommendations related to the effect of health IT on patient safety in a report titled, "Health IT and Patient Safety: Building Safer Systems for Better Care." The Office of the National Coordinator for Health IT commissioned the report and will use it to inform its development of health IT-related patient safety policies. - HHS Revises Meaningful Use Timeline.
On Nov. 30, 2011, HHS announced changes to the Medicare and Medicaid electronic health record incentive programs' meaningful use timeline. Under the changes, health care providers who meet Stage 1 meaningful use requirements in 2011 would not need to meet Stage 2 meaningful use requirements until 2014. - ONC Announces Plans for Dashboard To Assess Progress of Health IT Grants.
On Dec. 22, 2011, ONC published a notice in the Federal Register announcing plans to establish an "ONC Health IT Dashboard" to measure the effectiveness of grants awarded for a variety of health IT purposes. The Dashboard will include information from community college-based health IT training programs; individual physicians and hospitals; regional extension centers; state health information exchanges; and vendors that track health IT adoption and trends. ONC will use the Dashboard to compare the performance of grant recipients; develop a tool to evaluate the Medicare and Medicaid EHR incentive programs; and estimate state and national levels of health IT adoption. Researchers and the public will have access to the Dashboard. ONC will de-identify and aggregate any publicly accessible information.
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CfH issues tablets safety warning
13 January 2012 Shanna Crispin
NHS Connecting for Health has warned trusts about the risks of using tablet devices - saying they are much more likely to be stolen and to be used to inadvertently share patient information than other technology.
The ‘good practice guidelines’ say the use of tablets in commercial organisations is increasing and there is “pressure for NHS organisations to follow suit.”
But it warns: “These devices present a number of issues that are not necessarily found in more traditional technology solutions.”
The document states tablet devices are “inherently less secure” than traditional IT equipment and that this means they are not necessarily suitable for accessing sensitive and patient identifiable data.
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How to turn a tablet into a security tool
January 12, 2012 | Marcus Ranum, CSO, Tenable Network Security
It seems like it was just the other day that I was being asked whether laptop computing was going to have a big impact on security. Of course, it did, but mostly on the unprepared - the organizations that didn't ask, or even think about the question, ‘why would making computing more portable, more personal, and easier to steal/lose present a problem?’
By the mid-1990s I was simply answering the question with a sound-bite: "Distributed data is distributed vulnerability." Indeed, the last decade has treated us to an endless litany of breach disclosures along the lines of "laptop with customer database stolen from contractor's car," or "customer database found on USB stick in airport." Sobering news, always.
Twenty years later, portable devices have 10,000 times as much storage space, are smaller and shinier, and may be in an easier-to-lose form factor, such as a telephone-oid or tablet. Equally as important – there are more of them, and simple probability across your device population means that more will go astray, and do so with more data on them.
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Texas doctors lead open-notes movement
By Todd Ackerman, HOUSTON CHRONICLE
Published 10:01 p.m., Monday, January 16, 2012
Texas doctors are at the vanguard of what U.S. researchers say is an inevitable revolution to make consultation notes and other records easily accessible to patients.
The idea, at odds with the decades-old attitude that medical records belong to doctors because they're the only ones trained to interpret them, is being tested in an ongoing national study that has already confirmed that patients want to read their notes but most doctors are still resistant.
"Many doctors aren't there yet, but this is going to happen, this can't be stopped," said Jan Walker, a nurse at Harvard Medical School's Beth Israel Deaconess Medical Center in Boston and the study's lead author. "In today's more transparent society, patients want this - and it should be to everyone's benefit."
3 ways social media is transforming the doctor-patient relationship
January 17, 2012 | Chris Foster, Principal, Booz Allen Hamilton
Much like other advances in health information technology (HIT) such as electronic health records and telemedicine, social media is changing how doctors and patients interact. Social media empowers patients to seek out information, make more informed decisions, and partner with their health care providers on managing their care.
Historically, medical care has been primarily physician-centric — “take the doctor’s orders”; however, more recently, patients are playing an increasingly more active role in their treatment. At its very core, social media is a driver of a patient-centered model, promoting two-way continuous communication between supportive community networks, health care providers and patients through the most current, transparent, and immediate information available.
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Sculley: Health Tech Needs Usability, Not Flash
IT companies need to better understand the healthcare industry before they can change it, former Apple CEO tells CES audience.
By Neil Versel, InformationWeek
January 13, 2012
Former Apple and PepsiCo CEO John Sculley, now an investor in several healthcare companies, believes in the power of consumer-facing IT to transform parts of healthcare. But this cannot happen unless technology developers understand this complex industry and the vendors engage the people who actually pay for health services, he said.
"The thing that is missing is getting the people with the domain expertise aligned with the people with technological know-how to turn ideas into branded services," Sculley said Thursday in Las Vegas at the Digital Healthcare Summit adjunct to 2012 International CES.
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11 healthcare data trends in 2012
By Michelle McNickle, Web Content Producer
Created 01/06/2012
Mobile devices, data breaches and patient privacy rights were some of the most talked-about topics in health IT in 2011, and according to expert opinions complied by ID Experts, 2012 won’t be any different.
In fact, experts continue to predict an upswing in mobile and social media usage, response plans, and even reputation fallout. Eleven industry experts outlined healthcare data trends to look for in 2012.
1. Mobile devices could mean trouble. Healthcare organizations won’t be immune to data breach risks caused by the increased use of mobile devices in the work place, said Larry Ponemon, chairman and founder of the Ponemon Institute. A recent study confirms that 81 percent of healthcare providers use mobile devices to collect, store, and/or transmit some form of personal health information (PHI). But, 49 percent of those admit they’re not taking steps to secure their devices.
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- JANUARY 19, 2012
Health Care Is Next Frontier for Big Data
· By BEN ROONEY
Big Data—the ability to collect, process and interpret massive amounts of information—is one of today's most important technological drivers. While companies see it as a way of detecting weak market signals, one of the biggest potential areas of application for society is health care.
Historically, health care has been delivered by one doctor looking at one patient with only the information the doctor has at that time. But how much better if the doctor had access to information about thousands, or even tens of thousands, of people?
Acquiring medical data has, historically, been problematic. It is wrapped in layers of regulations and stringent safeguards and is expensive to collect.
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PACS market to hit $5.4B by 2017
January 18, 2012 — 2:45pm ET | By Dan Bowman
The worldwide market for picture archiving and communications systems (PACS), which continue to grow in popularity, is expected to reach $5.4 billion by 2017, up from $2.8 billion in 2010, according to a new report from GlobalData.
A combination of government initiatives to adopt IT in healthcare and advancements in technology as a whole will be two of the major factors contributing to such growth, the report's authors said. Specifically, as hospitals look to save money with regard to storing images, PACS adoption will continue to thrive, they said.
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Bacon calls for halt on Millennium
19 January 2012
Conservative MP Richard Bacon has called for a halt to all Cerner Millennium deployments following appointment problems and delays at the latest trusts to go-live with the system - North Bristol and Oxford.
Bacon, who has followed the progress of the National Programme for IT in the NHS for many years, said the two hospitals had been “brought to their knees” by the implementation of the new electronic patient record system.
“These deployments need to be stopped until we are sure that they can be managed safely,” he said; adding that the system should be "switched off" if it was not working for patients.
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Hack Attacks Now Leading Cause Of Data Breaches
Exclusive: Identity Theft Resource Center identifies hacking, followed by data lost in transit and insider attacks, as the leading data breach culprits in 2011.
By Mathew J. Schwartz, InformationWeek
January 12, 2012
The majority of data breaches stem from hack attacks, followed by data that's lost while physically in transit. That's according to a forthcoming study from the Identity Theft Resource Center (ITRC), which assessed all known information relating to the 419 breaches that were publicly disclosed in the United States in 2011. A copy of the report was provided to InformationWeek in advance of its release.
Last year, data breaches triggered by hacking--defined by the ITRC as "a targeted intrusion into a data network," including card-skimming attacks--were at an all-time high, and responsible for 26% of all known data breach incidents. The next leading cause of breaches was data on the move (18%)--meaning electronic storage devices, laptops, or paper reports that were lost in transit--followed by insider theft (13%).
Overall, malicious attacks--counting not just hack attacks but also insider attacks--accounted for 40% of publicly disclosed breaches, while 20% of breaches were the result of accidental data exposure.
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Tuesday, January 17, 2012
Meaningful Use Incentives Increasing, but Disparities Persist
Despite a sluggish start, federal incentive payments to hospitals have been rising significantly in recent months.
Data from CMS show that the nation's hospitals received nearly $741 million in incentive payments during October and November 2011 for implementing electronic health records. That figure for those two months is about $70 million more than what hospitals received during the first full fiscal year of the program, from its launch in October 2010 through September 2011.
But aggregate data on the incentive program obscure wide variations in how individual states are performing under the incentive program. Closer analysis of the CMS data shows that some states' hospitals have done well in accessing incentive payments, while hospitals in other states have received little or no funding. The analysis of the EHR incentive program payments to hospitals was prompted by results from quarterly surveys on meaningful use conducted by the College of Healthcare Information Management Executives.
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Vendors on a Buying Spree
Four more health information technology vendors have announced acquisitions, bringing the total during the first 12 days of 2012 to at least 10 deals.
Payer vendor The TriZetto Group has acquired Kocsis Consulting Group of Hudsonville, Mich., for an undisclosed sum. Kocsis offers training, compliance and change management software to bridge the gap between implementing new information systems and using them to their potential. Software modules cover user training, business/change readiness, process improvements, policy and procedure documentation, and compliance readiness such as HIPAA 5010 and ICD-10.
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By Joseph Conn
The IT VistA gets larger
Here are a few quick bits of news from last week about federal electronic health-record system incentive payments.
The 24th meeting of the WorldVistA community wrapped up a three-day run Sunday at University of California Davis. WorldVistA is a not-for-profit organization founded in 2002 to promote the use of an open-source version of the VistA system outside the Veterans Affairs Department, where the VA has been developing the EHR for more than 30 years.
Open-source maven Roger Maduro reported from the meeting that Oroville Hospital donated $150,000 to WorldVistA. Its members contributed or contracted for the production of code modifications needed to certify WorldVistA EHR software as capable of meeting federal meaningful-use criteria and to help IT staffers at 133-bed Oroville configure the system to their needs.
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A systematic approach to quality improvement
A look at successes, strategies behind some of the Thomson Reuters 15 Top Health Systems
Posted: January 14, 2012 - 12:01 am ET
About a decade ago, the board of directors of Tanner Health System in Carrollton, Ga., decided to make an absolute commitment to patient satisfaction and quality.
That commitment has gotten results, with the three-hospital system for the first time being named among Thomson Reuters' 15 Top Health Systems in the nation.
“We've been getting some confirmation that this long journey toward excellence is paying off,” says Loy Howard, Tanner's president and CEO. “In the journey of quality improvement, it's hard work. It really has to be, in my opinion, the focus of the whole organization.”
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Digitizing Health Records, Before It Was Cool
By MILT FREUDENHEIM
Published: January 14, 2012
VERONA, Wis.
THE push to move the nation from paper to electronic health records is serious business. That’s why a first look at the campus of Epic Systems comes as something of a jolt.
A treehouse for meetings? A two-story spiral slide just for fun? What’s that big statue of the Cat in the Hat doing here?
Don’t let these elements of whimsy fool you. Operating on 800 acres of former farmland near Madison, Wis., Epic Systems supplies electronic records for large health care providers like the Cedars-Sinai Medical Center in Los Angeles, the Cleveland Clinic, and Johns Hopkins Medicine in Baltimore, as well as health plans like Kaiser Permanente and medical groups like the Weill Cornell Physicians Organization in New York. In fact, Epic’s reputation as a fun-filled, creative place to work helps draw programmers who might otherwise take jobs at Google, Microsoft or Facebook.
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http://www.medcitynews.com/2012/01/how-to-sell-mobile-health-devices-even-when-hospitals-fear-theft/
How to sell mobile health devices even when hospitals fear theft
Thefts of portable digital health devices, like smartphones and tablets, accounted for half of data breaches in 2011. That kind of mobility is hurting the adoption of mobile health products.
Russell Dollinger has been working on strategies around the problem. Dollinger’s California startup Ingenuitor, which produces books and digital devices to overcome language barriers in hospital settings and medical situations, had a customer back off a mobile purchase over fears of device theft.
“We present our software to hospitals on carts and portable units,”Dollinger said. “One COO wanted portable devices. The next time we presented to the same hospital, the previous COO had left and the new one said, ‘We have to have a cart-based device.’ It was the same place, but the attitude changed because they were concerned about theft.”
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Enjoy!
David.
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