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HIMSS12 Preview: Kaiser to Share its EHR Journey Experiences
While many providers are working on their first full-blown electronic health record system, Kaiser Permanente has been through the process several times, starting back in the 1990s. Some of its facilities had EHRs long before others; its eight different regions tried out different systems at various times. Every time the organizational information technology strategy changed directions, it required full technological and operational overhauls.
Now, there's one EHR across the entire organization, encompassing 36 hospitals, 430 medical offices, more than 14,000 physicians, and 8.6 million members. Kaiser accounts for more than half the hospitals that have achieved HIMSS Analytics' Stage 7 EMR adoption--a complete paperless system with advanced use of integrated data. Kaiser recently introduced a mobile phone app to allow its members to access their medical records, make appointments, e-mail their physicians, and refill prescriptions.
It took seven years, but Senior VP and CIO Philip Fasano says the it was well worth the effort. Kaiser is starting to reap benefits that the entire U.S. health care system should get eventually, as long as providers embrace the advantages of integrated patient data.
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Thursday, February 02, 2012
UC-Merced Students Use Telehealth To Treat Diabetes
by Alice Daniel, iHealthBeat Contributing Correspondent
MERCED -- Business students at the University of California--Merced are launching an ambitious telehealth project to help underserved women in the Central Valley manage their gestational diabetes without having to make multiple doctor visits.
Through the project, patients will be able to send results of their blood sugar tests electronically to their health care providers.
By allowing data to be digitally transferred from blood sugar monitor to doctor, physicians can obtain necessary information without having to see patients directly, and patients can avoid multiple office visits.
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5 healthcare data governance best practices
By Sunil Soares, Director of information governance at IBM
Created 2012-01-31 09:49
Information governance is the formulation of policy to optimize, secure, and leverage information as an enterprise asset by aligning the objectives of multiple functions. In our experience, information governance practitioners face critical challenges in explaining the value to the business.
This article details the five best practices imperative to selling the value of information governance within healthcare:
1. Improve the reliability of data to support a 360-degree view of providers, members and patients. Healthcare organizations need to understand where providers practice, whom they refer to, and what patients they see. As a result, identity information such as name, provider identifier, state license number, Medicare number, Medicaid number is important to link multiple profiles of the same provider. It is also not uncommon for health plans to find that more than half of the contact information in their provider network directories is out-of-date. The network directory might include dead providers, as well as providers who might not have renewed their contracts for several years.
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Study: E-prescribing improves medication adherence
By mdhirsch
Created Feb 1 2012 - 10:23pm
Patients are more likely to pick up their prescription drugs when their physicians use e-prescribing to order them. Assuming they then take the drugs they've purchased, this trend should improve medication adherance, patient outcomes and reduce long-term healthcare costs.
That's the skinny from the latest study, conducted by Surescripts in collaboration with pharmacies and pharmacy benefit managers. Researchers analyzed data sets representing more than 40 million prescriptions. Patient first-fill medication adherence was 10 percent higher when physicians used e-prescribing.
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Cloud-based EHRs raise data rights questions
By mdhirsch
Created Feb 2 2012 - 8:49am
With cloud-based electronic health record systems becoming more popular, providers should carefully read their vendor contracts regarding their rights and use of their patients' data, according to American Medical News.
Gerard Nussbaum, director of technology services for the global management consulting firm Kurt Salmon Associates, tells amednews that since the data in the EHR is stored in the cloud, not at the host site, the vendor and others have access to the data, even if the provider owns it. That leads to issues regarding rights to the data, which the parties need to address.
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EHR Deployment Costs Approach $30,000 Per Doctor
Electronic health records move into the mainstream, thanks to Meaningful Use incentives. Most successful practices invest more in training, advanced functions, research shows.
By Ken Terry, InformationWeek
February 01, 2012
Physicians are starting to embrace electronic health records en masse, according to a new survey by the Medical Group Management Association (MGMA). Two caveats to bear in mind: Many of the EHRs in use still have minimal functionality, and the MGMA survey excluded solo and two-doctor practices.
According to the report, Performance and Practices of Successful Medical Groups, 51% of groups of three or more physicians are using some kind of EHR. Similarly, a recent government survey found that in 2011, 57% of office-based physicians had an EHR. But 34% of the respondents had what the government researchers defined as a "basic EHR." A basic EHR includes only a patient's medical history, demographics, diagnoses, medications, and allergies, as well as the ability to prescribe and view lab and imaging results electronically 
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Health IT sales growth predicted to rise only slightly in 2012
By kterry
Created Feb 3 2012 - 3:53pm
Despite rising investments by venture capital firms, the health IT field as a whole i [1]s poised for no more than 5 to 10 percent growth this year, financial analysts who attended a panel discussion hosted by the Nashville Health Care Council this week predicted.
Factors conducive to continued growth include the impending conversion to ICD-10, the analysts said in remarks reported [1] by Healthcare IT News. "I foresee a slightly better 2012, with the emphasis on slightly," said Darren Lehrich, managing director of Deutsche Bank Securities.
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Health data breaches up 97 percent in 2011
By Diana Manos, Senior Editor
Created 02/01/2012
CARPINTERIA, CA – Health data breaches in the U.S. increased 97 percent in 2011 over the year before, according to a new report by Redspin, a leading provider of IT security assessments.
The annual survey, "Breach Report 2011, Protected Health Information,” found breaches in all 50 states, and examined a total of 385 incidents affecting over 19 million individuals since the HITECH Act's breach notification rule went into effect in August 2009.
"Information security data breach in healthcare has reached epidemic proportions – the problem is widespread and accelerating," said Daniel W. Berger, Redspin's president and CEO.
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66% of healthcare IT executives concerned about monitoring tablets
Posted on 30 January 2012 by Roberta Prescott.
The concerns of healthcare IT executives trying to meet the demands of supporting consumer-grade computing devices are growing. A study — conducted by BizTechReports and published as a white paper by Panasonic (download here)– found major operational issues for media tablets in healthcare, with 66% of respondents stating consumer tablets create governance challenges for their organizations.
Other concerns include security, durability and electronic medical records(EHR) compliance. The risk management policies are meant to ensure that patients, practitioners and institutions are able to share information and collaborate, while limiting the chances of losing control of critical data. The survey also highlighted the control and remediation mechanisms that allow institutions to rapidly react and recover from unexpected situations that may expose the community of interest to risk. It also noted the productive end-to-end technology frameworks that optimize business processes from the end-point to back-office operation.
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Ireland gets upgrade for patient admin system
By Jamie Thompson, Web Editor
Created 02/02/2012
IMS MAXIMS has implemented the latest version of its Irish patient administration system across more than 50 healthcare organizations in the country. The upgrades will allow Ireland’s hospitals to meet national requirements and support advances announced by the Health Service Executive (HSE) to improve patient care.
The IMS MAXIMS software has been upgraded to support the interface to the National Integrated Medical Imaging System, which aims to make Ireland’s radiological services filmless, and the exchange of patient image data throughout the health service fast and secure.
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By Joseph Conn
Will the IT future be a dystopia?
Technology blogger Shelly Palmer has a futuristic warning in his recent post, "Google = Skynet … Yikes!"
Palmer began with a profession of love for technology and then fretted about the latest Google announcement on privacy, contemplating a frightening future of giant databases filled with personally identifying information (prescription records among them).
Also this week, electronic prescription company SureScripts issued a report on the inverse relationship between the amount of a patient's drug plan co-payment and willingness of a patient to show up and pay for the prescription—a good use of information in pursuit of better public policy. SureScripts said its review was based on more than 40 million prescription drug records, which were drawn from diverse sources. SureScripts garnered this information, for the most part, without patient consent, but it said the data had been de-identified so that no patient records were compromised.
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Mostashari expects big year ahead for data exchange
By Mary Mosquera, Contributing Editor
Created 02/03/2012
WASHINGTON – Health information exchange will ramp up significantly in 2012 because the necessary elements of interoperability will be in place, ONC chief Farzad Mostashari, told the Health IT Policy Committee at a meeting Feb. 1.
The health information exchange strategy means finally bringing together the standards, identity authentication certificates, governance for rules of the road, and the availability of directories or digital provider phone books.
These will enable providers to exchange information whether through a simple transaction for a referral or sharing a test with another provider or a more complex query for patient data.
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3 Essential Breach Prevention Steps
Attorney Also Offers Notification Insights
Jeffrey Roman
January 30, 2012
Encryption, staff training and audits of patient records access are three essential healthcare information breach-prevention steps, says attorney Robert Belfort.
Belfort urges healthcare organizations to encrypt data on mobile devices and media, educate staff about the sanctions they'll face if they're guilty of a breach and conduct internal audits of records access. "The belief that ... there's a high risk that if you access a record improperly you will be caught through some sort of audit trail review can have an important impact on behavior," he stresses.
In an interview with HealthcareInfoSecurity's Howard Anderson (transcript below) Belfort also notes organizations face a "difficult balancing act" in notifying patients of a breach and ensuring the risks aren't exaggerated.
The most difficult aspect of breach notification, Belfort says, is "figuring out how to frame the discussion in a way that balances the obligation to alert individuals to what's happened without causing unnecessary worry or exaggerating the risks that individuals really face."
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Improved Patient Problem List Enhances Diagnoses
New clinical decision support tool gives doctors a better patient problem list, reminding doctors of those medical issues and leading to improved care, say researchers at Brigham & Women's Hospital in Boston.
By Ken Terry, InformationWeek
January 30, 2012
A new clinical decision support tool developed by researchers at Harvard-affiliated Brigham & Women's Hospital in Boston can increase the completeness of patient problem lists in electronic health records (EHRs). Having all of a patient's diagnoses on a single list helps physicians provide better care, because they're more likely to treat a condition such as diabetes or hypertension if they're reminded of that problem when a patient visits.
Unfortunately, as a recent paper in the Journal of the American Medical Informatics Association noted, medical problem lists are often incomplete. In a previous study of a primary care network affiliated with Brigham & Women's, the authors found that "completeness ... ranged from 4.7% for renal insufficiency or failure to 50.7% for hypertension, 61.9% for diabetes, to a maximum of 78.5% for breast cancer, and other institutions have found similar results."
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Report: Data breaches from unencrypted devices up 525% in 2011
By danb
Created Feb 1 2012 - 1:45pm
Healthcare organizations need to "serve as their own watchdog" to increase security and decrease data breaches, a new report from IT security audit firm Redspin concludes. The increase in "bring your own device" policies at various hospitals, in addition to the continued implementation of electronic health record systems, are too much for government alone to regulate, the report's authors say.
The report digs into the latest major data breach figures--those breaches impacting 500 or more individuals--released by the U.S. Department of Health & Human Services' Office for Civil Rights [1]. With the addition last week of the 2011 Sutter Health [2] breach, which impacted 4.2 million patients, the number of major healthcare information breaches now sits at 385 since 2009.
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Halamka determined to upgrade DICOM standard for image sharing
By kterry
Created Jan 31 2012 - 3:39pm
John Halamka, CIO of Beth Israel Deaconess Medical Center (BIDMC) in Boston, had a personal experience recently that showed why the Digital Imaging and Communications in Medicine (DICOM) standard for transmission of medical images is not sufficient when it comes to cross-organization information exchange.
In a recent blog post [1], Halamka explains that his wife Kathy needed a follow-up visit following a breast cancer exam, and wanted to send her mammogram from her local hospital to BIDMC. It turned out that the only way to do it was to pick up a CD that contained the mammogram and the correct viewer and physically take it to BIDMC herself.
Halamka says that DICOM was created to move images across radiology systems within an organization. However, he said, "It is not sufficient for a healthcare information exchange world that uses the Direct implementation guide ... for content exchange among organizations. The fact that vendors such as LifeImage, Accelarad, and Merge Healthcare have created their own image sharing networks suggests that more standards work is needed to create an open ecosystem of image sharing among organizations."
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5 keys to discovering hidden data security risks
January 30, 2012 | Michelle McNickle, Web Content Producer
The threat posed to patient privacy by misused IT isn't anything new, and neither is all the "how to" coverage emphasizing the importance of protecting your organization from breaches. But, sometimes that’s easier said than done – something Earl Reber, executive director at eProtex, also agrees with.
“If your organization has some improvement to do in the area of data security, knowing where to start can seem overwhelming,” he said, adding that one needs to "begin to explore these issues deeply and work toward a long-term solution, as opposed to applying a Band-Aid. If you feel you can’t afford the time or resources to address these issues, truly, you can’t afford not to.”
Reber outlines five basic keys to discovering hidden data security risks.
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To Contain Hospital Costs, Leaders Must Look to IT
Edward Prewitt, for HealthLeaders Media , January 31, 2012
The federal government is offering bonus money to hospitals for meaningful use of healthcare IT, even as it terms 2012 the year of meaningful use. To spur developers to come up with better tools to track patients after discharge, the Office of the National Coordinator for Health IT has launched a challenge to create a Web-based application that could empower patients and caregivers to better navigate and manage a transition from a hospital.
Incentives like this are easy money, but they really shouldn't be necessary. Technology is the only means by which healthcare systems can make it out of their current impasse.
Last week, at one of our Roundtable events—HealthLeaders Media's gatherings of small groups of hospital executives to discuss topics of top concern—Dave Brooks, CEO of Providence Health and Services' Northwest Washington Region in Everett WA, said his system will need to cut costs by 10–15% over the next few years, beyond its already efficient operations.
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CNIO position on the rise
January 30, 2012 | Diana Manos, Senior Editor
OAK BROOK, IL – Chief Nursing Information Officer (CNIO) is a fairly new title, but it is growing in popularity and more and more organizations are recruiting for the position, according to Linda Hodges, vice president and leader of information technology search practice at executive search firm Witt/Kieffer.
An increasing number of nurses are setting their sites specifically on attaining a CNIO position, Hodges told Healthcare IT News in an exclusive interview.
“This is something that has become a passion for many people who went into nursing but also love IT,” she said. “They can see how this role can impact care, especially with the evolving new role of accountable care organizations.”
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Health organizations increasingly hiring chief nursing information officers
By kterry
Created Jan 30 2012 - 6:26pm
While the rise of chief medical information officers has gotten the spotlight recently, chief nursing information officers also are becoming more common. A growing number of healthcare organizations are recruiting candidates for this position, Linda Hodges, vice president and leader of information technology search practice at executive search firm Witt/Kieffer, told Healthcare IT News.
Today, most institutions hiring CNIOs are academic medical centers or large integrated healthcare systems, Hodges said. But that could change as more healthcare systems recognize that they need IT experts with nursing experience to help lead their health IT implementation, which is largely carried out by nurses.
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Consultant Describes Rocky Road Through the Health System
Paul Keckley, executive director at the Deloitte Center for Health Solutions, recently underwent knee surgery and things have not gone so well on the treatment and payment sides.
He’s been reminded that there’s nothing like using the health care system to see its strengths and weaknesses. In Deloitte’s latest weekly “Health Care Reform Memo,” Keckley lays his experiences over the first month following surgery and promises follow-ups, which Health Data Management also will publish:
It’s been 34 days since my knee surgery and subsequent clotting complication. I’ve used two hospitals in two states, three labs to draw blood to monitor my coagulation, and countless hours online trying to figure out my propensity for further complications that might lie ahead.
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Federal CTO Aneesh Chopra Resigns
Chopra, the first person to hold the federal CTO post and a strong voice behind Obama administration efforts on open government, will depart in February.
By J. Nicholas Hoover, InformationWeek
January 27, 2012
The nation's first federal chief technology officer, Aneesh Chopra, will step down from his White House position in early February, according to the White House.
Chopra, who joined the Obama administration in May 2009, has been a vocal force and leader for the Obama administration's technology and innovation policy. Chopra serves as an adviser to the president on innovation and a government liaison with academia and industry. In that role within the White House's Office of Science and Technology Policy, he has been an outspoken advocate of open government and has focused many of his efforts on innovations in healthcare, the smart grid, and education.
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5 dos and don'ts of EHR interface design
January 27, 2012 | Michelle McNickle, Web Content Producer
Sometimes, small tweaks can make a big difference, and according to Bob Hunchberger, a clinical informaticist for a 500-bed hospital, that couldn’t be truer when it comes to your EHR.
Hunchberger suggests five dos and don’ts of EHR interface design.
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Mostashari: 2012 Will be a Big Year for HIT
At least 100,000 providers will receive electronic health records meaningful use incentive payments, during 2012, Farzad Mostashari, M.D., National Coordinator for HIT, predicts in a new blog posting.
And that’s just the start, he says, laying what he sees as a turning point year. “In summary, I see 2012 as the year in which health I.T. truly comes of age.”
Mostashari tackles five major I.T. trends during the coming year, starting with the taking off of meaningful use after 20,000 eligible professionals and 1,200 hospitals received incentive payments in 2011.
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Personal health data better protected by ISO standard
2012-01-30
ISO has published a new technical specification which will increase protection of personal health information processed, stored and transferred by computer systems for subsequent use by clinicians and others in healthcare organizations. ISO/TS 14265:2011, Health informatics – Classification of purposes for processing personal health information, defines a set of high-level categories of purposes for which such personal health information can be processed .
Electronic health records (EHRs) are used more and more. They involve the systematic electronic collection of health information about individual patients or populations, such as information about the physical or and mental health of an individual or provision of health services.
Health information is usually documented by healthcare professionals as part of the process of delivering care, and subsequently used to support the continuing care of each patient. However, EHR information might also be needed and used to enable the healthcare organization (such as a hospital) to manage its services better and more safely, and for a wider range of purposes such as public health, education and research.
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Bipartisan Policy Center calls for more, better health IT
By Bernie Monegain, Editor
Created 01/27/2012
WASHINGTON – A think tank with a healthcare task force chaired by former Senators Tom Daschle, a Democrat, and Bill Frist, MD, a Republican, is advocating for improved and better-used health information technology. Among the group's recommendations is "robust" data exchange.
The Bipartisan Policy Center's Task Force on Delivery System Reform and Health IT released its report on Jan. 27.
Besides data exchange, the recommendations range from realigning incentives and payments to support higher quality, more cost-effective care to increasing the use of electronic health records.
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January 27, 2012 10:10 AM
Report: Electronic health records still need work
WASHINGTON — America may be a technology-driven nation, but the health care system's conversion from paper to computerized records needs lots of work to get the bugs out, according to experts who spent months studying the issue.
Hospitals and doctors' offices increasingly are going digital, the Bipartisan Policy Center says in a report released Friday. But there's been little progress getting the computer systems to talk to one another, exchanging data the way financial companies do.
"The level of health information exchange in the U.S. is extremely low," the report says.
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Halamka outlines BIDMC's ICD-10 processes, shares resources
By danb
Created Jan 30 2012 - 12:25pm
While Beth Israel Deaconess Medical Center CIO John Halamka, M.D., doesn't necessarily believe that ICD-10 is a worthwhile project--particularly because it is used for reimbursement [1] instead of for research as it in other nations--he realizes the importance of making sure his facility is right on top of the implementation.
In his latest blog post [2], Halamka provides updates on BIDMC's progress with ICD-10. His outline, while brief, also provides a how-to guide for other hospitals in similar situations.
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10 steps to a successful telemedicine program
By gshaw
Created Jan 30 2012 - 1:05pm
From market assessments to self-assessments, Becker's Orthopedic, Spine & Pain Management Review offers 10 best practices for implementing telemedicine in hospitals that want to improve access, reduce costs and boost quality of care.
"The first step is to do an honest assessment of your capabilities and the needs [of] communities," Tim Smith, M.D., vice president of research for the Center for Innovative Care at St. Louis-based Mercy Hospital, told Becker's. Mercy started its telemedicine process with a community needs analysis. The organization's leaders met with members of the community at different events to determine what healthcare services they most needed, according to the article [1].
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Chaos as hospital trust's £4m new IT system fails
Last updated at 2:04 AM on 29th January 2012
Hundreds of patients have had operations cancelled or been given appointments at non-existent clinics after the failure of a £3.9 million new computer system.
Major glitches in the system have forced doctors to send patients home without treatment because their notes could not be accessed. In other cases, patients were given the wrong appointments.
The system, Cerner Millennium, was introduced at North Bristol NHS Trust in December and was designed to replace all paper documents – including medical records – and cope with about 30,000 outpatient appointments a month.
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Enjoy!
David.
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