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February 7, 2012 | Research
A Therapist in Your Pocket
New smart phone, a virtual therapist and other novel technologies to treat depression
By Marla Paul
CHICAGO --- Brooding in your apartment on Saturday afternoon? A new smart phone intuits when you’re depressed and will nudge you to call or go out with friends.
It’s the future of therapy at a new Northwestern University Feinberg School of Medicine center where scientists are inventing web-based, mobile and virtual technologies to treat depression and other mood disorders. The phone and similar projects bypass traditional weekly therapy sessions for novel approaches that provide immediate support and access to a much larger population.
Also in the works at the National Institutes of Health-funded center: a virtual human therapist who will work with teens to prevent depression; a medicine bottle that reminds you to take antidepressant medication and tells your doctor if the dosage needs adjusting; a web-based social network to help cancer survivors relieve sadness and stress.
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Digital Doctoring
The digital revolution can spur unprecedented advances in the medical sciences, argues Eric Topol in "The Creative Destruction of Medicine."
By SCOTT GOTTLIEB
Among the most common reasons why people come to an emergency room are bouts of heart failure or pneumonia. Sometimes they have a touch of both. When I was doing my residency 10 years ago, we often struggled to distinguish swiftly one illness from the other. We ended up treating a lot of people for both ailments, until we could sort out later which was the primary culprit.
Over the past decade, the way that doctors approach this common clinical dilemma has been transformed with a simple innovation. A blood test for B-type Natriuretic Peptide (BNP), which is secreted by weakened heart muscle, can help distinguish between the two conditions. Another improvement in recent years: Doctors are replacing their stethoscopes with inexpensive, hand-held ultrasound scanners that can detect a failing heart right in the ER.
Such innovations are just the beginning of a transformation of medicine, says Eric Topol in "The Creative Destruction of Medicine." Dr. Topol, a prominent cardiologist and geneticist, envisions a technology-enhanced future where new tools are integrated into diagnosing and treating patients, transforming the handling of common medical problems.
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Survey: Shifts May be Coming in CMIO Demographics
A survey of chief medical information officers, with respondents tilted toward multi-hospital organizations in the South, finds that CMIOs are getting a little younger and the ranks of women are growing.
CMIO magazine conducted its third annual Compen$ation Survey between Nov. 21 and Jan. 6, garnering 217 responses. “Changes in salary since last year are minor, according to our survey,” the magazine notes. “The number of those on the highest end of the scale remained about the same as last year, but there was a shift in the lower pay categories. Slightly more earn a salary of $100,000 or less (14 percent compared with 12 percent last year). Seventeen percent make a salary of $300,000 or more, a number unchanged from last year. Twenty-six percent earn salaries between $100,000 and $200,000 compared with 24 percent last year; and 43 percent make between $200,000 and $300,000 compared with 47 percent last year.”
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2/09/2012 @ 12:27PM
The Future of mHealth: Healthcare Apps to Lower Insurance Costs
Healthcare insurers are using apps to streamline patient-care systems, by connecting with and educating members, and ultimately reining in spiraling costs.
The Future of mHealth is our series that explores opportunities and challenges of mHealth, which aims to put widespread access to healthcare within the reach of those who need it most.
Several large U.S. health insurance companies, including Aetna, WellPoint and UnitedHealth Group, currently offer mobile apps that help members find network providers and perform other simple functions.
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eHealth Initiative releases recommendations for accountable care
By Diana Manos, Senior Editor
Created 02/10/2012
WASHINGTON – The eHealth Initiative (eHI) issued a report on Thursday, providing health IT recommendations to support accountable care organizations.
Key recommendations from the report, titled “Support for Accountable Care: Recommended Health IT Infrastructure,” include:
- A health IT infrastructure that is flexible to support the changing needs of an accountable care organizational model;
- An infrastructure that supports the secure transfer, collection and storage of personal health data;
- A patient-centered system to engage and educate patients and caregivers; and
- A system that supports care coordination across the healthcare team and the patient.
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eRx makes steady gains in California, report shows
By Diana Manos, Senior Editor
Created 02/08/2012
EMERYVILLE, CA – Electronic prescribing is continues to grow steadily in California, potentially increasing the safety of the prescribing process, according to a new report from Cal eConnect.
About 25 percent of the state's physicians are sending prescriptions electronically, the report estimates, compared with 3 percent in 2007. At the same time, just 16 percent of eligible prescriptions are routed electronically, despite the fact that most community pharmacies are set up for ePrescribing.
"While much has been done to move California forward on ePrescribing, much more work is ahead," said Ron Jimenez, MD, co-chair of the Cal eConnect ePrescribing Advisory Group and a practicing pediatrician."The collaborative environment among health plans, providers and pharmacies is impressive and momentum is building toward improved, safer care for patients."
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Health technology for astronauts has earthly potential
By danb
Created Feb 10 2012 - 2:29pm
Two new healthcare technologies developed with astronauts in mind also show promise as real-world applications. The first, a biocapsule developed by NASA scientist David Loftus, has the ability both to diagnose and treat astronauts instantaneously. The second, an augmented reality unit developed by the European Space Agency, offers 3D guidance for diagnosing problems or performing do-it-yourself operations using a head-mounted display.
The biocapsule, Gizmodo reported [1], is composed of carbon nanotubes, and was initially developed for treating radiation effects on astronauts. Future treatment capsules are expected to have the ability not only to treat heat, exhaustion and sleep deprivation, but eventually diabetes and cancer, as well.
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More than 1.2 million patients in Eastern Ontario to benefit from two new ehealth solutions
February 8, 2012 (Ottawa, ON) - The Ottawa Hospital (TOH) and Hawkesbury & District General Hospital (HGH) today announced two innovative ehealth projects designed to better serve more than 1.2 million patients in Eastern Ontario.
In a provincial first, patients of The Ottawa Hospital are now benefitting from access to Ontario laboratories information system (OLIS) data through their clinicians thanks to the myTOH viewer. This means that important patient information will be available for clinicians to make treatment decisions within minutes or seconds compared to the previous hours or days.
OLIS is a cornerstone information system that connects hospitals, community laboratories, public health laboratories and practitioners to facilitate the secure electronic exchange of laboratory test orders and results. The ability to electronically share this information helps health care providers make faster and better patient care decisions.
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Are EHRs being used to stifle physicians?
By mdhirsch
Created Feb 9 2012 - 10:02am
Many physicians have been reluctant to embrace electronic health record systems [1], with concerns about their costs, usability and impact on workflow.
But is physician Adam Sharp, chief medical officer at healthcare start-up par80 and former CMO for online physician network Sermo, correct in stating that the real reason physicians should be leery of EHRs is that the technology is being thrust on physicians to control how doctors practice?
The goal of EHRs is to "wrestle control of healthcare away from the doctor-patient relationship into the hands of third parties who can then implement their policies by simply removing a button or an option in the EMR," he writes in a blog post [2].
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Why (some) doctors hate EHRs
By mdhirsch
Created Feb 9 2012 - 9:48am
Physicians realize that EHRs are inevitable. But many of them are still resisting adoption because they don't want the systems to come between them and their patients, according to a recent blog post by Adam Sharp, M.D.
In the post [1], he offered his take on why the adoption numbers of EHRs remain low despite the lure of incentives by the government. According to Sharp, founder of physician advocacy group Par 80, EHRs are unwieldy, expensive and inefficient; they don't improve productivity and don't necessarily lead to better outcomes.
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5 simple ways to realize ROI from your EHR
By Michelle McNickle, Web Content Producer
Created 02/08/2012
The steep cost of electronic health record systems in today's market makes seeing a return on investment that much more important. Luckily, there are a few basic ways to see financial gains after implementing an EHR. Heidi Jannenga, co-founder and COO, and Paul Winandy, CEO of physical therapy software WebPT, outline five basic ways to get ROI from your EHR.
1. The ability to see more patients. Once the implementation stage is over, the time typically spent on documentation with paper records can now be spent seeing more patients. And according to Jannenga and Winandy, an important part of seeing ROI by spending less time on documentation is workflow. “The workflow [needs to] match that of a practicing therapist or physician,” said Jannenga.
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Measuring ROI key to EHR success, adoption
By Loraine Lawson
Created Feb 10 2012 - 2:35pm
Measuring a return on investment for electronic health record systems is not just key to showing the project paid off, it also can be critical to the project's success and adoption, experts say. But it's not just about achieving ROI--it's about identifying the right metrics.
Typically, discussions winning over doctors to EHRs focus on quality of care issues. While that's important, Sherri Mesquita, an EMR/EHR consultant and project manager at Community Health Systems Inc., says doctors also care about other issues, including a system's ROI and its financial bottom-line impact.
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Millennium fug
The first Southern trust to go live with Cerner Millennium went live in 2005. Nearly seven years on, EHealth Insider takes another look at the “Live 7” deployments to see what – if any - benefits have been realised so far.
9 February 2012
Cerner Millennium has been back in the news in recent weeks, as local newspapers have reported significant problems at Oxford and North Bristol; the latest trusts to deploy the system as part of the National Programme for IT in the NHS.
The trusts say the introduction of such a big electronic patient record system is a massive operational change - and that while any short-term disruption for patients is regrettable, the long-term benefits will mean patients get better care.
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Cerner sites to report benefits
9 February 2012 Rebecca Todd
A series of 2011 benefits analysis reports for Cerner Millennium implementations at Southern trusts have been submitted to the Department of Health.
The reports will feed into an updated statement of benefits for the National Programme for IT in the NHS, and the £2.7 billion that it has spent on care records systems so far.
The DH was supposed to submit the update to the Commons’ public accounts committee by September last year.
Its failure to do so was criticised by the PAC, when it held hearings on the National Audit Office's third report on the programme last summer.
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CPOE reduces preventable adverse drug events
By danb
Created Feb 9 2012 - 3:17pm
Despite one recent study's findings that electronic health records are lacking in adverse drug event (ADE) detection [1], another study on computerized physician order entry systems came to the opposite conclusion.
The latter study [2], published in the Journal of General Internal Medicine, determined that CPOE systems can indeed reduce preventable adverse drug events. According to senior author David Bates, M.D., senior vice president for quality and safety at Brigham and Women's Hospital, researchers saw a 34 percent reduction in such drug events across five community hospitals in Massachusetts over a five-year span from January 2005 to September 2010. Two-thousand total charts were reviewed during the study.
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5 stages of EHR maturity and patient collaboration
By Michelle McNickle, Web Content Producer
Created 02/07/2012
By now, it’s apparent EHRs need to grow up. But, as patient-centered business models become increasingly popular, the EHR is also shifting into a vital part of the success of these organizations.
“The new ‘patient team’ business models, like ACOs, will require that EHRs mature into real-time care coordination and collaboration platforms that can help move organizations … from basic independent care into accountable care,” said Shahid Shah, software IT analyst and author of the blog The Healthcare IT Guy.
“But care coordination and collaboration aren’t just about adding patient messaging and simple health records sharing— in fact, they must become managers of digital biology and digital chemistry and be able to use that new data to help physicians across patient care teams better comprehend what is happening inside the patient so that they can actually improve health outcomes.”
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CSC plans massive job losses
2 February 2012 Rebecca Todd and Lyn Whitfield
CSC is about to announce massive job losses among staff working on its NHS account.
The move strongly suggests that the company is unlikely to win an advantageous new deal for the North, Midlands and East of England; or any deal at all.
However, in a statement confirming the news broken by eHealth Insider this afternoon, the company said "the action is mainly because we have now substantially completed many key development activities and are moving away from a focus on development work.
"This action is independent of contract negotiations. These are ongoing and we are therefore unable to comment on them."
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MU stage 2 to focus on sharing, patient engagement, CSC report says
By Mary Mosquera
Created 2012-02-08 12:54
Healthcare providers should double down on developing capabilities to coordinate care, engage with their patients, and electronically capture the data needed for quality reporting. They are likely to be required in the proposed rule for stage 2 of meaningful use, expected later this month.
The abilities of hospitals and physicians to enable patients to view and download their information and transmit summary of care records when patients move among care settings remain the most challenging to meet the next stage of meaningful use, according to a report from IT vendor CSC.
“The importance of these requirements goes beyond meeting the incentives for meaningful use,” said report authors Erica Drazen, managing director, and Jane Metzger, principal researcher, CSC’s Global Institute for Emerging Healthcare Practices.
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Getting serious about ICD-10: Lessons from the field
By gshaw
Created Feb 8 2012 - 12:45pm
To be honest, I can't quite remember the first time I heard the term "ICD-10." But I'm confident that when I did, I dismissed it as a "coding thing" that wouldn't be of interest to my audience of CIOs and other healthcare execs.
Reporting from last year's Healthcare Information and Management Systems Society conference, I referred to ICD-10 as "semi-looming" and made jokes about putting ICD-10 on the "middle burner." I posed the riddle "What's the opposite of sexy?" and almost everyone I tried it out on answered correctly: ICD-10.
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The imminent industry-association war over ICD-10
By Tom Sullivan, Editor
Created 2012-02-06 08:38
Just as the seceding South Carolinians firing on the Union Ship “Star of the West” became recognized as the first shot in the Civil War, the American Medical Association’s delegates voting to vigorously oppose ICD-10 may one day been seen as the salvo that set a conflict over coding sets in motion.
The stage is set for a war over U.S. adoption of ICD-10. Indeed, such a fight could pit industry associations that stand to profit from the code set against those representing the providers who have to actually implement and pay for the ICD-10 conversion.
Less than a week after AMA revealed the voting results, in fact, AHIMA CEO Lynn Thomas Gordon struck back with a public statement maintaining that “there are countless benefits that will come from the use of a 21st century classification system."
Then, the AMA’s second shot, a late-January letter calling on U.S. House Speaker John Boehner to block ICD-10, again drew fire from AHIMA, in the form of a warning that healthcare entities should continue keep proceeding with ICD-10.
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CSC Report Looks Ahead to Stage 2 Meaningful Use
A new report from Computer Sciences Corp. examines the lessons learned from attesters during Stage 1 of the electronic health records meaningful use program, and looks at criteria changes that could be in Stage 2.
The report includes a summary of Stage 1 criteria side-by-side with Stage 2 criteria proposed by the HIT Policy Committee, which advises the Department of Health and Human Services. HHS expects to soon publish a proposed rule for Stage 2.
The report, “Moving Ahead with Stage 2 of Meaningful Use,” also examines menu, or optional, Stage 1 requirements that large majorities of attesting providers deferred using.
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EMIS unveils new patient.co.uk
2 February 2012 Rebecca Todd
EMIS has re-launched its patient information website with a new look and plans for a a series of apps; including one that will let patients book an appointment from their smartphone.
Patient.co.uk receives 5m unique visits a month. The number of people viewing it on a mobile device rose from 8.6% to around 21% between January and December last year.
The re-launched site has a sleeker, more modern look and simpler navigation. A free patient.co.uk app also went online two days ago and has had 1,000 downloads already.
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IT 'super users' ease hospital culture change
By danb
Created Feb 7 2012 - 2:15pm
The employment or internal training of IT "super users"--individuals who are ahead of the curve when it comes to technology use--is becoming a common practice at hospitals looking to change their IT culture, according to an article [1] in the February CMIO magazine.
For instance, Michigan State University recently implemented a program to train 22 physician super users and 17 staff super users in using electronic medical records to meet Meaningful Use. The super users receive 26 hours of classroom training, according to CMIO, then tasked with providing support for other providers at the hospital. The trained super users are paid an $80-per-hour stipend for the classroom time and receive an additional 10 percent paid time for helping to train other providers, MSU chief medical information officer Michael Zaroukian told the magazine.
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Physician-patient emails: The debate rages on
By gshaw
Created Feb 7 2012 - 1:17pm
The question of whether or not physicians and patients should exchange emails seems fairly straight-forward. It is, after all, a simple yes or no question. But everywhere you look--from articles in the Wall Street Journal [1] to surveys [2] and research papers [3] to personal blog posts and tweets--the debate continues unabated.
Robert Sadaty, M.D., is among the latest to weigh in. Writing a blog post [4] for KevinMD.com, he explains why he gave up on email exchanges with patients--and why, he adds, will never go back.
"For sure, most patients loved using email," he writes. "The option to report any symptom or concern at any time of the day without having to bother with telephone menu prompts or dealing with the hassles of making appointments proved to be tremendously convenient. And for those questions that were straightforward and consisted of hardly two sentences at most, email at times was a definite time saver."
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What If Your Car Cared About Your Health?
Jim Molpus, for HealthLeaders Media , February 7, 2012
When I first heard that Ford and other auto manufacturers were researching how to build health monitoring devices and interfaces into cars, my thoughts immediately turned to how my good ole boy mechanic would fix the darned thing.
"Well, Jim, yer valves are gonna need a good cleanin.' I can turn them brake rotors one more time but that there glucose monitor, that's a fac'try part and be about next Tuesday before I can get that in."
I have a well-earned distrust of gadgets and have learned that the best-engineered machines excel at the task for which they are designed reliably and simply. So a car that needs few repairs, is comfortable, gets good mileage, and lasts longer than the payments do is fine by me. But Ford sees a larger opportunity to add the car to those places where you are concerned about your health, specifically in monitoring it.
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Health IT Managers Say Tablets Can Cause Problems
IT managers at healthcare organizations say tablets pose challenges for entering data into enterprise healthcare applications and can raise IT support costs.
By Nicole Lewis, InformationWeek
February 03, 2012
As the popularity of tablet use among physicians continues to grow so too has the challenges that come with integrating these devices into the health IT enterprise. That’s what a new study that polled 100 health IT managers reveals, with 74% of respondents saying tablets such as the iPad present challenges for entering data into enterprise healthcare applications and 66% say they believe providing technical support on consumer-grade tablets raises IT costs.
Published this week, the study--Diagnosis Danger: Governance & Security Issues Cause IT Concerns About iPad in Healthcare Setting--was conducted by BizTechReports, an independent research and reporting agency, in collaboration with Panasonic. The study gauged the perceptions of IT managers toward tablets as an increasingly vital tool that physicians use to enter medical data, access clinical applications, and view medical images.
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Microtest users guided by Guru
6 February 2012 Rebecca Todd
Microtest has launched a clinical data-sharing tool that enables remote access to GP patient records held in its Evolution system.
GURU means that GPs can log-in to see details about a patient they are treating in the community - such as medication, allergies and medical history - with all information live and updated.
Microtest managing director Chris Netherton said GURU had been in development for 18-24 months.
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Humber wants mobile Lorenzo
31 January 2012 Shanna Crispin
Humber NHS Foundation Trust has put its hand up to be one of the first to trial the mobile version of Lorenzo.
The trust is yet to go-live with the patient administration system, but its project team has told CSC it wants to be an early adopter of the additional mobile component of the system when it becomes available.
Humber is due to implement Lorenzo as part of the National Programme for IT in the NHS.
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GE releases patient portal
Written by Luke Gale
February 2, 2012
GE Healthcare has launched a new web-based patient portal, the Centricity Patient Online 13, which healthcare consumers can use to schedule appointments, pay bills, manage health information, send secure messages and receive reminders from providers.
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Natural language processing could eventually change medicine
By kterry
Created Feb 5 2012 - 11:35am
In a recent post on his Disease Management Care Blog [2], Jaan Sidorov, a physician with a keen eye for trends, speculated that natural language processing (NLP) might be used to pick up missing diagnoses from free text and perhaps even predict problems before physicians spot them. He cited a Mayo Clinic study [3] that found that the use of an NLP program to scan free text in encounter records was nearly as accurate as lab tests in showing whether patients had the flu.
This is not a new idea. The University of Utah School of Medicine has been conducting studies [4] of NLP for nearly a decade. But NLP is starting to become more capable, as shown by its growing use in computer-assisted coding. A VA study found [5] that the use of NLP with free text identified post-operative complications more accurately than claims data did.
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Monday, February 06, 2012
Meaningful Use in Year Two and Beyond: Informing the Efforts of RECs
by Christopher Harle and Nir Menachemi
Physicians and other eligible health care professionals have shown broad interest in the meaningful use incentive program. As we enter year two of the program, it is informative to look back at first-year participation to inform efforts aimed at increasing electronic health record adoption in future years. According to CMS, in 2011, 29,344 eligible professionals received a total of $570,350,910 in incentive payments through either the Medicare or Medicaid incentive programs. Participation ramped up at the end of the year, with 50% of all eligible professionals receiving their payments in November and December of 2011.
Of note in the CMS statistics is that nearly 173,000 providers registered for the program, indicating far more interest than actual participation thus far. This is not necessarily surprising given the many known obstacles to successful EHR adoption. The well-documented barriers extend beyond the commonly cited financial obstacles that the meaningful use program tries to address. The non-financial barriers include time and information constraints, environmental and organizational factors, as well as social and psychological obstacles. Therefore, an important policy question is how can these non-monetary barriers be overcome as the meaningful use program evolves?
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Enjoy!
David.
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