Welcome to the May 2013 edition of i2P - Information to pharmacists.
Economic turbulence seems to now be arriving in Australia with forecasts of high inflation rates, which also means high interest rates following on.
This type of economic forecast also means that banks will be more fractious with their borrowers. They are already offside with pharmacy due to the high level of bankruptcies over the past two years.
There is a pent up demand for a general wage increase for pharmacists impacting at a point in this month where pharmacy gross profit generally, is in decline.
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Volume 2 Number 1
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Volume 3 Number 1
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Volume 4 Number 1
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Volume 5 Number 1
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Volume 5 Number 4
Dr David More
From a Medical IT Perspective: I am vitally interested in making a difference to the quality and safety of Health Care in Australia through the use of information technology. There is no choice.. it has to be made to work! That is why I keep typing. Disclaimer - Please note all the commentary are personal views based on the best evidence available to me - If I have it wrong let me know!
This blog has only three major objectives.
Sunday, May 27, 2012
The Person-controlled Electronic Health Record. From Recommendation To Reality NOT!
I thought it would be useful to have a close look at where the NEHRS (PCEHR) sprang from and just how poor the thinking around its conception was. Here are the key message and the recommendations of an amazingly short 16 page document (removing the duplicated recommendations) that started all this:
The document is date 30 April 2009 and can be downloaded in full from here:
This document is a late addendum to the Interim Report of the National Health and Hospitals Commission and was released just before the final report in June 2009.
Person-controlled Electronic Health Records
o Health care is knowledge intensive. The timely and accurate communication of pertinent, up-to-date health details of an individual can enhance the quality, safety and continuity of health care.
o Current health information systems are disjointed, which often results in health care professionals operating with incomplete or incorrect patient information. It is estimated that up to 18 per cent of medical errors are a result of inadequate availability of patient information.
o As technology, work practices and medical knowledge continue to evolve in the coming years, the complexity of health care interactions will become greater, which means the need to document and readily access a patient’s health profile will become more critical.
o A person-controlled electronic health record would enable people to take a more active role in managing their health and making informed health care decisions.
o Investment in health IT lags well behind that of other information-centric consumer industries such as the financial and telecommunication industries, which have invested heavily over the last 20-30 years to achieve global connectivity.
o According to recent research commissioned by the National Electronic Health Transition Authority (NEHTA), 82 per cent of consumers in Australia support the establishment of an electronic health record (EHR).
o The implementation and widespread use of information technology in the health sector (e-health) is one of the most important enablers of personal health management and quality health care.
o The overall economic benefit from increased productivity and reduced adverse events that would be achieved with a national individual electronic health record in Australia has been estimated to be between $6.7 billion and $7.9 billion in 2008-09 dollars over 10 years.
o The protection of privacy and confidentiality is a key factor in winning widespread community acceptance and uptake of electronic health records.
o Health providers and the IT industry must work together to develop open, nationally-agreed standards for the secure electronic capture and storage of personal health information.
o The essential role of governments in a new e-health environment is to protect the public’s interest through legislative reform and ensuring people retain control over who has access to their personal health information.
Here are the recommendations.
1. We propose that, by 2012:
every Australian should be able to have a personal electronic health record that will at all times be owned and controlled by that person;
every Australian should be able to approve designated health care providers to have authorised access to their personal electronic health record; and
every Australian should be able to choose where and how their personal electronic health record will be stored, backed-up, and retrieved.
2. We propose that the Commonwealth Government legislate to ensure the privacy of a person’s electronic health data, while enabling secure access to the data by the person’s authorised health providers.
3. We propose that the Commonwealth Government must introduce:
unique personal identifiers for health care by 1 July 2010;
unique health professional identifiers (HPI-I), beginning with all nationally registered health professionals, by 1 July 2010;
a system for verifying the authenticity of patients and professionals for this purpose - a national authentication service for health (NASH) - by 1 July 2010; and
unique health professional organisation (facility and health service) identifiers (HPI-O) by 1 July 2010.
4. We propose that Australian governments drive the national development of open technical standards for e-health, and that they secure national agreement to open technical standards for e-health by 2011-12. These standards should include key requirements such as interoperability, compliance and security. The standards should be developed with the participation and commitment of industry, health professionals, and consumers.
5. We propose that the Commonwealth Government develop and implement an appropriate national social marketing strategy to inform consumers and health professionals about the significant benefits and safeguards of the proposed e-health approach.
6. We propose that significant funding and resources be made available to extend e-health teaching, training, change management and support to health care practitioners. The commitment to, and adoption of, e-health solutions by health care providers is key to the success of a person-controlled electronic health record.
7. We propose that the Commonwealth Government mandate that the payment of public and private benefits for all health and aged care services be dependent upon the provision of data to patients, their authorised carers, and their authorised health providers, in a format that can be integrated into a personal electronic health record, such that:
hospitals must provide key data, such as referral and discharge information, by 1 July 2012;
pathology providers and diagnostic imaging providers must provide key data, such as reports of investigations and supplementary information, by 1 July 2012;
other health service providers - including general practitioners, medical and non-medical specialists, pharmacists and other health and aged care providers - must transmit key data, such as referral and discharge information, prescribed and dispensed medications and synopses of diagnosis and treatment, by 1 January 2013; and
all health care providers must be able to accept data from other health care providers by 2013.
---- End Extract.
With a month to go it is clear we are nowhere near what was envisaged a little over 3 years ago and funded to the extent of almost $2 billion 2 years ago.
As you read the document it seems clear to me there is confusion about just what is being recommended and what it will do.
As always the Key Messages includes problems with information access and flows causing problems but totally lacks any clarity on just how much of the problem will be fixed by what is being proposed.
It is always good to also know that 82% of the public support something that they have no clear idea as to exactly what it is - like an EHR and I won’t even comment on the benefits claimed as they were claimed in the absence of any understanding as to what the system might actually do.
As far as the recommendations and the time frames suggested they do seem just a little ambitious (verging on fantasy even). (According the .pdf the author of the document is Peter one Broadhead who is an executive in DoHA who was involved in the NHHRC process but is now not even apparently associated with e-Health (if Google is to be believed) - smart man is all I can say.)
I will note in passing NASH is still not there, identifiers are not used by the majority of patients or practitioners, hospital are not ready to transmit information to repositories and there is hardly any planned personal control of where an individual’s information is held. And just how does one ‘own’ a clinical record that is in the hands of the Government?
Essentially the PCEHR is a thought bubble that has drifted off the reservation and will never deliver what was intended then and even what was planned when funding was allocated. It really is a model bureaucratic implementation fiasco.
Posted by Dr David More MB PhD FACHI at Sunday, May 27, 2012 3 comments
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Senate Estimates Hearings On E-Health Are Being Held 30th May 2012. Will Be Interesting.
As of Sunday May 27 2012 here is the program:
WEDNESDAY, 30 MAY 2012
Health and Ageing Portfolio
Department of Health and Ageing (DoHA)
7:15pm – 8:15pm
Outcome 10 Health System Capacity and Quality
Program 10.2: e-Health Implementation
National e-Health Transition Authority (NeHTA)
The link to the page is found here:
Here is the link to access the hearings and outcomes
Senate estimates hearings are broadcast live over the Internet. Details can be found here.
· To view the current transcript production status of Senate Legislation Committees considering estimates see the Estimates Transcript Schedule.
· To view published Hansards please visit Parlinfo.
----- End Extract.
Enjoy the hearing. Doubtless I will have a few words to say later in the week.
Posted by Dr David More MB PhD FACHI at Sunday, May 27, 2012 0 comments
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Saturday, May 26, 2012
Weekly Overseas Health IT Links - 26th May, 2012.
Here are a few I have come across last week.
Note: Each link is followed by a title and few paragraphs. 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.
National report shows surge in e-prescribing among health practitioners
By Erin McCann, Associate Editor
ARLINGTON, VA – By the end of 2011, 58 percent of office-based physicians were using e-prescribing, with solo practitioners contributing the most significant growth, according to Surescripts, which released today “The National Progress Report on E-Prescribing and Interoperable Healthcare Year 2011.”
Included in the report is data analysis that documents the prevalence of e-prescribing adoption and use in the United States from 2008 through 2011.
ONCHIT programs that assess HIT individual competence
Author Name : Stephen C. Burrows, DPM, MBA | Date : May 17, 2012
Many health professions have a mechanism for certifying individuals as to their knowledge and competence. While there have been a few to certify individuals in the field of healthcare information technology (HIT), none have dominated the field.
As part of a nationwide strategic plan for advancing the use of healthcare IT, Congress passed the HITECH Act and provided a significant amount of grant money for a number of initiatives. Included is a knowledge assessment program for HIT Professionals known as the Competency Examination Program. According to the ONCHIT, this program will “enable health IT professionals, employers, and other stakeholders to assess their own health IT competency levels or the competency of their health IT staff members, as appropriate.”
New HL7 program seeks to spur EHR participation
By Erin McCann, Associate Editor
ANN ARBOR, MI – Health Level Seven International (HL7) announced Wednesday the inception of its pilot membership program and launched a website aimed at increasing caregivers’ participation in the development of electronic health record (EHR) standards.
"For several years, the HL7 leadership has voiced its concerns about the typical first encounter with the standards development process,” said Charles Jaffe, MD, CEO of HL7. However, he added, “Now we are in a better position to translate the practical clinical expertise of these caregivers into tangible improvements in the interaction with the health record technology."
Experts get creative in protecting patient IDs in audit trails
May 18, 2012 | By Ken Terry
A body that advises the state of Massachusetts about health information exchanges has devised an unusual approach to maintaining the privacy of patient information while allowing the use of audit trails.
In a recent blog post, John Halamka, CIO of Beth Israel Deaconess Medical Center in Boston, explained that the technology workgroup of the Massachusetts State HIE Advisory Committee recently grappled with an issue that arises from the use of the Direct secure messaging protocol: When one provider sends a Direct message to another, it is surrounded by an electronic "envelope" that contains key information about senders, receivers and content in the form of metadata. While unauthorized parties cannot access that information, it is also unavailable for audit purposes.
Hospitals enlist vendors for data analytics help
By Susan D. Hall
Created May 17 2012 - 11:55am
Providers are increasingly turning to big tech companies to help their data mining efforts, according to an article  at Bloomberg Businessweek.
Vendors such as Microsoft, SAS, IBM and Oracle are giving mounds of data the once-over in an analytics industry that generated more than $30 billion last year, according to research firm IDC. That figure is expected to grow to $33.6 billion in 2012--and healthcare is a leading customer.
The article gives some enticing examples.
For example, a hospital in Washington, D.C., called in Microsoft to help look at readmission rates--the data helped pinpoint the infected room.
Google ranks high for health research, but all search engines lacking
Created May 17 2012 - 12:04pm
The top four search engines all provide "rich" health and medical information, but none of them stand out as the best, according to a new study  published in the Journal of Medical Internet Research.
The researchers, from the University of Missouri and China, compared the top four search engines--Google, Bing, Ask.com and Yahoo!--for usability and search validity. They noted that most people use just one search engine when conducting research on a health-related topic, and then view the websites only on the first page of the search. The researchers wondered if this was the best way to obtain information.
JAMIA: Why do some providers use HIEs and others not?
Written by Jeff Byers
May 15, 2012
Understanding end users' perspectives towards health information exchange (HIE) technology is crucial to the long-term success of HIE, according to researchers from Vanderbilt University School of Medicine in Nashville, Tenn., who developed an in-depth understanding of HIE usage by applying qualitative methods.
Publishing their findings in the May edition of the Journal of the American Medical Informatics Association, Kim M. Unertl, PhD, department of biomedical informatics at Vanderbilt Implementation Sciences Laboratory, and colleagues conducted an ethnographic qualitative study from January to August 2009 in six emergency departments (EDs) and eight ambulatory clinics in Memphis, Tenn.
Diabetes mobile app bolsters role of pharmacists in patient adherence
Posted By Stephanie Baum On May 16, 2012 @ 5:48 pm In MedCity News eNewsletter,SYN,
One of the most significant factors influencing healthcare costs is patient adherence or lack thereof. If diabetes patients don’t take their medications, watch what they eat and monitor their blood-glucose levels, they risk complications that can lead to hospitalization.
A semifinalist in Sanofi US’ (NYSE:SNY) Data Design Diabetes Innovation Challenge , iRetainRx  believes it can overcome that challenge by providing a cloud-based system to help patients and caregivers connect with pharmacists and providers. Using a mobile device such as a computer, iPad or smartphone, they can get a video link to their pharmacist to get answers to questions and pharmacists can call attention to issues such as risky drug interactions.
Thursday, May 17, 2012
A Look at Social Media in Health Care -- Two Years Later
by John Sharp
Two years ago I wrote an iHealthBeat Perspective, titled, "Social Media in Health Care: Barriers and Future Trends." Let's take a look at how far we have come and whether my predictions are on target.
Online Communities and e-Patients
Since 2010, pharmaceutical companies have joined startups, patient communities and providers in the social media realm. Many startups, particularly those enabling patient communities, have matured and broadened their scope. PatientsLikeMe has expanded to more than 1,000 conditions, CureTogether has gained the attention of major press outlets and 23andMe is defining personal genomics.
In addition, both PatientsLikeMe and 23andMe have published results in medical journals, bringing further validation to social networks and social media as having legitimate contributions to medicine. A PatientsLikeMe study, titled "Perceived Benefits of Sharing Health Data Between People With Epilepsy on an Online Platform," was published in the journal Epilepsy and Behavior, and a 23andMe study, titled "Efficient Replication of Over 180 Genetic Associations With Self-Reported Medical Data," was published in PLoS One, as well as the Journal of Medical Internet Research.
Data-Mining in Doctor's Office Helps Solve Medical Mysteries
By Jordan Robertson on May 15, 2012
When hospitals turn to Microsoft Corp., it's no longer just for the latest office software. Some are asking the technology giant for help in diagnosing their patients.
In one instance, a hospital in Washington, D.C., asked Microsoft to examine its medical records to determine why certain patients were getting sick soon after being discharged. The company crunched the data from MedStar Washington Hospital Center and found something surprising: Patients who stayed in the same room had come down with the same infection.
"There was a bug in the room -- people were getting infected," Scott Charney, vice president of Microsoft's Trustworthy Computing group, said recently at a security conference. Such infections are often caused by bacteria on medical instruments or furniture.
No 'bubble' for healthcare IT, analysts say
By Larry McClain, Contributing Writer
NASHVILLE, TN – Leading financial analysts scoffed at the notion of a healthcare IT “bubble” that could slow the pace of mergers and acquisitions this year. Speaking on a panel called “Financing The Deal” at the Nashville Health Care Council, they predicted that 2012 M&A activity would be brisk, though not superheated.
In the health IT sector, there’s currently a glut of buyers and not enough companies to acquire. There are many non-healthcare players like Lockheed-Martin wanting to buy healthcare IT companies – and many suitors for a limited number of clinical decision support companies. “There are still a lot of great opportunities for technology-enabled healthcare companies with a demonstrable ROI,” said David Jahns, managing partner at Galen Partners.
3M Health Data Dictionary Going Open Source
MAY 16, 2012 12:31pm ET
3M Health Information Systems will release a public version of its Healthcare Data Dictionary as open source software, making it free and available worldwide.
Placing the dictionary, called HDD, in the open source market is part of a contract 3M has reached with the Departments of Defense and Veterans Affairs. The departments will use HDD to enable semantic interoperability for its integrated electronic health record initiative.
Semantic interoperability enables the exchange of data with the meaning of data preserved, such as to normalize test results, which vary depending on the lab doing a particular test and the system it uses.
Barriers to mainstream genetic tests remain
Created May 16 2012 - 12:22pm
Although genome sequencing has shown promise as a tool for the type of preventive care that will be necessary for successful accountable care, several drawbacks--such as the potential for over-treatment--remain, according to a Wall Street Journal article .
In particular, over-treatment could result from unique genetic variations in each patient that could, at first, raise concerns, but ultimately might not cause any disease, Michael Watson, executive director of the American College of Medical Genetics and Genomics, told WSJ.
Even opt-in doesn't protect data exchange privacy
Created May 16 2012 - 1:58pm
The healthcare industry still has room for improvement when it comes to health information exchange privacy, even in states that have an opt-in or opt-out option, according to a recent article  from Bloomberg News.
Although not all states are required to tell patients if their medical data is being used, even those that do so aren't necessarily doing a good job, according to the article. In New York, for example, a state with an opt-in option for patients, studies published in March by the state's civil liberties union and the Consumers Union  determined privacy "rules of the road" to be undefined, patient education efforts to be weak, and the opt-in effort to be too broad. As it stands, a one-time opt-in allows "blanket permission" by providers to release all medical information.
May 13, 2012
Exploring the Role of Mobile Technology as a Health Care Helper
By STEPHANIE NOVAK
Two decades ago, a woman having a difficult birth in a Ugandan village would have had few options to get life-saving treatment if there was not a nearby health clinic. But today, mobile technology can help her get advice from a doctor in Kampala over the telephone, alert a community health worker about her situation, or even get her to a hospital.
Mobile technology is changing the landscape of health care delivery across the developing world by giving people who live in rural villages the ability to connect with doctors, nurses and other health care workers in major cities.
“Now, a phone call can compress the time that it would have taken before to come to that decision point and get the woman care more often and quickly,” said Dr. Alain Labrique, a professor of International Health and Epidemiology at Johns Hopkins University, in Baltimore.
Dr. Farzad Mostashari: 5 things government can do to improve health technology
By Chelsea Conaboy
May 15, 2012
What is the government’s role in developing new technology? Some would say to stay out of the way. Dr. Farzad Mostashari, the national coordinator for health information technology, said that’s overly cynical.
But, Mostashari said in an interview, government is no longer the major producer of innovative products and services that it once was, creating things for military purposes or space exploration that work their way into the consumer market.
“That’s not the model anymore,” he said. “The investments in research and development that are going on in the consumer technology space are now dwarfing the investment and innovation that are happening in, say, the military.”
ONC Announces Creation of CMO Role, Office of Consumer eHealth
May 16, 2012
In a blog post by the National Coordinator for Health Information Technology, Farzad Mostashari, M.D., the Office of the National Coordinator for Health IT (ONC) has announced the creation of the Office of the Chief Medical Officer and an Office of Consumer eHealth. The primary function of the Office of the Chief Medical Officer will be to infuse a clinical perspective across ONC on all activities which have clinical implications. The Office of Consumer eHealth will work on consumer engagement.
Report: HIEs failing at true interoperability
By Mike Miliard, Contributing Editor
While some $560 million in federal health information exchange funding may soon run dry, changing reimbursement models mean market-driven growth will continue, says a new report on HIEs from Chilmark Research.
Profiling 22 HIE vendors, the study, "2012 HIE Market Report: Analysis and Trends," shows a market that's evolving, making the shift toward serving healthcare organizations of all sizes as they position themselves for payment reform, its authors say.
Increasing HIE technology adoption is spurred by two factors, say researchers. First is the need to meet proposed Stage 2 meaningful use requirements, which put a far greater emphasis on data exchange. More crucially, big changes on the horizon with regard to reimbursement means healthcare organizations are implementing HIE technology to support community-wide care coordination.
Top 9 fraud and abuse areas big data tools can target
By Roger Foster, Senior director, DRC’s high performance technologies group, and advisory board member of the technology management program at George Mason University
Fraud and the abuse of healthcare services in the U.S. cost an estimated $125-175 billion annually. This represents the second largest component of the $600-850 billion surplus in healthcare spending. Healthcare organizations and government agencies must leverage big-data collections of patient records and financial billing to identify and eliminate system abuses.
Web First: Q&A with Allscripts CEO Glen Tullman
By Bernie Monegain, Editor
CHICAGO – In real estate, it’s all about location, location, location, they say. In healthcare IT, you might say it’s about integration, integration, integration. Allscripts CEO Glen Tullman is keenly aware of how critical product integration is, he says, and he’s working on it. It’s the difficulties with integration that seem to have led to the EHR company’s recent troubles – at least it’s what Allscripts customers and analysts mention most often. Then came April 25 and the ousting of Allscripts’ board chairman, which triggered three board members to quit in protest, the departure of its CFO (for reasons unrelated, according to the company) and a dismal quarterly report, all of which led to stock price plunging 44 percent.
Living in a box
Health minister Earl Howe launched South London and Maudsley NHS Foundation Trust’s MyHealthBox project on Tuesday. Reporter Rebecca Todd went along to hear more about the innovative online patient records scheme.
15 May 2012
“Exciting” was the word of the day for speakers at the launch of MyHealthBox. “Innovative” and “empowering” also popped up more than once as people spoke about why patient controlled records are a good idea.
MyHealthBox uses Microsoft’s HealthVault platform to create a patient record for South London and Maudsley NHS Foundation Trust’s service users.
The online portal can pull data from the trust’s Electronic Patient Journey System and from primary care - and patients can contribute to it themselves.
Maudsley launches HealthVault-based PHR
15 May 2012 Rebecca Todd
South London and Maudsley NHS Foundation Trust is today launching personal online health records for its patients, using Microsoft’s HealthVault platform.
Director of information strategy, Mike Denis, presented on the MyHealthBox project at the Health+In4matics conference in Birmingham last week.
He told attendees the project was a partnership between the trust, the Institute of Psychiatry and service users. It aims to improve patients’ engagement in their care and the use of outcome measurements across the trust.
Debate: Can mobile apps achieve what pills can't?
By Susan D. Hall
Created May 15 2012 - 12:47pm
In a pair of point-counterpoint articles  at Forbes, contributors Dave Chase and David Shaywitz face off on the question of whether mobile apps could someday be more effective than prescription drugs--a response to health app company Happtique's plans to build a platform for physicians to "prescribe" apps to their patients .
Chase, the CEO of patient portal and relationship-management company Avado.com, sounds a dire warning  that apps pose a huge threat to a lethargic pharma industry. He likens pharma execs to those of the newspaper industry 15 years ago, who saw the landscape changing around them, but did too little to adapt.
Chase urges pharma execs to get out of the stands and put more skin in the game in terms of money and people.
New research disputes claims EHRs improve diabetes care
By Susan D. Hall
Created May 15 2012 - 1:24pm
Contrary to previous research, the use of electronic health records failed to improve care for diabetic patients in a study  published in the Annals of Family Medicine.
Robert Wood Johnson Medical School at the University of Medicine & Dentistry of New Jersey researchers compared data from 16 practices in the Northeast that used EHRs and 26 practices that did not, assessing the care for 798 patients.
They found, in fact, that patients at clinics using paper records were more likely to meet all of three targets for hemoglobin A1c levels, low-density lipoprotein cholesterol and blood pressure after two years than those in practices that used EHRs.
Berwick on Analytics: Technology Is Ready, but Doctors Need Help
Scott Mace, for HealthLeaders Media , May 15, 2012
If Marcus Welby, MD, were practicing on TV today, would he be letting data drive his decision-making? I'm on a journey to find the answer to this and related questions. Last week this journey took me to Atlanta for a HealthLeaders Media Roundtable on business intelligence and predictive analytics, and then onward to North Carolina for a conference dedicated to healthcare analytics.
While in North Carolina, I got to sit down with Don Berwick, MD, former administrator at the Centers for Medicare & Medicaid Services, and prior to that, founding CEO of the Institute for Healthcare Improvement. We talked about data analytics, but our discussion ranged far and wide around healthcare IT. Here is a portion of our conversation.
7 common myths about data encryption
By Michelle McNickle, Web Content Producer
Although data encryption is becoming a valuable resource to protect against breached PHI, according to a new report by WinMagic Data Security, certain myths and misconceptions about it still exists.
"IT professionals, at the enterprise level, frequently turn to encryption for protecting data," read the report. "Although encryption is a proven technology that delivers strong, effective data security, common myths and misconceptions about it persist, even among some people who are generally knowledgeable about computers. All too often, the myths surrounding encryption are based on misunderstanding of the technology or outdated concepts."
The report outlines and debunks seven common myths about data encryption.
Defense Department outlines joint EHR plans
By Joseph Conn
Posted: May 14, 2012 - 4:00 pm ET
The Defense Department has released an outline of how the proposed joint electronic health-record system for use by the Military Health System and the Veterans Affairs Department's healthcare organization is to be developed.
The 55 page report (PDF), "Department of Defense Enterprise Architecture to Guide the Transition of the DoD Electronic Health Record, and Related Matters," was submitted to Congress by Dr. Jonathan Woodson, assistant secretary of defense for health affairs.
The "envisioned target state" of the joint EHR is "a coordinated, 'best-of-breed' approach that includes a mix of existing SOA (service-oriented architecture)-compliant capabilities, commercial-off-the-shelf, open-source and custom systems." The Defense Department's Manpower Data Center will be the "single identity management source," the report said, while the department's Defense Information Systems Agency will run the EHR's data centers. The EHR will have a common user interface.
Emphasis on Support in Decision Support
Greg Freeman for HealthLeaders Media , May 14, 2012
This article appears in the May 2012 issue of HealthLeaders magazine.
Computer-based clinical decision-support systems offer great opportunities to improve care and reduce costs, but healthcare leaders have to remember who's ultimately in charge: the human operating the computer. Implementing even the best technology for decision support can become a costly, frustrating failure that ultimately degrades patient care if you don't factor in the human element.
That was one of the lessons learned when Penn Medicine in Philadelphia adopted a computerized physician order entry system. Penn Medicine used the Eclipsys Sunrise Clinical Manager to achieve 100% CPOE in the inpatient setting. In addition, 1,800 physicians actively use the Epic electronic medical record system in the ambulatory setting.
Physicians make about 15 million hits per year in Penn's internally developed physician portal to view patient information and results. All physicians have access to an internally developed data warehouse that maintains 2.4 billion rows of data to help ensure patient safety and quality care, as well as support clinical trials and research.
ONC taps public for help on nationwide exchange
By Mary Mosquera, Contributing Editor
WASHINGTON – The Office of the National Coordinator for Health Information Technology is calling for public comment on proposals for rules of the road to govern the nationwide health information network (NwHIN).
ONC will use the comments to help it develop a notice of proposed rulemaking (NPRM), according to a May 11 announcement in the Federal Register preview section. Once it is officially published May 15, the public will have 30 days to offer its views.
ONC seeks help on a range of topics, including the creation of a voluntary program under which entities that enable electronic health information exchange could be validated based on meeting ONC-established “conditions for trusted exchange.” ONC also wants to hear views about the scope and requirements included in the initial conditions for trusted exchange and processes used to revise them over time.
SaaS EMRs gaining favor, says KLAS
By Mike Miliard, Managing Editor
OREM, UT – More and more providers are taking software-as-a-service EMRs seriously, according to a new KLAS report. They're intrigued by the systems' lower price and easy maintenance, and reassured by advances in the security of cloud-based data storage.
The study, "SaaS EMR 2012: Is It For You?" assesses the performance of software-as-a-service EMR products from vendors including AdvancedMD, athenahealth, Bizmatics, CureMD, MedPlus/Quest Diagnostics, MIE, OptumInsight, Practice Fusion, Sevocity and Waiting RoomSolutions.
NHS Direct to pilot GP appointment app
11 May 2012 Chris Thorne
NHS Direct is considering a pilot that will allow patients in Lincolnshire to use a smartphone app to book appointments with their GP.
EHealth Insider understands that negotiations are taking place with some GPs in Lincolnshire to start allowing practice systems to directly interface with NHS Direct, for a trial to start this autumn.
The trial would involve patients using a GP appointment booking smartphone app or the NHS Direct website to book their own appointment, linking directly into the GP system.
Telemedicine, mHealth will connect with EHRs when providers are motivated
Created May 14 2012 - 6:34am
In a discussion at the recent American Telemedicine Association (ATA) conference, panelists bewailed the absence of electronic health record vendors from the meeting, according to a post  in NHIN Watch.
"Politically, commercially--it's an issue," said Hon Park, M.D., CEO of Diversinet, which provides secure two-way connectivity for mHealth applications. Pak said that mHealth apps, EHRs, and health information exchanges must be integrated for effective care coordination, according to the post.
Michael Lemnitzer, an executive with Philips Home Healthcare Solutions, said his company is "working aggressively" with EHR vendors to develop interfaces, because 90 percent of Philips' contracts with healthcare providers require connectivity with EHRs. Lemnitzer predicted that by 2015, the majority of EHR companies would have interfaces for telemedicine applications. For that to happen, he said, more interoperability standards would be necessary, according to the post.
Tablet Use Nearly Doubles Among Doctors Since 2011: Report
By: Brian T. Horowitz
With the Apple iPad the most popular mobile device, doctors have almost doubled their use of tablets in the last year, according to a new report by Manhattan Research.
Doctors have nearly doubled their use of tablets since 2011, a May 10 report by Manhattan Research revealed.
In its annual "Taking the Pulse" study, Manhattan Research found that tablet use by doctors reached 62 percent in 2012, compared with 35 percent of physician tablet adoption in 2011.
VA's 7 steps to protect VLER data
By Mary Mosquera
The Veterans Affairs Department has described how it will protect the information of veterans and military service members that it shares as part of the virtual lifetime electronic record (VLER) program.
The VLER program enables the electronic sharing of health, benefit, disability determination and administrative data with VA, Defense Department and participants in the nationwide health information network (NwHIN) Exchange.
VA published in the May 11 Federal Register a notice of a Privacy Act System of Records, in which federal agencies detail how they will manage personal information according to federal security requirements. Robust privacy and security safeguards can increase trust and confidence in health information exchange.
May 14, 2012, 8:58 a.m. EDT
InterSystems Launches Next Generation of HealthShare
Strategic Informatics Platform Enables Breakthrough Solutions For Connected Care and Active Analytics
CAMBRIDGE, Mass., May 14, 2012 (BUSINESS WIRE) -- InterSystems Corporation, a global leader in software for connected care, today launched the next generation of its InterSystems HealthShare(TM) strategic informatics platform for interoperability and active analytics. Designed originally for public health information exchanges (HIEs) at regional, state and national levels, HealthShare has been extended and rearchitected to also deliver the advanced technologies needed by integrated delivery networks (IDNs).
InterSystems' Revamped HIE Platform Mines Patient Data for Patterns
By: Brian T. Horowitz
InterSystems has launched a new version of its HealthSense platform that features data-modeling and enhanced analytics to allow doctors to search through unstructured data.
InterSystems, an IT vendor that powers many state health information exchange (HIE) platforms, has introduced a new version of its HealthSense record-exchange software that adds new data modeling and analytics capabilities.
Announced May 14, the latest version features InterSystems' iKnow technology, which allows doctors to search through unstructured narratives of patient histories. Most clinical data, such as images and text, are unstructured and in multiple file formats.
Monday, May 14, 2012
Business Partners: A New Risk to Health Data Security?
by John Moore, iHealthBeat Contributing Reporter
Third-party business partners represent a significant security risk to health care providers, who may need several layers of protection to ensure the security of patient data.
The HIPAA Privacy Rule refers to third parties as "business associates" and defines them as individuals or organizations that handle protected health information, or PHI, in the course of working with a covered entity. The category may cover a range of companies, including data processing firms, IT consultants and cloud computing providers.
HIPAA's Security Rule calls for covered entities to create contracts with business associates to ensure that the partner "will appropriately safeguard" PHI. The HITECH Act of 2009 further strengthened HIPAA's rules regarding business associates and security obligations.
Stage 2 EHRs Require Meaningful Patient Engagement
Many of the government’s proposed Stage 2 Meaningful Use criteria for e- health records won't be easy to meet. Here's how providers are meeting the challenge.
By Paul Cerrato, InformationWeek
May 14, 2012
For many healthcare organizations, Stage 2 Meaningful Use feels more like Stage 2 cancer: a threat to life and limb. AdTech Ad
As written, the proposed regulations will require providers to give more than half of patients e-access to their health information; make sure more than 10% view, download, or transmit their health information to a third party; and provide more than 10% with EHR-generated educational resources.
Those are high hurdles, especially for smaller hospitals and practices. Several health IT and clinical stakeholders have taken the Centers for Medicare and Medicaid Services to task on these issues.
Health Min to scrap electronic health records
14 May 2012
Prague, May 11 (CTK) - The IZIP patients' e-health files project, subsidised by the state-controlled VZP insurer for ten years now and widely criticised as disadvantageous for the state, will be wound up, Prime Minister Petr Necas and Health Minister Leos Heger agreed on Thursday, Heger's spokesman told CTK.
The VZP, the country's biggest health insurer whose board of managers comprises 10 representatives of the government and 20 representatives of parties in parliament, invested 1.8 billion crowns in the IZIP project in the past decade.
Heger's spokesman Vlastimil Srsen said an assessment of the project's hitherto results has shown that the IZIP does not work effectively. That is why the ministry has decided "not to protract the agony," he said.
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