Wednesday, October 22, 2014

It Seems Practice Management System Vendors Have Been Warned There Are Significant Issues With The PCEHR That Won't Be Fixed Until December 2014.

This alert was sent out today. I am told many system providers (not just Genie) are affected.

Potential issue with PCEHR overviews

We have been alerted by the Department of Health about a potential risk identified within the PCEHR system. This is impacting the way a small number of documents can be viewed in an eHealth record.
This issue results in some Medicare, prescription and dispense documents presenting in the Document List but not appearing in the Medicare Overview or the Prescription and Dispense View.
A permanent solution for this issue has been identified and will be implemented in December 2014 by the Department of Health.
In the meantime, please do not rely on the Medicare Overview or Prescription and Dispense View within the Genie PCEHR-viewer to necessarily provide a complete list of information from a patient's eHealth record. It is recommended that you use the Document List to view all documents.

Here is the link:


This looks to me to have potential safety of use of the PCEHR issues surrounding it. I wonder why there is not an alert on the Department web site and why there is not a press release from the Minister? (Nothing found as of time of writing on the DoH Site)

One really wonders why it needs so long to be rectified?

David.
 

 

Senate Estimates Alert - e-Health Scheduled 3:10pm -4pm Today 22/10/2014

To watch go to the following link:

http://www.aph.gov.au/

Then select the Watch Parliament Tab and click on Senate Estimates / Community Affairs Hearing.

Enjoy!

David.

Late Update - Committee is running very, very late.

D.

Tuesday, October 21, 2014

Edward Gough Whitlam - My Thanks

Gough,

For getting rid of conscription (yes I was sucked in), providing major changes to health and education (yes I really benefited) and getting rid of the death penalty - many thanks!

We won't see his likes again I believe. The meanness we now see in public policy just shows how badly we are presently led - IMVHO. We can care and fund things - but no one wants to try!

Pity about that.

David.

Ebola And Technology Intersect With Hopefully Some Useful Outcomes.

This appeared a day or so ago.

CDC, ONC Target EHR-Based Ebola Screening

OCT 17, 2014 7:30am ET
An initiative launched last year by the Centers for Disease Control and Prevention and the Office of the National Coordinator for Health IT to help providers meet Stage 1 and 2 meaningful use public health objectives is now focusing its efforts on Ebola electronic screening tools.
In August 2013, CDC and ONC established the Public Health Electronic Health Records Vendors Collaboration Initiative. However, with recently confirmed cases of Ebola in the United States, the initiative—which includes public health practitioners and EHR vendors—is currently aimed at trying to get vendors to configure EHR systems to support screening protocols for the deadly disease.
“The overall goal here is for us to explore ways in which the electronic medical record can serve as a prompt to help our healthcare professionals around the country identify individuals that may be at risk for Ebola,” said Dana Meaney Delman, M.D., deputy lead of CDC’s Medical Care Task Force (Ebola Response), during an Oct. 16 CDC/ONC webinar soliciting industry feedback.
“This is a special edition of our normal community of practice calls that we hold with public health and the EHR vendor community,” added Jim Daniel, public health coordinator at ONC. “We do meet on a monthly basis. Please send an email to meaningfuluse@cdc.gov so you can join this group. We talk about other public health and meaningful use measures normally, and we’ll be focusing on Ebola as long as we need to.”
According to a statement from the group, “the EHR vendor community has responded with components within their respective tools to address Ebola and assist within a healthcare environment.” Jon White, M.D., ONC’s acting chief medical officer, told the webinar audience on Thursday that CDC and ONC will be having a separate follow-on call with members of the HIMSS Electronic Health Record Association to gain input.
The CDC has developed a clinical algorithm for “evaluation of the returned traveler” and a checklist for patients being evaluated in the U.S. for Ebola. The objective of the Public Health EHR Vendors Collaboration Initiative is to include a travel history and assessment of pertinent clinical signs and symptoms in an electronic format that can help clinicians diagnose patients infected with Ebola and to isolate them. According to Delman, CDC wants to “ensure that there are mechanisms for healthcare providers to rapidly identify individuals that may have suspected Ebola” and “how we can translate this algorithm into an electronic medical record prompt and perhaps even a decisional tool.”
More here:
This is a really sensible idea. I wonder can the major providers of practice systems in Australia tweak their systems, as a precaution, to achieve a similar outcome.
Surely our tightwad government could manage to stump up a few $ for the vendors to make some carefully considered changes to make sure the right questions are asked early and that the responses are optimal. The small investment they may make might turn out to be the smartest thing they have ever done.
The whole thing becomes even more urgent when we see the issues that have arisen with some system in the US.
Here is a typical link
David.

Monday, October 20, 2014

Weekly Australian Health IT Links – 20th October, 2014.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a 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.

General Comment

Another quiet and pretty news less week. Lots of private sector activity but the Government is just a black hole with no light or information escaping!
Interesting to see Google Glass gradually becoming more mainstream. The impact of health is far from clear and we will only see what the outcome of the technology a good few years from now.
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Epic Pharmacy injects $1.5 million into Flamingo for healthcare VRM software

Epic Pharmacy managing partner Cathie Reid to join Flamingo board
Adam Bender (Computerworld) on 14 October, 2014 13:48
Epic Pharmacy has invested $1.5 million in Flamingo, an Australian developer of vendor relationship management (VRM) software.
Under the agreement, Epic – which provides hospital, oncology and aged care pharmacy services – and Flamingo will co-create healthcare services for Australian consumers.
The cloud-based Flamingo software is meant to aid businesses in their retention efforts by connecting the business and customer in a “co-creation laboratory” in which customers can customise how they interact with the company, what they’re looking for in the product, and other elements of the customer service experience.
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How social media is changing the healthcare landscape

There seems to be a significant growth of social media usage in the Australian healthcare industry.
In the past years we have seen surprisingly influential social media campaigns, like AHPRAaction, ScrapTheCap, InternCrisis, and very recently NoAdsPlease. These campaigns not only rally for better health care policies; they also signal a shift towards more transparency and accountability.
Characteristics of the social media campaigns are:
  • They spread quickly and generate a lot of media attention
  • The participants are very passionate about their cause
  • They are often supported by different groups including consumers
  • They may or may not be supported by professional organisations
  • They are very effective.
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Victorian emergency services’ dispatch system upgraded in response to audit

Emergency Services Telecommunications Authority (ESTA) spends $13 million on computer aided dispatch (CAD)
Hamish Barwick (Computerworld) on 14 October, 2014 16:30
An audit of Victorian emergency response ICT systems by the Victorian Auditor-General’s Office (VAGO) has led to a $13 million upgrade of a computer aided dispatch (CAD) system and associated networks.
The upgrade was completed on 1 October, 2014 and is designed to improved network and CAD resilience. In addition, $15 million has been earmarked this year to upgrade the Emergency Services Telecommunications Authority (ETSA) telephony system for call-taking and dispatch.
An ESTA spokeswoman said that the CAD upgrades now mean that there is greater functionality for call-takers and dispatch staff, more robust technical infrastructure, improved disaster recovery and increased network redundancy across the network to make it more reliable.
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15 October 2014

Australian manufacturers of medical devices given a level playing field

The Assistant Minister for Health, Fiona Nash, today confirmed that, under the Government’s Industry Innovation and Competitiveness Agenda, new regulations will be introduced to allow Australian manufacturers to obtain market approval for most medical devices using conformity assessment certification from European notified bodies.
“With these changes, Australian manufacturers can choose to either have conformity assessment conducted by the TGA or an alternative conformity assessment body, such as a European notified body," Minister Nash said.  
“This will cut red tape, provide more flexibility for local medical device manufacturers and, in many cases, enable devices to get to market more quickly, which will benefit the public.” 
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National launch of vital signs 2014: the State of safety and quality in Australian health care

Professor Villis Marshall, Chair of the Australian Commission on Safety and Quality in Health Care, today released Vital Signs 2014: The State of Safety and Quality in Australian Health Care.
 Vital Signs 2014 provides an overview of a series of key topics in relation to the safety and quality of Australia’s health care system.
Professor Marshall said “Vital Signs 2014 is structured around three important questions that members of the public may ask about their health care. Will my care be safe? Will I get the right care? Will I be a partner in my care?”
Each question is considered in its own section using examples of key health issues in Australia, such as healthcare associated infections, dementia and delirium, and health literacy. These sections are followed by two case studies, which focus on the quality of care in some important clinical areas. These case studies present a detailed description and analysis of key quality issues that affect outcomes for patients.
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Performance data caution

Sarah Colyer
Monday, 13 October, 2014
A SURVEY of senior US hospital managers has reinforced concerns about the worldwide trend to publish hospital performance outcomes on websites such as MyHospitals, with claims by the study participants that the measures used are meaningless.
The survey, published in JAMA Internal Medicine, obtained responses from chief medical officers and other leading executives at 380 US hospitals, who were asked about America’s Hospital Compare website. (1)
Hospital Compare is more detailed than Australia’s more recent MyHospitals site, and includes reports on “processes of care” measures such as the percentage of patients hospitalised for acute myocardial infarction treated with β-blockers, as well as condition-specific mortality and readmission rates, patient experience measures and cost and volume measures.
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Orion Health still assessing demand for IPO

Orion Health, a hospital software provider in New Zealand, is still assessing investor demand for its much-anticipated initial public offering that may raise over $NZ100 million ($A90.2m) ahead of its November listing.
It is understood that Orion is meeting fund managers in New Zealand today, after having conducted a round of meetings with Australian fund managers earlier. Orion has not officially set a timeline for the IPO, although sources are expecting the company to list by the end of November.
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Cloud solution delivers a clean bill of health

Jennifer Foreshew

HEALTHCARE provider Mercy Health found underinvestment in IT infrastructure had hurt performance and caused a lot of downtime.
The IT team spent inordinate amounts of time dealing with old hardware and software issues, instead of providing service and supporting new implementations and capabilities.
“The capacity of the IT department to engage more dynamically to accommodate the needs of the business was severely hampered,’’ Mercy Health chief information officer Dmitri Mirvis says.
“It became a no brainer for us that we should be going into the cloud for the data centre as a ­cost-effective and future-proof ­approach.’’
Mercy Health, which has 5500 employees, has 31 sites across NSW, Victoria, Western Australia and the ACT.
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Pharmacy must take chances to broaden services: Sansom

15 October, 2014 Chris Brooker
The next community pharmacy agreement will provide a vital opportunity to integrate pharmacy into the primary care network and ensure its survival, eminent pharmacist Lloyd Sansom believes.   
Speaking at PAC14 in Canberra last Friday, Emeritus Professor Sansom, the chair of the Pharmaceutical Benefits Advisory Committee, said the political will exists in Australia to increase the scope of pharmacy practice, but the profession must not just expect this to happen as a matter of course.
“In many ways this agreement [6CPA] is more important than any of its predecessors because it provides the opportunity to look at innovative ways of finding additional sources of revenue, and new ways to practice,” he said.
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Online symptom checker drawn up by doctors

13 October, 2014
Sponsored Content  Healthdirect Symptom Checker
A new online symptom checker, designed by doctors, will provide credible health information for the growing number of Australians who are to relying on the internet for medical advice.
Based on a program created by the National Health Service in the UK, the healthdirect Symptom Checker is a tool designed to help patients access accurate, safe and clinically validated information and advice about their symptoms, 24 hours a day, 7 days a week.
With approximately 60% of Australians turning to the internet to find answers about diseases and symptoms*, it’s clear that the web is now a key companion to health decision-making.
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Updated: Conformance Profiles for Specialist Letter and Common Clinical Document

Created on Thursday, 16 October 2014
NEHTA has released an updated version of the PCEHR Conformance Profile for the Specialist Letter document type.
Specialist Letter documents can now also be generated for the following three usage scenarios:
  • Specialist letters sent that are not in response to a clinician's referral (self-referral)
  • Specialist letters sent to referrers without a known HPI-I or HPI-O
  • Specialist letters containing recommendations for addressees without a known HPI-I or HPI-O.
The Specialist Letter – PCEHR Conformance Profile has been updated to allow for these additional usage scenarios. The Specialist Letter template packages have been adjusted to reflect these changed requirements.
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New features and new look for MedicalDirector Clinical and PracSoft Summer release

MedicalDirector is excited to be bringing medical practices a list of fresh functionality and features in our upcoming MedicalDirector Clinical and PracSoft Summer release. We have also have taken the opportunity to refresh the entire business to reflect these changes!
“Bringing our customers solutions that work for them is our priority,” says CEO Phil Offer. “The new release features have been prioritised based on an extensive process to gather customer feedback”, he said.
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First reported case of Google Glass internet addiction disorder

Date October 16, 2014 - 10:37AM

Stan Schroeder

When a 31-year-old man receiving treatment for alcoholism was required to remove his Google Glass while completing rehab, he reportedly started to feel frustrated and irritable without the device. He had been wearing Glass for up to 18 hours a day, only taking it off when he slept and bathed.
According to the journal Addictive Behaviors, this was the first case of internet addiction disorder (IAD) involving the use of Google Glass.
"The withdrawal from this is much worse than the withdrawal I went through from alcohol," the journal quotes the man as saying, noting several Behaviours seemingly tied to the man's addiction to Glass, such as dreaming as though he were looking through it. "He would experience the dream through a small gray window," the journal stated.
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Doctor Google will see you now: search giant tests live medical advice

Date October 14, 2014 - 10:35AM

Stan Schroeder

It seems Google is trying to bring an end to all the fake "diagnoses" resulting from folks searching for their symptoms and arriving at the wrong conclusions — or at least alleviate the problem.
An image posted to Reddit shows a Google search for knee pain, and an option for the user to video chat with a doctor about their symptoms.
The company has now confirmed to several outlets that it's a new feature Google is trying out. A spokesperson told Gizmodo, "When you're searching for basic health information ... our goal is provide you with the most helpful information available. We're trying this new feature to see if it's useful to people."
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$27 a month: Turnbull sets out rules to counter TPG FTTB threat to NBN

Communications minister outlines new rules that would force telcos to open up their superfast broadband network to competing retail service providers
Rohan Pearce (Computerworld) on 15 October, 2014 11:35
Communications minister Malcolm Turnbull has published the draft licence condition for telcos that want to roll out infrastructure that competes with the National Broadband Network.
The licence condition, which will require carriers to offer access to their network to retail service providers for $27 per month per port, was drawn up in the wake of a finding by the Australian Competition and Consumer Commission that TPG had not violated 'anti-cherry-picking' rules with its rollout of fibre-to-the-basement (FTTB) services.
The new licence condition would apply to so-called superfast broadband services — that is, those with a download speed of 25Mbps or faster — delivered to residential customers.
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Can HFC be NBN Co's saviour?

NBN Co boss Bill Morrow’s decision to create a separate HFC division was always on the cards. And, as far as connecting Australians to the National Broadband Network (NBN) is concerned, the move can’t come soon enough.
While hiving off the hybrid fibre-coaxial (HFC) network as a separate unit can be interpreted as the first step in a very long journey of splitting up NBN Co, Bill Morrow and his team and have more pressing concerns at the moment.
You have to build the NBN first before you can start thinking about ripping it apart.
The recruitment in July of Dennis Steiger, who brings substantial experience in the HFC space, was an early indication of the sort of role he was destined to play in the new NBN Co regime.
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Why Commodity Hardware Isn't Always The Right Choice

October 15, 2014
Most server rollouts are built on commodity hardware: using standard Intel-based systems running general-purpose stacks, which offer the promise of being able to easily switch between providers. That model isn’t disappearing, but in some contexts engineered systems — platforms which have a much tighter integration between hardware, server and application layers — can be more helpful.
The topic of engineered systems was front and centre during an Oracle media briefing in Sydney yesterday (which we’ve already covered in a discussion of developing for Google Glass). Oracle’s regional director for Fusion Middleware Damien Parkes noted that according to Gartner, engineered and integrated systems are currently a $US6 billion a year market. In 2015, Gartner predicts 35 per cent of total server sales will come from this category.
Obviously, Oracle has a vested interest in promoting engineered systems: it will make more money if it can sell its customers both hardware and software. But that doesn’t mean that the benefits aren’t real for some users.
eHealth for NSW, which provides manages IT platforms for health services across the state, is looking to engineered systems to provide further performance improvements on its systems. It has almost completed a massive upgrade to its core payroll systems. That project took three years and covered 140,000 staff. “With that consolidation and the push to move everything to an online presence, we’re seeing the uptake of our platform grow rapidly,” Farhoud Salimi, corporate IT director for eHealth For NSW, told the briefing.
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Quantum teams claim world records

John Ross

THE University of NSW is claiming world records in the nascent field of quantum computing, after two teams implanted exceptionally accurate quantum “bits” — the processing units of the theoretical computers — into silicon.
The breakthroughs could help make the super powerful computers a reality in as little as five years. “Until you’re able to show that you’ve got bits that keep their memory without losing it in a flash, you’re not really in the game,” said UNSW physicist Andrew Dzurak, co-author of two papers published this morning in the journal Nature Nanotechnology.
“Now we know how to make incredibly good ones — the best in any solid state system, in terms of accuracy. Now’s the time to work with industry to try and get these (computers) built.”
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My computer almost carked it

Date October 16, 2014

The Venture

Tony Featherstone is a specialist writer on small companies and entrepreneurs

The unthinkable happened to my business: a vicious virus almost killed my main computer. Not just one virus, but 43 simultaneously wreaking havoc.
When I woke early to print a boarding pass, the computer screen was purple. No software icons, log-ins or files. Just purple. Several reboots later, a screen appeared saying Windows had not reloaded properly and another restart was needed. Half asleep, I hit okay – only to restart the virus and help it spread. 
Rushing to the airport, I wondered if the computer could be saved, how much work was lost, and which clients needed the “dog-ate-my-homework” excuse. I guessed the worst-case scenario was a week of lost work, given the previous back-up.
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Enjoy!
David.

Sunday, October 19, 2014

Is It Time To Declare The PCEHR As A Failure That Is Moving In The Wrong Direction?

There was a very interesting meeting that has considerable impact on where e-Health is heading globally held in the last few days.
There are reports here:

Interoperability's 'game-changer'

Posted on Oct 17, 2014
By Bernie Monegain, Editor
Charles Jaffe, MD, CEO of standards organization HL7, came away from the joint meeting of the federal Health IT Policy and Health IT Standards committees earlier this week, thinking that the industry could move faster on interoperability. And HL7 has just the thing to change the game.
"I don't try to denigrate the success; I try to celebrate it," he told Healthcare IT News.
He blames a stuck-in-the-past approach for the slow pace of progress.
"We embrace a lot of technology that is technology for the past and ways of doing things that were important in the past rather than understanding the ideas that fundamentally change the way we achieve interoperability."
Top of mind for effecting that change is HL7's FHIR, he says. The acronym stands for Fast Healthcare Interoperability Resources. Pronounce it "fire."
According to HL7's official description, "FHIR combines the best features of HL7’s Version 2, Version 3 and CDA product lines while leveraging the latest Web standards and applying a tight focus on implementability."
As Jaffe puts it, "FHIR represents a departure from the notion of messaging and document-centric ideas."
"FHIR is such a significant advance in accessing data, delivering data and the enormous, enormous flexibility inherent in the model," he adds. FHIR doesn't specify the content; FHIR specifies what we mean by the content."
He describes FHIR as a platform and a set of rules.
"If you want to use it for consumer or patient-centric information delivery, or you want to use it for a novel idea about wellness, you can. It doesn't limit you the way messaging does. Moreover when you want to query a system, you don't have to have a registry. FHIR allows you to query systems that have FHIR capability independent of registries. Not only is it easy to use and is fast to develop and implement, but it's also inordinately flexible."
Lots more here:
More coverage is here:

'Actionable' steps to interoperability

Posted on Oct 16, 2014
By Tom Sullivan, Editor, Government Health IT
The highly anticipated final recommendations from the JASON task force arrived on Wednesday afternoon.
JASON, a group of independent scientists who advise the federal government, issued a November 2013 report to the Department of Health and Human Services, the Office of the National Coordinator for Health IT and the Agency for Health Research and Quality on the matter of interoperability.
The resulting analysis, not surprisingly, was highly critical of the current state of interoperability and electronic health record systems vendors.
ONC, for its part, has since established a task force to consider the JASON report.
Calling it the capstone of Wednesday’s joint HIT Policy and Standards Committees meeting, John Halamka, MD, CIO of Beth Israel Deaconess Medical Center and vice chair of the HIT Standards committee, explained that the JASON task force essentially "takes a set of general recommendations and turns them into actionable next steps."
More here:
and lastly here:

CHIME, HL7 applaud ONC road map, JASON task force recommendations

October 16, 2014 | By Dan Bowman
Health industry groups expressed optimism following the Oct. 15 meeting of the federal government's Health IT Policy and Standards committees to discuss a draft interoperability road map unveiled by the Office of the National Coordinator for Health IT.
In particular, the College of Healthcare Information Management Executives and Health Level Seven International (HL7) viewed the road map as a step in the right direction. CHIME Director of Federal Relations Jeff Smith (pictured right), who was critical of the interoperability vision paper published in June from which the draft road map stems, told FierceHealthIT that the updated document represents a "marked improvement" from its predecessor.
"The vision paper was very short on details and wasn't at all clear as to what the next version of things would look like," Smith said in a phone conversation. "Based on what we saw yesterday and based on the conversations that were had at the policy committee, things bode well for the next phase and it sounds like ONC is taking diligence in trying to put together something that is both technically robust, as well as considerate of various policies that fall outside the purview of technical standards."
Smith said CHIME will pay close attention to the governance piece of the road map, calling ONC's recommendations neither good nor bad.
Lots more here:
Essentially what has happened here is that the US has concluded the future direction for e-Health interoperability can be summarised thus:
“Top of mind for effecting that change is HL7's FHIR, he says. The acronym stands for Fast Healthcare Interoperability Resources. Pronounce it "fire."
According to HL7's official description, "FHIR combines the best features of HL7’s Version 2, Version 3 and CDA product lines while leveraging the latest Web standards and applying a tight focus on implementability."
As Jaffe puts it, "FHIR represents a departure from the notion of messaging and document-centric ideas."
"FHIR is such a significant advance in accessing data, delivering data and the enormous, enormous flexibility inherent in the model," he adds. FHIR doesn't specify the content; FHIR specifies what we mean by the content."
This essentially says that the US has decided against progressing the complicated parts of CDA and HL7 V3 while building on what is working in the simpler exchangeable clinical documents and focussing on proven Web Standards and actual implementability rather than having NEHTA developing 1000 page specifications which are still struggling to see the light of day.
At the very least DoH and NEHTA must now respond to the direction being adopted in the US and explain to our system developers what is in and what is now out of future plans. The lack of a recently re-confirmed Standards pathway for the Australian E-Health is  deeply problematic given the seismic shifts we are seeing in the US recognising that HL7 V3 has essentially failed and a new path is needed.
As the number of comments to the blog last week makes clear lots of people are interested and we need some clarity about what is going on! It seems to me the Standards base on which the PCEHR has been built may be simply about the become at worst obsolete or at best become an unmaintained technology backwater.
David.

AusHealthIT Poll Number 240 – Results – 19th October, 2014.

Here are the results of the poll.

Should Federal Government Agencies Simply Just Get Out Of E-Health In Australia?


Yes 47% (141)

Probably 6% (18)

Neutral 1% (3)

Probably Not 28% (86)

No 18% (53)

I Have No Idea 0% (1)

Total votes: 302

The closest vote I have seen so far (53% to 46%) - with a small majority thinking the Feds should just leave it others to sort all this out.

Interestingly the definite Yes vs No vote was 47% to 18%.

Again, many, many thanks to all those that voted!

David.

Saturday, October 18, 2014

Weekly Overseas Health IT Links - 18th October, 2014.

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.
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FTC, ONC put vendors on notice

Posted on Oct 10, 2014
By Mike Miliard, Managing Editor
The Federal Trade Commission has some news for health IT vendors whose zeal for competitive marketshare outweighs their willingness to share data: they're watching, and will step in where necessary.
"We are working with ONC staff to identify potential competition issues relating to health IT platforms and standards, market concentration, conduct by market participants, and the ability of health IT purchasers to make informed buying decisions," wrote FTC officials in a blog post this week.
Healthy competition "is central to improving health care quality and outcomes, reducing costs, and improving the consumer experience," write Tara Isa Koslov, of FTC's Office of Policy Planning; Markus Meier, of its Bureau of Competition and David R. Schmidt, of its Bureau of Economics.
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Commonwealth Fund: 5 ways to improve health IT development, adoption

October 10, 2014 | By Dan Bowman
Several challenges persist when it comes to development and adoption of digital health tools. To that end, a pair of Commonwealth Fund reports published this month outline strategies to boost such innovation, and examine how some organizations currently are taking advantage of new technologies.
In the former report, "Taking Digital Health to the Next Level," the authors say that because many who enter the healthcare industry do so from other industries, ideas and solutions often aim to resolve "low-hanging fruit" challenges such as dietary intake. In that same vein, they say, entrepreneur and developer workflow knowledge often is minimal, meaning innovations designed aren't as effective as current tools in need of updating.
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Study: Connected healthcare device sales to surpass $3B by 2019

By: Aditi Pai | Oct 9, 2014
Connected healthcare device sales will exceed $3 billion globally by 2019, according to a report from analysis firm Juniper Research.
Juniper explains that the connected healthcare devices it looked at include blood pressure cuffs, oximeters for diabetes, and sleep monitors for sleep apnea.
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Satisfaction with EHR systems grows among physicians

Exclusive survey gathers physician usability ratings of the top EHR systems in five key areas

Publish date: OCT 09, 2014
Considering the dissatisfaction that many physicians have expressed about electronic health records (EHRs), you might think that most doctors hate these systems. But, according to an exclusive Medical Economics survey, 55% of physicians are fairly or very satisfied with their EHRs, and 54% believe they have helped improve the quality of care.
Forty-five percent of respondents said that EHRs have had a positive financial impact on their practices. Most of that is probably related to the Meaningful Use incentives from the government, says Michelle Holmes, MBA, a Seattle-based principal with ECG Management Consultants. “I don’t think it’s the norm for people to say the profitability of their practice is better after EHR implementation than before it, from a productivity and cost perspective.”
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Report: 8 motivators for the adoption of digital health

By: Brian Dolan | Oct 9, 2014
The Commonwealth Fund published a report recently focused on how those working to bring digital health services to market can help such technologies overcome the market barriers they currently face.
The firm’s writers defined digital health as “tools as those that can be used in health care to compress large amounts of information (e.g., words and images) on small storage devices for easy preservation or transmission via the internet or other telecommunications networks. A related term, connected health, refers to the use of technology (often consumer technologies) to provide health care remotely.”
After interviewing 16 providers, investors, startup founders and others working in digital health, the researchers came up with five over-arching recommendations for those working to help digital health services find adoption. 
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ONC, FTC partner to promote competition in the health IT market

Written by Helen Gregg (Twitter | Google+)  | October 08, 2014
The ONC and the Federal Trade Commission have come together in an effort to foster competition in the health IT market.
During a March workshop, the FTC and the ONC heard various stakeholder complaints about the state of the current health IT market, including missing or inaccurate information about products' prices and limitations, a lack of interoperability among products and vendors that purposefully restrict data flow between systems.
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Northern Ireland outlines draft eHealth strategy

Neil Merrett Published 10 October 2014
Consultation paper identifies need to address reliance on paper systems and digital exclusion as key challenges for new health and social care ICT strategy
A five year ICT strategy to modernise Northern Ireland's health and social services has been detailed as part of a new consultation paper unveiled by the country's Health and Social Care Board (HSCB).
The paper is the last of three strategic documents to be published by the HSCB since 2011 and outlines a draft plan to overhaul the provision of health and social care in order to address the dual changes of "limited increases in funding" and public demand for more accessible electronic services. As part of a wider consultation process , the HSCB has said it will be accepting recomendations and responses to the draft strategy until Friday January 9, 2015.
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New E-Script Standard Comes to Long-Term Care

OCT 9, 2014 7:03am ET
The long-term care industry in November is changing its standard for electronic prescribing, as the federal government is requiring that those who e-prescribe must use the SCRIPT standard of the National Council for Prescription Drug Programs.
Many long-term care facilities that have been e-prescribing have used Health Level Seven standards because SCRIPT has not supported LTC and other post-acute care workflows. However, version 10.6 of SCRIPT better supports workflows and is the standard that the industry must adopt when e-prescribing, says Terri Weckle, senior vice president of strategic products at PointClickCare, a vendor of clinical, financial and administrative software serving 9,000 skilled nursing and assisted living facilities.
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KLAS: 6 percent of providers have attained 'advanced' interoperability

October 7, 2014 | By Marla Durben Hirsch
Providers are on the path to interoperability, but they're not necessarily crediting their vendor for it, according to a new report from KLAS Research.
In the report, EMR Interoperability 2014: Where are We on the Yellow Brick Road, KLAS says that 82 percent of 220 providers interviewed said that they felt at least "moderately" successful at interoperability, but it was due to their own efforts, not those of their vendor. Only 6 percent had achieved advanced interoperability. 
Health information exchanges were the top interoperability platform, with 20 percent of providers using them to achieve interoperability. However, almost one-third (32 percent) stated that no interoperability feature or platform had made an impact to improve care delivery.
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ONC taps RTI to develop road map for HIT Safety Center

October 9, 2014 | By Dan Bowman
The U.S. Department of Health & Human Services and the Office of the National Coordinator for Health IT on Wednesday awarded a contract to Research Triangle Park, North Carolina-based RTI International to design a roadmap to its health IT safety center.
The focus of the safety center, an idea initially proposed by the Institute of Medicine in a report published in November 2011, will be the collection of benchmark data on health IT-related adverse events in an effort to improve patient safety. The Food and Drug Administration Safety and Innovation Act report, released jointly in April by ONC, FDA and the Federal Communications Commission, included a recommendation to create the safety center, for which $5 million was allocated in ONC's 2015 proposed budget.
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Interoperability remains a barrier for health data exchange organizations

October 9, 2014 | By Susan D. Hall
Echoing previous surveys, eHealth Initiative's latest poll of health data exchange organizations finds them struggling with interoperability issues.
Cost and technical challenges are the key barriers to interoperability, respondents said. The three most-cited issues were the cost of building interfaces to connect disparate systems, getting consistent and timely response from EHR vendor interface developers and technical difficulty of building interfaces.
Overall, 135 organizations responded, including 74 community-based health information organizations, 25 statewide efforts and 26 healthcare delivery organizations.
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Sheffield to spend £33m on Lorenzo

9 October 2014   Lis Evenstad
Sheffield Teaching Hospitals NHS Foundation Trust has become the tenth trust to sign up to take the Lorenzo electronic patient record system from CSC and estimates the project will cost £33m over ten years.
The trust, which plans to go live at the end of 2015, submitted a business case to the Health and Social Care Information centre's CSC LSP Programme Board, which has been approved.  It expects the project will deliver a return on investment of 3.3.
CSC was contracted to deploy Lorenzo to all trusts in the North, Midlands and East of England as part of the National Programme for IT. However, the company struggled with the development of the system, which became subject to serious deployment delays.
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Stakeholder Coalition Calls on Congress to Pass HIT Legislation

OCT 8, 2014 7:40am ET
A coalition of 58 patient organizations, providers and vendors sent a letter Oct. 7 to members of Congress urging them to pass legislation this year to “provide clarity and certainty for appropriate, risk-based oversight of health information technology.”
The urgent appeal to lawmakers is in direct response to a proposed strategy and recommendations for a risk-based regulatory framework for health IT publicly released in April and developed by the Food and Drug Administration, the Office of the National Coordinator for HIT and the Federal Communications Commission. Based on functionality and risk, the draft regulatory framework for HIT focuses on what a product does regardless of the platform on which it operates. 
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90% of providers believe EHR interoperability improves care

Author Name Jennifer Bresnick   |   Date October 8, 2014   |  
The vast majority of healthcare providers believe that EHR interoperability and fluid health information exchange are critical for delivering high quality patient care, cutting costs, and improving the experience of frustrated and weary clinical staff, according to a report by peer60, but just over half believe that government mandates such as meaningful use are the best way to achieve a connected healthcare system.
The survey of 350 healthcare leaders included top executives, informaticists, nursing staff, and IT professionals using a number of the top EHR vendors in the field: Cerner, Allscripts, Epic, McKesson, NextGen, and Meditech, among others.  Ninety-one percent of the participants believed that EHR interoperability can improve clinical outcomes, and 89% said the same of fiscal outcomes.  A whopping 97% believe that they would see greater adoption of interoperability features if they were more readily available in their current health IT systems.
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Prescription Database Privacy Case Heads For Legal Showdown

10/8/2014 09:36 AM
California Supreme Court will decide whether the state's medical board breached patient privacy when it used data from a state prescription database to discipline a physician.
To combat "doctor shopping," "pill mills," and addiction to medications such as pain and anti-anxiety pills, many states have created databases that track the doctors who prescribe and patients who take these medications. Used by pharmacies and practices to ensure consumers aren't seeing multiple physicians to get controlled substances, these databases also have become a tool for law enforcement -- and at least one medical board's investigative arm.
But could investigators' access to these records, which also include non-controlled medications, jeopardize patient privacy, especially when data segues from deidentified to clearly identified information and patients are called upon to hand over their complete medical records as part of an investigation? How are patients affected? And could the evolving new healthcare model -- which demands more synergies between clinicians and consumers -- be damaged if doctors cannot openly discuss topics such as weight?
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Providers: EHR vendors underwhelm with interoperability

Posted on Oct 08, 2014
By Erin McCann, Associate Editor
It may not come as any surprise: Electronic health record vendors don't play well with others. At least that's according to healthcare providers who say, in the lion's share of cases, their EHR is not interoperable with others. 
So finds a new report put out by health IT research firm KLAS, which underscores a less than ideal reality: In excess of $25 billion in EHR incentives has been paid out to providers and hospitals to subsidize these behemoth EHR systems, which, in most cases, don't talk to each other. In fact, less than half of providers say their EHR vendor is interoperable with other vendors, according to the KLAS data. 
Perhaps even equally as striking is the fact that only 20 percent of providers are "optimistic" about vendor collaboration initiatives – for instance the CommonWell Health Alliance, which bills itself as an independent trade association composed of health IT vendors.  
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Health IT oversight requires legislative action, groups argue

October 8, 2014 | By Dan Bowman
Close to 60 health IT stakeholders--including the American Medical Informatics Association and Health IT Now--want to see congressional involvement in clarifying appropriate risk-based oversight of health IT.
In a letter sent to Congress on Oct. 7, 58 organizations said that now is the time for legislation "that achieves the complementary goals of protecting patients, ensuring safe and effective care and fostering innovation in the rapidly growing health IT field."
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Patient feedback holds promise of better record accuracy

Laura Pedulli
Oct 07, 2014
Patient access and feedback to their EHR can improve accuracy of medication lists, according to a study published in eGems (Generating Evidence and Methods to Improve Patient Outcomes).
A group of researchers from NORC at the University of Chicago, the University of Massachusetts Amherst and Geisinger Health Systems analyzed the impact of Geisinger’s online platform, launched in 2011, that allows patients to provide feedback on their medication lists before a doctor’s visit. Any feedback is routed to a Geisinger pharmacist, who reviews it and follows up with the patient before changing the medication list shared by the patient and the clinicians.
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Are e-health records at fault for Ebola mistakes?

A design flaw in the e-health records system in Dallas may have made it difficult for an ER physician to see the patient’s travel history.

Computerworld | Oct 8, 2014 1:23 PM PT
A Dallas man who became the first person diagnosed with Ebola in the U.S. has died. And while the hospital that treated him has retracted a claim that its electronic health records (EHR) system contributed to a lapse in his diagnosis, experts are skeptical that the system worked properly.
Data integration is often underestimated and poorly implemented, taking time and resources. Yet it
The problem isn't that the patient's recent travel to West Africa hadn't been documented. Instead, it's that a physician would have had to search the EHR for that history in order to find a link to Ebola, according to Judy Hanover, research director at IDC Health Insights.
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Smartphones ‘Rebooting’ Medicine, Shifting Power to Consumers

OCT 7, 2014 7:28am ET
Eric Topol, M.D., chief academic officer of San Diego’s Scripps Health, has seen the future of medicine—a future based on a fundamental shift in who accesses and owns medical data—or what he calls the “rebooting” of medicine.
“You are your data but more importantly each individual needs to own their data. That’s where we need to be,” Topol told an audience at last week’s AHIMA conference in San Diego. “People deserve the respect that comes from data because the information science that we’re into now and going into much deeper has to be taken on by patients.”
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HP splits: What about healthcare piece?

Posted on Oct 06, 2014
By Tom Sullivan, Editor, Government Health IT
The venerable IT giant Hewlett-Packard announced on Monday that it is splitting itself into two companies.
A newly christened Hewlett Packard Enterprise will house software and services, networking technologies, as well as its big iron servers and storage, while the other entity, HP Inc., will consist of its PCs, notebooks, tablets and, of course, printing systems.
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Is the post-EHR era upon us?

Posted on Oct 07, 2014
By Mike Miliard, Managing Editor
When announcing his company's seismic $1.3 billion acquisition of Siemens Health Services this past summer, Cerner CEO Neal Patterson noted the deal was meant, in part, to help the electronic health record giant chart a course for the "post-meaningful use" era.
Buddying up with a company as broadly skilled as Siemens was meant to be a strategic pivot toward "the next decade," said Patterson. "The alliance we're creating will drive the next generation of innovations that embed information from the EMR inside advanced diagnostic and therapeutic technologies."
Well, perhaps "post-meaningful use" isn't quite the mot juste.
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GPs practices can opt out of care.data

3 October 2014   Sam Sachdeva
GP practices could take an “opt-out by default” stance to the care.data programme without breaching the Data Protection Act, the Information Commissioner’s Office has said.
Speaking at the Emis National User Group conference in Nottingham, Dawn Monaghan, the public services strategic liaison group manager for the Information Commissioner’s Office, addressed queries from GPs about whether they could opt all of their patients out of the controversial programme.
The care.data programme will extract data sets from different organisations, starting with GP practices, and link them to an expanded set of Hospital Episode Statistics within the 'safe haven' of the Health and Social Care Information Centre.
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A third of GPs live with EPS R2

7 October 2014   Lis Evenstad
A third of GP practices in England are now live with the Electronic Prescription Service Release 2, the Health and Social Care Information Centre has said.
A spokesperson from the HSCIC told EHI that it is aiming for more than 40% of GPs to be live with EPS R2 by the end of March 2015 and that “based on current progress we estimate that 70% of GPs will be live by end of December 2016.”
EPS R2 allows practices in England to produce prescriptions electronically. These are digitally signed and sent to the pharmacy chosen, or “nominated”, by the patient.
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Telemedicine poised for tipping point despite remaining hurdles

October 7, 2014 | By Katie Dvorak
The health industry has reached a tipping point for telemedicine to become a standard of practice nationwide, according to panelists speaking at U.S. News and World Report's Hospital of Tomorrow conference in the District of Columbia on Tuesday.
The panelists, whose work with the technology range from teleradiology and teleICU to telesurgery and teleoncology, spoke about its growing role in healthcare and the hurdles that remain for implementation.
Billing, reimbursement and licensure still remain the biggest barriers to expansion of the technology, the panelists said.
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Texas Health's retraction about EHR flaw may set a dangerous precedent

October 7, 2014 | By Marla Durben Hirsch
Is anyone else as concerned as I am about Texas Health Presbyterian Hospital Dallas' actions these past few days?
And I'm not just talking about the clearly troublesome misdiagnosis of Thomas Eric Duncan, who was sent home from the hospital's emergency department despite having the Ebola virus. He's now fighting for his life.
I also am referring to the hospital's waffling of the mistake.
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Exclusive: Facebook plots first steps into healthcare

SAN FRANCISCO Fri Oct 3, 2014 4:50am EDT
 (Reuters) - Facebook Inc (FB.O) already knows who your friends are and the kind of things that grab your attention. Soon, it could also know the state of your health.
On the heels of fellow Silicon Valley technology companies Apple Inc (AAPL.O) and Google Inc (GOOGL.O), Facebook is plotting its first steps into the fertile field of healthcare, said three people familiar with the matter. The people requested anonymity as the plans are still in development.
The company is exploring creating online "support communities" that would connect Facebook users suffering from various ailments. A small team is also considering new "preventative care" applications that would help people improve their lifestyles.
In recent months, the sources said, the social networking giant has been holding meetings with medical industry experts and entrepreneurs, and is setting up a research and development unit to test new health apps. Facebook is still in the idea-gathering stage, the people said.
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Ochsner Health System first Epic user to fully integrate with HealthKit

Written by Helen Gregg (Twitter | Google+)  | October 06, 2014
New Orleans-based Ochsner Health System has announced it is the first to fully integrate Apple's new mobile health platform with its Epic EHR system.
On Sunday, the health system successfully imported the first patient's HealthKit data directly into the Epic record.
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Health Information Interoperability Proving More Difficult Than Once Thought

Focus on functionality could help health care providers share data in pursuit of better outcomes.

By Neil Versel Oct. 7, 2014 | 6:50 p.m. EDT
Interoperability of health information systems is a centerpiece of Stage 2 of the federal Meaningful Use incentive program for electronic health records – a phase that began a full year ago for some hospitals – but as the thousands of providers struggling to make the jump from Stage 1 are finding, achieving the vision of an interoperable, nationwide network of EHRs is proving to be elusive.
At a breakout session Tuesday morning at the U.S. News Hospital of Tomorrow conference in Washington, one veteran of health information exchange policy and practice illustrated just how difficult interoperability can be when dealing with an industry as complex as health care.
Micky Tripathi, founding president and CEO of the Massachusetts eHealth Collaborative, a nonprofit that supports health information "communities," pulled out an old PowerPoint slide from 2003, when he was the head of the fledgling Indiana Health Information Exchange. Then, HIE was seen as a clean circle of data movement from hospital to clinic to laboratory to payer to patient, with a centralized data repository in the middle.
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Healthcare Big Data Debate: Public Good Vs. Privacy

10/6/2014 11:55 AM
Big data's role in healthcare could be hindered by government privacy regulations such as HIPAA, say experts at the Body Computing Conference. Who should own health data?
Big data is good for medical science, but potentially risky for the patient. By amassing and analyzing massive quantities of digital information from multiple sources, including an emerging class of wearable devices and smartphone apps, medical professionals will be well equipped to solve major health problems and warn people of emerging threats like the Ebola virus.
That's the goal, anyway. But big data's role in healthcare may be hindered by government privacy regulations such the US Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, and Breach Notification Rules, which regulate the security and disclosure of personal health information by health insurers, medical care providers, and other entities.
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Toward Health Information Exchange

Scott Mace, for HealthLeaders Media , October 7, 2014

Policy and technical limitations are pushing providers to choose HIE systems that lack universal integration.

This article appears in the September 2014 issue of HealthLeaders magazine.
Providers are taking many paths—some public but, more and more, private—toward electronic health information exchange.
Despite more than $500 million being spent over the past five years by the federal government to promote HIE, many states have no HIE today, forcing providers to turn to regional or private HIE organizations to realize the benefits of such information exchange.
Those organizations include such entities as Healtheway, descendent of the federal government's Nationwide Health Information Network Exchange; NATE, the National Association for Trusted Exchange, which is attempting to link all state-level HIEs across the United States; and the CommonWell Health Alliance, a vendor-based not-for-profit consortium (of which Epic is not a member). There also is a growing number of EHR vendor-specific HIE networks, such as Epic's Care Everywhere.
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Patient Surveillance System Cuts Mortality by 15 Percent

OCT 3, 2014 10:14am ET
Adoption of a mobile device-based patient surveillance system cut mortality in British hospitals by 15 percent, according to researchers.
A study published in BMJ Quality and Safety looked at mortality rates for Queen Alexandra Hospital, Portsmouth, and University Hospital Coventry between 2005 and 2010, during the introduction of the VitalPAC electronic system--developed by The Learning Clinic in London--for recording patient observations. It found a 15 percent drop in mortality in each hospital following the system’s introduction, amounting to a reduction in deaths of more than 370 a year in each hospital.
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Debate grows in big data use for patient care

October 6, 2014 | By Susan D. Hall
In the absence of clinical trials for guidance, physicians and researchers increasingly are looking at the troves of data that exist--on thousands or millions of patients with similar conditions--to set a course for patient care, according to an article in The New York Times.
It cites a case of a 13-year-old girl showing symptoms suggesting kidney failure who was airlifted to Stanford's Packard Children's Hospital. She was diagnosed with lupus, but rheumatologist Jennifer Frankovich had seen similar patients with lupus develop life-threatening blood clots.
Turning to a database of all the lupus patients seen at the hospital over the previous five years, she convinced the care team to administer clot-busting drugs to the girl, who then did not develop blood clots. But there's no way to tell whether Frankovich actually was on the right track, according to the article.
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Telemonitoring reduces readmissions 44 percent in 4-year, 500-patient study

By: Jonah Comstock | Oct 3, 2014        
A new study from Pennsylvania hospital system Geisinger Health Plan shows that remote monitoring of congestive heart failure patients can reduce readmissions by 38 to 44 percent and produce a return on investment of $3.30 on the dollar.
The long-term study of 541 patients began in 2008 and just concluded in 2012. Patients used a Bluetooth-connected weight scale from AMC Health that also included interactive voice surveys about shortness of breath, swelling, appetite and prescription medication management, designed to detect acute events before they happen. Weight data and survey answers were transmitted in near-realtime to the patients’ care team, allowing them to respond to warning signs in a timely manner. This is the second study Geisinger has published on this technology.
“Evidence that points to the significant value of remote patient monitoring in enhancing population health management efforts continues to mount,” Nesim Bildirici, president and CEO of AMC Health, said in a statement. “We are thrilled that a second Geisinger study quantifies this benefit for patients diagnosed with heart failure. As the nation’s healthcare system continues its transition to value-based care and shared-risk arrangements gain traction, reducing hospital admissions and lowering the overall cost of care continue to escalate in importance.”
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Philips receives FDA clearance for two telehealth apps

By: Aditi Pai | Oct 3, 2014        
Philips received FDA 510(k) clearance for two of its telehealth applications, eCareCoordinator and eCareCompanion. Both apps are part of a Philips program called Philips Transition to Ambulatory Care (eTrAC), which aims to reduce hospital readmissions by providing patients with the tools to make their transition to the home.
“The FDA clearance of the Philips eCareCoordinator and eCareCompanion applications marks the first major step in realizing our vision for a digital health platform that seamlessly integrates data to transform the way we deliver patient care,” Philips Healthcare Informatics Solutions and Services CEO Jeroen Tas said in a statement. “These applications address both clinician and patient needs, providing clinicians with better access and analysis around patient data while empowering patients to manage their own health with direct access to care teams. The deeper insights into patient conditions will help enable more efficient and cost-effective care for improved outcomes.”
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Dallas Hospital Alters Account, Raising Questions on Ebola Case

DALLAS — Health officials’ handling of the first Ebola patient diagnosed in the United States continued to raise questions Friday, after the hospital that is treating the patient and that mistakenly sent him home when he first came to its emergency room acknowledged that both the nurses and the doctors in that initial visit had access to the fact that he had arrived from Liberia.
For reasons that remain unclear, nurses and doctors failed to act on that information, and released the patient under the erroneous belief that he had a low-grade fever from a viral infection, allowing him to put others at risk of contracting Ebola. Those exposed included several schoolchildren, and the exposure has the potential to spread a disease in Dallas that has already killed more than 3,000 people in Africa.
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Health Care Industry Looks To Shore Up Email Security

by John Moore, iHealthBeat Contributing Reporter Monday, October 6, 2014
Email ranks among the most widely used forms of business communication -- and one that is widely subject to cyberattack.
Email attachments may deliver a malware payload. Phishing scams, in which attackers mimic trusted brands, can harvest personal information from unsuspecting users. Assailants may crack email accounts or sniff network traffic to steal plain-text messages in transit.
Health care organizations, however, trail other industries when it comes to email security. Agari, an email security solutions provider in California, recently assigned health care the lowest email security score of all the industries it studied. The company's Q2 Email TrustIndex, published in August, analyzed 14 health care companies and classified 13 of those as "easy targets" for attackers.
Kristen Alexander, head of marketing at Agari, said health care has climbed the ranks as a target for cyber criminals. Patient information is a key attraction.
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Enjoy!
David.