Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, March 25, 2015

Can We Read Anything Into This Announcement? Might Be A Straw In The Wind.

This appeared a late last week.

Australian Medicines Terminology (AMT) Support Group Meeting

Created on Wednesday, 18 March 2015
The AMT Support Group structure is changing to an open forum, an opportunity exists for interested individuals to participate in the ongoing development of the AMT.
If you have a background in medicines management and are keen to be involved, please forward an expression of interest to help@nehta.gov.au. 
The next meeting (via teleconference) is scheduled for Wednesday 29 April 2015 10 am – 12 pm AUS Eastern Daylight Time.
The Australian Medicines Terminology (AMT) is produced by the National E-Health Transition Authority (NEHTA) to standardise identification of medicines for use within Australian electronic medicine management systems. A Support Group consisting of clinicians, jurisdiction representatives and computer system vendors meets regularly to provide expert guidance on relevant terminology issues.
For more information on the AMT see http://www.nehta.gov.au/our-work/clinical-terminology or email help@nehta.gov.au 
Here is the link.
NEHTA does not have a track record of asking for expert input in forums from the e-Health Community as far as I recall so I was prompted to ask myself why now?
Might it be NEHTA is seeing major change on the way and so is beginning - after almost a decade - to change its ways or is it preparing to be shut down?
The AMT is currently a topic of hot dinner party conversation so why the AMT for volunteer input?
What do readers think is going on - other explanations?
There is an advertisement currently on Seek for a Senior Legal Counsel - and it has a contract and date of June 30, 2015.
Here is the link:
 We need to keep an eye out for other hints, given the secrecy we see around e-Health at present!
David.

Tuesday, March 24, 2015

The PCEHR Might Be A Little More Useful If It Had A ‘Blue Button’. Could Not Be Too Hard.

There have been a few mentions of the Blue Button recently.
I spotted this a few days ago.

Blue Button, PHRs gaining traction

Posted on Mar 18, 2015
By Mike Miliard, Editor
The healthcare industry is becoming more enlightened about the benefits of the Blue Button Initiative, and adoption of personal health records continues to grow, according to a new report from the Workgroup for Electronic Data Interchange
WEDI conducted its first survey on Blue Button's use for exporting patient healthcare records in 2013; as a follow-up, it conducted another poll of stakeholders – including providers, payers, vendors and clearinghouses – in late 2014.
In a letter this week to U.S. Department of Health and Human Services, WEDI offered the following takeaways from the report.
  • Electronic health record and medical device data is flowing into PHRs. "While provider respondents remained relatively consistent in their use of integrated EHRs, a significant increase occurred for government respondents from 60 percent in 2013 to 100 percent in 2014. Both of these groups saw medical device data increase, with government respondents going from zero in 2013 to 25 percent in 2014. The shift for provider respondents is likely reflective of greater participation in Meaningful Use incentive programs. "
  • Use of Blue Button still has room to grow. "The overall shift of awareness appears to have decreased, but upon further review of responses by respondent type, we found greater participation by behavioral and allied health providers in 2014. We believe the provider respondent increase of no awareness from 32 percent in 2013 to 49 percent in 2014 is impacted by the increase of more provider respondent types in 2014 that are ineligible for meaningful use incentives."
  • Offering PHRs to all patients, not just certain populations, is key. "Respondents are at varying stages in terms of PHR implementation, some have implemented, others are implementing this year and others are still in the planning stages. What remains constant is the high percentage (80 percent in 2014) of respondents that are offering the PHR to all patients/members as opposed to only making it available to select subsets of their patients/members."
More is found here:
I also noted this report:

Blue Button Awareness, Personal Health Record Usage Grows

MAR 17, 2015 7:56am ET
Awareness of the Blue Button Initiative—a public-private effort to provide patients with easy, secure online access to their health information—is slowly building, as is usage and adoption of personal health records among key industry stakeholders.
That is the finding of a new survey conducted by the Workgroup for Electronic Data Interchange, which included 274 respondents. Providers, health plans, vendors and clearinghouses were re-surveyed in late 2014 to determine Blue Button adoption compared to a similar 2013 WEDI survey.
In a March 13 letter to Health and Human Services Secretary Sylvia Mathews Burwell, WEDI provided HHS with the results of its survey conducted from Oct. 31, 2014 to Dec. 8, 2014. Key findings include: 
*Relying on integrated electronic health record and medical device data to populate personal health records (PHRs) increased. While provider respondents remained relatively consistent in their use of integrated EHRs, a significant increase occurred for government respondents from 60 percent in 2013 to 100 percent in 2014.
*Ensuring awareness of Blue Button as an industry-wide tool remains an opportunity.
More here:
The idea with the Blue Button is that the patient can download a STANDARDISED summary clinical record from their care provider and can then have it to upload to their PHR, review and correct its contents or give it to other care providers for information etc.
It seems to me that if for some reason we continue on with the PCEHR (which I do not recommend) the same functionality should exist with the PCEHR.
Its time there was something individuals could take away and share from the PCEHR if they desire!
David.

Monday, March 23, 2015

Weekly Australian Health IT Links – 23rd March, 2015.

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 week with silence on e-Health becoming deafening. I wonder what is going on. Leaks welcome before the metadata laws pass the Senate!
I have to say I am not keen on any threat of jail related to this meta-data issue. I feel this is a bit of Governmental overreach.
Interesting to see more and more discussion on telehealth and related matters in the last few weeks.
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https://www.mja.com.au/journal/2015/202/5/implementing-telehealth-core-business-health-services

Implementing telehealth as core business in health services

Sabe Sabesan and Jenny Kelly
Med J Aust 2015; 202 (5): 231-232.
doi: 10.5694/mja14.01021
The many benefits for the rural sector suggest it is time to integrate telehealth models into routine clinical practice
The uptake of telehealth in Australia has been increasing steadily, but continued uptake relies on clinical champions. Australian telehealth models cover a wide range of medical specialties and subspecialties.1 However, most telehealth services in Australia are currently optional, which acts as a barrier to the growth and uptake of these models.
Many successful telehealth networks have been established by incorporating telehealth models of care as part of the core business of hospitals and health services, rather than as an academic activity or a pilot project. While some may argue the evidence base for telemedicine is “weak”,2 we assert there is sufficient evidence for these models to be integrated into routine clinical practice.
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Ailing eHealth system on mend

An audit of the Department of Defence's eHealth System (DeHS) has found a number of significant flaws in its implementation.
Auditor-General, I an McPhee said that overall, Defence's planning, budgeting and risk management for the system had been deficient, resulting in substantial cost increases, schedule delay and criticism within Government.
"During the initial phases of the project, Defence did not scope and cost key components of the project; validate project cost estimates and assumptions; obtain Government approval when required; follow a project management methodology; or adequately mitigate risk by adopting fit-for-purpose governance and coordination arrangements," Mr McPhee said.
Audit finds Defence implementation flawed
"Defence's planning and management of the initial phases of the DeHS project were well below the standards that might be reasonably expected by Defence's senior leadership, and exposed the Department to reputational damage."
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Canadian FHIR Connectathon

Posted on March 18, 2015 by Grahame Grieve
FHIR® North
Canada’s FHIR Connectathon

Event Details
Date: April 29th
Time: 9:00AM – 6:00PM
Location: Mohawk College, 135 Fennel Ave W, Hamilton, ON L9C 1E9
Room: Collaboratory (2nd Floor – Library)
Registration Cost: $45.00 (Entry, lunch, coffee break, pizza dinner)
Registration Site: http://www.mohawkcollegeenterprise.ca/en/event_list.aspx?groupId=3
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Australian Medicines Terminology (AMT) Support Group Meeting

Created on Wednesday, 18 March 2015
The AMT Support Group structure is changing to an open forum, an opportunity exists for interested individuals to participate in the ongoing development of the AMT.
If you have a background in medicines management and are keen to be involved, please forward an expression of interest to help@nehta.gov.au. 
The next meeting (via teleconference) is scheduled for Wednesday 29 April 2015 10 am – 12 pm AUS Eastern Daylight Time.
The Australian Medicines Terminology (AMT) is produced by the National E-Health Transition Authority (NEHTA) to standardise identification of medicines for use within Australian electronic medicine management systems. A Support Group consisting of clinicians, jurisdiction representatives and computer system vendors meets regularly to provide expert guidance on relevant terminology issues.
For more information on the AMT see http://www.nehta.gov.au/our-work/clinical-terminology or email help@nehta.gov.au 
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Call to bring Centrelink payment system ‘into 21st century’

Fran Foo

THE Abbott government has been urged to fast-track the estimated $1 billion replacement for a Centrelink mainframe system by one of its key architects who says Canberra can no longer afford to rest on its laurels.
Kevin Noonan was one of the system’s designers when Centrelink’s Income Security Integrated System was built more than 30 years ago. The antiquated ISIS, which runs on the Model 204 mainframe, is responsible for the delivery of $150bn in social security payments annually. Changes to the largely manual system are cumbersome.
Mr Noonan, now government IT lead analyst with consultancy Ovum, said the Department of Human Services was “running a 20th century system for 21st century needs”.
“The challenge is at the core; we have a system that’s built around old ways of thinking,” Mr Noonan said.
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Senior Legal Counsel

  • Fixed term contract
The National E-Health Transition Authority Limited (NEHTA) was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for e-health in Australia.
NEHTA is currently recruiting people with a desire to make a difference to health outcomes, that are passionate about the use of e-health to meet these goals and who have the relevant experience to deliver solutions in a highly complex stakeholder and technical environment. In these roles you will be working with consumers and clinicians who will be defining how models of care can be improved using the PCEHR. You will be delivering the solutions that will be in place for your grandparents, parents and your children... and for you as you engage with the public and private health system.
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7 simple strategies to avoid e-health disasters

In healthcare we’re often confronted with poor quality software. Bugs and security issues are common, and the design is usually not intuitive. I spoke to Frank (not his real name), an insider in the health IT industry. Frank gives us an interesting look behind the scene and seven strategies for developing or implementing new software.

“Any industry can be a target for poor software,” says Frank, “but healthcare certainly has its fair share. Believe it or not, medical software is unregulated. Medical software that runs on a computer, mobile phone or tablet does not fit the definition of a medical device in section 41BD of the Therapeutic Goods Act 1989, as they were not intended by the manufacturer to be used for therapeutic purposes.”
“How many software developers have clinical employees? Do these employees have input into design or are they there to sell the dream?
“There is a serious gap between software design and the real-world application. Often software developers do not fully understand what is actually required by the healthcare industry to support the services that they provide.”
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Patient info stored online as NZ pharmacies connect to ePrescription repository

5:00 AM Thursday Mar 19, 2015
Nicholas Jones
New ePrescription service to keep digital record of scripts and may benefit GPs.
Details of people's prescriptions are being fed into an online repository from pharmacies across the country.
The Ministry of Health says information is encrypted and kept in a secure system only accessible by approved health professionals.
But it admits that people who aren't satisfied with those measures cannot opt out.
All New Zealand pharmacies are now connected to the ePrescription service, and nearly all general practices will be on board within months.
Pharmacy Guild chief executive Lee Hohaia said people would be unlikely to notice a change.
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Monetizing medical data is becoming the next revenue stream for hackers

The personal details in medical records fetch higher prices than stolen credit card numbers
The personal information found in health care records fetches hefty sums on underground markets, making any company that stores such data a very attractive target for attackers.
"Hackers will go after anyone with health care information," said John Pescatore, director of emerging security trends at the SANS Institute, adding that in recent years hackers have increasingly set their sights on EHRs (electronic health records).
With medical data, "there's a bunch of ways you can turn that into cash," he said. For example, Social Security numbers and mailing addresses can be used to apply for credit cards or get around corporate antifraud measures.
This could explain why attackers have recently targeted U.S. health insurance providers. On Tuesday, Premera Blue Cross disclosed that the personal details of 11 million customers had been exposed in a hack that was discovered in January. Last month, Anthem, another health insurance provider, said that 78.8 million customer and employee records were accessed in an attack.
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Virtual baby: Fly-in, fly-out worker uses Samsung Gear VR to be part of son's birth remotely

Date March 15, 2015 - 5:09PM

Hannah Francis

An Australian fly-in, fly-out (FIFO) worker has used virtual reality technology to witness the birth of his child while interstate.
Jace Larke took a contract electrician job in Queensland to feed the three mouths – and another on the way – back home in Perth, even though his four weeks on, one week off roster meant he'd miss the due date of his pregnant wife, Alison.
"Jace being the sole breadwinner, we were worried if he had put his hand up and asked for indefinite time off, with the contract coming to a close, they would have said don't bother," Mrs Larke told Fairfax Media.
"A lot of people are being laid off . . . that's the reality."
Live streaming the birth of their third son, Steele, in virtual reality three weeks ago was "the next best thing", she said.
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Virtual technology breakthrough allows WA mum to deliver world first long-distance birth

  • March 15, 2015 4:19AM
  • AMY HARRIS
  • PerthNow
NOT even 4000km could keep Jason Larke from the birth of his child.
In a world first, Mr Larke was “in the same room” as his wife Alison when she delivered their third child in a Perth hospital last month, in a breakthrough in virtual technology.
Wearing a streaming headset developed by Samsung, Mr Larke – a fly-in, fly-out electrical contractor based in Chinchilla in Queensland – experienced the birth of his son Steele in real time via cameras set up in the Perth birthing suite.
Waving to his wife and mother-in-law, Mr Larke was able to “walk” around the room and see and hear all the sights and sounds of his son’s arrival from his Queensland bedroom. The couple were selected to take part in the experiment, which could herald a breakthrough for couples who find themselves separated during childbirth.
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Journalist jail threat in metadata law

Sarah Martin

JOURNALISTS face two years in jail for reporting on a warrant system under new national security laws aimed at protecting press freedom.
After agreeing on measures to prevent the exposure of whistleblowers in the government’s proposed metadata collection regime, the Coalition and Labor yesterday gave the green light to the new laws coming into effect in 2017.
Under the legislation, which will go the Senate next week, telecommunication companies will be forced to keep encrypted information about email, phone calls and text messages — but not the content — for access by law enforcement agencies for two years.
Amid warnings from media companies that the regime would have a chilling effect on press freedom, the government agreed to establish a “public interest ­advocate” and a “journalist information warrant” to prevent the identity of confidential sources being exposed. Labor had insisted on the amendments as a condition of its support.
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'This level of secrecy is unacceptable': Senate committee slams NBN roll out

Date March 20, 2015 - 7:16AM
A parliamentary committee has accused NBN Co of secrecy over future costs of rolling out the broadband network.
The Greens-Labor dominated Senate committee tasked with overseeing the NBN has produced a damning second interim report, accusing NBN Co of releasing a glossy version of its public corporate plan by omitting forecasts for financial years after 2014/15.
It also accuses the company of manipulating forecasts for political purposes.
Additionally, NBN Co refuses to divulge names of companies that have signed contracts and the "substantial new costs" incurred, the committee claims.
"This level of secrecy is unacceptable," the report says.
NBN Co is still too "uncertain" to reveal how much technology will cost or how long it will take to build, the report states.
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'Dark web' keeps criminals out of reach of metadata retention laws

Date March 18, 2015

Liam Tung

Criminals and terrorists are taking cover in a part of the web that can't be Googled. It's called the 'dark web', it's growing and Australia's data retention law will do nothing to help police track its most dangerous users, experts say.
If you've followed the rise and the fall of the online drug store Silk Road, you know of at least one website on the dark web — a space that Google doesn't index, and that from time to time causes headaches for law enforcement and security agencies.   
The recent guilty verdict for the Silk Road's ringleader however demonstrated the dark web isn't impenetrable. And late last year Europol seized 400 websites on the dark web and arrested 17 people alleged to be selling illegal goods. 
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The truth about the rise of robots

Robots' capacity for autonomous movement and their ability to perform an expanding set of tasks have captured writers' imaginations for almost a century. Recently robots have emerged from the pages of science fiction novels into the real world, and discussions of their possible economic effects have become ubiquitous. But a serious problem inhibits these discussions: there has so far been no systematic empirical analysis of the effects that robots are already having.
In recent work we began to remedy this problem. We compiled a new dataset spanning 14 industries (mainly manufacturing industries, but also agriculture and utilities) in 17 developed countries (including European countries, Australia, South Korea, and the US).
Uniquely, our dataset included a measure of the use of industrial robots employed in each industry, in each of these countries, and how it has changed from 1993-2007. We obtained information on other economic performance indicators from the EUKLEMS database.
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Rise of the machines: is there anything to fear?

Stephen Cave
What happens when ultra-intelligent computers begin to improve themselves? We should not assume they’ll have our best interests at heart, warns Stephen Cave
Our Final Invention: Artificial Intelligence and the End of the Human Era, by James Barrat, St Martin’s Griffin, RRP$16.99, 336 pages
In Our Own Image: Will Artificial Intelligence Save or Destroy Us?, by George Zarkadakis, Rider, RRP£12.99, 384 pages
Eclipse of Man: Human Extinction and the Meaning of Progress, by Charles T Rubin, Encounter Books, RRP$23.99, 200 pages
Smarter Than Us: The Rise of Machine Intelligence, by Stuart Armstrong, Machine Intelligence Research Institute, RRP£2.99/$4.99, 62 pages
We humans have got where we are today by being the cleverest creatures in town. In the absence of claws, wings or venom, intelligence is our evolutionary special power. And it has served us well, as we have risen to dominate great swaths of this planet. But now, institutions across the world — including universities, defence agencies and internet giants — are striving to create something that will knock us off this top spot. They are working towards machines that will be cleverer than we are; towards not merely artificial intelligence, but artificial super-intelligence. As a species, we are racing to create beings that will supplant us in our own evolutionary niche. What are we thinking?
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Windows 10 embraces iris scans, facial recognition

Microsoft is embracing biometric login with a new feature of Windows 10 that recognizes faces, fingerprints and irises for authentication.
Microsoft is embracing biometric login with a new feature of Windows 10 that can recognize faces, fingerprints and irises for authentication it claims is more secure than passwords.
Windows Hello can be used to authenticate users but also applications, data and Websites without storing passwords on devices that support the feature.
The company says facial and iris recognition require infrared cameras on Windows 10 devices in order to distinguish individuals even in varying lighting conditions.
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Enjoy!
David.

Sunday, March 22, 2015

Microsoft Joins The Major A****** Category With Skype Updates

They try to have you not notice that they are re-setting defaults on the search engine and home page.

Grow up will you MS. Your endless updates are bad enough without this trickery!

David.

Now This Has To Be A Real Worry Unless A Few Important Lessons Are Taken On Board!

I noticed this rather interesting announcement a few days ago.

Health ministry to set up National eHealth Authority to develop Integrated Health Information System

Ramesh Shankar, Mumbai
Friday, March 20, 2015, 08:00 Hrs  [IST]
The Union health ministry will soon establish the National eHealth Authority (NeHA) which will be the nodal authority that will be responsible for development of an Integrated Health Information System (including Telemedicine and mHealth) in India, while collaborating with all the stakeholders, viz., healthcare providers, consumers, healthcare technology industries, and policymakers.
The Authority will act as a promotional, regulatory and standards setting organization to guide and support India’s journey in e-Health and consequent realization of benefits of ICT intervention in health sector in an orderly way.  It will be responsible for enforcing the laws & regulations relating to the privacy and security of the patients health information & records.
One of the major goals of the Authority is to guide the adoption of e-Health solutions at various levels and areas in the country in a manner that meaningful aggregation of health and governance data and storage/exchange of electronic health records happens at various levels in a cost-effective manner. It will facilitate integration of multiple health IT systems through health information exchanges.
Another mission of NeHA is to oversee orderly evolution of state-wide and nationwide electronic health record store/exchange system that ensures that security, confidentiality and privacy of patient data is maintained and continuity of care is ensured.
The NeHA has been envisaged to support formulation of policies, strategies and implementation plan blueprint (National eHealth Policy/Strategy) for coordinated eHealth adoption in the country by all players; regulation and accelerated adoption of e-health in the country by public and private care providers and other players in the ecosystem; and to establish a network of different institutions to promote eHealth and Telemedicine/remote healthcare/virtual healthcare and such other measures.
More here:
Talk about a sense of déjà vu!
All they seem to have done is drop the letter “T” from our old friend NEHTA!
One has to hope NeHA can learn from all that has gone before.

Here is another link that provides a lot of details on the plans:

http://www.dailymail.co.uk/indiahome/indianews/article-3005690/NeHA-s-helping-hand-sick-Records-government-hospital-patients-available-online.html
Reading through this article I am really worried about the level of confidence and optimism expressed. Certainly the other countries cited (UK, Aus. and Canada) have yet to make a great fist of it in countries that are much smaller and much less diverse!

All I can hope is that this new organisation takes the suggestion to do a few things as it starts up - noting that the idea of NeHA is very new and there is a very long way to go..
First it needs to have a close look at all the reports done on NEHTA over the years from Deloittes and the Boston Consulting Group etc - given the similarity of the initial mandate.
This link will provide at least a start on what is needed!
Second they need to have a look at the way the US Office Of The National Co-ordinator for Health IT operates in terms of transparency, openness, consultation, standards setting and industry engagement. The ONC has done a good job in these areas.
Third they really need to get on the ground all over the world and research what has worked (or not) and see what has the best chance to work in a huge country like India.
Fourth they need to be very clear projects like this are very hard to get right and always take a great deal longer than anyone anticipates.
All I would do is wish them luck and encourage them to work very hard to learn from history!
David.

AusHealthIT Poll Number 262 – Results – 22nd March, 2015.

Here are the results of the poll.

Should The Australian National Audit Office Look Into The PCEHR?


Yes 98% (124)

Maybe 0% (0)

Neutral 0% (0)

Probably Not 0% (0)

No 2% (3)

I Have No Idea 0% (0)

Total votes: 127

This has to be the clearest outcome ever and we can only hope someone is listening!

Good to see such a good number of responses!

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

David.

Saturday, March 21, 2015

Weekly Overseas Health IT Links - 21st March, 2015.

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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Congressman Takes Aim at EHR Interoperability with Draft Bill

MAR 13, 2015 7:43am ET
Rep. Michael Burgess (R-Tex.), a physician and member of the House Energy and Commerce Subcommittee on Health, has drafted legislation that would establish a congressionally-appointed advisory committee to develop an EHR interoperability standard required for certification that would go into effect by 2018.
The draft bill calls for the termination of both the Health IT Policy and HIT Standards Committees, which are to be replaced with a 12-member advisory committee composed of providers, qualified EHR developers, insurers, group health plans, and other stakeholders. Six of the committee members would be appointed by the House Speaker and minority leader, while the other six would be appointed by the Senate majority leader and minority leader.
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Docs are unhappy, and mHealth isn't helping

Posted on Mar 13, 2015
By Eric Wicklund, Editor, mHealthNews
Docs nationwide are unhappy and exhausted in their current roles, and rather than helping, mHealth tools are only adding to the problem. At least that's the finding of a recent survey that took pulse of physician misery levels. 
In the long run, physicians expect mobile health tools to serve to their advantage, but right now, it's just too much on their plates, according to the Geneia's Physician Misery Index survey. 
"Physicians see mobile health as a long-term solution and a short-term nuisance," said Heather Lavoie, chief operating officer of Geneia, the Harrisburg, Pa.-based cealth IT company that conducted the survey. "It's actually adding to their problems right now."
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Clinical decision support: It's about more than technology

Posted on Mar 12, 2015
By Mike Miliard, Editor
It's natural to frame thinking and discussion about clinical practice in terms of technology.
But when it comes to clinical decision support, that's the wrong approach, says Jerome Osheroff, MD, a former chief clinical informatics officer and editor-in-chief of HIMSS' CDS guidebook series and the principal and founder of TMIT Consulting, which aims to help providers, agencies and vendors improve processes and outcomes.
To do so, he says, "presumes that clinical decision support is a tool, or an EHR-based intervention." That's not accurate.
Osheroff has been making the case for years that a more inclusive vision of CDS was necessary to ensure it's deployed properly, and that the improved outcomes it promises are realized.
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EHR market expected to reach $24B by 2020

Written by Elizabeth Earl | March 12, 2015
The global EHR market has expanded at a prodigious rate in the last five years and is expected to continue to grow rapidly between 2014 and 2020, reaching $23.98 billion by 2020.
The current market is valued at $15.56 billion The market is expected to grow at an annual rate of 6.4 percent for the next six years. Large- and medium-sized hospitals have widely adopted EHR systems, but smaller hospitals are expected to drive the market in the future, according to a report from Transparency Market Research.
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Nurses say lack of medical device connectivity, interoperability creates medical errors

By: Jonah Comstock | Mar 12, 2015
Lack of medical device connectivity and interoperability are big contributors to preventable medical errors, according to a recent survey of nurses. According to the 526 registered nurses who participated in the survey, which was commissioned by the Gary and Mary West Health Institute and conducted by Harris Poll, nurses end up shouldering a lot of the burden of medical devices and electronic health records that don’t integrate well together.
Half of the nurses surveyed said they had personally witnessed a medical error that occurred because of a lack of device coordination.
The problem, West Health contends in its report, is that the many different medical monitoring devices in the hospital don’t communicate with each other. Some can communicate indirectly through the EHR, but others need to have their readings manually transcribed onto paper charts by nurses, which opens up a lot of room for error. Forty-six percent of nurses said an error is extremely likely to occur if data is manually transcribed from one device and then entered into an EHR or another device.
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Lessons from Ebola: EHR design can impact medical malpractice litigation

March 10, 2015 | By Marla Durben Hirsch
The use and design of a provider's electronic health record can have an impact on medical malpractice litigation, as shown by the recent misdiagnosis of the first Ebola patient in the United States, according to Sharon McQuown, R.N., MSN, LNCC, with the Law Office of Frank L Branson in Dallas, Texas.
McQuown, speaking at the American Bar Association Health Law Section's 16th Annual Conference on Emerging Issues in Health Care Law in Orlando March 6, pointed out that the focus of the problem was the misdiagnosis of the patient in Texas Health Resource's emergency department (ED), which caused the patient to be discharged the same day. He returned and was admitted three days later, confirmed to have Ebola, and died shortly thereafter. The malpractice suit was filed Nov. 12 and settled that day.
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How CPOE can reduce length of stay

Posted on Mar 12, 2015
By Anthony Vecchione, Contributing Writer
Computerized provider order entry, along with bedside bar coding and electronic health records has had a tremendous impact on patient safety and outcomes.
In their poster presentation at the 2015 HIMSS Annual Conference & Exhibition in Chicago, "CPOE Associated with Shorter Length of Stay in a Community Hospital," Richard Schreiber, MD, intends to help attendees understand that is a strong statistical correlation between the increases in rates of CPOE with a drop in length of stay.
In a July 2014 study published in Applied Clinical Informatics, Schreiber, chief medical informatics officer at Holy Spirit Hospital in Camp Hill, Pa., and co-author Steven Shaha, noted the correlation came out to be in the vicinity of about 63 percent.
"That is, about 63 percent of the reduction in length of stay correlates with the rise in CPOE rates. This was true overall, and was statistically significant for 13 of the 19 disciplines for which we had data," Schreiber told Healthcare IT News.
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Are seniors really game for health IT?

Posted on Mar 12, 2015
By Michelle Ronan Noteboom, Contributing writer
Over Christmas, my 79-year-old father visited me for a few days and joined us for Christmas Eve mass. Just before the service started, my father’s phone rang. He quickly pulled the phone out of his pocket and silenced it. As he did, the people behind us started giggling and said, “Hey look! It’s a flip phone!”
It is a little funny to see my dad with his quaint flip phone, similar to the one I had about eight years ago. My father, who refuses to attempt texting and never checks his voicemail, will probably never switch to a smart phone since the flip phone already has more features than he’ll ever use.
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Access monitoring key to thwarting insider health security threats

March 12, 2015 | By Susan D. Hall
West Virginia United Health System is taking an aggressive stance against inappropriate access of patient records, according to assistant chief information officer Mark Combs.
Though it had a read-only system with sign-off procedures, its previous policy allowed employees to use their work access to look at their own records, he says in an interview with HealthcareInfoSecurity.com.
That has now changed.
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Study: Using CDS Improves Mortality Rate for Pneumonia Patients

March 11, 2015
A new study, led by researchers at Intermountain Medical Center in Salt Lake City, found that using advanced clinical decision support (CDS) tools can reduce mortality for pneumonia patients. 
The researchers studied the impact of an advanced computer program designed at Intermountain, which combs through a patient's medical information and risk factors in real time to alert an emergency department physician if the patient likely has pneumonia. Once the diagnosis is confirmed, it calculates severity assessment and provides management recommendations based on current North American guidelines. They found that use of the tool saved up to 12 lives over the course of a year, compared to routine care standards. 
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Fear of data breaches leads 21% of patients to withhold information from physicians

Written by Elizabeth Earl | March 11, 2015
The national attention on the risk of data breaches may be keeping patients from sharing information with physicians.
A survey from Austin, Texas-based software advising firm Software Advice of 243 people found that 45 percent of respondents were moderately or very concerned about security breaches involving personal health information. Nearly a quarter, 21 percent, withholds personal information from their physicians for fear of a data breach.
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Doctors on This Site Rate Drugs to Give Patients More Power

Online reviews are every business’s nightmare and every consumer’s obsession. We rely on them as we scour restaurants on Yelp, search for power tools on Amazon, choose movies on Netflix, and shop for artisanal jewelry on Etsy.
But when it comes to prescription medication, too often, we take what our doctors give us, no questions asked. That’s a major problem, considering nearly 70 percent of Americans take prescription drugs, according to the Mayo Clinic. And it’s especially troubling because, as comedian John Oliver brilliantly conveyed in a recent episode of Last Week Tonight, in far too many cases, the doctors prescribing those drugs are on the payrolls of the very companies that sell them.
With a new product called RateRx, Ron Gutman, CEO of the digital health startup HealthTap, aims to take on this lack of transparency. RateRx will let doctors from all over the world rate the effectiveness of certain medications for certain ailments. They’ll also be able to leave comments about those drugs and rate other doctors’ answers. From that data, patients will be able to surface the best answers to make informed choices about the drugs they take.
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Talking the talk

The language of systems integration has shifted from interoperability to ‘paperless’ working and ‘integrated’ care. The tacit assumption seems to be that the technical bit has been solved, and these phrases are well understood. But is that the case, Daloni Carlisle asks?
There was a time when “systems integration” had a well understood meaning in NHS IT. It meant linking different systems to get an administrative or clinical job done. By and large, it meant doing that in the acute sector.
Not anymore, it would seem. The language has changed. People now talk about ‘paperless’ working and ‘integrated’ care. The tacit assumption is that the technical aspects of interoperability have been solved, so debate can skip on to what it is meant to achieve.
Also, that what it is meant to achieve is clear to all parties. Yet these assumptions may not, in fact, be justified; given the wide range of approaches that are now being taken, both in hospitals and beyond them.
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Are you maximizing the value of IT?

Posted on Mar 10, 2015
By Chris Nerney, Contributing Writer
Over the past few years, U.S. healthcare organizations have poured billions of dollars into information technology. But what kind of return are healthcare providers getting on these massive investments? And how can they maximize the value of IT to both improve patient care and streamline operations?
HIMSS15 attendees can explore the answers to these questions at the annual conference’s first Health IT Value Suite, which will feature patient and healthcare provider success stories that illustrate the ROI possible from health information technology during a time of huge change to the U.S. healthcare system.
“There’s a lot of pressure on health IT from the C-suite and boards of directors to deliver better care, improve patient outcomes and save money,” says Patricia Wise, HIMSS vice president of healthcare information systems. “Simultaneously, regulatory forces from the government are pushing organizations toward value, and the payment structure is being influenced by this.”
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John Halamka: CIOs should scrutinize cloud services

March 10, 2015 | By Katie Dvorak
While the cloud holds promises for health IT, chief information officers must look at the services offered to them with a discerning eye, Beth Israel Deaconess Medical Center CIO John Halamka says in a post in the Wall Street Journal.
He says CIOs should look at a variation of software as a service (SaaS), which is operated by a third party and thus does not require new hardware or software installation. The variation, which Halamka calls "Outcomes as a Service," is the blending of business processes, people and technology work to achieve goals.
In Outcomes as a Service "economic incentives are aligned perfectly ... because downtime or poor application functionality results in immediate reduction in cloud vendor income," he writes.
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Telemedicine dangers must be addressed

March 11, 2015 | By Katie Dvorak
Despite the promise of telemedicine in improving healthcare, there are downsides to such technology that need to be addressed, according to Russ Alan Prince, president of consulting firm R.A. Prince & Associates Inc.
One impediment to using telemedicine effectively is glitches, he says. If malfunctions occur, it could negatively impact a patient's care and health, Prince writes in Forbes. A glitch could cause allergy information not to be stored in a medical record, which in turn could have severe repercussions, he says. In addition, medical device implants could also malfunction and harm a patient.
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Telemedicine via PCPs Ups Diabetic Retinopathy Screenings

Marcia Frellick
March 10, 2015
Researchers have found long-term positive results when primary care physicians (PCPs) use telemedicine to screen for diabetic retinopathy.
Steven Mansberger, MD, MPH, from the Devers Eye Institute in Portland, Oregon, and colleagues found that telemedicine increased the percentage of diabetic retinopathy screening examinations. They also found that most participants did not require referral to an eye care professional after the screening and that diabetic retinopathy levels were relatively stable during the study period. Results were published online March 5 in JAMA Ophthalmology.
This finding suggests that PCPs can use telemedicine with nonmydriatic cameras to take retinal images without dilation, send images for remote evaluation, and watch for disease worsening over time.
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Why Health Information Must Be Available Where and When Consumers Need It

by Angela Kennedy Wednesday, March 11, 2015
Lydia Washington, MS, RHIA, CPHIMS -- senior director of HIM Practice Excellence at the American Health Information Management Association -- contributed to this Perspective.
One year ago, I found myself putting in relentless effort to compile an accurate medical record for my daughter after she was diagnosed with the genetic disease Cystic Fibrosis at age 11. I experienced many frustrations in my attempt to gather my child's medical records. Due to an incorrect entry in my daughter's medical record, the inheritable condition was overlooked. The records included an inaccurate statement that had been copied and pasted into all subsequent records for nine years.
Gracie is just one example of why a commitment to consumers must be made that we can provide health information where and when they need it. We need a guarantee that information will be available, accessible, accurate and complete. Copy-paste and copy-forward pose risks to patient care. In my daughter's case, perhaps if the information had been reviewed or audited for accuracy, she would have received an earlier diagnosis. This audit is not just the responsibility of the caregiver but also the responsibility of the patient.
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HIE Pushes Value Propositions in CA

Christopher Cheney, for HealthLeaders Media , March 11, 2015

Creating a health information exchange that serves as an independent medical record repository for the majority of California's residents has tremendous potential for payers, providers, and patients.

David Watson is seeking to capitalize on a golden opportunity in The Golden State.
The University of Southern California graduate is CEO of Cal INDEX, one of the most ambitious health information exchange initiative's in the country. A pair of major payers formed the non-profit HIE in August 2014, with Blue Cross of California and Anthem Blue Cross committing $80 million in seed money to help launch the not-for-profit organization.
In a recent interview, Watson told me how Cal INDEX is building a wealth of healthcare information on the foundation of 9 million records drawn from Blue Cross's benefactors.
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Apple Launches Software Framework, Apps to Aid Medical Research

MAR 10, 2015 7:32am ET
With more than 700 million iPhones sold globally, Apple has built a new open source software framework that it hopes will revolutionize medical research by turning iPhone users into powerful diagnostic tools for gathering health data.
At Apple’s March 9 product launch event, the company announced ResearchKit, a new platform for researchers to host mobile apps designed to dramatically change how the antiquated methods of medical research—and the treatment of diseases—are conducted.
“One of the biggest challenges researchers have is recruiting,” said Jeff Williams, Apple’s senior vice president of operations. “Small sample sizes—sometimes 50 to 100 people—limits our understanding of diseases. Another issue is subjective data.”
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Nurses want probe into EMR failure

Posted on Mar 10, 2015
By Erin McCann, Managing Editor
Nurses at a California hospital are asking state officials to investigate the failure of the hospital's electronic medical record system, an incident they said led to the closure of its emergency room and compromised patient safety.
The EMR system at the 420-bed Antelope Valley Hospital in Lancaster, California, reportedly failed last weekend, resulting in clinicians unable to review patient labs, verify physician orders and access patient records, according to the California Nurses Association and the National Nurses United union. 
"Our entire electronic and data system failed," Feb. 27 wrote Antelope Valley's Maria Altamirano, RN, on behalf of California Nurses Association, in a letter to the Los Angeles County Department of Public Health. Due to the failure, the hospital, Altamirano explained, had to close its emergency department because it failed to have adequate backup plans in place. 
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Care.data on hold until election

3 March 2015   Sam Sachdeva
Lingering questions dogging NHS England's controversial care.data programme will hold up data extractions until after the May general election, Tim Kelsey has confirmed for the first time.
However, NHS England's director of patients and information told EHI News that communications about the programme will still be sent to patients in pilot areas as part of the pathfinder phase.
Speaking at the e-Health Week conference in London, Kelsey said the organisation is still working on its response to a significant number of questions about the programme, raised by an independent review, that must be answered before it can move ahead.
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Scottish data share plan survives vote

9 March 2015   Thomas Meek
Scottish government plans to share data from a central NHS database with other public bodies have narrowly survived a Holyrood vote.
The proposals put forward by the SNP government were voted through by 65 to 60, helped by MSP Aileen Campbell who took time out from maternity leave especially to vote.
As reported by EHI News in February, the SNP said it wants to share non-medical data from the NHS central register, which holds details of everyone born or registered with a GP in Scotland, with the HMRC and other public bodies.
This is mainly in order to keep track of taxpayers from April 2016, when the country is set to implement its own rate of income tax.
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U.S. health IT market to grow at 6%+ over next 4 years — 5 things to know

Written by Anuja Vaidya | March 09, 2015
The use of information technology is seeing major growth in the U.S. healthcare industry, and it is no secret that health IT will form the foundation of value-based healthcare delivery.
Here are five key trends in the health IT market, according to a report released by Market Research Store:
•    The healthcare IT market in the United States is estimated to grow at a compound annual growth rate of 6.01 percent from 2015 to 2019.
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Seeing medical records might ease hospital patients’ confusion

By Lisa Rapaport
Mon Mar 9, 2015 11:54am EDT
(Reuters Health) - Letting patients see their medical records while they’re in the hospital might ease worry and confusion without extra work for doctors and nurses, a small study suggests.
"The hope is that increased transparency achieved by sharing electronic medical records with patients while they're in the hospital would make them more engaged in their care, more satisfied, and more likely to ask questions and catch errors," said lead study author Dr. Jonathan Pell, an assistant professor at the University of Colorado in Denver.
Patients didn't think they could catch medical errors, “so that piece didn't come out the way we had hoped it would," Pell said. "But we were also pleasantly surprised that many of the doctors and nurses didn't see their work load increased by patients having access to their records."
These days patients more often have access to electronic medical records from checkups and outpatient treatments, but typically only after care is completed – and not for procedures while they're in the hospital.
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HIE Reduces Medical Imaging Redundancies 25%, Study Says

Christopher Cheney, for HealthLeaders Media , March 10, 2015

A health information exchange in New York State is helping several dozen healthcare providers coordinate care and reduce costs, researchers say.

Health insurance exchanges are capable of reducing redundancies in medical imaging, which contributes significantly to care coordination and cost-efficiency gains for healthcare providers, research conducted in New York state indicates.
A study, recently published in the American Journal of Managed Care, focuses on the Rochester Regional Health Information Organization, a nonprofit HIE launched in 2006. The study found that dozens of healthcare providers shared medical imaging data through the Rochester HIE, reducing the odds of redundant medical imaging by 25%.
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The Best Interoperability Game in Town

Scott Mace, for HealthLeaders Media , March 10, 2015

The ONC's Interoperability Standards Advisory gives providers some things they can start demanding from their vendors and service providers, and gives those same vendors and service providers some notion of which products and services customers will actually buy.

Are your health IT systems using SNOMED-CT? How about RxNorm? How about the HL7 Consolidated CDA?
Until May 1, you have a chance to weigh in on these and numerous other industry standards which, as likely as not, will eventually find their way into regulation as required technical standards in health IT systems in the U.S.
Overshadowed by the release of the proposed 10-year ONC Interoperability Roadmap on January 30, the lesser-publicized 2015 Interoperability Standards Advisory was not originally envisioned to be released at the same time, or even to exist.
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Moscow eHealth a Model for the UK

The approach that Moscow City Council has adopted to create an open platform to support health and social care services in Moscow which uses some of the same technology as the Code4Health platform would seem to have relevance to the UK and in particular is a good fit for the needs of emerging new approaches to the integration of health and social care like that recently announced for Manchester.
Many of you will know about HANDI-HOPD the HANDI Open Platform Demonstrator  that we have been working on for the last few months, this has now morphed into the NHS Code4Health Platform launched by NHS England during eHealth Week in London this week (5th March 2015).  However, what you probably won’t know is that one of the key pieces of technology available on the platform is the same as that which is currently powering the whole of the eHealth system in Slovenia and even more impressively Moscow.
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5 health IT billionaires you know

Posted on Mar 09, 2015
By Bernie Monegain, Editor-at-Large
The Forbes 2015 list of the richest people on the planet has become longer this year with the addition of even more billionaires. We found five health IT pioneers on the list you've probably heard of.
There are 1,826 billionaires in the world. This year's Forbes list includes 290 newcomers. The top three on the list are Bill Gates, who made his $70.2 billion via Microsoft; Carlos Slim Helu, who garnered his $77.1 billion in the telecom business; and Warren Buffet, investor extraordinaire, who racked up $72.7 billion.
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7 tips for EMR success from Stage 7 hospitals

Posted on Mar 09, 2015
By Amanda Burkey, New media producer
Since 2006, HIMSS Analytics has identified a total of 200 hospitals as Stage 7 facilities on the HIMSS Analytics EMR Adoption Model. As challenging as this goal is, new Stage 7 facilities are added each year.
Thirty more hospitals and 1,021 ambulatory facilities reached paperless status in 2014, and will be congratulated next month at HIMSS15. Each of these provider organizations has overcome challenges inherent in achieving a paperless environment. Take advantage of their experiences and keep these seven lessons in mind during your Stage 7 journey.
1. Include all the key stakeholders.
"Balance the need for speed with the need for inclusiveness. Finding the right balance requires an understanding of the culture of your organization and the ability to think like your stakeholders. On one hand if you include everyone you don’t move fast enough and you lose trust; on the other hand if you don’t include the right people you have a hard time with adoption. Respect for people and organizational mission is usually the common ground."
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How colleges are incorporating health IT into nursing education

March 9, 2015 | By Katie Dvorak
Health IT is taking over healthcare education--including for aspiring nurses.
At Mount Aloysius College in Cresson, Pennsylvania, high-tech mannequins are helping nursing students get as close to real-life scenarios as possible.
For the class, Nursing Care of the Family, IT specialists manipulate the mannequin's vital signs--they can mimic breathing and have blood pressure--as the students work to save their "patient," according to an article at the Military Times.
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mHealth Advocates Fear Net Neutrality

by Rebecca Vesely, iHealthBeat Contributing Reporter Monday, March 9, 2015
While much of the Internet community expressed elation over the Federal Communications Commission's Feb. 26 vote to protect net neutrality, some mobile health advocates said that the rule could harm patients.
The divide over the rules is expected to continue, with possible congressional action and legal challenges over the rules.
"We think this is a big step backward for innovation and creativity," said Joel White, executive director of Health IT Now, which represents providers, employers, carriers and payers, including Aetna, athenahealth, Boeing, Intel, McKesson, Samsung and Verizon. He added, "FCC is treating the Internet as a utility. That was big in the 1930s. The Internet is far more than a water pipe or an electricity cable. It is an engine of creativity."
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Enjoy!
David.