2008 HIT News
August 1, 2008
Governor plans to give Minnesotans access to PHRs by 2011
Minnesota Gov. Tim Pawlenty has proposed to give all Minnesotans access to an online personal health portfolio by 2011.
As the first step in this effort, the governor has directed the Department of Finance and Employee Relations to seek proposals for a secure and portable online personal health portfolio for each of the state's approximately 50,000 employees in 2009...
"Minnesota's healthcare system must be market-driven, patient-centered and quality-focused," Pawlenty said. "Minnesota took a giant step forward to transform our healthcare system this year. Now Minnesota will lead the nation in the development of portable personal health records and expanded consumer-directed healthcare spending accounts for state employees."
The portfolio will offer:
- Electronic access to test results;
- Access to one's own medical records electronically;
- Instant access to immunization records; and
- Prescription history and detection of interactions.
"In healthcare, information is power. Right now the consumer is the only person in the system without access to their healthcare information," Pawlenty said. "We need to turn that around and allow the consumer to build their own healthcare portfolio, control who has access to it and take it with them wherever they go for the rest of their lives."...
To read the entire article go to: http://www.healthcareitnews.com/story.cms?id=9691
August 1, 2008
Providers cite decreased Medicare payments as greatest challenge, EMRs as potential solution
Dealing with decreased payments from Medicare and insurers was cited as the biggest concern of healthcare providers in a recent survey by data and network service provider IVANS, Inc.
To help close the "payment gap," many of these providers say they are turning to information technology...
More than 60 percent of survey respondents believe the use of electronic health records can have a significant impact on improving their businesses, and greater than 65 percent have already implemented or plan to implement EHR systems. Eight-five percent believe that Health Information Exchanges can facilitate information sharing for improving patient care.
Eighty-five percent of providers surveyed cited lack of budget as the biggest challenge to technology adoption, followed by lack of expertise and getting staff to use technology. Healthcare providers surveyed seem to view technology as a viable method for doing more with less, but they are not sure they have the internal resources to leverage it. ..
To read the entire article go to: http://www.healthcareitnews.com/story.cms?id=9688
July 31, 2008
Telemedicine in California: Progress, Challenges, and Opportunities
Telemedicine — the use of telecommunications and information technologies to provide health care remotely — has the potential to improve health care by bridging time and distance barriers, reducing delivery costs, and altering referral patterns among physicians. Yet although telemedicine has been around for a number of years, and despite the success of telemedicine programs in rural pockets of California, its use in the state is not widespread.
This report examines the evolution of telemedicine in California and identifies the technological, financial, regulatory, and user-related hurdles that may be stifling further progress. It finds that while some patients have benefited from early innovators who transformed inventive technology projects into statewide telemedicine programs and e-health networks, the impediments to broader adoption remain daunting.
Although the authors acknowledge the persistence of such barriers, they also suggest that given the explosive growth in Internet use, the expansion of remote communication models, and the relentless pressure to cut the cost of care delivery, the time may finally be ripe for telemedicine. The report concludes by exploring questions about the key factors that could affect the proliferation of telemedicine technology in California...
To read the entire article go to : http://www.chcf.org/topics/view.cfm?itemid=133682
July 27, 2008
Privacy should be #1 PHR priority, CCHIT committee says
While other issues matter, privacy should be the top priority in setting certification criteria for PHRs, according to a task force run by the Certification Commission for Healthcare Information Technology. The CCHIT's Personal Health Records Advisory Task Force recommended not only that PHRs protect private patient information, but also that they be able to send and receive data from varied data sources including ambulatory and hospital EMRs, labs and pharmacies.
The committee's work builds on prior research done by the National Alliance for Health Information Technology, which developed standardized definitions for six key health IT terms. These include that PHRs would conform to nationally recognized interoperability standards, and also, that individuals would manage PHR data.
To learn more about the PHR task force's recommendations:
- read this Modern Healthcare piece (reg. req.)
Source: http://www.fiercehealthit.com/story/privacy-should-be-1-phr-priority-cchit-committee-says/2008-07-27?utm_medium=nl&utm_source=internal&cmp-id=EMC-NL-FHI&dest=FHI
July 17, 2008
Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2008
Authors: The Commonwealth Fund Commission on a High Performance Health System
Overview
National Scorecard on Health System Performance 2008 http://www.commonwealthfund.org/usr_doc/site_docs/slideshows/NatlScorecard/NatlScorecard.html
download individual report charts in ChartCart.
Prepared for the Commonwealth Fund Commission on a High Performance Health System, the National Scorecard on U.S. Health System Performance, 2008, updates the 2006 Scorecard, the first comprehensive means of measuring and monitoring health care outcomes, quality, access, efficiency, and equity in the United States. The 2008 Scorecard, which presents trends for each dimension of health system performance and for individual indicators, confirms that the U.S. health system continues to fall far short of what is attainable, especially given the resources invested. Across 37 core indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with U.S. and international performance benchmarks. Overall, performance did not improve from 2006 to 2008. Access to health care significantly declined, while health system efficiency remained low. Quality metrics that have been the focus of national campaigns or public reporting efforts did show gains.
Executive Summary
Every family wants the best care for an ill or injured family member. Most are grateful for the care and attention received. Yet, evidence in the National Scorecard on U.S. Health System Performance, 2008, shows that care typically falls far short of what is achievable. Quality of care is highly variable, and opportunities are routinely missed to prevent disease, disability, hospitalization, and mortality. Across 37 indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with benchmarks of best performance achieved internationally and within the United States...
To read the entire article go to: http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=692682
July 14, 2008
Business Case Needed To Argue for EHR Adoption, Experts Say
In most cases, the U.S. health care system does not provide incentives for physicians or hospitals to share clinical data with other health care providers, raising barriers to widespread adoption of the technology, Computerworld reports.
Charles Jaffe -- CEO of Health Level 7, which develops data standards for health care organizations -- said, "The problem we have in this country is a lack of business reasons for integrating." He added, "What is the business case for two competing hospitals to share data? None."
For example, five major hospitals in San Diego held a series of meetings about three years ago to consider sharing information stored in their respective EHR systems.
However, the hospitals decided not to pursue the plan because economic benefits were inadequate.
Joshua Lee, medical director of information services at the University of California-San Diego Medical Center, said, "The financial and oversight responsibility would fall on the medical centers, even though it's a very intangible benefit to the medical centers."
Although studies show that EHRs, computer physician order entry and other technology applications can improve the quality of health care, health care providers generally are not compensated for improvements to care, according to John Quinn, chief technology officer for HL7.
John Halamka, CIO at Harvard Medical School and Beth Israel Deaconess Medical Center, said, "The provider bears the cost, but most of the benefits accrue to other parties," particularly insurers and other health care payers.
Shaun Grannis, a medical informatics researcher at the Regenstrief Institute in Indianapolis, said that Regenstrief is working to develop an economic model for health information exchanges that would be sustainable over the long term, but he said that such projects continue to rely on "a patchwork of funding" (Mitchell, Computerworld, 7/14).
Source: http://www.ihealthbeat.org/articles/2008/7/14/Business-Case-Needed-To-Argue-for-EHR-Adoption-Experts-Say.aspx?topicID=54#
June 26, 2008
Broad Coalition Releases First Privacy Guidelines for PHRs
On Wednesday, Microsoft, Google and dozens of other health care organizations approved the first-ever privacy framework for personal health records, the AP/Washington Post reports.
The Connecting for Health guidelines were created to address consumer advocates' concerns that HIPAA medical privacy rules do not apply to PHR companies. Privacy advocates worried that patients' data could be obtained by the government, insurers or marketers without necessary protections (Liedtke, AP/Washington Post, 6/25).
Over 18 months, the Markle Foundation and 46 other electronic service providers, consumer advocates, medical associations and other stakeholders created the guidelines (Vanac, Cleveland Plain Dealer, 6/26).
Scope of Guidelines
The PHR guidelines address:
- Authentication of consumers;
- Audit trails;
- Restrictions on identifying information;
- Portability of patient data;
- Security and systems requirements;
- Provisions for consumer consent; and
- Policies for notifying patients when their information is breached (Health Data Management, 6/25).
The guidelines will be enforced by existing federal and state consumer protection laws based on oversight by private, independent groups, according to the Markle Foundation (Goldstein, Bloomberg News, 6/25).
PHR providers -- including Dossia, Google, Microsoft, Intuit and WebMD -- said they will have to make minimal changes on their PHR platforms because of the new privacy framework (Enrado, Healthcare IT News, 6/25).
PHR Survey
On Wednesday, the Markle Foundation also released a survey, conducted by Columbia University professor emeritus Allan Westin, on consumer attitudes toward PHRs. The survey of 1,580 individuals found that:
- 2.7% of respondents, or about 6.1 million U.S. residents, have a PHR;
- 57% of those without PHRs cited privacy concerns for not having a PHR (Health Data Management, 6/25);
- Eight in 10 respondents said PHRs could improve their health; and
- Nearly nine in 10 respondents said online privacy practices played a significant role in their signing up to use PHRs (Cleveland Plain Dealer, 6/26).
Source: http://www.ihealthbeat.org/articles/2008/6/26/Broad-Coalition-Releases-First-Privacy-Guidelines-for-PHRs.aspx?topicID=54 June 20, 2008
CCHIT sets tests for inpatient, ER e-health records
The Certification Commission for Healthcare Information Technology (CCHIT) approved final criteria today for certifying inpatient and emergency department electronic health records.
It also published standards for a new category of certification — enterprise EHRs — to cover vendors that provide interoperable outpatient, inpatient and emergency room records.
Dr. Mark Leavitt, CCHIT chairman, said the approvals mean outpatient and inpatient EHRs must now be able to exchange clinical in the Continuity of Care Document format, “making basic elements of health records, such as medications and allergies, interoperable and portable for the first time.”
The first applications for products to be certified against the new criteria will be accepted Aug. 1-14.
This concludes CCHIT’s work on its 2008 agenda for establishing health IT certification criteria. It published final outpatient, child health and cardiovascular medicine criteria May 20 and will take certification applications for those products July 1 - 14.
CCHIT said it would set up a July 10 teleconference for vendors interested in the new certifications.
Source: Government HealthIT - http://www.govhealthit.com/online/news/350436-1.html
June 19, 2008
Only 4 percent of U.S. physicians have a fully functional electronic health records system and 13 percent have a basic one, says a study in the June 19 online edition of the New England Journal of Medicine.
The survey of 2,758 physicians - which claims to be the most up-to-date and comprehensive picture of EHR adoption trends - shows that 16 percent of physicians said their practice had purchased an EHR but had not yet employed it.
Another 26 percent said their practice was planning on purchasing a digital record-keeping system within the next two years.
The RWJF also provided a $600,000 grant for the first two years of work on a forthcoming nine-chapter report on healthcare IT titled "Health Information Technology in the United States: Where We Stand, 2008," co-authored by the Institute for Health Policy at Massachusetts General and George Washington University.
The authors define a fully functional EHR as one that has a broad range of capabilities including order entry and clinical decision support. A basic EHR is one with a minimum set of functionalities such as recording laboratory data and clinical notes and electronic prescribing.
Physicians who serve a higher proportion of minority, uninsured or Medicaid patients were equally likely to have an EHR as others.
Physicians who practiced in groups of at least 50 were three times more likely as those in very small practices (three doctors or less) to have a basic EHR. Yet only a minority of physicians in these larger groups (17 percent) had a fully functional EHR and 49 percent did not have an EHR at all.
"The cost of an EHR system is the most commonly cited barrier to adoption," said DesRoches. She noted that two-thirds of physicians without EHRs cite affordability as the reason they don't have an EHR. Other reasons include finding the right EHR, concern about return on investment, and fears that the system will become obsolete quickly.
The study's authors said EHR adoption could be enhanced by helping doctors buy the technology through loans, incentive programs or direct payments. DesRoches noted that physicians are especially interested in legal protection from personal liability for record tampering by external parties.
http://www.healthcareitnews.com/story.cms?id=9438
Electronic Health Records in Ambulatory Care — A National Survey of Physicians: http://content.nejm.org/cgi/content/full/NEJMsa0802005
June 18, 2008
4 percent of U.S. doctors use EHRs, new study finds
A milestone study of the adoption of health information technology has produced findings that one of the study’s authors calls troubling and the other calls very sobering.
The survey of 2,758 U.S. doctors, sponsored by the Office of the National Coordinator for Health IT (ONC), found that only 4 percent had a fully functional electronic health record system. Another 13 percent had a basic or partially functional EHR system.
A 2006 study, also sponsored by ONC, found that as many as 9 percent of doctors had fully functional EHR systems. However, Dr. Karen Bell, director of ONC’s Office of Health IT Adoption, said the survey parameters were different.
“There is an increase,” Bell said at a press conference to discuss the results, which were reported today in an online edition of the New England Journal of Medicine.
The earlier survey, undertaken by the same team, found that 24 percent of doctors had some sort of computerized record system, but the question allowed them to count billing systems and other kinds of systems not directly related to health care.
Dr. David Blumenthal, director of the Institute of Health Policy at Massachusetts General Hospital and a co-author of the study, said, “We need to get moving a lot faster than we have been if we are going to take full advantage of this technology and realize its promise for medicine."
His colleague, Massachusetts General researcher Catherine DesRoches, said she found reason for hope in the findings. Forty-two percent of the doctors surveyed said their practice had bought an EHR system but had not yet implemented it or they were planning to buy one in the next two years.
“Physicians who use these systems like them,” she said, and they reported that the technology supported better patient care.
But, DesRoches said, doctors are uncertain whether they will get a financial return on their investment in EHRs, and they are fearful of new legal liabilities that could arise. Cost, she said, is the No. 1 barrier to doctors’ adoption of the technology.
Although ONC had touted the previous survey as a benchmark from which to measure future EHR adoption, Bell said the more recent one is “a true benchmark.” She said an agency of the Centers for Disease Control and Prevention will repeat the survey using the same survey instrument in the future.
The Robert Wood Johnson Foundation funded a nine-chapter report on health IT adoption, including the survey results, that will be available on its Web site July 2.
Source: Government HealthIT - http://www.govhealthit.com/online/news/350433-1.html
June 10, 2008
CCHIT adds personal health records to 2009 agenda
Paul McCloskey
The Certification Commission for Healthcare Information Technology launched its 2009 agenda today by naming members of a task force that will advise it on the fast-moving field of personal health record technology.
CCHIT also named members of 10 work groups that will develop new criteria for approving other categories of health IT.
CCHIT chairman Dr. Mark Leavitt said PHRs would “require a new perspective that is patient-centric and consumer focused,” that would be provided by a new team of experts. "The PHR Advisory Task Force will contribute strategic and policy guidance in this new area for us,” Leavitt said.
The 10 work groups will update criteria for ambulatory, inpatient, emergency department electronic health records as well as optional child health and cardiovascular certifications. Other groups will focus on interoperability, security, and privacy. The commission also set up new work groups for personal health records and behavioral health...
Source: http://www.govhealthit.com/online/news/350417-1.html
June 3, 2008
Coodinated Federal Health IT Strategic Plan Released
The Office of the National Coordinator for Health Information Technology has just released a four-year plan for advancing HIT. The plan identifies two areas of emphasis: patient-focused healthcare and population health.
A copy of the complete plan as well as a plan synopsis can be found at www.hhs.gov/healthit or click on
HHS HIT Strategic Plan (.pdf 679KB)
HHS HIT Strategic Plan Summary (.pdf 501KB)
Source: ONC - National Coordinator for Health IT News
May 28, 2008
House proposes bill to help small physician practices pay for health IT
Members of the House Committee on Energy and Commerce proposed a bill to help doctors pay for healthcare IT and improve patient privacy protection.
Source: Healthcare IT News
|
|
