Personal Health Records Will Play an Important Role in the Exchange of Health Information

“Early successes in healthcare interoperability are paving the way for more health information exchanges in the near to mid future. Separate networks, including personal health records, will connect to form larger networks, and despite continuing skepticism surrounding the burgeoning technology, health information exchanges look set to become a typical part of the patient experience.”
Article
RedOrbit, 13 November 2008

Nursing Systems Could Be a Platform for Quality Improvement

“Complexity Compression” — a term coined by the Minnesota Nursing Association — aptly captures the essence of today’s nursing world. More demanding regulations on patient documentation, multifaceted IT initiatives, new training requirements and a sicker population are heightening both indirect and direct care workloads for nurses. Indeed, we are often expecting our nurses to do more with less.”
Article
Tonushree Jaggi, iHealthBeat, 28 October 2008

Rand study touts benefits of unique patient identification system

“A Rand Corporation study finds that the use of unique patient identification numbers would help improve healthcare quality and efficiency.
The creation of such an identification system has a price tag of about $11 billion, but researchers believe it would return even more in benefits to the nation’s healthcare system.”
Article
Molly Merrill, Healthcare IT News, 21 October 2008

Physicians sought in electronic health records program

“Efforts to recruit 200 primary-care physician practices for a federally funded electronic health records demonstration project have been hampered by two hurricanes, but officials hope to meet the goal by the Nov. 26 deadline.”
Article
Ted Griggs, Advocate Business, 9 October 2008

“Patient Portals”

“According to the Deloitte 2008 Survey of Health Care Consumers, over 70 percent of consumers want their hospital to provide online access to an integrated view of their medical information, including test results, doctor visits and hospital stays. Yet the percentage of hospitals that have deployed a true patient portal is still in the single digits.”
Article
Peter Kuhn, Acumeme, 8 October 2008

Health-e Information Technology Act of 2008

“To promote the adoption and meaningful use of health information technology, and for other purposes.”
Preliminary bill text
US House of representatives

National Quality Forum Endorses National Consensus Standards for Health Information Technology

“To improve quality and efficiency and reduce errors and unnecessary treatments across the healthcare system, the National Quality Forum (NQF) has endorsed nine new national voluntary consensus standards for health information technology (HIT) in the areas of electronic prescribing, electronic health record (EHR) interoperability, care management, quality registries, and the medical home. These HIT structural measures are intended to help providers assess the efficiency and standardization of current HIT systems and identify areas where additional HIT tools can be used.”
Article
PRNewswire, 29 August 2008

Do Hospitals With Electronic Medical Records (EMRs) Provide Higher Quality Care?

“This study investigates how hospital electronic medical record (EMR) use influences quality performance. Data include nonfederal acute care hospitals in the United States. Sources of the data include the American Hospital Association, Hospital Quality Alliance, the Healthcare Information and Management Systems Society, and the Centers for Medicare and Medicaid Services case-mix index sets. The authors use a retrospective cross-sectional format with linear regression to assess the relationship between hospital EMR use and quality performance. Quality performance is measured using 10 process indicators related to 3 clinical conditions: acute myocardial infarction, congestive heart failure, and pneumonia. The authors also use a propensity score adjustment to control for possible selection bias. After this adjustment, the authors identify a positive significant relationship between EMR use and 4 of the 10 quality indicators. They conclude that there is limited evidence of the relationship between hospital EMR use and quality.”
Abstract
Abby S. Kazley, Yasar A. Ozcan, Medical Care Research and Review, Vol. 65, No. 4, 496-513 (2008), DOI: 10.1177/1077558707313437

Supporting Quality with Information Technology

“Next week, I’m meeting with the BIDMC Board’s Patient Care Assessment and Quality Committee (PCAC) to discuss the 2009 tactics for improving quality with information technology. The overall presentation includes 2008 accomplishments, 2009 goals, the national context, and our general approach. I’ve chosen to communicate the specifics in the context of the Joint Commission’s 2008 Patient Safety Goals.”
Article
John Halamka, Life as a Healthcare CIO, 18 June 2008

Electronic records improve the quality of health care but high cost still a barrier

“Large hospitals are partnering with smaller hospitals and physicians to bring down the cost of using electronic medical records. It is a quiet change, but one that holds the promise of dramatically improving efficiency and the quality of health care for patients.
Article
Michael T. de los Reyes, Medill News Service, 28 May 2008

Using Hospitalists to Maximize Inpatient Information Technology, Part 2

“This is the second installment in two-part series on the symbiotic relationship between hospitalists and health information technology. Last week, the author explained how hospitalists can help an organization derive full value from its IT investments. This week, he describes how a mobile application assists hospitalists in collecting valuable data about their patients.”
Article
Brian Levy, HHNMostWired, 14 May 2008

An integrated strategy of knowledge application for optimal e-health implementation: A multi method study protocol

“Background
E-health is increasingly valued for supporting: 1) access to quality health care services for all citizens; 2) information flow and exchange; 3) integrated health care services and 4) interprofessional collaboration. Nevertheless, several questions remain on the factors allowing an optimal integration of e-health in health care policies, organisations and practices. An evidence-based integrated strategy would maximise the efficacy and efficiency of e-health implementation. However, decisions regarding e-health applications are usually not evidence-based, which can lead to a sub-optimal use of these technologies. This study aims at understanding factors influencing the application of scientific knowledge for an optimal implementation of e-health in the health care system.
Methods
A three-year multi-method study is being conducted in the Province of Quebec (Canada). Decision-making at each decisional level (political, organisational and clinical) are analysed based on specific approaches. At the political level, critical incidents analysis is being used. This method will identify how decisions regarding the implementation of e-health could be influenced or not by scientific knowledge. Then, interviews with key-decision-makers will look at how knowledge was actually used to support their decisions, and what factors influenced its use. At the organisational level, e-health projects are being analysed as case studies in order to explore the use of scientific knowledge to support decision-making during the implementation of the technology. Interviews with promoters, managers and clinicians will be carried out in order to identify factors influencing the production and application of scientific knowledge. At the clinical level, questionnaires are being distributed to clinicians involved in e-health projects in order to analyse factors influencing knowledge application in their decision-making. Finally, a triangulation of the results will be done using mixed methodologies to allow a transversal analysis of the results at each of the decisional levels.
Conclusions
These results will be highly relevant to inform decision-makers who wish to optimise the implementation of e-health in the Quebec health care system. This study is extremely relevant given the context of major transformations in the health care system where e-health becomes a must.”
Article
Marie-Pierre Gagnon, France Legare, Jean-Paul Fortin, Lise Lamothe, Michel Labrecque and Julie Duplantie, BMC Medical Informatics and Decision Making 2008, 8:17 doi:10.1186/1472-6947-8-17

UK hospitals adopt US records system

“The University of Pittsburgh Medical Center (UPMC) and Newcastle-upon-Tyne Hospitals, a NHS Foundation Trust in the UK, today announced an innovative partnership to deploy electronic health record (EHR) technology.”
Article
HospitalHealthcare.com, 28 April 2008

New Hampshire to Improve Health IT Infrastructure

“Governor John Lynch today directed the Citizens Health Initiative to develop a plan for improving the state’s health information infrastructure to improve health care quality and affordability for New Hampshire citizens.”
Article
Government Technology, 23 April 2008

Saving lives and money

“Investments in health care technology can save money and save lives.
Imagine if you were unconscious because of a car accident and the doctors in the emergency room could know, with a few clicks of a computer mouse, that you have a heart condition and what medications you are taking, or if the new specialist you are seeing could easily look up your recent X-ray or blood test results and within seconds have them available to discuss with you, or just simply that you no longer had to fill out the same forms with the same information that you have done 100 times before.”
Article
Steve Maier, Patty O’Donnell, Rutland Herald, 17 April 2008

Brooklyn Bridges

“A Tower of Babel’s worth of languages and customs make Brooklyn, N.Y., a captivating place to live or visit but a challenging arena in which to practice medicine. The variety of spoken languages creates gaps in health information, and an aging population adds to the complexity.”
Article
David Perera, Government Health IT Notebook, 17 April 2008

Technology plays a critical role in health insurer’s new foundation

“The use of information technology is the focus of a foundation formed by The Regence Group, which will fund $2.5 million in healthcare projects in its first year and $4 million per year thereafter.
The Regence Group is the largest health insurer in the Northwest-Intermountain Region. Its new foundation has identified three funding priorities: The use of technology to engage and educate healthcare consumers, healthcare access and quality, and improvements to the way the healthcare system supports individuals and families during the end-of-life process.”
Article
Bernie Monegain, Healthcare IT News, 17 April 2008

Quality Labelling and Certification of Electronic Health Record Systems in Europe

“On May 5th 2008, prior to the eHealth 2008 Conference in Portoroz-Slovenia, the results of the Q-REC Project will be presented in the joint EuroRec - SDMI/Prorec.SI workshop called “Quality Labelling and Certification of Electronic Health Record Systems in Europe”.”
Article
e-HealthNews.eu, 17 April 2008

Creating EHR Networks in the Safety Net

“Most community clinics and health centers have yet to make the transition to electronic health records (EHRs), despite mounting evidence that they can help raise the quality of medical care, increase patient safety, improve efficiency, and produce significant cost savings.
While studies have found that the primary barrier to EHR adoption is cost, research also shows that successful implementation requires investments beyond the price of the software, including significant amounts of planning and preparation, optimizing the system after installation, and training for key personnel. Small, independent health care providers often lack either the financial or staffing resources to fund and sustain such efforts.
One solution is the EHR network — an information technology partnership focused on community clinics and health centers that provides services to support the adoption of EHRs and other applications. This issue brief explores the network approach to EHRs and its potential to increase adoption rates among these crucial providers of safety-net medical services.
In developing the brief, Manatt Health Solutions employed a variety of primary and secondary research techniques, including interviews with clinic members of EHR networks and conversations with industry and academic experts. The authors conclude that a network approach can provide California’s community clinics and health centers with the infrastructure and support necessary to efficiently implement EHR systems.”
Report
Manatt Health Solutions, for Californian Health Foundation, April 2008

The Patient’s Perspective in the Dutch National Technical Agreement on Telemedicine

Abstract:
In 2007, the Dutch National Technical Agreement (NTA) for Tele-medicine was established.
Telemedicine deals with care processes.
The goals of Telemedicine were defined broadly, including quality of life in non-medical terms as seen from the patient’s perspective: 1) independence, 2) self-reliance; 3) participation in society and social life and 4) self-determination (autonomy through freedom of choice) for the care consumer and his environment.
Quality aspects were defined at three levels:
1) patient level Telemedicine must be in line with his needs
2) level of information provision, such as: patient’s rights in information control were also defined in the NTA: the care consumer has ultimate control over his own data. The care consumer decides who, in which functional capacity within the care process, is entitled to access which data at which level (reading) and is entitled to process it in some way: making additions, changes or possibly deleting (writing). On request, the healthcare provider must allow the care consumer access to his own data as quickly as possible and/or provide a copy of (part of) the record.
3) level of business processes, e.g.it is important that the care process is designed on the basis of statutory requirements for the allocation and registration of the roles, rights and obligations of all actors concerned.
For quality assurance, the processes must be defined on the basis of the function that they perform in the achievement of the goals (intended outcome), from the starting situation (input). The intended outcome means that the needs or require-ments of the involved parties are fulfilled.
The quality of the Telemedicine service must be assured in a cyclical and ongoing process. This can best be done by developing a quality management system based on indicators and criteria for quality.

Wouter J. MEIJER
Partner ICTUS Netwerk, writing member NTA project group

To be published in “Medical and Care Compunetics 5″, IOSPress, 2008.
To be presented at the ICMCC Event 2008.

EMRs Might Work for Physicians in PHM

“Despite the continuing pressure on physicians to invest in electronic medical records, only about one-quarter have done so, and usually in large medical groups. There are numerous quality and efficiency of care reasons for making the investment, but these often fail to persuade physicians, who tend to feel that others gain most of the benefits while they suffer all of the costs.”
Article
Scott MacStravic, World HeathCare Blog, 26 March 2008

New project encourages use of electronic medical records

“You trust doctors to figure out what’s wrong with you, but they trust you to remember your immunizations, allergies, medications, parents’ health histories and other bits of information that may or may not matter. Or they trust scribbled notations in a paper medical file that they might not have in hand when they need it. As a result, you might not receive the care you need.”
Article
Mike Leavitt, St. Louis Post-Dispatch, 13 March 2008

Health care is transforming with computer technology

“Antoinett Kolnicki’s doctor suggested sending a prescription order to her pharmacy through the Internet two months ago.
Then the Bartlett senior citizen learned she could view the results of her blood and cholesterol tests on a computer, rather than waiting for a doctor’s phone call.
“It’s a wonderful thing,” Kolnicki said about these new services, which are part of the health industry’s trend toward electronic health and medical records for patients.”
Article
Christine S. Moer, The Beacon news, 9 March 2008

Telephone Medical Consults Answer the Call for Accessible, Affordable and Convenient Healthcare

“America’s healthcare facilities and medical professionals are perceived as the best in the world. Yet our healthcare system appears to be outdated or even broken, with persistent challenges regarding access to care, quality, affordability and convenience.
Keeping our nation competitive requires innovative approaches and initiatives from both public and private sectors. To meet our responsibility and provide healthcare for all Americans, including the most vulnerable citizens, we must confront the rising cost of care, strengthen the doctor-patient relationship with support for the medical home, and implement programs that deliver reliable, high-quality and reasonably priced healthcare to all who need it.
Today, telemedicine technology is stepping into this role. Through the use of advanced telecommunications and computer networking technologies, physicians are not only able to consult with one another but are also able to consult with patients, diagnose and treat specific medical problems. A physician with advanced and complicated telemedicine systems can actually perform complicated and invasive procedures on patients remotely located. Though once considered extraordinary and experimental, the practice of telemedicine is now considered to be effective and well accepted by both the medical community and the patients receiving the services.
The knowledge and skills gained in telemedicine programs are impacting routine care for non-emergency medical problems with telephone medical consults gaining momentum largely the result of consumer receptivity and cost-savings. Currently, more than 1.5 million Americans have access to this option with significant growth projected as more employers, health plans and other benefits payers recognize the opportunity for improving access to quality care and reducing expenditures.’
Report
Newt Gingrich, Richard Boxer, Byron Brooks, Center for Health Transformation, 2008

Value of Health Care Cost, Quality Web Sites Might Be Overestimated

“Three-fourths of health care opinion leaders responding to a November 2007 Commonwealth Fund/Modern Healthcare survey said that increased quality and price transparency is important or very important to improving the U.S. health care system.
In the last couple years, several states, payers and other health care organizations have responded to this demand for transparency by developing online health care cost and quality Web sites. The thinking is that by providing consumers with information to make informed health care decisions and by injecting competition into the health care market, costs will decrease and quality will increase.
However, consumers so far have been slow to use the information, and physicians often don’t know how or if they should act on the data. Touting the sites as a mechanism to transform the health care system might be overestimating their value, some health experts say.”
Article
Kate Ackerman, iHealthBeat, 8 February 2008

Analysis Calls For Medical Device Information To Better Serve Patients And Doctors

“The approval process for medical devices does not involve the same rigorous review used for pharmaceuticals, and this needs to change in order to improve health outcomes, say researchers from the University of California, San Francisco.”
Article
ScienceDaily, 1 February 2008

Health IT pioneer questions national EHR adoption strategy

“A health information technology standards pioneer and physician is questioning whether encouraging doctors to use e-health records is really a good idea.
In an article for the March/April issue of the Journal of the American Medical Informatics Association, Dr. Donald Simborg wrote that the government’s policy of promoting EHR adoption, “if not modified, may backfire” and fail to achieve its goals of enhancing the quality of health care while holding costs down.”
Article
Nancy Ferris, Government Health IT, 31 January 2008

Information technology improves health care

“We Americans have the most advanced medical science and the best-trained medical professionals in the world, but we are not getting the best possible medical care. Our medical professionals are practicing 21st-century medicine with 19th-century tools. They’re using paper charts that aren’t always where they need to be, with handwritten notes that read like a cipher. They can’t easily compare notes from clinical practice to see what works. As a result, Americans can’t tell how good their care is or how much it costs. They also suffer needlessly from medical errors that could be avoided.”
Article
Mike Leavitt, The Commercial Appeal, 31 January 2008

Report: Incentives key to implementing electronic health records

“Incentives are a key to convincing doctors and hospitals to computerize patient health records, a report by a state task force recommends.
Incentives could include higher payments by insurers for doctors who use electronic records, said task force member James B. Wieland, of the Baltimore health law group Ober/Kaler.”
Article
Examiner.com, 29 January 2008

Electronic Health Record System Could Save Maine $50M Annually

“Maine physicians, hospitals and public health officials on Wednesday unveiled a statewide electronic health record system, called HealthInfoNet, as part of an effort to improve health care quality, reduce medical errors and slow the growth of health care costs in the state, AP/Foster’s Daily Democrat reports. Advocates estimate that the system will save $50 million annually by eliminating duplicate and unnecessary tests, procedures, prescriptions and hospital admissions.”
Article
Medical News Today, 23 January 2008