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ABC Radio National Covers The Roll Out Of the NEHRS (PCEHR) and The Report Is Pretty Sceptical. | Australian Health Information Technology

Thu, 17 May 2012 02:00:03 -0400

The following segment was heard on The World Today at around lunchtime. 12:18:00 17/05/2012 AMA flags problems with E-records, six weeks before roll-out The Australian Medical Association says 'all singing, all dancing' patient controlled electronic health records won't be available, when the new system starts in July. The AMA's president Dr Steve Hambleton says he suspects most practices don't have the right software to use the system. The Government says it's already paid millions to help doctors upgrade their systems You can download the audio for the story from this link. http://mpegmedia.abc.net.au/news/audio/twt/201205/20120517-twt03-health-records.mp3 As always there will be a transcript available - probably by the time you read this. This report seems to follow up on a couple of speeches at a conference made by the Health Minister and the AMA President. Here is a report of what went on. E-health rollout likely to be slow: Labor From: AAP May 16, 2012 5:17PM ...

This is the initial part of the post - read more by clicking on the title of the article. David.

Health Law 2.0 Session at Health 2.0 Spring Fling - Boston | HealthBlawg

Wed, 16 May 2012 23:18:44 -0400

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

Patients want to use social media tools to manage health care - amednews.com | Healthcare IT Weblog

Wed, 16 May 2012 22:54:45 -0400

Reblogged from My Lymphoma Journey:

Not surprising as so many of us shop, bank, and interact on the web.The most requested online services:

availability of appointments
appointment reminders
referral to specialists

There is a high level of trust in physicians in contrast to, and not surprisingly, drug companies.

Patients want to use social media tools to manage health care – amednews.com.

Vensa Health adds rich content to patient information | Pulse+IT Magazine

Wed, 16 May 2012 22:45:00 -0400

Auckland-based mobile health specialist Vensa Health (http://www.vensahealth.com) is in beta testing of a new application that will enable clinicians to add richer content to electronic communications with patients. Vensa's M-Site (http://hp.vensahealth.com/SolutionsServices/mHealthforHospitals/MSite.aspx), which is being trialled now with primary care clinics in New Zealand, is a way of attaching a

Device Manufacturing 101: Orthopedic Implants and Instruments | Medgadget

Wed, 16 May 2012 17:09:47 -0400

We’re constantly giving you the scoop on the latest in orthopedic devices from our clinical and design perspective, but have you ever wondered about the steps that go into manufacturing these devices? There’s a lot of work in the process that turns an idea into an actual physical product, and often times it’s something we don’t think about.

During our recent trip to Northeast Indiana, we had the opportunity to visit a number of manufacturing sites and learn the high-tech processes and technology that go into producing orthopedic implants and instruments. Here’s how it works!

Device Manufacturing 101: Orthopedic Implants and Instruments | Medgadget

Wed, 16 May 2012 17:09:47 -0400

Infra-Red Retinal Prosthesis Restores Sight From an Ultra-Thin Package | Medgadget

Wed, 16 May 2012 17:08:25 -0400

Scientists at the Stanford University School of Medicine are developing a new type of retinal prosthesis which aims to simplify the complex surgery associated with existing, bulkier implants. The prosthetic comprises a pair of goggles and an implanted retinal sensor made up of an array of light-sensitive photodiodes.

The goggles incorporate a miniature camera, a pocket computer for processing the camera data, and an LCD screen embedded into the goggles for displaying the data. The LCD screen beams images using laser pulses of near-infrared light to a photovoltaic ultra thin silicon chip implanted beneath the retina. The chip, in turn, translates the infra-red pulses to neural pulses in the retina which can be processed as images in the brain. The key selling point for the new implant is the elimination of wires and cables and the relative simplicity of implantation.

Infra-Red Retinal Prosthesis Restores Sight From an Ultra-Thin Package | Medgadget

Wed, 16 May 2012 17:08:25 -0400

Imaging Software syngo.via Helps Save Time without Compromising Accuracy | eHealthNews.EU Portal / All News

Wed, 16 May 2012 17:00:01 -0400

Siemens Healthcare conducted a study with six customers in Germany, Austria and Spain to quantitatively and qualitatively measure the efficiency of the software syngo.via compared to a conventional Advanced Visualization workstation.

Imaging Software syngo.via Helps Save Time without Compromising Accuracy | eHealthNews.EU Portal / All News

Wed, 16 May 2012 17:00:01 -0400

Tunstall Showcases New Mylife Patient Portal | eHealthNews.EU Portal / All News

Wed, 16 May 2012 17:00:00 -0400

Tunstall Healthcare, the leading provider of telecare and telehealth solutions, is showcasing its latest telehealthcare solutions at this year's Scottish Telehealth and Telecare Congress 2012 event in Glasgow. At the event, Tunstall is demonstrating its new patient portal, mylife, which allows users to access secure information relating to their condition at the click of a button.

Tunstall Showcases New Mylife Patient Portal | eHealthNews.EU Portal / All News

Wed, 16 May 2012 17:00:00 -0400

CIO Unplugged 5/16/12 | HISTalk

Wed, 16 May 2012 16:09:26 -0400

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

The Good Boss

One of my assignments as a young captain was serving as the convoy commander for our combat engineer battalion. We were moving over 250 vehicles across the state of Colorado. Given the size and type of vehicles (Hummers, dump trucks, semi-tractors carrying bulldozers), we covered a good 15 miles of highway end to end.

I missed a turn and inadvertently split my convoy in two. Applying a few off-road techniques, I’d put the pieces back together within a couple of hours. But not before catching the attention of the battalion commander.

At our next stop, I steeled myself for one of the famous ass-chewings our commander was known for. We both stepped out of our Hummers. He looked at me and said, “Carry on, Marx!” He spun back around and climbed into his vehicle.

That was it. And you know what? For me, that’s all it took and he knew it. He purposefully chose a different form of discipline for that situation. Later, he told me that he could tell by the look on my face that I had learned the lesson and understood the gravity. He did not have to say anything more. And he didn’t.

Earlier this year, I posted the Bad Boss. It is always easier to point out the negative over the positive. So what is the Good Boss?

I don’t believe there is a magical checklist of Good Boss attributes. There are too many variables and permutations. Put simply, the Good Boss first and foremost does not follow a checklist. She understands every person is unique and should be treated as such. Just like my commander following my convoy fiasco.

I crowdsourced for input. Here is a compilation of attributes of a Good Boss. This is not research or academia or consultant or stats based on one person’s experience. It is not a checklist. These are ideas, and I imagine they reflect the thinking of your staff as well. Ponder the following and adopt as your situation dictates.

Ensures Appreciation and Value

Thanks subordinates regularly
Demonstrates gratitude in words and action
Rewards success
Personalizes awards and recognition
Listens often
Gives the subordinate glory for success

Mentoring

Takes active interest in the subordinate’s career and guides growth in the job
Teaches the subordinate how to best interact with customers
Encourages professional development and provides educational opportunities
Willing to learn from the subordinate
Hopes one day the subordinate will step into his position
Guides the subordinate to their ultimate goal, even if it means losing them

Fairness

Never steals ideas from subordinates
Always honest and ethical to the core
Does not undermine anyone
Possesses a strong work ethic
Treats everyone without bias (race, religion, ethnicity, gender, age)

Performance

Sets high but reasonable standards and removes non-performers
Gets more out of subordinates than they can get from themselves
Sustains the continuity of the organization by hiring only “A” players
Provides insightful and regular feedback
Elevates performance without the subordinate even noticing
Provides appropriate tools and training for the job

Team

Holds individuals accountable to performance standards so the team does not suffer
Represents team and department with passion and confidence
Makes the subordinate feel proud to be on the team
Takes public responsibility for the action of the team when failures occur

Transparency

Makes themselves transparent and vulnerable
Admits errors and apologizes without excuse
Gets to know subordinate as a person (family, hobbies)
Is in tune with their emotions and not afraid to show it (smile, laugh, cry)
Shares their wisdom in decision making and is open to other possibilities

Vision

Encourages vision
Articulates and lives the mission and values of the organization
Tells the subordinate when to be practical and when to dream

Positive

Remains positive when things don’t go as planned
Always finds the good in bad situations

Individuality

Does not micromanage and allows for creativity and self-expression
Welcomes and supports innovation and creativity
Recognizes individuals strengths and positions people accordingly
Knows when to be the boss, friend, or mentor
Knows when to lighten difficult moments

Style

Leads by influence and not by position
Jumps In the trenches as needed
Walks the talk and shows flexibility
Trusts, respects, and gives benefit of the doubt
Possesses high emotional and social intelligence

Miscellaneous

Promotes work-life balance
Allows for downtime
Able to charm Joint Commission surveyors!

Is this how your employees describe you? Which of these attributes will strengthen your leadership? Remember, one size does not fit all. Treat everyone in the style that works best for that individual and circumstance.

Be the boss! The good boss.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

Hospital at Full Census; Surgery Patients Discharged Too Early? | Lab Soft News

Wed, 16 May 2012 13:31:20 -0400

We need beds. Discharge every patient you can. Most hospital-based physician will be familiar with this refrain. The problem is that it can lead to premature discharges of some patients, particularly post-op ones who may require closer monitoring and sophisticated nursing care. Revenue-driven surgery and poor planning result in some surgical patients being discharged too early concludes a pair of logistical studies conducted by researchers at the University of Maryland (see: Revenue-driven surgery drives patients home too early). Below is an excerpt from the article:

The studies show a correlation between readmission rates and how full the hospital was at the time of discharge, suggesting that patients went home before they were healthy enough. The researchers recommend better planning and other logistical solutions to avoid these problems ....“Discharge decisions are made with bed-capacity constraints in mind,” [said one of the study authors]. “Patient traffic jams present hospitals and medical teams with major, practical concerns, but they can find better answers than sending the patient home at the earliest possible moment,”[he added]. [The studies] found that patients discharged when the hospital was busiest were 50 percent more likely to return for treatment within three days....Surgeons and hospitals are incentive-driven to perform as many surgical procedures as feasible....“The hospital has to maintain revenue levels to meet its financial obligations. Surgeons are working to save lives and earn a livelihood. It’s what they do....“If the hospital says ‘sorry there are no beds available,’ there’s a lot of tension and pressure from both sides to keep things moving.” These problems are much more likely at large hospitals, which tend to provide more advanced, specialized surgeries not accessible at smaller, community institutions,the researchers say. Patients often have to travel a great distance for the procedures, so hospital delays become expensive for both them and the care providers. The study findings cover surgical discharge data from fiscal year 2007 covering more than 7,800 surgery patients who collectively spent 35,500 nights at the facility....Also, he suggests that hospitals increase the flexibility of where patients go post-surgery. Allowing them to be moved to units with empty beds, for example, could also lessen premature discharges.

All of this makes great sense to me. Now comes the interesting part. How are patients and their relatives supposed to convince a surgeon not to discharge a patient prematurely in the face of pressure from "upstairs". The latter often comes from hospital physician executives. The best argument, echoing the discussion in the excerpt above, is that the patient is not ready to go home and stands a good chance of being readmitted. This is an argument that will resonate with a surgeon if it is likely. A good surgeon, in fact, will have an understanding of which patients will do best at home and which should remain in the hospital for a longer stay. A patient's family should stand their ground and appeal a perceived premature discharge if the facts are on their side. Here's an excerpt from an article relating to premature hospital discharge (see: New Medicare Rules Protect Against Premature Hospital Discharge):

As a result of litigation initiated in 2003, hospitalized Medicare patients will now be better protected against being forced out of a hospital before they can be safely cared for at home or in a nursing home. The new regulations require that patients be given notice of their discharge rights on admission (although it can occur up to two days later) and again at least four hours before discharge. If patients or their families believe the discharge will be premature and not in a patient's best interest, they are entitled to an expedited review of the discharge decision. If they request an expedited review, the patient can remain in the hospital without charge at least until noon of the day following an independent agency's review. The independent review agency is called a Quality Improvement Organization (QIO), and the patient must get in touch with its staff by phone or in writing before the close of business on the day the hospital plans to send the patient home. The QIO demands that the hospital give the patient a detailed, written explanation of her medical condition and the basis for the proposed discharge.

EchoBlog Joins EchoJournal | Medgadget

Wed, 16 May 2012 13:28:37 -0400

A community of physicians who are actively involved with our video sharing site EchoJournal now has a collaborative blog where they’re discussing the latest echocardiography videos, clinical concepts and ideas. EchoBlog can be accessed from the EchoJournal website, or directly by going to EchoBlog.com.

If you are a cardiologist, anesthesiologist, radiologist, medical student, or just a person interested in cardiac ultrasounds, EchoJournal is where you can develop your knowledge and consult with others. To learn and discuss, you can watch new cardiac videos that are added almost every day, or you can browse through our video archives. To store or share, you can upload your own clips. The site has a growing membership base, and solid traffic stats. EchoJournal is curated by David E. Winchester, MD, a cardiologist at the University of Florida.

EchoBlog Joins EchoJournal | Medgadget

Wed, 16 May 2012 13:28:37 -0400

Angel Catheter Combines Central Venous Catheter with IVC Filter for Pulmonary Embolism Prevention (video) | Medgadget

Wed, 16 May 2012 12:40:55 -0400

BiO2 Medical has received CE Mark approval for the Angel Catheter, a nitinol inferior vena cava (IVC) filter permanently attached to a central venous catheter, for the use of preventing pulmonary embolism in critically ill patients. The multi-lumen catheter can be used like a normal central venous system for administering medications, fluids or blood products, blood sampling and monitoring of central venous pressure. At the same time it provides pulmonary embolism prophylaxis by means of the attached IVC filter.

The primary patient population is critical care patients in whom anticoagulation therapy poses a high risk of complications, including major bleeding and death, and in which patients are at highest risk of venous thromboembolism (VTE). The filter can be easily removed when the central line is removed, once the danger of VTE has been resolved.

Angel Catheter Combines Central Venous Catheter with IVC Filter for Pulmonary Embolism Prevention (video) | Medgadget

Wed, 16 May 2012 12:40:55 -0400

Cost versus worth of technology in healthcare | HealthBlog

Wed, 16 May 2012 12:40:03 -0400

Two articles caught my attention this week amid of the flurry of news about jobs, the market and the economy. The first, Not retiring at 65: Physician goes from anti-EHR to pro-ACO , was about a 65 year old physician in Tucson who is not only delaying...(read more)

An Update on Altapure’s Ultrasonic Clinical Environment Sterilization System | Medgadget

Wed, 16 May 2012 11:42:54 -0400

Back in February, we wrote about Altapure‘s adaptation of military sonar technology to sterilize clinical environments. During our recent trip to northeast Indiana, we had the opportunity to visit Altapure’s home on the campus of the University of Notre Dame.

Since our last mention, Altapure has been able to not only get their product on the market, but is already working on a newer version of the device that clocks in at 1/3 the size of the current model but has the same power.

An Update on Altapure’s Ultrasonic Clinical Environment Sterilization System | Medgadget

Wed, 16 May 2012 11:42:54 -0400

Nidek AFC-330 Automated Fundus Camera Cleared in U.S. | Medgadget

Wed, 16 May 2012 11:23:00 -0400

NIDEK (Gamagori, Japan) has received FDA clearance to market its AFC-330 fundus camera in the U.S. The unit is an all-in-one system that contains both the camera and the processing computer, negating the need for another machine to remain nearby.

The device is the company’s most automated model, and features automatic alignment along the three axis, uses a lower brightness flash, and has dampened mechanical components, among other advances.

Nidek AFC-330 Automated Fundus Camera Cleared in U.S. | Medgadget

Wed, 16 May 2012 11:23:00 -0400

The device is the company’s most automated model, and features automatic alignment along the three axis, uses a lower brightness flash, and has dampened mechanical components, among other advances.

The Current Health IT and EHR Bubble | EMR and HIPAA

Wed, 16 May 2012 10:39:57 -0400

I had a really great conversation with Shahid Shah, Jenny Laurello and John Moore at Health 2.0 about the bubble that we’re sitting in right now. John Moore’s response to my question, “When do you think the bubble will pop?” was priceless: “Which bubble?” Yes, we might be seeing multiple bubbles in healthcare IT: EHR, HIE, mobile health, etc.

For this blog, I’m most interested in the EHR bubble. Obviously, the bubble in this case is the creation of the $36 billion in EHR stimulus money that’s being handed out thanks to ARRA and the HITECH act. With over 600+ EHR vendors and a limited number of customers (I think there’s about 700,000 physicians in the US), there are going to be quite a few EHR vendors that won’t make it.

With that said, I don’t think the EHR bubble will pop like it has in other industries. In fact, I think the current IT industry bubble is going to be a much bigger problem. What’s amazing to me is how you can make a decent EHR business with only a few hundred doctors. Sure, a few hundred doctors won’t create 10 times return to investors, but those who take a conservative approach to building their EHR company could get by with what I believe is an astoundingly small customer base. Physicians are just that valuable.

Shahid Shah described EHR as a cottage industry and so cottage EHR companies will survive. I’m not exactly sure how he’d described cottage industry, but I think the regional nature of healthcare is definitely an influence on this. I’m sure many could argue that long term this strategy won’t work, but I believe at least for the forseeable future we’re not going to see the EHR bubble pop for a while.

As I think about the EHR companies I know, they all seem to have plenty of cash to make it through meaningful use stage 2 and likely all the way to meaningful use stage 3 at least. We’ll see how the smaller EHR companies do post meaningful use stage 2, but I don’t see any EHR vendors not making it to meaningful use stage 2. They’ll at least make it to MU stage 2. Then, based on their adoption results (or not) we may see a few EHR vendors run out of money.

What do you think? Are we in an EHR bubble? When will the EHR bubble pop? What other healthcare IT bubbles do you see?

Healthcare IT’s Success is Truly in the Eye of the Beholder | EMR and EHR

Wed, 16 May 2012 10:20:08 -0400

I’ve come across few articles recently that really validate the notion that the success of healthcare IT is really in the eye of the beholder, or in some cases, the editorialized results of a study.

Take, for example, the following headlines:

“EHR Use Not Linked to Improved Diabetes Care Quality, Study Finds”
and
“App Improves Diabetes Management Among Teenagers, Study Finds”

I find it hard to believe that if formally connected, the second study couldn’t somehow influence the first. In other words, if a mobile health app can improve diabetes management among teenagers, shouldn’t whatever data that app is capturing transmit successfully to the teen patients’ EHRs for easy access by their doctors? And then couldn’t that doctor digest that information, picking out patterns in the patient’s behavior that is either positively or negatively impacting their diabetic condition and overall health, to better inform care protocols?

I’m taking big leaps of logic here, since the first study found that not only was there no correlation between the use of an EHR and “increased adherence to clinical guidelines for care processes and treatments,” but there was actually a “higher probability of meeting certain targets for blood pressure and A lc levels after two years” at practices without such systems. (Seems like these outcomes might be due more to end-user experience than the technology itself.)

The second study doesn’t even mention EHRs, but I wonder how many of the 20 teens participating in the study see doctors who have this type of technology, how many of those doctors know their patients are participating in the study (all I’d assume), and how many are feeding the app’s info into an EHR.

Surely if a smartphone app is helping a diabetic teenager better adhere to medication regimens, then the EHR their doctor could potentially be using would somehow tie in to better clinical outcomes. Another study to start, perhaps?

The second set of headlines that gives me pause (and kinda makes me chuckle) includes:

“Physician Use of Tablets has Nearly Doubled Since 2011”
and
“Not all Doctors and Nurses are Happy with an iPad in the Hospital Setting”

Neither headline surprises me. We all know that adoption of mobile health tools is growing, if not by leaps and bounds then at least steadily. It would make sense that providers are adopting tablets in relation to this. Every technology has its detractors, so of course not everyone is going to be happy with how an iPad works in a clinical setting, just as not every provider is going to want to install an EHR. I do wonder, though, how the same set of users mentioned in the second article would rate a different kind of tablet if given the opportunity to use one.

I find the first sentence to be kind of hard to believe: “It looks as if most doctors and nurses would rather not touch the iPad at work (or deal with any other kind of tablet computing).” If “most” doctors and nurses would rather have nothing to do with tablets at work, than how can physician use of tablets have doubled since last year?

So you see, the “success” of healthcare IT seems to depend on whose writing about it. I have a feeling the American Forest and Paper Association might be behind the very first one.

This Is NOT ME, I Promise!!! | Dalai's PACS Blog

Wed, 16 May 2012 10:12:00 -0400

Image courtesy of PoorMD.com and DiagnosticImaging.com.

Do visit PoorMD.com for some absolutely hilarious medical cartoons...

Career paths in Health Informatics | Forum Discussions - Health Informatics Forum

Wed, 16 May 2012 09:53:06 -0400

Could you please help me find the career paths in health informatics? currently pursuing BSc in Public health Informatics. what do I study to become a good lecturer in Health Informatics?

Current Trends in the Healthcare Workforce | DrFirst

Wed, 16 May 2012 09:33:41 -0400

A perfect storm is brewing in the healthcare industry. Experienced workers are leaving the industry at a far higher rate than qualified workers are entering — and the medical industry is rapidly expanding. Clinton Wingrove, EVP and principal consultant at Pilat HR Solutions, mentions several factors causing this shift and offers suggestions for how the storm might [...]

Quality Systems Acquires The Poseidon Group | HISTalk

Wed, 16 May 2012 07:23:52 -0400

Quality Systems, Inc. announced this morning that it has acquired The Poseidon Group, an Atlanta-based emergency department information systems vendor. Quality Systems will integrate the Navigator PC and NavigatorWeb EDIS modules into its NextGen Inpatient Solutions small hospital product line.

NextGen Healthcare Inpatient Solutions EVP Steve Puckett was quoted as saying, “This acquisition provides our clients additional value by extending our hospital suite portfolio of advanced solutions to the Emergency Department. This product along with our surgical services suite will help support our rapid growth upward into the community hospital market.”

The acquisition closed May 1. Terms were not disclosed.

Best HI Course Between Karolinska Institutet, Stockholm and City University, London | Forum Discussions - Health Informatics Forum

Wed, 16 May 2012 06:20:02 -0400

What is in your opinion the best Health Informatics course (taking in account also future job opportunities) between the ones offered by Karolinska Institutet, Stockholm and City University, London?

Thanks,

Andrea

Former FDA Commissioner Andrew Von Eschenbach Joins Another Board–Banyan Biomarkers | The Medical Quack

Wed, 16 May 2012 03:10:01 -0400

Banyan Biomarkers provides analytical services to pharmaceutical companies, biotechnology companies and investigators at academic research institutes. The company has a focus on traumatic brain injury and developing assays to qualify biomarkers. BD

Former FDA leader von Eschenbach Named to Viamet Board of Directors

Former FDA Commissioner, Dr. Andrew von Eschenbach Finds a Home on the Board of HistoSonics

Former FDA Chief Dr. Andrew von Eschenbach Appointed to the Board of Directors For BioTime and OncoCyte

ALACHUA, Fla.--(BUSINESS WIRE)--Banyan Biomarkers, Inc. today announced that Andrew von Eschenbach, MD, former Commissioner of the Food and Drug Administration (FDA) and former Director of the National Cancer Institute (NCI), was elected to its Board of Directors.

“Banyan Biomarkers is developing a technology that would revolutionize how we diagnose and evaluate the traumatic brain injuries that are taking a devastating toll on soldiers, athletes, and accident victims. I am eager to contribute to Banyan Biomarkers’ efforts to rapidly bring such hope for a better outcome to so many in desperate need,” stated Dr. von Eschenbach.
http://www.businesswire.com/news/home/20120509005103/en/Banyan-Biomarkers-Announces-Andrew-Von-Eschenbach-Joins

It Is Time For the Readers Of This Blog To Do Some Work And Help With Australian E-Health Openness and Transparency. | Australian Health Information Technology

Wed, 16 May 2012 02:30:01 -0400

As I reported a few days ago we are in the twice yearly process of Senate Estimates Committee hearings. This is an opportunity for Senators to ask bureaucrats and responsible Ministers probing questions on just what is going on behind the scenes in their Department and to try and winkle out some information and accountability. Both NEHTA and the E-Health Team from DoHA attend and are questioned for about 1 hour. It is likely this will be happening in the sessions between Monday 28 May to Thursday, 31 May 2012. It would be fair to say that my experience of having watched the live feeds of the last few years of these Q & A sessions suggests the bureaucrats are really first cousins of Sir Humphrey Appleby of ‘Yes Minister’ in terms of their capabilities to talk for the hour and say essentially nothing despite the best efforts of those asking the questions to have some light shone in the dark internal holes of the Department. From this I have concluded that what is needed...

This is the initial part of the post - read more by clicking on the title of the article. David.

I hope to see you at the #ASCO12 tweetup | Medicine and Technology [part of HCPLive]

Wed, 16 May 2012 00:52:00 -0400

ASCO is the American Society of Clinical Oncology and their annual meeting is coming up June 1-5 in Chicago. I hope to see you at the #ASCO12 tweetup on Saturday, June 2 from 3:00pm - 4:00pm (CDT). This year, the tweetup will be led by:

Dr. Robert Miller @rsm2800
• Trends in Twitter Use by Physicians at the American Society of Clinical Oncology Annual Meeting, 2010 and 2011
• Practical Guidance: The Use of Social Media in Oncology Practice

Dr. Mike Thompson @mtmdphd
• The Role of Twitter and Social Media in Clinical Trials
• Decoding QR Codes for ASCO Posters

Dr. Brian McGowan @BrianSMcGowan
Joining via Skype
• The Meaningful Use of Social Media by Physicians
• Data Highlights from Physician Adoption of Social Media for Life-long Learning

Learn more about the #ASCO12 tweetup here.

MD3 and PracSoft training sessions for Queensland | Pulse+IT Magazine

Tue, 15 May 2012 23:52:00 -0400

Health Communication Network (HCN) (http://www.hcn.com.au) is holding a series of training sessions for users of Medical Director 3 (http://www.hcn.com.au/Products/Medical+Director) and PracSoft (http://www.hcn.com.au/Products/Pracsoft) in Brisbane next month. The training sessions – MD3 on Friday, June 22 and PracSoft on Friday, June 29 – will be held at the Redcliffe

Call for committee nominations for HISA NSW | Pulse+IT Magazine

Tue, 15 May 2012 20:24:47 -0400

The NSW branch (http://www.hisa.org.au/members/group.asp?id=85325) of the Health Informatics Society of Australia (http://www.hisa.org.au) has called for nominations to join its branch committee. Nominees will be elected at the branch's AGM, being held on Thursday, June 21, at St Vincent's Private Hospital's function room in Darlinghurst, Sydney. Nominations open on Wednesday,

Guide to the Patient's Journey | eHealthNews.EU Portal / All News

Tue, 15 May 2012 17:00:01 -0400

In this publication we are welcome to follow editors on a patient's journey through the health care system. Just as you possibly noticed during eHealth Week in Copenhagen, a patient's journey should be well-connected, especially considering the situation today when all too often patients are asking for more coherent treatment. By reading this publication, you will gain new insights into how health care can be built up around a patient's needs.

Guide to the Patient's Journey | eHealthNews.EU Portal / All News

Tue, 15 May 2012 17:00:01 -0400

IMS MAXIMS Electronic Records System Donated to 'Flagship' Cancer Charity | eHealthNews.EU Portal / All News

Tue, 15 May 2012 17:00:00 -0400

A new electronic records system donated by IMS MAXIMS is helping a charity with its highly valued work to support people with cancer and their families. CancerCare, which serves North Lancashire and South Lakeland, is a vital source of advice and information - also providing complementary therapies to improve people's quality of life at a time of stress and worry.

IMS MAXIMS Electronic Records System Donated to 'Flagship' Cancer Charity | eHealthNews.EU Portal / All News

Tue, 15 May 2012 17:00:00 -0400

News 5/16/12 | HISTalk

Tue, 15 May 2012 16:46:47 -0400

Top News

Accretive Health sends a detailed response to Senator Al Franken, who is investigating the company’s hospital collection practices. The company says its primary purpose is to help patients by making sure they use the benefits to which they are entitled, also adding that the company follows HFMA guidelines, including making it clear that services won’t be withheld for financial reasons. Accretive says it complies with all federal laws, including HIPAA, and that all but one of its missing laptops was encrypted and that one was because a now-fired employee messed up. The company also hires a boatload of influential guns-for-hire former politicians to polish its tarnished reputation: former HHS Secretaries Mike Leavitt and Donna Shalala, former Senate majority leaders Tom Daschle and Bill Frist, and former CMS administrator Mark McClellan. Newt Gingrich on Line 1?

Reader Comments

From MT Hammer: “Re: Transcend Services (now Nuance). Medical transcriptionists file a class action lawsuit against the company for labor law violations.” The 13 named transcriptionists claim that Transcend violated federal labor laws by paying them per line of text transcribed or edited but not for related activities such as looking up information, thereby dropping their compensation below the $7.25 federal minimum wage. I’m surprised that Transcend hired them as work-from-home employees instead of independent contractors, but maybe the company provides more direction than would be expected for a contractor.

From David Stock-Man: “Re: Quality Systems/NextGen. Anyone have thoughts on the company missing its numbers and shares getting crushed?” QSII announced preliminary Q4 results last Thursday, with expected revenue for the quarter of $107-111 million and EPS $0.24-0.27, blaming revenue recognition delays for missing expectations and issuing guidance down for the fiscal year. FY2013 guidance calls for revenue and earnings growth of up to 25%. Some folks on the stock message boards are crying foul, saying that pro traders were taking huge put positions in the shares right before the announcement, suggesting the possibility that word leaked out (without having any proof, of course.) Shares that were trading in the $45 range just a handful of weeks ago are down to $30. Above is a one-year graph of QSII (blue) and the Nasdaq (red). Shares have a long track record of steady growth, are now priced relatively cheaply, and the company’s margins are good, so if you’re feeling confident that this is just a bump in the road, you get to buy shares at a discount (and if you’re wrong, you get to lose even more money). All I know is that quite a few of the old-school EMR vendors seem to be failing to meet lofty expectations lately despite billions of taxpayer dollars being spent to help them sell product, so if not now, when?

HIStalk Announcements and Requests

Thanks very much to the 68 readers who donated to support the four young daughters of Epic analyst and long-time HIStalk reader Tim Dodson of Children’s Medical Center (TX), who passed away recently at 34. Including the three of us who matched $250 in contributions dollar for dollar, our total contribution was $5,495, which I’ve deposited to the fund set up by Tim’s wife Wendy for the girls, flagging it with a note saying it came from Tim’s fellow HIStalk readers. I covered the credit card fees, so every dollar you donated went directly to support the children. Those of us who chipped in know that it could have been us who died young and unexpectedly, leaving a family deprived of not only their loved one, but of their primary breadwinner as well. You did good.

Acquisitions, Funding, Business, and Stock

The Trizetto Group announces that its subsidiary Gateway EDI has acquired NHXS, a provider of contract compliance and point-of-service adjudication workflow automation. Gateway will incorporate NHXS’s capabilities into its EDI and RCM offerings.

Wolters Kluwer sells its prescription data business to PE firm Symphony Technology Group.

Simplee, which offers free online medical expense management tools for consumers, raises $6 million in a Series A funding round.

Sales

Unity Health System (NY) selects Phytel’s Atmosphere platform as part of its infrastructure for population health management.

Cape Cod Healthcare (MA) chooses Courion Suite for user access management for its Siemens Soarian system, scheduled for a December go-live.

Stewart Webster Hospital (GA), a 25-bed critical access hospital, selects the ONE EHR from RazorInsights.

The State of Arizona contracts with Mosaica Partners for consulting help in updating strategic and operations plans for the state’s HIE.

Orange Coast Memorial Medical Center (CA) selects PerfectServe’s clinical communication platform.

Hartford Hospital (CT) will deploy OTTR’s transplant system, including the recently announced OTTRvad module for ventricular assist device patients.

Norton Sound Health Corporation (AK) will deploy ambulatory and inpatient solutions from NextGen.

Chesapeake Regional Medical Center (VA) contracts with ICA Informatics to develop an HIE for its integrated delivery network.

Boston Medical Center (MA) signs a five-year license agreement with Streamline Health for use of its business intelligence and analytics solutions in 19 physician group practices, while Bronx-Lebanon Hospital Center (NY) extends its licensing agreement with Streamline Health for five years.

North Texas Accountable Healthcare Partnership (TX) selects Orion Health’s HIE solution to connect its 12,000 physicians.

Advocate Health Care (IL) selects Merge Healthcare’s cardiac imaging and informatics solution. Merge also announces that 12 radiology and orthopaedic practices have selected its EHR products.

Aetna selects Kony Solutions’ KonyOne Platform for its mobile health app.

People

The Massachusetts eHealth Institute names Laurance Stuntz (NaviNet, CSC Healthcare) as director.

e-MDs hires former CO-REC director Robyn Leone as director of public policy and government initiatives.

M*Modal brings on Kathryn Twiddy (Quintiles, Misys) as chief legal officer.

Blair Butterfield (GE Healthcare IT) joins VitalHealth Software as president of its North American division.

Announcements and Implementations

Rockford Memorial Hospital (IL) goes live next spring on the health system’s $40 million Epic system. Rockford’s physician group has been live since last year.

SoutheastHEALTH and Missouri Delta Medical Center join forces to build and manage a $3.5 million networking and data storage center for their organizations and other medical providers. Both hospitals will also install a $12 million Siemens Soarian system over the next year.

Austin Diagnostic Clinic (TX) goes lives on PatientKeeper Charge Capture for its 120 physicians.

Aetna Pharmacy Management offers its members new services based on their prescription claims data: (a) switching to once-per-day meds when appropriate; (b) recommending trying a less expensive single component of a combination drug; (c) flagging prescription that have been taken longer than recommended; (d) sending prescribers a letter for daily doses that exceed that listed in product labeling; and (e) identifying cases where a new prescription may indicate that a previous one caused side effects.

Medical billing and financial management vendor Fi-Med Management says it will expand its services and add 145 new jobs in the Milwaukee area. It says its new software can help hospitals identify over- and under-charging and avoid audits.

Other

Allscripts will train and hire 40 City College of Chicago graduates, whose salaries will be paid by the City of Chicago for their first six months.

Cerner customer The Hospital de Denia achieves HIMSS Analytics Europe Stage 7, the first Spanish hospital and the second in Europe to do so.

A Northwestern Memorial Hospital (IL) employee is charged with identity theft after a police search of her home, triggered by her use of several credit cards to pay her water bill, uncovers the credit card numbers, birth dates, and Social Security numbers of more than 50 patients.

Last weekend I had the chance to snuggle with a relative’s new baby, which reminded me of this recent article. Laptop magazine compiled a list of 15 current technologies that newborns will never see, including wired home Internet, Windowed operating systems, hard drives, the mouse, desktop computers, and fax machines. If I had written the article, I would have put an asterisk by a few of them (desktops, fax machines) and added, “Not applicable to healthcare because providers are resistant to change.”

Sponsor Updates

Surgical Information Systems recognizes five hospital systems with 2012 SIS Perioperative Leadership Awards, among them Holy Spirit Hospital (PA – above.)
Certify Data Systems ranks as a tier one enterprise HIE vendor in the Chilmark 2012 HIE Market Report.
CynergisTek expands its portfolio of offerings to include the HIPAA Surveyor Solution Series and the HIPAA Audit Readiness Solution Portfolio.
AHA Solutions and GetWellNetwork host a Webinar featuring Texas Children’s Hospital and its interactive patient care RFP process.
PatientKeeper awards Ashe Memorial Hospital (NC) its customer innovation award.
EHRConsultant’s AIMSConsultant division provides advice on choosing the right anesthesia information management system.
Informatica releases its Informatica 9.5 platform, designed to maximize customers’ return on big data.
BridgeHead Software will sponsor The Big Event social gathering at the 2012 MUSE International Conference May 29-June 1.
Computerworld honors Lehigh Valley Network (PA) with its 2012 Laureate award and NASCAR Teamwork award for its innovative use of DigitalShare, T-System’s ED patient documentation system that’s based on Shareable Ink technology.
Barrington Orthopedic Specialists (IL) selects NextGen’s EHR, PM, portal, and other solutions for its 15-physician practice.
College Park Family Care Center (KS) selects eClinicalWorks EHR for its 91 providers.
Emerson Hospital (MA) integrates Access Intelligent Forms Suite with its Meditech Magic system.
Kareo upgrades its billing system clients to a new release, which includes enhanced claim scrubbing capabilities.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

St Jude Medical Launches EnligHTN Renal Denervation System | Medgadget

Tue, 15 May 2012 16:18:11 -0400

It seems that renal denervation systems are popping up like daisies these days. Today at the EuroPCR meeting in Paris, France, St. Jude Medical announced CE Mark Approval and the launch of its EnligHTN renal denervation system. Like other renal ablative systems, this one is approved to reduce blood pressure in patients with hypertension resistant to medical therapy.

Similar to the Vessix Vascular V2 system, the EnligHTN has multiple electrodes which potentially saves time during the ablation procedure, as four ablations can be performed without catheter repositioning.

St Jude Medical Launches EnligHTN Renal Denervation System | Medgadget

Tue, 15 May 2012 16:18:11 -0400

GNUmed 1.2 - more screenshots | GNUmed for the masses

Tue, 15 May 2012 15:12:00 -0400

It is time for some more screenshots of the upcoming GNUmed release. Enjoy

Flexure-FET Biosensor Promises High Sensitivity for Medical Diagnostics | Medgadget

Tue, 15 May 2012 13:14:54 -0400

Researchers from Purdue University are reporting in the Proceedings of the National Academy of Sciences the development of a novel new biosensor that combines mechanical and electrical components that together make the device more sensitive than either alone.

The device, known as Flexure-FET biosensor, measures a sample’s mass, size, and electrical charge. If the sample is not charged, the mechanical measurements are still effective, making the sensor applicable in a variety of situations. The device is able to detect DNA fragments and proteins in a sample, making it potentially a highly useful tool in detecting cancer and generally for the growing field of personalized medicine.

Flexure-FET Biosensor Promises High Sensitivity for Medical Diagnostics | Medgadget

Tue, 15 May 2012 13:14:54 -0400

U of Wisconsin to Build Reactorless Mo-99 Medical Isotope Generation Facility | Medgadget

Tue, 15 May 2012 12:39:17 -0400

The radioisotope molybdenum-99 (Mo-99) is a source for the commonly used radiomarker technetium-99m applicable in cancer diagnostics and life science research, but it’s in short supply and there are no American manufacturers of the material. Producing Mo-99 involves bombarding highly enriched uranium (U-235) with an intense beam of neutrons, which normally means you’ll need a nuclear reactor and have to answer to authorities that deter nuclear weapon proliferation to make the stuff. Last year the Canadian government gave $15 million to the Canadian Light Source, a 2.9 GeV synchrotron facility, to develop a method of using X-rays to manufacture molybdenum-99.

Following up on their own $4.6 million investment last year in NorthStar Medical Radioisotopes to do the same, America’s National Nuclear Security Administration (NNSA) has partnered with the Morgridge Institute for Research at the University of Wisconsin to build an $85 million facility that will use an accelerator to generate Mo-99.

U of Wisconsin to Build Reactorless Mo-99 Medical Isotope Generation Facility | Medgadget

Tue, 15 May 2012 12:39:17 -0400

Smart Diabetes Monitor VerioIQ Tracks Glucose Patterns (interview) | Medgadget

Tue, 15 May 2012 12:34:54 -0400

Sometimes it seems that there are almost as many diabetes monitors, or glucometers, as there are people with diabetes (well, not really, but you get the point). Furthermore, each one seems to tout a different set of features that differentiate it from the rest. So when we at Medgadget were approached by the people at Life Scan about their new OneTouch Verio IQ Meter, we were curious to learn more. Described as “the first meter ever that looks for patterns of highs and lows—and alerts you, right on screen, when it finds one,” the VerioIQ is a hand-held monitor with a simple array of four buttons, a color display screen, memory to hold 750 recordings, and bilingual (English/Spanish) capability.

Like most current glucometers, it provides the user a lance to draw blood via finger-prick. This editor was provided with a complimentary review device and found it to be user-friendly, though had to lend it out to a diabetic colleague who was impressed enough with the added features. The key development is the VerioIQ’s PatternAlert system that detects time ranges during a five-day period during which the patient’s glucose is running abnormally high or low, thus virtually eliminating the need for a logbook. For those with extremely well-managed diabetes this is likely not as much of an issue, though it’s clear how patients with more variable glucose levels may benefit.

Smart Diabetes Monitor VerioIQ Tracks Glucose Patterns (interview) | Medgadget

Tue, 15 May 2012 12:34:54 -0400

Appropriate Use of Social Media and Social Networking in Medical Practice | Christina's Considerations

Tue, 15 May 2012 11:26:43 -0400

The Federation of State Medical Boards has released Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice. It addressed the physician-patient relationship, professional and ethical standards and provides recommendations for state medical boards to consider in educating their licensees on the proper use of social media and social networking websites.

The following recommendations are also included:

Physicians should only have online interaction with patients when discussing the patient’s medical treatment within the physician-patient relationship – and these interactions should never occur on personal social networking or social media websites.
Patient privacy and confidentiality must be protected at all times, especially on social media and social networking websites. Although physicians may discuss their experiences in non-clinical settings, they should never provide any information that could be used to identify patients.
Physicians should be aware that any information they post on a social networking site may be disseminated to a larger audience, and that what they say may be taken out of context or remain publicly available online in perpetuity.

One study in JAMA found that 92% of state medical boards in the United States have received reports of violations of online professionalism, so this guidance is really a bit overdue. But, I'm glad both the boards and licensed physicians now have some clearly defined expectations and guidelines for moving forward.

For all of my nursing followers, similar guidance is also available in a previous post.

Making the Case for EMR VARs | EMR and HIPAA

Tue, 15 May 2012 11:18:28 -0400

In the comments of a post by Dr. Gregg, someone made a really interesting case for going with an EMR VAR instead of the EMR vendor itself. Of course, this commenter was named “EMRVAR” which probably means they come from a VAR. So, you have to take these comments with a grain of salt, but their comments are worth considering. Here’s the case they made for VARs.

My Advice: Seek out a VAR – Value Added Reseller that cares more about you and your practice then any BIG NAME EMR CORPORATION that only cares about its stock valuation on any given day.

VARS

A VAR is an advocate for your practice – a Var’s many installs weigh more heavily than any one customer that the BIG EMR Corp has.

A VAR deploys technology from several vendors and adapts these products and services to its customer specific needs

A VAR partners with several product manufacturers and service providers. Though partnerships are formed, it is important to realize that a VAR is an independently owned and operated business that is not bound by any one corporation products, services and policies.

A VAR is often located locally to the communities it serves

The VAR model is important in healthcare and the above comments state a pretty good case for the EMR VAR. I find it interesting that in many respects this is the case that small EHR vendors make as well.

What has been your experience with EMR VARs?

Health 2.0 Boston | EMR and EHR

Tue, 15 May 2012 11:07:51 -0400

I’m in Boston enjoying meeting with a lot of really smart people at Health 2.0. As usual, the biggest value of the conference is the people you meet and the hallway conversations you have with those people. I’ll certainly be doing posts over the next couple weeks related to those conversations.

The other highlight of Health 2.0 was hearing Jonathan Bush speak. He was in true Jonathan Bush form and he’s great because you can guarantee that he’ll never give the same speech twice. As one person said in the hallway, the connection between him thinking it and him saying it is very short. It’s so short that it has no filter. My biggest complaint with Jonathan Bush’s talk was that they only gave him 20 minutes on stage. Not nearly enough.

For those who couldn’t make it, here’s the main points that Jonathan Bush provided:
1. “Don’t bite off more than you can chew.”
2. “You need your partner’s ‘id’ as well as their signature.”
3. “Culture trumps capability.”

This is all really good advice for healthcare startup companies. One other thought from Jonathan Bush:

.@Jonathan_Bush compares entrepreneurial survival to paramedics’ attention to the ABCs…focus on first things first. #health2con #EMS

— Carissa O’Brien (@CarissaO) May 15, 2012

Here are some other good takeaways from Health 2.0 Boston that were tweeted out:

Steve Krein: Introductions are easy, being prepared for the meeting and what follows is hard #health2con

— Matthew Holt (@boltyboy) May 15, 2012

Very good advice and appropriate at Health 2.0 Boston since the focus of it is about partnerships.

The core problem is “uncompensated care.”#health2con

— EMR, EHR and HIT(@ehrandhit) May 15, 2012

There’s a compelling story if you look at how much uncompensated care physicians provide.

Game On! Gamification Tries to Engage Healthcare Providers, Patients | HL7 Standards » HL7 Blog

Tue, 15 May 2012 09:04:45 -0400

The way to a nurse’s heart is through chocolate. Don’t know what I’m talking about? Next Halloween drop your excess bags of candy off at the nearest nurses’ station and see what happens. You’ll probably be reminded of the Discovery Channel’s Shark Week. And we’re not particular. Three pounds of M & M’s is just [...]

The Emerging Role of ACOs; How to Define and Reduce Unnecessary Services | Lab Soft News

Tue, 15 May 2012 08:44:31 -0400

The need to develop an Accountable Care Organization (ACO) is one of the leading priorities of most hospital executives but there continues to be ambiguity about what an ACO is and what it is designed to accomplish (see: Hospital Executives Search for the Formula for an Accountable Care Organization; The End of Health Insurance Companies by 2020?). A recent article in The Atlantic discusses emerging healthcare models and then provides more details about ACOs (see: The 5 Mega-Trends That Are Changing the Face of Health Care). Below is an excerpt from the article about emerging models with ACOs being one of them. Read the whole article if you have time.

As the sweeping transformation in health care takes hold, several models appear to be taking shape. Each has its strengths and weaknesses and each presents opportunities and risks, but the following three deserve serious analysis and represent different points on the risk spectrum:

Bundled payments model: calculates total historical payments for the various components of a bundle and then discounts or at least holds constant that amount, placing the responsibility for cost and quality control in the hands of the collective providers.
Accountable Care Organization (ACO) model: seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients.
Capitation model: sends a fixed per-patient prepayment of premium dollars to a provider in return for medical services....

ACOs. For their part, ACOs are hardly proven, but in theory they should achieve results. The overarching idea is to get patients who aren't being treated in a coordinated manner into a system that can deliver care more effectively. The upsides to ACOs are:

Physicians and other professionals have an opportunity to reap financial benefits of efficiency driven by quality.
Hospitals that get involved can partially make up for declining volumes associated with higher quality and efficiency.
Patients currently accessing services in a disjointed manner are likely to have a better overall health care experience in a coordinated system.
Quality is likely to be enhanced because of coordination and aligned incentives.
Providers will likely increase collaboration. Existing risk-bearing organizations can increase "membership," and many have already developed at least a portion of the infrastructure and have experience managing risk....

The ACO model, if more broadly accepted, could have a major impact on hospitals, especially because the overall goals here are to reduce unnecessary services and provide better overall health care, which would mean less traditional business for them. A prime issue is that costs--for labor, devices, supplies, equipment, and construction--aren't addressed. And the Affordable Care Act exacerbates this situation by creating additional taxes, such as those levied on device manufacturers and payers, that will be passed through to purchasers.

My general impression is that most hospital executives and, in fact, most healthcare professionals like nurses and physicians, don't have any idea about how to reduce unnecessary services. In fact, most of this group might have a hard time even defining unnecessary services. This is because most were trained and have practiced in an era of plenty where greater delivery of services was praised and elimination of services was criticized. Part of the dilemma lies in the fact that all services industries are highly dependent on labor costs (and new technology in the case of healthcare). Both sets of costs are difficult to ratchet down. In my opinion, part of the solution to the reduction of unnecessary services is engaging patients to take more ownership for their own health. Clearly, most of them need some advice about how to achieve this goal. Healthcare consumer education will thus be one of the major goals. Much of this will be accomplished via the web and social media but we have a long way to go to learn how to do it from both the hospital and consumer perspectives.

It’s Time To Check What We Were Promised With The PCEHR Two Years Ago. | Australian Health Information Technology

Tue, 15 May 2012 02:30:02 -0400

Here is the press release - (I have highlighted the important and not delivered bits in italics): Personally Controlled Electronic Health Records for All Australians Australians will be able to check their medical history online through the introduction of personally controlled electronic health records, which will boost patient safety, improve health care delivery, and cut waste and duplication. 11 May 2010 Australians will be able to check their medical history online through the introduction of personally controlled electronic health records, which will boost patient safety, improve health care delivery, and cut waste and duplication. The $466.7 million investment over the next two years will revolutionise the delivery of healthcare in Australia. The national e-Health records system will be a key building block of the National Health and Hospitals Network. This funding will establish a secure system of personally controlled electronic health records that will...

This is the initial part of the post - read more by clicking on the title of the article. David.

InterSystems gets active with HealthShare | Pulse+IT Magazine

Mon, 14 May 2012 22:35:03 -0400

InterSystems (http://www.intersystems.com.au) has extended its HealthShare (http://www.intersystems.com/healthshare/index.html) strategic informatics platform, adding patented new technology called iKnow that allows users to retrieve and use unstructured data such as dictated notes, images and free text. It has also added new Active Analytics technology that enables up-to-the-minute patient data to be analysed

Healthbank upgrades telehealth service, sets sights on expansion | Pulse+IT Magazine

Mon, 14 May 2012 21:50:27 -0400

Clinical software and telehealth developer Healthbank (http://www.health-bank.com) has released an upgrade to its Healthbank Consult (http://www.healthbankconsult.com.au) telehealth service, and is now intent on expanding its market throughout Australia. Healthbank, which markets an electronic health record to clinicians based on its parent company Medtel's WinChart (http://www.winchart.com.au) peri-operative anaesthetic solution,

The Value of the Checklist When Selecting Your EMR / EHR | Medical Software Guides

Mon, 14 May 2012 21:09:00 -0400

By Sheldon Needed

The famous doctor and medical writer/professor Atul Gawande has written extensively on the huge benefits that a simple checklist affords in medicine, in industry, in life: Checklists offer protection against arrogance and forgetfulness, as well as being mindful of every last and important detail. Dr. Gawande explains how surgery, the construction of airplanes, and any other multi-stepped and multi-faceted procedure that involves multiple decisions –each simple, but dependent on each other– benefit from the use of a simple checklist.

That is: Before going ahead with x, perform or check:

By implementing such a simple concept in hospitals, many lives have been saved, industrial accidents have been avoided, and outcomes have improved in many areas. Checklists are “Best Practices” mandated into operating procedures that are enforced. People are often loathe to submit to something so simple as following a checklist srupulously, but it works. It goes without saying that a checklist consulted during the process of medical software selection can yield great benefits as well (it may even, in the very long run, help save lives!)

We, as people implementing complex medical software systems, have to be humble and systematic enough to learn a great deal from this idea:

Before you go whole-hog with a decision to implement a particular EMR / EHR, or before deciding on the type of EMR /PM you want: think it through, weigh the implications of decisions, in other words: make a smart checklist. Don’t be swayed by a glitzy demo. Weigh each critical point and factor it into your decision..

If you have thought these issues through for your practice, and can work up a meaningful checklist about what you need in a product, and which products offer you what you need, more power to you: But many of us are not that clear-headed, especially when we have so many other things to do, and when advertising tempts us with benefits that may or may not be available to us with certain medical software.

If you do not have this checklist in hand or in your head, CTS offers you a thorough checklist, the EMR / EHR DemoScorecard , that is easy to use and completely free of charge: it is excel-based, allows you to choose only the features you need and want to compare, and helps you rate and score vendor demonstrations as you move along in the selection process.

Some of the specific uses of the EMR / EHR DemoScorecard

Perform a pre-demo needs medical office needs analysis to make sure you evaluate the functionality needed to manage your practice
Customize software demos to your exact requirements
Score each software demo based on your ratings of chosen necessary features
Compare features and options for different packages side-by-side
Streamline the demo process and save valuable time
Reduce your risk of selecting the wrong EMR software by developing a fact-based analysis of each program

The areas covered in the medical software checklist include almost anything you might want to consider when making your software selection:
Areas Covered

EMR / EHR
Ease of Use/Learning
Security/HIPPA
Procedure/Diagnostic Codes
Fee Schedules
Insurance Companies
Practice Management Accounting
Work Flow
Appointment Scheduling
Insurance Verification
Account/Patient Information
Billing Claims
Managed Care, Case Management
Hospital Tracking
Clinical Documentation
Document Management Reporting
Training

It is easy to get the Demo Scorecard Checklist at no cost. Just sign up for the CTS Medical software selection kit, and you will be able to download the Demo Scorecard /Checklist right away.

Look at a service that compares high quality EMRs by module such as the CTS Medical Software download kit, and see what different vendors offer in the way of patient portal features.

Curbside Consult with Dr. Jayne 5/14/12 | HISTalk

Mon, 14 May 2012 19:20:22 -0400

Over the last several months, there have been quite a few articles and studies about the growing phenomenon of mobile device distraction. Smart phones, tablets, and other devices have become ubiquitous. It’s almost unusual to see a group dining in a restaurant without devices littering the table. I don’t need to mention the danger of distraction while driving or otherwise being on the street and using a mobile device.

I wasn’t surprised then to see four Tweets in the last 24 hours that addressed the issue. There’s quite a buzz around psychologist Larry Rosen’s book iDisorder: Understanding Our Obsession with Technology and Overcoming Its Hold On Us. Some of his ideas are pretty common sense, such as the recommendation that families should have dinners where technology is not allowed at the table. I do agree with his point that technology might be making us dumber – the “Google effect” may make us less able to remember facts when we know that they are at our fingertips through search engines. His acronym for wireless mobile device (WMD) is accurate when you consider its other meaning: weapon of mass destruction.

Maybe having been required to be accessible 24×7 during my medical school and residency years jaded me, but until the last year or two, I had never been one of those people to compulsively carry my cell phone. Even now I don’t always answer it. Definitely not during a meal or a social event unless I’m on call or waiting for a specific return call.

The advent of the smart phone has made it easier to be in touch, though. I find texting or e-mailing to be less disruptive than taking a phone call as long as it’s self limited. However, when you open your e-mail to send a quick note to your staff or a colleague, it’s awfully tempting to troll through your account(s) to see what else is in there, and down the rabbit hole you go.

Like any other dependency, some have an easier time returning to real-time socialization than others. Some also have a hard time switching from texting-based communication to the traditional written word. This becomes apparent when I work with young people who can barely write grammatically correct sentences, but can text like crazy. In addition, despite having vast social networks, many are isolated when it comes to the skill of face-to-face communication.

An opinion piece in The Wall Street Journal proposes that, “We ought to group these machines with alcohol and adult movies.” I’m not sure I disagree. I’ve had to conduct interventions with parents who can’t seem to understand that their 11-year-old children shouldn’t be playing with an iPhone while I’m trying to take the child’s history and perform a physical exam.

Often, the phone belongs to the child, not the parents. That still baffles me given the cost of a data plan. I’ve had to explain more than once that when parents complain that children are spending too much time on the phone or with video games, it’s the parents’ job to put limits on those items.

What do you do, though, when the offenders are adults? It doesn’t seem like we have collectively developed the skills to police ourselves. I can’t imagine using a Bluetooth phone to make personal calls while performing surgery or surfing the Internet while administering anesthesia. We know it happens, however. I’ve had physicians complain that the EHR makes it to difficult to complete their documentation, one of them as she sat doing holiday shopping on her phone.

Do we need to put device behavior clauses in our medical staff bylaws along with rules about documentation deadlines and appropriate interpersonal behavior? Should facilities create WMD-Free Zones to allow us to decompress? Or do we just throw up our hands in defeat?

Have a suggestion on the wide-open field of WMD etiquette? E-mail me. I’ll try to read it in between surfing the net for animal-print crystal phone cases and signing charts.

E-mail Dr. Jayne.

EHR Design Talk with Dr. Rick 5/14/12 | HISTalk

Mon, 14 May 2012 19:09:43 -0400

Pane Management — Part 1

The quantity of detail is an issue completely separate from the difficulty of reading. Clutter and confusion are failures of design, not attributes of information.

– Edward Tufte, Envisioning Information

We’ve been considering a high-level EHR user interface design that employs multiple panes within a single screen to display all the categories of data in a patient encounter.

In my last post, I discussed how mouse hovers or clicks can be used to expand and contract panes as needed. Excellent reader comments by Dr. Gregg and Dr. Robert Lafsky have made it clear it would be helpful to explore the limits of how much EHR data can be effectively displayed within an unexpanded pane.

In other words, can a relatively small pane present information at a high data density without creating clutter and confusion? Can multiple panes on a single screen be used to display most of the relevant data for a patient encounter, even before expanding or moving panes?

In my T-Sheet post, we explored one advantage of a single page or single screen view of the data. Each category of data is assigned to a fixed location on the page, allowing us to organize abstract data using our highly-evolved capacity to remember things by their spatial location.

A second advantage of a single page or single screen view is that we can rapidly access information by simply redirecting our gaze toward any part of the display. These rapid eye movements, lasting about a tenth of a second, are so integral to the way we take in and process information that most of the time we are not even aware of them.

Because data anywhere on a single page or screen is immediately available by using these ‘saccadic’ eye movements, we can simply retrieve it rather than remember it. Thus, the single screen design largely eliminates both the working memory problem and the cognitive costs of navigation. It also reduces complexity by reducing the total number of EHR screens needed.

For a single screen design to work, however, the individual panes need to be thoughtfully designed. Each pane needs to present a high density of data without clutter. We have already seen one problematic pane design, based on scrolling, that does neither.

Let’s return to the medication data set we’ve been working with. Here is the first part of the medication screen:

This design has lots of problems:

It uses hard-to-read, all upper-case lettering for the drug names and dosages.
The numeric values in the dosage column are not right aligned.
The instructions are written in a form more appropriate for the patient than the clinician.
The instructions present different classes of data (number, route, frequency, and notations) as text rather than in separate columns.
The horizontal lines separating the rows of data are distracting.
There is no way to re-order the medications in the list by importance, class or physician preference.
Other than using all upper-case letters, the names of the medications are not emphasized.
Abbreviations are underutilized.
No effort has been made to eliminate redundant or self-explanatory information.

Many of these problems are improved with the redesign below:

Surprisingly, this small pane display contains almost as much information as the larger display above. Not only is this redesigned pane easier to read, it requires only 30% of the screen area needed for the first design. The redesign also uses the same number of pixels as the problematic pane with scrollbars design. Here are all three designs shown at the same scale:

Many computers now support monitor resolutions of 2.1 megapixels (full HD) or higher. The redesigned pane, at 57K pixels, takes up less than 3% of a full HD display:

By taking advantage of the greater display resolution now available and by using multiple well-designed small panes, the amount of EHR information available in a single screen view can be significantly increased.

Well-designed small panes can present detailed EHR information accurately, efficiently and simply. Multiple high data density panes displayed on a single screen, with each pane assigned to a fixed location, is an extremely powerful design. It allows us to use two highly-developed components of our visual system — our capacity to organize data spatially and our ability to access that data using rapid eye movements — to make sense of complex EHR information.

The take-home lesson is that no matter how good a user interface is, less is better. Eye movements are by far the easiest and most efficient way for humans to access or retrieve visual information. They beat using a mouse or other device to navigate, scroll, or expand panes hands down.

There will still be times, however, when expanded panes are needed. I look forward to discussing this issue in my next post.

Next Post:

Pane Management — Part 2

Rick Weinhaus MD practices clinical ophthalmology in the Boston area. He trained at Harvard Medical School, The Massachusetts Eye and Ear Infirmary, and the Neuroscience Unit of the Schepens Eye Research Institute. He writes on how to design simple, powerful, elegant user interfaces for electronic health records (EHRs) by applying our understanding of human perception and cognition. He welcomes your comments and thoughts on this post and on EHR usability issues. E-mail Dr. Rick.

Meaningful Use Stage 2 Battle Lines Are Drawn | EMR Straight Talk

Mon, 14 May 2012 17:12:52 -0400

Interested stakeholders have submitted their comments regarding the Proposed Rule for Meaningful Use Stage 2. Providers and their professional organizations, vendors and HIT industry associations, and consumer groups advocating on behalf of patients have written detailed—and often lengthy—tomes for CMS and ONC to consider.

Sadly, the overly aggressive nature of the proposed requirements for Stage 2 is pitting providers against patients. Providers, with support from the EHR vendor community, express concern that the bar is being raised too high and too quickly to be practical, while consumer groups argue that we would be missing an opportunity by not raising it even higher. The pleas from both sides are equally passionate and well intentioned.

However, this should not be a battle—the fact that it has turned into one is most unfortunate. I believe that all stakeholders are truly committed to the same goal: higher quality, safer, and more convenient care for patients, provided efficiently and at a reasonable cost. Everyone agrees that meeting these goals requires moving towards increased interoperability and greater patient engagement, but it is the specifics of these requirements—as proposed for Stage 2—that are stirring up the controversy.

We need to advance at a reasonable pace, one that is challenging but not overwhelming. The risk of pushing providers to the point where the requirements are perceived to be unrealistic, unmanageable, and overly burdensome—particularly as incentives dwindle to insignificant levels—is that they will abandon the program as unachievable. If that happens, the continued success of the incentive program will be in jeopardy. No one’s goals will be met.

Meaningful Use Stage 2 Battle Lines Are Drawn | EMR Straight Talk

Mon, 14 May 2012 17:12:52 -0400

Diagnostic Error in Medicine Conference 2012 | Medicine and Technology [part of HCPLive]

Mon, 14 May 2012 17:09:00 -0400

I hope to see you at the 2012 Diagnostic Error in Medicine Conference that will be held at Johns Hopkins University this November 11-14, 2012.

More information about the conference can be found here.

The Diagnostic Error in Medicine Conference (DEM) is dedicated specifically to diagnostic error in medicine. The ultimate goal of this conference is to improve patient safety by reducing the likelihood of diagnostic error in medicine. Minimizing diagnostic error is an essential component of safe patient care, and towards this end the conference activities are organized to summarize the current state of the field, to review active research, and to consider emerging ideas on the education and research agenda that should be implemented to reduce diagnostic error.

The Society to Improve Diagnosis in Medicine is committed to encouraging research, promoting education, and building awareness about misdiagnosis.

Liver Transplant: Patients Can Now be Monitored from their Home | eHealthNews.EU Portal / All News

Mon, 14 May 2012 17:00:02 -0400

Allowing transplant patients to leave the hospital early and recover at home is now possible. ISMETT has launched a telehealth monitoring project for 30 Sicilian liver transplant patients during the post-transplant follow-up period.

Liver Transplant: Patients Can Now be Monitored from their Home | eHealthNews.EU Portal / All News

Mon, 14 May 2012 17:00:02 -0400

East Lancashire Hospitals NHS Trust orders Ascribe's ePrescribing and Business Change Consultancy | eHealthNews.EU Portal / All News

Mon, 14 May 2012 17:00:01 -0400

Ascribe announced the order of their electronic Prescribing and Medicines Administration (ePMA) solution by East Lancashire Hospitals NHS Trust ("East Lancashire"), together with Business Change Consultancy services to assist with associated cultural, IT and process changes designed to improve patient safety and increase operational performance.

East Lancashire Hospitals NHS Trust orders Ascribe's ePrescribing and Business Change Consultancy | eHealthNews.EU Portal / All News

Mon, 14 May 2012 17:00:01 -0400

AxSys Technology Unveils Enhanced Excelicare | eHealthNews.EU Portal / All News

Mon, 14 May 2012 17:00:00 -0400

AxSys Technology has unveiled its enhanced Excelicare clinical IT platform to provide NHS Trusts and primary care providers with a clear alternative to portals and a cost effective way to build electronic patient records (EPR).

AxSys Technology Unveils Enhanced Excelicare | eHealthNews.EU Portal / All News

Mon, 14 May 2012 17:00:00 -0400

Affordable Care Act and Employee Health | EMR and EHR

Mon, 14 May 2012 13:41:02 -0400

Over at healthaffairs.org, there was a super interesting brief on Affordable Care Act and its forthcoming changes regarding employee health. Starting in 2014, employers will be able to offer incentives to employees regarding their enrollment in employee wellness programs. Employers can offer incentives such as monetary rewards for positive employee behavior like enrolling in a smoking cessation program, or joining a gym at discounted rates. Or these can work like the proverbial stick, by imposing penalties on non-compliant employees, e.g. increasing the cost of participating in an employer health plan by $1000 for employees who say they have smoked in the last year.

Now all those good components of the ACA will still be applicable i.e insurance companies will not be able to refuse patients based on prior medical history. But I can’t help but notice the irony of the ACA being used to discriminate between a healthy employee and a sick one.

One of the examples cited in the brief is that it will be legal for an employer to offer a health plan to employees who fulfil certain wellness criteria such as enrolling in a gym in addition to the other health plan options available to its other employees. The cost of the other health plan options to a truly unwell employee could well be so exorbitant as to make it impossible for him/her to enroll in it. Options for such employees could be to enroll through a spouse’s plan or purchase private insurance through the health information exchanges. The brief says that there are plugs for these sorts of employer excesses, such as companies with over 50 employees will be penalized even if one employee enrolls in a subsidized state insurance program in lieu of the company sponsored one.

I’m also wondering if there will be any kind of guidelines for companies to design their incentive/penalty programs. Health and wellness are incredibly nuanced issues. For every person who can exercise a half hour a day and lose a pound a week, there are those who seemingly subsist on air and water and barely make a dent in their BMI. Genes determine plenty of factors in a person’s helath profile, including weight, propensity to develop certain conditions and so on. It makes me wonder if we’re oversimplifying things by gauging employee wellness based on criteria such as gym enrollment.

Plus what if you have lots of people like me who might enroll in a gym and never see the inside of it beyond the first few days? Simple enrollment might not be enough. But, to my mind at least, tying enrollment to outcomes has the unfortunate whiff of a mini nanny state in the making. Who wants to be the person at the company weigh-in whose BMI has come down by .1 while the muscled, rippled company health club employee looks at you quizzically? Not me.

I also worry about the unwell employee who feels pressured into signing up for risky activities (from his/her health perspective), simply in order to get the rewards offered or to avoid the penalties. S/he might have something truly tangible to lose both ways.

I would love to see how ACA transforms in the next couple of years but right now I think I have way too many unanswered questions.

Revlimid Raises Secondary Cancer Risk for Second Primary Malignancies | Lab Soft News

Mon, 14 May 2012 10:45:11 -0400

A new subdiscipline within oncology is getting increased attention -- survivorship (see: Cancer Survivorship, an Emerging Subdiscipline in Oncology; Cancer Survivorship and the Role of PCPs in Continuing Care of Cancer Patients). As cancer increasingly comes to be viewed as a chronic disease, more attention is being paid to the long-term medical problems of cancer survivors such as the drug damage to normal organs and also new cancers secondary to cancer therapy. Here's an account of second primary malignancy risk due to Revlimid (see: Cancer drug Revlimid (lenalidomide) raises secondary cancer risk). Below is an excerpt from the report:

The U.S. Food and Drug Administration (FDA) is informing the public of an increased risk of second primary malignancies (new types of cancer) in patients with newly-diagnosed multiple myeloma who received Revlimid (lenalidomide). Clinical trials conducted after Revlimid was approved showed that newly-diagnosed patients treated with Revlimid had an increased risk of developing second primary malignancies compared to similar patients who received a placebo. Specifically, these trials showed there was an increased risk of developing acute myelogenous leukemia, myelodysplastic syndromes, and Hodgkin lymphoma.

Revlimid is used to treat newly-diagnosed multiple myeloma so its target is, obviously, plasma cells and their precursor cells. It's probably no surprise, therefore, that other myelopoietic and lymphopoietic cell lines could be affected by this drug. All of these cells have a high turnover rate in the bone marrow and lymph nodes. Here's an excerpt from the summary of a scientific article published in Sweden to give you some idea of the scope and scale of second primary neoplasms among patients with haematolymphoproliferative malignancies (see: Second primary neoplasms among 53 159 haematolymphoproliferative malignancy patients in Sweden, 1958–1996: a search for common mechanisms):

The Swedish Family-Cancer Database was used to analyse site-specific risk of second primary malignancies following 53,159 haematolymphoproliferative disorders (HLPD) diagnosed between 1958 and 1996....Among 18 960 patients with non-Hodgkin’s lymphoma (NHL), there was over a 3-fold significant increase in cancer of the tongue, small intestine, nose, kidney and nervous system, squamous cell carcinoma (SCC) of the skin, NHL, Hodgkin’s disease (HD) and lymphoid and myeloid leukaemia. Among 5353 patients with HD, there was over a 4-fold significant increase in cancer of the salivary glands, nasopharynx and thyroid, NHL and myeloid leukaemia, and over a 1.6-fold increase in cancer of the stomach, colon, lung, breast, skin (melanoma and SCC), nervous system and soft tissues and lymphoid leukaemia. Among 28 846 patients with myeloma and leukaemia, there was a significant increase in cancer of the skin, nervous system and non-thyroid endocrine glands and all HLPD except for myeloma.

There are at least three explanations for second primary neoplasms among patients with haemato-lymphoproliferative disorders: a genetic predisposition to later malignancies, lifestyle issues, and the lingering effects of treatment for the first neoplasm. What is certain, however, is that surveillance for secondary neoplasms among these patients needs to be in high-gear. My own view is that such surveillance is best accomplished in specialized cancer centers but I think that many such centers may view their mission as emphasizing treatment over surveillance. However, this attitude is now being modified with greater emphasis on cancer survivorship. This is a welcome change.

Government Healthcare IT Dashboard from ONC | EMR and HIPAA

Mon, 14 May 2012 10:40:30 -0400

One movement that I and I’m sure many of you have seen unfolding by HHS and ONC in particular is what Todd Park calls Data Liberacion. As Todd Park has moved to CTO of the US, I expect he’s going to take the data liberation movement beyond healthcare.

The latest addition to the Healthcare Data Liberation movement by ONC is the Health IT Dashboard that was put up by ONC.

Here’s the description of what’s possible for the website:
The Dashboard currently provides summary information about all ONC HITECH grant programs, and detailed data from the Regional Extension Center, and Community College Consortia to Educate Health IT Professionals programs.

Using ONC’s Health IT Dashboard, you can:

Generate maps of health IT adoption statistics for common groups of health care providers & hospitals,
Examine the impact of ONC’s Recovery Act grant programs implementation at national and local levels
Download and analyze the data for your own research projects.

I haven’t had much chance to dig into the data. As I do, I’ll write future posts on what I find. Also, there’s nothing better than crowd sourcing the look at large amounts of data. So, if you’ve found some data that’s interesting, let us know in the comments.

Weekly Australian Health IT Links – 14th May, 2012. | Australian Health Information Technology

Mon, 14 May 2012 02:30:02 -0400

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 Clearly the big news of the week was the recent Federal Budget. It seems overall that over the forward estimates e-Health (very broadly defined) are being cut back just a little. Go here to see the overall picture. (E-Health is about 1/3 way down the page) http://www.health.gov.au/internet/budget/publishing.nsf/Content/budget2012-glance.htm My sole remaining question is to wonder just what the $33.4M for the present financial year is to be spent on. Seems like a lot for about six further weeks. I guess we will find out in due course. ----- http://www.rustreport.com.au/issues/latestissue/transforming-healthcare-it/ Transforming healthcare IT May 7, 2012 Healthcare is the fastest...

This is the initial part of the post - read more by clicking on the title of the article. David.

AusHealthIT Poll Number 121 – Results – 14th May, 2012. | Australian Health Information Technology

Mon, 14 May 2012 00:48:26 -0400

The question was: Should NEHTA and The E-Health Group From DoHA Be Merged To Form A New E-Health Agency Under Standard Federal Government Controls? For Sure - 16 (45%) Probably - 6 (17%) Maybe - 5 (14%) Definitely Not - 8 (22%) Votes 35 Quite an interesting outcome with almost ½ the votes saying for sure and a good deal more supporting the idea - only 22% strongly against. Again, many thanks to those that voted! David.

This is the initial part of the post - read more by clicking on the title of the article. David.

EMR Data Inaccuracies, EMR and Labs, and the Database of Healthcare | EMR and HIPAA

Mon, 14 May 2012 00:37:58 -0400

As you read this post, I’m probably on a red eye flight to attend Health 2.0 Boston. I’m really excited to attend Health 2.0 Boston. I think Matthew Holt is always interesting and so I hope I get a chance to interview him while I’m there. Plus, I think it’s large enough to bring out some important people, but not so large that you’re overwhelmed and can’t connect with those who attend.

Also, even if you’re just in Boston and not planning to attend Health 2.0 Boston, we’re going to be doing a tweetup on Tuesday evening. I call it the after party. I’m not sure where we’ll do it, but watch @ehrandhit on Twitter and I’ll tweet out the exact time and location for the tweetup. I look forward to seeing all my Boston Healthcare IT friends.

Now, without further ado, some interesting EMR tweets:

5 reasons #data inaccuracies occur in EMRs bradjust.us/J2qqLe #EMR #EHR

— Brad Justus (@Brad_Justus) May 13, 2012

The interesting part of the story linked above is that all of the inaccuracies could happen on paper as well.

RT @withyouDrWu Passive display of lab costs to clinic docs EMR ->less ordering cheaper tests #sgim2012 Horn @CostsofCare

— Vinny Arora (@FutureDocs) May 12, 2012

Reminds me of the announcement that said that physicians order more labs with EHR. I know we implemented the lab cost display in our EHR, and I’m sure that the cheaper tests were ordered, but that was certainly due to the type of clinic that I implemented the feature.

@ehrandhit Liked your thinking in #EHR – Database of Healthcare ow.ly/aHNAl CLOUD sees whole Internet as database 1/2 #HITsm

— CLOUDHealth (@CLOUDHealth) May 4, 2012

The idea of the internet as a database is very interesting. It’s probably too forward thinking to be really practical today, but we’ll definitely get there. It’s just a question of how quickly. We’re already seeing indications of this. It’s amazing what you can build in a weekend using “internet parts” through powerful APIs.

Note: This post has been a meaningful use free post.

Free seminars on NPC and eProcurement | Pulse+IT Magazine

Sun, 13 May 2012 23:00:00 -0400

GS1 Australia (http://gs1au.org) and the National E-Health Transition Authority (NEHTA) (http://www.nehta.gov.au) are hosting seminars in Melbourne and Sydney next week to introduce the healthcare supply chain industry to their latest initiatives in national health supply chain reform and the use of GS1 standards. Purchasers, suppliers and distributors of medicines,

Doubting the cost savings of health information technology | Healthcare IT Weblog

Sun, 13 May 2012 22:47:18 -0400

Reblogged from My Lymphoma Journey:

A post indicating the results of a study that showed that imaging orders increased with computerized health systems, with increased duplication and costs. Concluding quote:

Perhaps it is not enough just to have a health IT system but rather it is the quality of connectivity between health IT systems (coupled with a less litigious environment) that produces the anticipated cost-saving advantages of health IT and the true effects on physician behavior?

Health 2.0 Spring Fling 2012 Tweetstream, Starting with Health Law 2.0 | HealthBlawg

Sun, 13 May 2012 22:44:10 -0400

Health 2.0 Spring Fling comes to Boston this week. The pre-conference code-a-thon is already history. I'm going to help kick things off with a Health Law 2.0 session on Monday. For those who'd like to follow along at home Monday and Tuesday, here's the tweetstream; the hashtag is #health2con.

&amp;amp;amp;lt;a href=&amp;amp;quot;http://www.coveritlive.com/mobile.php/option=com_mobile/task=viewaltcast/altcast_code=5fdd5ee5a5&amp;amp;quot; _mce_href=&amp;amp;quot;http://www.coveritlive.com/mobile.php/option=com_mobile/task=viewaltcast/altcast_code=5fdd5ee5a5&amp;amp;quot; &amp;amp;amp;gt;Health 2.0 Spring Fling 2012 - Boston&amp;amp;amp;lt;/a&amp;amp;amp;gt;

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

HCN training sessions for NSW | Pulse+IT Magazine

Sun, 13 May 2012 22:00:00 -0400

Health Communication Network (HCN) (http://www.hcn.com.au) is holding a series of training sessions for users of Medical Director 3 (http://www.hcn.com.au/Products/Medical+Director), PracSoft (http://www.hcn.com.au/Products/Pracsoft) and Blue Chip (http://www.hcn.com.au/Products/Blue+Chip) in Sydney next month. The training sessions – PracSoft on June 13, MD3 on June 14 and Blue Chip on June 15

MyPractice releases 12.4 update | Pulse+IT Magazine

Sun, 13 May 2012 21:45:00 -0400

New Zealand-based clinical software vendor MyPractice (http://www.mypractice.co.nz) has released version 12.4 of its popular practice software. The new release includes enhancements to its waiting room management function, which allows users to display patients in the waiting room in the order in which they arrived, and to display an arrivals list