Friday, September 19, 2008

Need To fix the issue at root...

Hospitals Slow To Help Doctors Adopt EHRs, Study Finds

The federal government has eased physician self-referral and anti-kickback regulations to encourage hospitals to subsidize doctors' adoption of electronic health records, but most hospitals are not taking advantage of the temporary change in policy, according to a Center for Studying Health System Change study released Thursday, Modern Healthcare reports. 

The relaxed physician self-referral and anti-kickback regulations are set to expire Dec. 31, 2013.

Looking at 24 hospitals in 12 representative metropolitan areas, researchers found that only seven hospitals were pursuing a strategy to provide financial or other support to doctors to purchase EHR systems, with just four hospitals reporting that they had begun implementing their plans or that implementation was scheduled for the near future.

The remaining 17 hospitals were in various planning and evaluation stages and did not expect to take action this year.

The report found that the two main factors motivating hospitals to support physician EHR adoption were improving quality and efficiency and "aligning physicians more closely with the hospital."

Hospitals said they were not doing more to subsidize EHR adoption because of the burden of ongoing health IT projects, budget limitations and a lack of physician interest.

The Robert Wood Johnson Foundation funded the study (Robeznieks, Modern Healthcare, 9/18).

Wednesday, September 10, 2008

Can IT Help Hospitals Improve Their Relationships With Community Physicians?

In boardrooms across the country, health system chief executives are searching for any tactic that might better align hospital and physician interests. Downward pressure on physician incomes has placed unprecedented strain on hospital-physician relations. At a minimum, doctors are increasing their productivity by reducing the time they spend on hospital initiatives. On the other of end of the spectrum, some physicians are competing directly with local hospitals through physician-owned outpatient centers. 

From a hospital perspective, this growing disconnect could not come at a more inopportune time. From reining in supply costs by standardizing preference items to enhancing quality on reported metrics by complying with evidence-based guidelines, physicians hold the power to make or break hospitals' most critical priorities. Health system executives have responded by experimenting with a wide variety of strategies to exert greater influence over physicians. 

So what does this have to do with IT? Until the spring of 2007, not a whole lot. That's when HHS and IRS ruled that hospitals and other key stakeholders could subsidize up to 85% of the costs of electronic health records for physician offices. A new hospital-physician alignment strategy was born. Prior to the changes, the Stark Act and federal anti-kickback rules were interpreted to bar hospitals from donating technology or making other gifts to doctors or independent physician practices. 

Hospital leaders theorize that subsidizing EHRs can generate significant goodwill with physicians. They envision a world in which the seamless transfer of information between the physician office and the hospital would encourage doctors to admit patients to that hospital. In its Annual Survey of Executive Opinions on Key Information Technology Issues, 
Modern Healthcare reported that more than 70% of hospitals already extend IT benefits to physicians through the waiver program or plan to do so in the next two years.

Challenges of Physician Office EHR Implementation

While their peer executives celebrated the Stark ruling, hospital CIOs cringed. During recent Advisory Board research on physician office EHR implementation, one hospital IT executive commented, "I used to view Stark as my friend. I could tell independent physicians, 'I would love to help, but Stark won't let me.' ... Philosophically, it's not too hard to argue that the physician office [electronic health record] would be wonderful, but the fact of the matter is that I'm faced with an unlimited list of capital requests just from my own facilities, never mind trying to take on all the needs of physician offices." 

The challenges of implementing EHRs in independent community physician offices are numerous. They include: 

  • Allocating the necessary resources within an already overburdened hospital IT department;
  • Educating physicians on the hardware and infrastructure investment they must make without the hospital's support;
  • Integrating physician office data with information from inpatient systems (which might not be integrated themselves);
  • Accelerating change management within independent community physician offices where the hospital has little or no authority; and
  • Protecting physician productivity (and income) following implementation.

For hospitals subsidizing physician office EHRs, the stakes are high and failure is not uncommon. 

While serving as the National Coordinator for Health IT, David Brailer wrote, "Clinicians who purchase an EHR and who attempt to change their clinical practices and office operations face a variety of risks that make this decision unduly challenging. Implementation failure and partial use of EHRs are commonplace."

Effects on the Hospital-Physician Relationship

To be sure, offering physician office EHRs to community physicians will change the hospital-physician relationship, but not necessarily for the better. Hospital IT departments will effectively become vendors for their community physicians, providing services to doctors for a fee, albeit a heavily discounted fee. 

Because most physicians expect the same level of service and flexibility offered by vendors, many hospitals have turned to a vendor-hosted application service provider model. While outsourcing affords a number of benefits, it limits the hospital's opportunity to build close relationships with physicians and potentially restricts access to patient information. Furthermore, early adopters have found that even when implementation is outsourced, many physicians still hold the hospital accountable for successful deployment.

Beyond any hoped-for improvements in physician-hospital relations, there is genuine value in collecting and communicating information between care settings. Wiring community physician offices with an interoperable office-based EHR holds the potential to elevate care quality by breaking down information silos across sites of care. 

With poor information transfer causing 20% of adverse drug events, there is a clear opportunity to reduce these events and the associated costs through office-based EHR adoption. In order to achieve these community-wide gains, however, a critical mass of physicians must adopt the office-based EHR, and the systems must be interoperable with inpatient systems. 

Unfortunately, securing interoperability is fraught with roadblocks, including the multitude of vendor products, uncertainty over data ownership and physician concerns with patient privacy. As a result, only about a third of family practice physicians with an office EHR have an interface with the hospital, according to a survey conducted by 
Family Practice Management.

Hospital executives viewing EHR subsidies as a powerful strategy for aligning interests with their community physicians should consider that the negative ramifications to hospital-physician relations of a failed implementation might very well outweigh any potential goodwill generated from a successful deployment. Hospitals and health systems hoping to strengthen their relationships with community physicians through EHR subsidies might be better off considering alternative strategies.

Source : Matt Cinque (iHealthbeat)

U.S. Lags Behind Other Countries in EHR Adoption

The U.S. trails other countries in electronic health record adoption, according to a recent Commonwealth Fund report, Modern Healthcare reports.

EHR use in the U.S. increased from 17% in 2001 to 28% in 2006, according to the report. However, if adoption continues at the current rate, it will take more than 30 years to expand clinical support tools to all U.S. physicians, the report states.

Meanwhile, 98% of physicians in the Netherlands, 92% of physicians in New Zealand and 89% of physicians in the United Kingdom have adopted EHRs. In addition, 79% of physicians in Australia and 42% of physicians in Germany have adopted EHRs. 

Canada's adoption rate is lower than the U.S., with 23% of physicians using EHRs (DerGurahian, 
Modern Healthcare, 7/18).

Source : ihealthbeat.

How Long Will It Be Until the Majority of U.S. Hospitals Use EHRs?

Forty-six percent of respondents said they believe that most U.S. hospitals will use electronic health records within 10 years, while 31% of respondents predicted that the majority of U.S. hospitals will use EHRs within five years, according to a new survey by health care technology firm Picis.

Fifteen percent of respondents said most U.S. hospitals will use EHRs within 15 years, while 8% said it will be 20 years before most hospitals use EHRs. 

The survey also found that nearly 90% of respondents said they believe that EHRs are going to "revolutionize" the health care system. 

More than 55% of respondents said patients would be more likely to want to visit a hospital that has an EHR system, while about 3% said patients would be less likely to want to visit a hospital with an EHR system, according to the survey. About 42% of respondents said an EHR system would not make a difference in whether patients wanted to visit a hospital.

Results are based on a June survey of 325 physicians, nurses, IT technicians and hospital administrators. 

Source: Picis

Telemedicine Adoption

Interesting : Online Tool Lets Seattle-Area Residents Compare Health Care Performance

The Puget Sound Health Alliance has launched an online tool that lets consumers research the performance of medical facilities in the Seattle area, the Seattle Post-Intelligencer reports.

The Community Checkup report lets users search for performance data on several health conditions, including diabetes, heart disease and depression. The site also provides information on how consistently health care facilities provide recommended care to patients. 

The Web site includes performance results for 26 hospitals, 14 medical groups and many clinics in the Seattle area. 

The information on the site was compiled using public data from HHS. Later this year, the Health Alliance will publish the second Community Checkup report and update the online information (Black, 
Seattle Post-Intelligencer, 9/9).

Tuesday, June 24, 2008

Long, Winding Road to EHRs Full of Political Twists, Turns

Nice Article found at iHealthbeat

We should stop pretending that there is nothing political about establishing a network with the commendable objective of reducing medical errors. Despite the motivation provided by the Institute of Medicine's report suggesting thousands of lives would be saved by reducing medical errors and despite the thin veneer of bipartisan support demonstrated by former House Speaker Newt Gingrich (R-Ga.) and Hillary Clinton (D-N.Y.) sharing the stage as cheerleaders, we simply do not have a consensus on how to use electronic health data.Most of us like the idea of having new health information tools, but we disagree on how to use them in many areas. The debate is not only between privacy advocates and business interests. It's also about abortion and reproductive rights. It's about the discrimination that exists over sexuality, mental health, disabilities of all kinds and genetics. This is no screed over the U.S.'s piecemeal approach to confidentiality. That's the way we do things here. We cut deals where we can and avoid the issues that are too contentious. We call that incremental progress. And that is the inherent problem we confront as we muddle along in electronic records. The policies we adopt to govern a national system of electronic records will only reflect those political areas in which there is no strong opposition. And that's not counting the debate over technology, which has not been easy either.So the health care system is not likely to get simpler or significantly more efficient any time soon because of electronic records.If we dodge the social issues surrounding the information, what does that leave us with?Let's remember how we got here: The debates over HIPAA -- the source of the neglected first-born electronic health record.
HIPAA Hoppin' Down Memory Lane
The road to EHRs did not get off to a rousing start if you consider that the health care industry couldn't agree on a common billing format. So it asked the federal government to impose one in HIPAA. Medical privacy and data security requirements were the price. Recognizing that medical privacy was a broader issue than health care billing, Congress gave itself three years to pass a comprehensive approach. The environment got messier when Congress failed to pass comprehensive legislation in 1999 as planned. The Senate tried to put something together, but nothing could pass the Senate Health, Education, Labor and Pensions Committee. The Newt Gingrich House did not seriously consider legislation except for a few hearings and a last-minute political exercise to deprive the Democrats of an issue in the 1998 midterm elections.Why didn't Congress act?Abortion. Abortion is always a show-stopper in Washington.Ironically, one of the other reasons was states' rights. In addition to traditional concerns over pre-emption, many states had already imposed special protections for HIV, genetics and other sensitive areas. No one was going to put a cap on the privacy of that information. Even if you put abortion aside, there are other telling examples of our aversion to dealing with the issues raised by more easily sharing health information. The fear of pain is preventing Washington from even discussing state workers' compensation programs. The anxiety in this area is so intense that no one even mentions the fact that HHS has done nothing to develop the HIPAA transaction standard for a first report of injury.
A Makeshift Rule
For those who think bureaucrats like nothing better than to write rules, they do. But you'd be wrong about HIPAA. HHS hoped Congress would expand on the limited language in HIPAA. The department knew that whatever rule it wrote would be complicated and incomplete.And that's what we got. HHS ended up writing a makeshift rule that generated almost a half a million words of regulation and explanation. And it had to stretch to cover health care contractors.Predictably, the rule spawned confusion and hostility from every direction. One problem was that the public was unaware of the new and legitimate ways their health information was zipping around the cosmos.Another problem was that patient data was free prior to HIPAA. New health care industries were born from our new ability to generate and manipulate large amounts of patient data. The cost of entry was relatively modest. Asking for patient permission for data requires money. The HIPAA privacy rule, much in the same way environmental rules changed industrial America, changed the business model for health care. Electronic records will change the business model further.
Live Free or Die
While most of us could easily respond to a choice between health and privacy, i.e., life and death, most of us also would still insist on a certain quality of life free from intrusion. However, we should not forget that the special protections for psychotherapy, substance abuse, HIV, genetics and other sensitive areas did not arise in a vacuum. We're pretty touchy about certain topics either on principle or out of fear of discrimination.A good example of our touchiness was the public outcry in the summer of 1998 when the National Committee on Vital and Health Statistics held hearings in Chicago on the creation of a unique patient identifier mandated by HIPAA. The flap caught policymakers by surprise. After all, a unique patient identifier was the logical way to go to efficiently operate an electronic billing system.Policymakers, however, failed to account for the public's fear of government intrusion and the potential for a national citizen's database. (It's hard to tell how that would play out in today's debate over immigration.) The opposition was so heated and widespread that those in Washington were treated to a congressional hearing in which Ralph Nader and Phyllis Schlafly both testified in opposition to the patient ID. In response to the outcry, Congress imposed and continues to impose a funding moratorium on any work on the patient identifier.This was even before the proposed HIPAA privacy rule was issued in 1999.
Those Pesky States
States' rights helped kill a comprehensive medical privacy bill in the late 1990s. Ironically, that issue is stalling electronic records now.Ten years ago during the congressional debate over medical privacy, Sens. Patrick Leahy (D-Vt.) and Robert Bennett (R-Utah) were trotting out charts showing how states had few or no laws to protect medical privacy.But Congress failed to act by 1999 after raising the alarm that the states didn't protect patient data.Then what happened?States went on a tear to adopt medical privacy laws. Because the states tried to fill the void left by Congress' failure to act, there now is a "problem."
Still No Stomach To Expand HIPAA -- What Now?
There was a growing recognition that the HIPAA privacy rule had to change to meet the new world of EHRs. The National Committee on Vital and Health Statistics, for example, explicitly said that the HIPAA privacy rule was not capable of dealing with all the issues raised by EHRs -- and most notably electronic records controlled by consumers.To be clear, the HIPAA privacy rule was designed to regulate EHRs -- just not all of them and not everyone who had access to them. So here we are 12 years after HIPAA became law. Congress still faces the same issues: abortion and state preemption. But now it also has to confront how to deal with many more organizations and business interests that should be covered by medical privacy rules because of PHRs.However, Congress is not seriously entertaining a HIPAA rewrite. It's trying to reach agreement on the tools for sharing health information and studiously ignoring how political the information itself is. For patients, going to the doctor is ... well ... going to the doctor. The problem is that the information is sliced and diced by regulations and criminal statutes that defy comprehension and planning.We have a 52-room structure (don't forget the territories) with federal floors and Chinese walls but very little in the way of a roof that provides comprehensible protection. And the plumbing is a mess.How do EHRs and PHRs that cross state lines deal with state laws with differing ages of consent and child abuse reporting requirements or state mental health and genetics laws or the state health privacy rules under the Gramm-Leach-Bliley Act or The Family and Medical Leave Act or The Family Educational Rights and Privacy Act ... you get the idea. Congress is trying to reach agreement where agreement can be reached on technology and doggedly leaving the rest of the issues to work themselves out ... or not.So if you thought the HIPAA privacy rule was confusing, brace yourself for privacy regulation in the world of national EHRs. I think we can agree on that.

Source: iHealthBeat(by Dennis Melamed)

Thursday, June 19, 2008

Landmark Survey Finds Low Rates of Physician EHR Adoption

New research published Wednesday in the New England Journal of Medicine found that fewer than 20% of U.S. physicians use some form of electronic health records, the New York Times reports.Experts say the study, funded by HHS and the Robert Wood Johnson Foundation, is more definitive than previous research because it is based on a larger sampling and a detailed survey. Fifty-one percent of physicians in practices of 50 or more doctors said they use EHRs, while fewer than 9% of physicians in small practices reported using EHRs.Physicians surveyed cited cost as the primary barrier to EHR adoption (Lohr, New York Times, 6/19). The study's authors estimate that the cost of transitioning from paper records to EHRs is about $60,000 (Davis, USA Today, 6/19).In addition, 54% of physicians without EHRs said that finding an EHR system that met their needs was a "major barrier" to adoption. Doctors also cited the time-consuming transition to EHRs as a barrier (New York Times, 6/19).
The survey of 2,758 physicians nationwide found that:
42% said their office had purchased an EHR system but had not yet deployed it or were planning to purchase one in the next two years;
13% said they had a basic or partially functional EHR system; and
4% said they had a fully functional EHR system (Ferris, Government Health IT, 6/18).Of the surveyed physicians who use EHRs, the survey found:
86% said the systems helped to avoid medication errors;
85% said they improved the delivery of preventive care;
82% said using EHRs improved the quality of clinical decisions (New York Times, 6/19); and
About 60% of physicians who use more basic EHR systems responded positively to them (Alesci, Bloomberg News, 6/19).The survey also found that physicians who treat more affluent patients were just as likely to adopt EHRs as those who treat low-income patients, although the study's co-author, David Blumenthal, said more research is necessary to ensure there is not a disparity (USA Today, 6/19).The researchers who oversaw the survey recommended that policy leaders look for guidance from other countries whose cost-sharing strategies have boosted EHR adoption into the 90% range. The survey was conducted between September 2007 and March 2008 (Conn, Modern Healthcare, 6/18). Karen Bell, director of HHS' Office of Health IT Adoption, said CDC will repeat the survey using the same survey instrument in the future (Government Health IT, 6/19).
Catherine DesRoches of Massachusetts General Hospital in Boston and the lead author of the study, said, "Clearly the results show we are a long way from universal adoption by 2014." President Bush has set a goal for most U.S. residents to have EHRs by 2014 (Steenhuysen, Reuters, 6/18).Bell said she is "heartened" by the growing response among physicians to adopt EHR systems, noting, however, that the study shows "we are a long way from universal adoption" (USA Today, 6/19).Blumenthal, director of the Institute of Health Policy at Massachusetts General Hospital, said, "We need to get moving a lot faster than we have been if we are going to take full advantage of this technology and realize its promise for medicine" (Government Health IT, 6/18).David Brailer, former National Coordinator for Health IT, called the findings "very encouraging" but noted that doctors are unsatisfied with existing EHR products. He said, "What we see is a deficit in innovation, and that is something innovators and the capital market can address" (New York Times, 6/19).

Sunday, June 15, 2008

Massachusetts Insurer Partners With Google on PHR Project

On Thursday, Blue Cross and Blue Shield of Massachusetts announced that it is partnering with Google Health to allow its members to import their claims data into Google's personal health record tool, the Boston Globe reports.BCBSMA said it is the first insurer to sign on to the PHR program, which it says will help patients manage their medical care (Krasner, Boston Globe, 6/13).Beginning this fall, BCBSMA members could have online access to information on their medications, diagnoses and office visits if they consent to the program and open a Google Health account (Health Data Management, 6/12). However, the level of patients' access to the data also will depend on their health providers' technological capabilities.Steven Fox, a BCBSMA vice president leading the online project, said the partnership could "improve compliance with treatment protocols" (Boston Globe, 6/13).
Privacy Protections
Susan Leahy, spokesperson for the health plan, said, "We do have a confidentiality agreement in place with Google but no business agreement because we are not disclosing (personal health information) to Google for BCBSMA's operations or purposes" (Conn, Modern Healthcare, 6/12).

Americans Want Next President To Prioritize Health IT Efforts

More than half of U.S. residents think the next president should make health IT a top priority, according to a new survey sponsored by Kaiser Permanente, Healthcare IT News reports (Monegain, Healthcare IT News, 6/13).The survey, conducted in May by consulting firm StrategyOne, found that 73% of respondents said the value of EHRs outweighs the associated risks, up from 61% in 2007. In addition, the percentage of U.S. residents who have "seen, read or heard about" EHRs has increased from 43% in 2007 to 57% in 2008.The survey also found that:
65% of respondents said they have gone online to learn about a medical condition (Pulley, Government Health IT, 6/13);
61% of respondents said they prefer insurance companies that use EHRs;
47% said they prefer physicians who use EHRs; and
38% said they have used their insurers' online tools (Healthcare IT News, 6/13). Kaiser, which recently partnered with Microsoft on its personal health record platform, is calling on the health care industry to better educate consumers about the benefits of EHRs.

Source: iHealthbeat

Tuesday, May 6, 2008

Wow !!!! now thats called country wide acceptance.

What Percentage of General Practitioners in Europe Use Computers?

Every general practitioner in Hungary uses a computer, but just 57% of general practitioners in Lithuania report using a computer. Overall, 87% of general practitioners in Europe use a computer in their physician office.

Tuesday, March 18, 2008

New Era on Horizon....Weak & Weaker Continues...

Misys Pays $330 Million to Merge Unit With Allscripts

Misys, the IT software group, is spinning off its healthcare division and merging it with smaller US rival Allscripts to create a more powerful player in the growing market for electronic medical records.
The complex deal, which will see Mike Lawrie, Misys chief executive, become executive chairman of the enlarged group, is being paid for via a share placing of 43m shares to raise £75m.
ValueAct Capital, the US hedge fund and largest shareholder in Misys, will underwrite the 175p a share placing and will enlarge its holding from 19.4 per cent to 25.8 per cent on completion of the deal.
Misys will contribute $330m in cash to the enlarged group and will own 54.5 per cent on a fully diluted basis. Allscripts’ existing shareholders will receive a $330m special dividend following the completion of the deal. The enlarged US group will retain a Nasdaq listing.
Misys will retain control of its banking, Treasury and capital markets division, which will retain its London listing.
The London listed shares of Misys surged more than 18 per cent or 25¾p in lunchtime trading to 167½p as investors noted the significant premium payed by ValueAct to increase its shareholding in the group.
“There is a huge opportunity to capitalise on the fundamental shift taking place in the high growth, ambulatory healthcare sector where innovative technology can improve the delivery of care,” Mr Lawrie said in a statement to announce the deal.
“Combining our businesses will create a company better able to take advantage of this opportunity and to maximise value for both sets of shareholders.”
Glen Tullman, chief executive of Allscripts, said the clinical software sector was growing rapidly. “Merging two of the leading businesses within this sector will create a comprehensive platform of products and services that can better serve a wider range of customers and will capitalise on this opportunity.”
Both groups said the enlarged company would provide a range of software services to the healthcare industry in the US. The merger will create savings of $25m to $30m within three years.
The number of physicians using electronic health records in the US is growing. The federal government is expected to encourage its development and the market as a whole is expected to grow to about $5bn by 2015.
Allscripts is headquartered in Chicago and distributes medications to 40,000 physicians in the US and more than 700 hospitals.
Misys said as well as the share placing it had agreed a new $305m debt financing package to complete the deal, which is expected to increase earnings after its first full year.
The group said trading at its other divisions was ahead of expectations and it expected revenue for this year to be between £479m and £488m compared with £469.7m last year.
The demerger of the healthcare division is the latest upheaval for a company that has faced significant change in the last few years.
Less than two years ago Kevin Lomax, co-founder and significant shareholder of the software group, led an attempt to buy Misys which failed. The collapse of the auction led to the departure of Mr Lomax and the appointment of Mr Lawrie, a veteran of the IT industry, who joined from ValueAct.
Mr Lawrie said on Tuesday the agreement with Allscripts will “transform Misys into a growth company.”
The company said that it would drop dividend payments following this year’s payment at the end of the financial year in May.
ValueAct, which has gradually increased its ownership of Misys in the last two years, welcomed the agreement with Allscripts.
“I applaud Mike Lawrie’s turnround of Misys,” said Jeff Ubben, founder of ValueAct. “This is a major step in pursuit of Misys’ growth strategy.”
Source: Financial Times, London

Thursday, March 13, 2008

What's Easier - Choosing A Spouse Or An EMR?

This is an interseting forum i found on EMR UPDATE. This was the first Post on it.

What's Easier - Choosing A Spouse Or An EMR?
Reply Contact
I would have to say I was more certain about my spouse. I knew right away that she had all of the features I would ever need. No demo's needed. I didn't have to call other users to confirm things or compare demo notes,(I am so dead if she reads this).
The only downside is the implementation has taken well over ten years so far and there have been multiple upgrades that I have to keep figuring out how to use. Also, the damn user manual keeps on changing. Other than that, we are a fully integrated system and have produced three great superbills.
Lowell Kleinman, MD
Another one

OK; here we go. My wife doesn’t read this forum so I can post with impunity.
Return on investment:
The spouse is generally a good ROI, continuing to yield benefits long after the initial investment. Depending upon the spouse, however, the maintenance fees can be staggering. An EMR has a poor ROI.
The spouse is much more costly to terminate than an EMR. However, it’s fun playing the field once the dissolution of the relationship is complete from both the spouse and an EMR. (I must confess; I have had affairs/demos with competing EMRs while still using Medinotes).
Many EMRs allow access via a PDA. This is also a feature of spouses (unfortunately) via the same PDA/cell phone combo. Unfortunately, the spouse doesn’t lock up periodically disallowing contact. .
Ease of use
It’s much easier and enjoyable to push the buttons on a spouse than an EMR. Pushing the wrong button, however, means trouble for days. It simply can’t be resolved by a reboot.
Many EMRs are easily customizable. This is not the case with spouses.
Similarly, the spouse and EMR demos often look great. Once you’ve made the purchase, however, and have hands-on experience over time, the imperfections really start to show. You can sometimes get a fully functional demo of an EMR, but this is much more difficult with a spouse.
Hardware requirements:
EMRs often require larger hard drives with each new release which in this day of cheap hard drives, is easily accomplished. Despite what the Enzyte commercial says, it’s much more difficult to get a larger hard drive to accommodate a spouse.
In addition to increasing hardware requirements with each release, the size of the software also increases. Ditto the spouse (though the software never asks you how it looks in a particular outfit).
You can often acquire a spouse without a vendor. This is more difficult with an EMR. After you demo an EMR which looks horrible, be weary of the vendor who tells you, “but it has a great personality.” You can acquire both, however, now on the internet.
EMRs can cause headaches and crashing of the hard drive. Spouses have headaches and often don’t even allow the hard drive to spin up.

Hope no-one is offended; it’s all in good fun.

If you interested reading all of it.

Wednesday, March 12, 2008

One More on band wagon of PHR.

Aetna Announces Plans for Personalized Online Health Tool

Aetna officials on Wednesday announced plans to offer a new online search tool that will give members no-cost access at to medical information, information on local physicians who can address their needs and cost information based on their medical histories and coverage levels, the San Francisco Chronicle reports (Colliver, San Francisco Chronicle, 3/12).

Aetna developed the service, called SmartSource, in partnership with Healthline Networks, a medical database software developer. The insurer is using information about members' medical claims and diagnostic tests, as well as the topics they have searched for, to tailor SmartSource searches.Aetna will offer the service to employers that purchase health insurance through the company. The insurer hopes to use the program to attract and retain business from companies with concerns about health care costs (Freudenheim, New York Times, 3/12).

About 30,000 Aetna employees have tested the service, and the company plans to expand the service to about two million members by the end of 2008 as part of a pilot program before making it available to all 16.8 million members (San Francisco Chronicle, 3/12).

Privacy Concerns
One of the biggest challenges associated with connecting online research to personal health data is the reluctance by patients to share health information that might be used inappropriately or affect job opportunities and insurance premiums, according to the Times.

Meg McCabe, vice president for online programs at Aetna, said that the new service is secure and that the company will not use any information related to the service to increase or reduce premiums or reject membership applications (New York Times, 3/12).

Aetna officials added that they would not sell or share information or target ads at consumers based on their search history.

In addition, because Aetna is a health insurer, it is required to comply with federal health privacy laws that do not apply to companies like Microsoft and Google, according to Greg Sterling, an analyst at Sterling Market Intelligence (San Francisco Chronicle, 3/12).

Source: iHealthbeat

Monday, March 3, 2008

Google CEO Details Online Personal Health Record Service

Google CEO Details Online Personal Health Record Service

At the Healthcare Information and Management Systems Society's annual conference on Thursday, Google CEO Eric Schmidt detailed a new online personal health record service, called Google Health, the AP/San Jose Mercury News reports (Reed, AP/San Jose Mercury News, 2/28). According to the Wall Street Journal, the Web site, which will compete with similar sites operated by Microsoft and Revolution Health Group, "could boost the nation's fledgling efforts to adopt electronic medical records" (Lawton/Worthen, Wall Street Journal, 2/28).The system will store patients' health records online and allow users to import records from different health provider systems. Google Health also will let users search for doctors and find health care information from Google Scholar, discussion groups and other sources (Mills, CNET News' "News Blog," 2/28). In addition, third-party developers will develop direct-to-consumer services, such as medication tables or immunization reminders (AP/San Jose Mercury News, 2/28).
Privacy Concerns
Some health care professionals have raised concerns about the use of PHRs to sell advertisements and the possibility that the federal medical privacy rule issued after the enactment of the Health Insurance Portability and Accountability Act does not cover records stored online (Wall Street Journal, 2/28).Schmidt said that Google would not share any information with outside entities without the patient's consent. "Our model is that the owner of the data has control over who can see it," he said, adding, "And trust for Google is the most important currency on the Internet."Schmidt also noted that the company will not use advertising to support Google Health and that it is relying on increased Web traffic to make the site profitable. Schmidt compared the new service to Google News, which is not ad-supported.Google is currently testing the PHR service with 1,370 volunteers at the Cleveland Clinic. Schmidt did not specify when the service would be available to the public but said the company was working to release it soon (AP/San Jose Mercury News, 2/28).
Future Partners
Google said that future partners on the project would include hospitals, pharmacies, insurers and other health care stakeholders, including:
American Heart Association;
American Medical Association;
Cedars-Sinai Medical Center (CNET News' "News Blog," 2/28);
Duane Reade (AP/San Jose Mercury News, 2/28);
Long's Drugs;
Lucile Packard Children's Hospital at Stanford University;
Quest Diagnostics;
University of California-San Francisco;
Walgreen; and
Wal-Mart Stores (CNET News' "News Blog," 2/28).

Source : iHealthbeat.