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

Nice Article found at iHealthbeat

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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)

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).
Findings
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).
Reaction
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).

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

Why to be Vegetarian

http://video.google.com/videoplay?docid=853667912823391921

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.

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

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
Lowell Kleinman, MD
http://www.drkleinman.com/
http://www.old-fashionedhousecalls.com/
===============================================================
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.
Termination:
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).
Mobility:
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.
Customization:
Many EMRs are easily customizable. This is not the case with spouses.
Demos:
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.
Software:
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).
Acquisition:
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.
Headaches:
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.
http://www.emrupdate.com/forums/t/2068.aspx

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

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:
Aetna;
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.

Proud to Be Gujarati ( From Gujarat State of India)

http://www.youtube.com/watch?v=H6A91F2W7XM

No-Cost EHR Interoperability Testing Software

A no-cost, open-source software tool for testing the interoperability of electronic health record systems will be available to vendors March 21, 2008, Government Health IT reports.The tool, which is being jointly developed by the Certification Commission for Healthcare IT and Mitre, will allow vendors to ensure that their EHR systems can exchange information on patients treated by more than one provider.

The tool, called LAIKA, also will initially support testing of the Health Level 7/ASTM Continuity of Care Document, a core set of patient information including: Name; Address; Health problems; and Medications (Ferris, Government Health IT, 11/9).Mark Leavitt, chair of CCHIT, said, "This project is an important first step in our journey toward testing and certifying the interoperability of health IT systems" (Merrill, Healthcare IT News, 11/9).

CCHIT and Mitre have undertaken this open-source project without government support, Government Health IT reports.Developers will demonstrate the tool at the Feb. 12, 2008, CCHIT meeting (Government Health IT, 11/9).

Source: iHealthbeat

Microsoft Acquires Health Information Technology From Global Care Solutions

Microsoft today announced it would acquire software and intellectual property from Global Care Solutions, a health-information systems developer based in Bangkok, Thailand. The financials of the deal were not divulged. acquires care from global health information microsoft solutions technology

The privately held company's information technology will partner with Microsoft to provide hospitals around the world with resources to more efficiently manage scheduling, medical records, and billing in a multitude of languages.

Global Care Solutions originally developed its system with Bumrungrad, an internationally acclaimed hospital out of Bangkok, in mind. The facility treats more than 1.2 million patients from 190 countries annually. The GCS system aids the staff in managing clinical workflow so efficiently that it boasts an average wait time of 17 minutes.

With the technology giant virtually in the news every day, shareholders haven't responded to the acquisition in an overly dramatic way. As of 12:15 p.m., MSFT is at $34.80, down 0.63%, yet notably trading more than 17% above its 80-day and 160-day moving averages.

Source : IB times

Docs need EHRs, but shouldn't count on ROI

The “tipping point” for placing electronic health records into physician practices has already been reached. But the probability of seeing any return-on-investment after implementation remains years away.

William Bria, MD, chief medical information officer at Shriners Hospitals for Children, voiced these opinions at the HIMSS Virtual Conference & Expo on Tuesday. Bria headlined an education session at the event entitled “How to Introduce the EMR in your Office with Minimal Bother. ”

“Implementing an EHR system is not a minimal fuss for a practice, it’s a major fuss,” said Bria, who also serves as chairman of the board of the Association of Medical Directors of Information Systems. “If done poorly it can be a disruptive mess.”Bria emphasized the complexity of turning a paper-based practice into a digitized healthcare space, but he stressed that major gains in patient care could be achieved, so long as workflow was optimized.

“The workflow aspects of healthcare are similar in complexity to those in aerospace,” he noted. “When you talk about automating a medical practice, that complexity has to be given some respect.”Bria cited research by the Indianapolis-based Regenstrief Institute that found physicians using EHRs only spend about 0.43 additional minutes with each patient, when duplicate and administrative tasks are taken into account.

And those physicians surveyed firmly believed that information technology improved patient care, Bria added. Determining the ROI associated with EHR use is difficult for physician practices, Bria told conference attendees. The “real” cost of implementation isn’t just the investment in computer hardware, software, and vendor support services.

“The hidden cost of an EHR is the amount of time you’re going to have to spend changing your practice as a result of implementing,” Bria said. “You will be inefficient initially as a result of the change. That’s why an EHR implementation is a long-term process.”It’s important for physicians to ask tough questions of EHR vendors, Bria affirmed. He said that the EHR certification process run by the Certification Commission for Healthcare Information Technology could make purchasing decisions easier.

Nevertheless, physician practices need to more clearly explain their day-to-day workflows to vendors. “Physicians need to tell a vendor’s sales staff exactly how their practice works and what they need from EHR software,” said Bria. “You need to ask a vendor specific questions.”Some of those questions might include: Does an EHR automate suggestions or orders for common health screenings (such as vaccinations and cancer screenings)? Will it allow data input by “less-expensive” employees in the physician practice (as opposed to physician-only input)? Will the EHR provide high quality actionable data for all of the providers? No ambulatory EHR product is a good fit for every practice, Bria said, and no single system provides perfect clinical decision support.

For this reason, Bria cautioned that physicians should not assume an “automatic diffusion of improved quality of care” after buying an EHR. “I’ve been doing applied medical informatics for 30 years, and the match between the technology and what we do as physicians is not yet where we need to be,” said Bria. “But that doesn’t mean you should wait [to implement healthcare IT]. You just need to get involved and make sure a product is configured to your practice’s needs.”


Source: Healthcare IT News

Device Makers Push Bill To Reimburse for Telemedicine

Device Makers Push Bill To Reimburse for Telemedicine

The Advanced Medical Technology Association is pushing legislation pending in the Senate that would require Medicare to reimburse physicians for remotely monitoring patients with chronic diseases, which the group argues can enhance care and reduce hospitalizations, Government Health IT reports.

AdvaMed is trying to get the bill, with some of its coverage scaled back to reduce costs, included in the Medicare bill being drafted in the Senate Finance Committee.To support its position, AdvaMed released a report, called "Telehomecare and Remote Monitoring: An Outcomes Review," which details the Veterans Health Administration's advanced use of telemedicine.

The report notes that some studies on the benefits of remote patient monitoring do not rigorously compare patient outcomes of those with home monitoring against those without. The report also acknowledges that some costs will increase as a result of remote monitoring.

However, the report concludes that evidence shows remote monitoring "may be one of the only economically viable ways to manage an aging population, the prevalence of chronic disease and the growing constraints on health care spending" (Ferris, Government Health IT, 10/31).

WellPoint, Zagat To Launch Online Physician Rating Tool

Health insurer WellPoint, which provides benefits to about 35 million people, and Zagat Survey on Monday announced that they will launch an online physician survey tool in January 2008 to let their members rate their experiences with doctors, Indianapolis Star reports (Lee, Indianapolis Star, 10/23).

WellPoint members will be able to rate physicians on a zero-to-30 scale based on:

• Availability;
• Communication;
• Office environment; and
• How much members trust them (Reuters, 10/22).

WellPoint said that each entry on the Web site will contain a physician's contact information, the scale ratings for each category and the percentage of members who recommend the physician (Fuhrmans, "Health Blog," Wall Street Journal, 10/22).

Patients also can include comments or recommendations, although the system will have a filtering process to restrict inappropriate information, Jason Gorevic, WellPoint's chief marketing and product officer, said.

Reaction

Physicians and consumer advocates say that while the online tool could offer useful consumer information, the ratings will not measure the quality of medical care, the Star reports.

Deanna Willis, an assistant professor of family medicine at Indiana University, said, "The people who are going to be motivated to go and do something like this are going to be really happy or unhappy ... The voice in the middle is more likely to get lost."

Jon Marhenke, president of the Indiana State Medical Association, said that physicians could learn about flaws in their appointment scheduling systems but added that the site will not be an indication of the "quality of medical care provided."

Ron Pollack -- executive director of Families USA, a consumer group -- said, "While I'm in favor of more information, I'm not sure this information might not turn out to be misleading."

Gorevic added that the ratings are not meant to replace information on quality and costs (Indianapolis Star, 10/23).

Now this what i am looking forward to : Virtual reality technology will find buyers in healthcare industry

virtual reality applications have experienced double-digit growth both worldwide and in the U.S. since the turn of the century, and the 2010 U.S. market for virtual reality in surgery, medical education, therapy and other areas will grow to $290 million, according to a new report from research firm Kalorama Information.

Kalorama’s report, entitled Virtual Reality Market in the US Healthcare Sector: Markets for Remote Surgery, 3D Modeling, Pain Distraction and Other Applications,claims that VR applications have “revolutionized” the global healthcare industry.

The report surveys the current U.S. market for VR applications including growth factors and trends, forecasts, and a demand-side analysis demonstrating the drivers for VR applications.

Kalorama notes that VR applications provide opportunities to perform medical tasks in a risk-free environment and make training assessable to large numbers of students. VR simulators also allow medical professionals to remain up-to-date on the latest technical procedures required in their profession.

Current VR applications assist in numerous medical modalities from pre-operative planning and robot-assisted surgery, to medical curricula to teach anatomy of body parts. VR also allows for the visualization of medical data that can be integrated and simulated into 3D models to gather insights into the cause and effects of injuries. VR is even used as an alternative therapeutic for pain and depression, and can replace or reduce pharmaceutical usage in some cases.

“While still at a very nascent stage of commercialization, VR technologies are being widely used by the Department of Defense, medical schools and hospitals, and manufacturers of medical equipment on a variety of levels with significant benefit,” notes Steven Heffner, executive publisher of Kalorama Information. “The establishment of industry standards should lead to rapid commercialization of products, and ongoing technological advancements will only further the market, particularly in the surgery segment.”

Source: Healthcare IT News

Unique Experience of American Banking Customer Service.

Yesterday, I had very unique experience of Customer Service of a Large Bank and Mathematical Skills of the people who are efficiently helping people who called customer service.

Scenario: ( the data used is to illustrate the example)

Time : 9:00 pm

Krishan checks his bank statement online and see some error in interest rate that has been applied and decided to call the customer representative of the Bank.

( in btw error was...... They gave $3 interest rate on $ 1200 last month where as they gave $ 2.80 interest on $1500 Current month.....with fixed interest savings account)

The ring goes and then Polite computer voice tells you all the deals they have and i can do banking online and all crap....and since i tried all the digits on phone finally they transferred to me to Person but before that i have to enter my 16 digit account Number and last 4 digit of SSN. Now you assume that person who picks up phone knows this already but noooooooo..

He like This xyz bank how can i help you( very lazily...no enthusiasm and i thought may be he is hungry as its dinner time so i said i am fine as long as he can answer). I explained him the above interest error scenario. The first answer he gives me is... Sir, Interest can go down..... I told him if you don't know about your own bank's saving account that it has fixed interest rate. Then he is like sir, you must have withdrawal money out of account that can reduce the interest. And i was like can't u see on your screen the balance you are giving me interest rate on is higher than last time and that says it should have higher interest than last month regardless i withdrew money or not... He is like Sir did you calculate Interet rate that it is actually correct or not....( as if i am free and just decided to call him to say hi...how are you doing..... how is your day going ).. I said...forget about using calculator...If the interest rate stays same ..then if your balance increased over the period of the time you get higher interest not lower....He is like computer calculates our interest.....(I am like....can't he see its wrong.)..then he just stopped talking all of sudden and i thought he must be checking something.....so i waited like 5 min on the phone ( no hold music nothing)....now i was like something is wrong...i keep on saying hello you there...no response......( it seems that he put on mute and went to get dinner or something)....... after 10 min i hang up and called again.

Now guess what same whole thing again............................but this time the guy who was on the phone was nice....and he assumed that i am smart enough to calculate interest and i am right and he is like i will put you on hold for a while.....he comes back and say i will transfer you to some department he said and those people will take care of it. and Transferred me to this other dude.

and he like this is XYZ bank how can i help you....( I am like ohhhhhhhhhhhhh my GOD......not again i don't want to tell whole this again)....i did the whole story again...he again gave me crap of computer can't be wrong, you must have withdrew some money & interest change... And i am like ..........look this is the third time i am explaining all this and if you don't understand what i am trying to tell you please transfer me to someone who can understand...and this is the last time i am trying to explain you.
--- I have not withdrew any money of this account everrrrrrrrrrr so forget abt just last month
---- this account has flat fixed interest rate....doesn't change.
----- Simple Math rule....higher balance get higher interest than lower balance with same interest rate.

Again...he is like i have to do some research....he goes come back again.....it seems there is a mistake we will adjust your interest and will get u letter.

So out all this 1 & 1/2 trouble.. i was like can you please even tell me how can this happen....he is it must be computer....( i am like oh my god...another gebbsy coding......)

BUT LEARNED SOMETHING VALUABLE ......CHECK THE INTEREST RATE EVERYTHING MONTH....SORRY CORRECTION...CALCULATE YOUR INTEREST RATE EVERYTHING MONTH THAT IT IS CORRECT........

AND TAKE LARGE CUP OF COFFEE WHEN YOU CALLED BANK SUPPORT WITH SOME SIMPLE MATH PROBLEM.....

P.s. Still haven't got that interest adjusted to account...so looking forward to this utmost satisfying experience again tonight.

Have Online Consumers Used Health Search Engine Sites To Find Health Information?

Seventy percent of online consumers surveyed said they have used a Web-based search engine to find health-related information, but just 7% of online consumers surveyed said they have used a health-specific search engine, according to a survey by Forrester Research.

Fifty-nine percent of respondents who reported using a health search engine were ages 41 years old or younger, according to the survey.

In addition, consumers who have used a health search engine reported higher technology optimism and ownership of broadband connections.The survey also found that 31% of online consumers who have used a health search engine said that the health information they find online often is difficult to understand, compared with 13% of respondents who have not used a health search engine.

In addition, 32% of respondents who have used a health search engine said they find the amount of health information available online intimidating, compared with 14% of respondents who have not used a health search engine, according to the survey.Results are based on a Q2 2007 survey of 5,551 online U.S. consumers.

Source: Forrester Research

Microsoft joins lawmakers, activists to demand patient privacy rights

Lawmakers, corporations and activists joined today to urge Congress to protect patients' medical privacy rights. Activists say such rights are not adequately protected, especially when it comes to electronic health records.

At a Capitol Hill briefing sponsored by the Coalition for Patient Privacy, at least 46 states, national organizations and corporations, including Microsoft, petitioned Congress to include adequate patient protection in any healthcare IT legislation it may pass.

Today's request is based on the Coalition's extensive 2007 patient privacy principles and calls for privacy that applies to all health information regardless of the source, the form it is in, or who handles it.

According to Deborah Peel, MD, founder and chair of Patient Privacy Rights, the Coalition
developed the privacy principles to serve as standards for legislation. Today's effort is just a small part of a greater effort to curtail passage of currently proposed federal healthcare IT legislation that Peel said offers consumers no control over access to personal health information.
Today's briefing follows the coalition's endorsement of Microsoft's new patient-protected personal health record platform announced last week - a product Peel said is based on the coalition's privacy principles.

Frank Torres, consumer affairs director at Microsoft said protections such as those defined by the oalition are needed to ensure the creation of a healthcare IT ecosystem that consumers can trust. "We can empower people to lead healthy lives, while putting them at the center and in control of their health information," Torres said.

In Peel's view, privacy protections must follow the data. "There should be no secret health databases, and no one should be able to access personal health information without informed consent," Peel said. "All Americans want their children and grandchildren to be judged on their abilities, not on their health or genetic records."

Rep. Ed Markey, (D-Mass. ), chair of the House Privacy Caucus, was a speaker at today's briefing and one of the signers of the letter to Congress.

"Medical information is probably the most sensitive and personal information that we have about ourselves," Markey said. "Without strong privacy safeguards, a health IT database will become an open invitation for identity thieves, fraudsters, extortionists or marketers looking to cash in on our medical histories."

Markey said he would be working with Congress to craft legislation that both promotes the use of healthcare IT and preserves patient privacy. "A nationwide, seamless, effective health IT network holds tremendous promise in terms of better coordinated care, reduced medical errors and reduced costs," Markey said, "but in order to fulfill that promise, such a network must have tough privacy safeguards."

Source : Healthcare IT News