Telehealth Monitor

In the first quarter of 2009, chief information officers experienced significant IT budget revisions, according to a survey by Gartner.

The IT research and advisory company’s survey of 900 CIOs was conducted March 1 to April 30, 2009, and sought to gauge the potential impact of macroeconomic concerns on IT budgets. The results were compared to results of the Gartner Executive Programs (a membership based organization of more than 3,600 CIOs worldwide) 2009 CIO Survey, conducted from September to December 2008, which had more than 1,500 responses.

CIOs in the original survey reported a flat budget with a minor increase of 0.16 percent. CIOs responding to the survey in the first quarter of this year now report a weighted average decline of 4.7 percent. More than 90 percent of firms changing their budgets made a reduction in the first quarter, with the average reduction being 7.2 percent. Fifty-four percent of respondents reported no change in their IT budget, with the remaining 4 percent reporting an increase in their IT budget.

via Survey: Healthcare saw budget increase in first quarter of 2009 | Healthcare IT News.

Even as the healthcare IT industry awaits the official definition of “meaningful use” from the federal government, a new report from KLAS examines which electronic medical record products should fit that description.

The report, “Meaningful Use Leading to Improved Outcomes,” assesses how well core clinical vendors are delivering solutions for CPOE, nursing automation, medication administration and other key areas.

Nine EMR vendors are profiled in the report: Cerner, CPSI, Eclipsys, Epic, GE, McKesson, Meditech, QuadraMed and Siemens.

via No vendor is perfect on ‘meaningful use,’ report concludes | Healthcare IT News.

THE only hurdle for creating a digital database of US medical records is the adoption of federal rules to guide the effort because the technology is already in place, Perot Systems Corp chief executive Peter Altabef said.

Perot Systems, founded by former presidential candidate H. Ross Perot, provides technology consulting to health care providers and other customers. The company is based in Plano, Texas.

Discussing why few hospitals and doctors had fully digital records, Mr Altabef, 49, said: “The kinks have been ironed out.

“This isnt really a technology question as much as a policy and standards question. From a technology standpoint, this is not putting a man on the moon, this is not creating a Manhattan Project. This technology in large part already exists. Its really just making sure people know what to do and have the funds to do it.”

via Policy holds up US medical records | Australian IT.

THE COST CONUNDRUM

What a Texas town can teach us about health care.

It is spring in McAllen, Texas. The morning sun is warm. The streets are lined with palm trees and pickup trucks. McAllen is in Hidalgo County, which has the lowest household income in the country, but it’s a border town, and a thriving foreign-trade zone has kept the unemployment rate below ten per cent. McAllen calls itself the Square Dance Capital of the World. “Lonesome Dove” was set around here.

McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.

via Annals of Medicine: The Cost Conundrum: Reporting & Essays: The New Yorker.

Experience fostering health IT in Virginia informs the new technology chief’s wide view of innovation

The Obama administration’s top technology official said he will actively support the efforts of Dr. David Blumenthal to advance the adoption of health information technology, one of the president’s priorities for health reform.

Aneesh Chopra said he would use his position in the White House as the country’s chief technology officer and assistant to the president to support Blumenthal, the national health IT coordinator, by concentrating on innovation, digital security and “pushing the levers of government.”

Before accepting the federal position, Chopra was secretary of technology for Virginia. The Senate approved his nomination in May.

via Chopra will use CTO position to advocate for health IT — Government Health IT.

As President Barack Obama prepared to meet with Congressional Democrats Tuesday to discuss healthcare reform, the White House Council of Economic Advisers released a report that highlights both the upside and the downside of technology.

On the plus side, healthcare IT could lead to high-value care by providing key information to providers rapidly. The the down side includes the overuse of diagnostic technology such as MRIs.

“For many types of medical conditions, a patient may have a choice of several methods or treatments, each having different benefits or risks,” the council noted. “Systematic examinations of the merits of different treatments and dissemination of the results of those examinations to patients and providers is one mechanism for promoting high-value care.  Health information technology may play an important role in increasing the rate at which new information broadly diffuses to providers and is incorporated into practice behavior.”

via White House report highlights ups and downs of healthcare technology | Healthcare IT News.

The Certification Commission for Healthcare Information Technology has published on its Web site the criteria and test scripts developed during 2009, along with a newly developed “Concise Guide to CCHIT Criteria.”

The guide maps the criteria to the characteristics of a qualified electronic health record as specified in the American Recovery and Reinvestment Act of 2009 (ARRA) and highlights the 2009 criteria changes. The commission is also planning to transition its certification program timelines to adapt to the new requirements of ARRA.

The criteria, released on May 29, pertain to ambulatory (office-based), inpatient (hospital-based), enterprise and emergency department electronic health records. CCHIT also published criteria for the new stand-alone electronic prescribing certification, the ambulatory add-on options in child health and cardiovascular medicine. The accompanying “Concise Guide to CCHIT Criteria” is specific to the ambulatory and inpatient criteria.

via CCHIT at work on new timelines, new programs | Healthcare IT News.

President Obama will meet with influential Senate Democrats on Tuesday to discuss overhauling health care, as the White House releases a report asserting that revamping the system would increase the income of a typical family of four by $2,600 in 2020, and by $10,000 in 2030.

The Democrats on two Senate committees that are drafting health legislation have been invited to the White House to meet with Mr. Obama, hours before he leaves for the Middle East and Europe. As part of a push to secure Congressional passage of a bill this year, the administration will also make the case on Tuesday that reforming health care is critical to fixing the economy.

“If we don’t do this we’re going to be facing a real mess 30 years from now,” Christina Romer, the chairwoman of the White House Council of Economic Advisers, told reporters Monday on a conference call to discuss her new report, “The Economic Case for Health Care Reform.”

via Senators Set to Visit White House to Discuss Health Care Overhaul – NYTimes.com.

From the same engineers that designed Google Maps comes an online collaboration tool called Google Wave that attempts to answer the question: What would email look like if it was invented today, instead of some 40 years ago before the Internet even existed? Some have called Google’s answer to that question a Twitter-killer, but given the application’s status as an open-source project, it could have far greater implications.

via What happens when Google Wave hits Google Health? | mobihealthnews.

To his frustration, Steven Schwartz often encounters patients who have no idea what each of the pills they’ve been popping is called.

“But usually they can tell you what it looks like,” the Georgetown University Medical Center family practitioner said. “They might say it’s a blue, triangular pill for hypertension.”

Armed with an iPhone, Schwartz is able to play detective.

He uses an application called Epocrates to input pill characteristics, such as color, shape and clarity. The software replies with a list of medications and images that match those criteria, allowing him to deduce what the patient is taking.

via Doctors and Medical Students Embrace Smartphones – washingtonpost.com.

A recent study showed that 64 percent of doctors use smartphones, such as an iPhone or a BlackBerry. Medical schools, such as Georgetown University and Ohio State University, are beginning to give them out to students.

And I can certainly see the allure. They’re more powerful than PDAs, and there’s a wealth of medical applications that are being written for the devices. More importantly, they can replace several devices – namely, the PDA, phone, and pager – and instead of a Batman-like belt of electronic tools, doctors can simply carry one.

via Will smartphones replace the pager? | iPhone | BlackBerry | iPod Touch.

Popular medical blogger Dr. Kevin Pho, also known as KevinMD, has a noteworthy post on the growing popularity of smartphone use in hospitals and smartphones’ “inevitable” displacement of pagers. A recent study by Manhattan Research found that 64 percent of doctors use smartphones like BlackBerrys or iPhones. Each of those platforms support mobile applications that provide pager functionalities.

BlackBerry partner Wallace Wireless offers a pager service called WIC Pager. Wallace points out that since many healthcare workers already carry a smartphone, “a single device solution reduces the costs and resources necessary to manage the traditional pager and cellphone combination.” WIC Pager can leverage cellular networks as well as in-building WiFi. It also “allows for quick responses by implementing a one-click call back feature,” which trumps legacy pagers one-way flow. The service also offers “real-time reporting on all pager alerts” so administrators can keep track of messages, too.

via Prediction: Smartphones to replace pagers in hospitals | mobihealthnews.

A federal standards committee working with the National Coordinator for Health Information Technology has established workgroups that will deliver reports in 90 days on three areas of standards for health IT: clinical quality, clinical operations and privacy/security, according to an announcement in the Federal Register.

Under the economic stimulus law, the Health and Human Services Department’s National Coordinator for Health IT will oversee $17 billion in incentive payments to physicians and hospitals that adopt certified health IT systems. The coordinator also will establish a process to certify electronic health record solutions produced by vendors and will set details on implementation.

Congress created the Health IT Standards Committee and the Health IT Policy Committee to make recommendations to the national coordinator.

via Health IT standards panel creates workgroups — Federal Computer Week.

A New England Journal of Medicine article calls for the establishment of an independent institute for technology assessment and says electronic health records could “appreciatively” boost quality of care.

“The Proposed Government Health Insurance Company – No Substitute for Real Reform, “ was written by Victor R. Fuchs, professor emeritus of economics at Stanford University in Stanford, Calif.

“Cost control requires fixed budgets for basic coverage so that expenditures and revenues are in balance, as well as a payment system for providers that gives incentives for cost-effective care,” Fuchs wrote. “It also requires an independent institute for technology assessment to provide physicians with needed information and to create a value-conscious environment for future biomedical innovations. Also, the average quality of care could be raised appreciably if every patient had access to an accountable care organization that used electronic health records effectively, provided coordinated care, and monitored processes and procedures.”

via EHRs could boost quality of care, according to New England Journal of Medicine | Healthcare IT News.

The Obama administration’s ambitious plan to accelerate the adoption of electronic patient records will be a “steamroller” that drives the consolidation of the health technology industry and threatens many small physician practices, predicts Leonard M. Fuld, head of a large competitive-intelligence firm.

In an interview on Wednesday, Mr. Fuld summarized the conclusions of a “war game” his firm organized last month, “The Battle for Healthcare Information,” and added some postgame observations of his own.

The 35 participants in the business strategy-and-forecasting exercise were students from four graduate business schools — the Wharton School at the University of Pennsylvania, the Graduate School of Business at Columbia, the Sloan School of Management at the Massachusetts Institute of Technology and the Kellogg School of Management at Northwestern.

The government’s $19 billion plan to hasten the use of electronic health records in hospitals and doctors’ offices is intended to improve care and curb costs. But the government pump-priming will also set off an acquisition spree as large technology companies buy health information-technology specialists to grab market share, the war-game participants concluded. Allscripts, Epic and Cerner, they said, could well be targets for larger companies like I.B.M., Microsoft, Oracle and McKesson.

via Electronic Patient Records Will Force Consolidation in Health Care – Bits Blog – NYTimes.com.

The Cyber Secure Institute, an analysis and advocacy institute for effective cyber security, has released recommendations for safeguarding heath data in the wake of recent breaches.

Last month, hackers broke into a Virginia government Web site that tracks prescription drug abuse and attempted to ransom almost 8.3 million patient records and 35.5 million prescriptions for $10 million.  And last December, Lawanda Jackson pleaded guilty to violating federal privacy laws by selling private medical data from celebrities, including Britney Spears, Farah Fawcett and Maria Shriver, to the National Enquirer tabloid.

Last October, someone hacked into Express Scripts, one of America’s largest processors of pharmacy prescriptions, and threatened to release personal information of millions of Americans unless their demands were met. That investigation is ongoing.

“These recent attacks provide cause for real concern among cybersecurity experts and healthcare professionals alike. Inadequate cybersecurity systems put our most personal data at risk,” said Rob Housman, executive director of the Cyber Secure Institute.

via Advocacy organization calls for improved protection of online health data | Healthcare IT News.

The Office of the National Coordinator for Health Information Technology is testing an online template for an electronic personal health record that will be tested with consumers through October, according to an announcement.

An electronic personal health record typically includes a person’s health information, including a health history, vaccinations, allergies, test results and prescription information. Several vendors, including Google, Microsoft, Revolution Health and WebMD, are providing tools for such records as a service to consumers.

Because the concept is new and use sensitive information, and because vendors typically offer such information in different formats, the Health and Human Service Department’s national coordinator for health IT is developing an online model with the goal of allowing consumers to make informed decisions about selecting and using such records, states a Federal Register notice of May 22. Public comments are due in 30 days.

via HHS tests template for electronic health record — Federal Computer Week.

Long-term treatments for diabetes, high blood pressure and other chronic killers work only if patients care for themselves properly.

That’s why doctors, hospitals, and high-tech companies such as Dallas-based AT&T Inc. are so excited about a new generation of devices that let medical professionals track patient progress.

These wireless devices automatically send doctors stats that people already measure – weight, blood pressure, etc. – so doctors can intervene at the first sign of trouble rather than waiting till patients feel bad enough to seek help.

The Department of Veterans Affairs already uses such “telehealth” technology on 35,000 patients.

Now, private health groups – working with insurers, universities and technology makers – have begun tests that could lead to widespread deployment over the next couple of years.

“A lot of this is old technology,” said Bob Miller, executive director of AT&T’s communications-technology research department. “But we’re putting it together in ways that will help millions of people live dramatically better lives.”

via AT&T, other firms test devices to help monitor patients from afar | News for Dallas, Texas | Dallas Morning News | Technology and Telecom News | Dallas Business News .

Looks like the Wall Street Journal’s rumor mill piece was right: As we reported earlier this week, Intel and GE are planning to work together to market home-health monitoring solutions leveraging wireless sensors that aim to prevent falls, increase medication compliance and treat sleep apnea. The companies plan to invest $250 million over the next five years for research and development into this emerging market. Intel and GE predict that the home-health monitoring market will grow to $7.7 billion by 2012, which means it would more than double from today’s $3 billion home-health monitoring market.

via It’s official: Intel, GE partner on mHealth | mobihealthnews.

“The economy has hit bottom,” Scripps Health’s Dr. Eric Topol declared during his keynote at the CTIA Wireless event in Las Vegas this week. “But at the same time there has never been more wireless innovation in the medical community.”

Topol spent much of his twenty five minutes onstage describing and demonstrating examples of that innovation. 

“As a cardiologist I never thought I would be seeing from a smart bandaid on my phone a continually streaming electrocardiagram,” Topol said. “I never thought this would be possible, but, of course, it is ready now.”

Topol then showed a real-time wireless bandaid for monitoring electrocardiograms that he said the FDA approved last month. The product was developed by Corventis.

“Let me do a demo of this, [the smart bandaid] is right on me now. Let’s take a look: Here’s my electrocardiogram. I noticed my heart rate went up a bit since this morning… That’s interesting.”  

Topol said that the ability to remotely monitor someone who has had heart failure with a solution like this has extraordinary potential. He also said that remote monitoring for heart failure patients alone is projected to create savings of $10 billion per year. If you add diabetes and chronic congestive pulmonary disease wireless remote monitoring to that figure, we could save another $10 billion a year by virtue of remote wireless monitoring, Topol said.

via Topol: Remote monitoring will save $20+ billion | mobihealthnews.

Senior living community administrators predict that during the next five years “smart home” technology and wireless connectivity will help attract residents, according to The Trends in Senior Living survey conducted by the Mather LifeWays Institute on Aging. The survey polled operators within 107 senior living organizations, which represent some 435 senior living communities in 13 states. The operators also said that they expect home health services, wellness programs, internet-based education and smaller and “greener” facilities will bring in more residents. 

“The survey results tell us that it will not be business as usual for senior living communities in the years ahead,” said Linda Hollinger-Smith, Vice President, Mather LifeWays Institute on Aging. “It’s clear that with the projected decline in the 75 to 84 age population over the next decade, senior living organizations will need to identify their niche to attract this generation prior to the arrival of the Baby Boomers.”

via By 2013: 39% of senior communities will be “smart homes” | mobihealthnews.

Health information technology leaders made the case for linking the economic stimulus plan to the broader goals of health reform, including improved heath care services and population health, at a conference in Washington, D.C., yesterday.

The health IT provisions of the stimulus were designed to correct the failure of the market to spur the adoption of health IT and to demonstrate its value. In doing so, it will also be a tool to meet the aims of health reform, said Dr. David Blumenthal, the nation’s health IT coordinator, at a May 20 conference sponsored by the Brookings Institution.

Under the American Recovery and Reinvestment Act, physicians and hospitals will be entitled to increased Medicare and Medicaid payments starting in 2011 if they can demonstrate “meaningful use” of electronic health records. ONC has said they would define the term by early summer.

via Blumenthal: Stimulus a ’sweetener, not determinant’ of health IT adoption — Government Health IT.

The economic stimulus legislation will increase e-prescribing adoption to more than 75 percent of prescribers in five years, according to a consulting firm that conducted a study on behalf of a pharmaceutical group.

The stimulus bill, and its $19 billion investment in health information technology, will spur a fourfold increase in e-prescribing over current levels, according to the analysis by Minneapolis-based Visante. The firm estimates that e-prescribing will save public and private payers $78.2 billion in the first 10 years once the 75 percent adoption rate is achieved, thanks to a reduction of medication errors and hospitalizations.

The Medicare Improvements for Patients and Providers Act of 2008, which offers physicians a 2 percent bonus on their Medicare claims for e-prescribing and a 1 percent penalty by 2012 for non-compliance, was expected to yield only a 40 percent adoption rate by 2014, according to Visante.

via Stimulus legislation expected to boost e-prescribing adoption to 75% – – Modern Medicine.

A health technology trade association has asked the Obama administration to require that any electronic health-record equipment receiving stimulus funding be certified by a group the association helped to start and run, documents show.

The Healthcare Information and Management Systems Society, which represents 350 technology vendors and 20,000 members, was a key force behind the decision to include $36.5 billion in the stimulus package to create a nationwide network for medical records.

A Washington Post review last week showed that the group, known as HIMSS, worked closely with vendors, health-care researchers and others to create nonprofit advocacy groups and generate research data to convince policymakers that such a system could save tens of billions of dollars, and that the government needed to subsidize Medicare and Medicaid providers to buy the equipment.

via Group Seeks Sway Over E-Records System – washingtonpost.com.

A new study suggests that patients are open to having electronic medical records play a more central role in their care.

A research team at Beth Israel Deaconess Medical Center in Boston led the study to determine how patients feel about converting to EMRs. Key findings suggest patients want full access to all of their medical records, are willing to make some privacy concessions in the interest of making them transparent and fully expect that computers will play a major role in their medical care, even substituting for face-to-face care.

via Study reveals patients’ attitudes toward EMR conversion | Healthcare IT News.

Certification organization to adjust schedule, policy handbook to reflect mandates

The Certification Commission for Healthcare Information Technology will put its 2009-2010 programs on hold and update its certification policies in light of guidance contained in the American Recovery and Reinvestment Act.

CCHIT said today it will defer the launch of its latest certification programs until it has reviewed the Office of the National Coordinator for Health IT’s forthcoming standards and certification criteria. ONC will deliver a draft rule containing those items to the Health and Human Services Department by Aug. 26, according to ONC’s plan for complying with ARRA. CCHIT’s certification cycle was set to begin July 1.

Organization officials said their review of the draft rule will ensure that the certification programs conform to ARRA incentive requirements.

The organization is also revising the Certification Handbook to reflect what it termed the expanded applicability of electronic health record certification under ARRA.

via CCHIT to adapt programs to federal health IT agenda — Government Health IT.

To his frustration, Steven Schwartz often encounters patients who have no idea what each of the pills they’ve been popping is called.

“But usually they can tell you what it looks like,” the Georgetown University Medical Center family practitioner said. “They might say it’s a blue, triangular pill for hypertension.”

Armed with an iPhone, Schwartz is able to play detective.

He uses an application called Epocrates to input pill characteristics, such as color, shape and clarity. The software replies with a list of medications and images that match those criteria, allowing him to deduce what the patient is taking.

via Doctors and Medical Students Embrace Smartphones – washingtonpost.com.

Officials at the Centers for Medicare and Medicaid Services plan to spend as much as $905 million by September 2015 on information technology systems that can support and monitor the $17 billion in incentive payments to doctors and hospitals authorized under the economic stimulus law, according to a new planning document.

Under the law, CMS and the Office of the National Coordinator for Health IT ONC will develop the policies and requirements for distributing the incentive payments that will start in fiscal 2011. To qualify for the payments, providers must adopt health IT and show “meaningful use” of electronic patient records.

CMS will use its funds to develop, implement and maintain IT systems that will assess and deliver the payments accurately to eligible providers. The systems are expected to include applications for determining eligibility, enrolling applicants, making payments, reporting on quality, and providing financial accountability and monitoring, according to the plan, which was posted online at Recovery.gov on May 15.

via CMS to spend $905M on IT systems support — Federal Computer Week.

A high-level committee set up to advise the Office of the National Coordinator for Health Information Technology pledged Friday to concentrate on forming health IT standards that support the practical daily work of physicians and hospitals.

Members of the Health IT Standards Committee, in its first meeting since being created by the economic stimulus law, said it would create three work groups to pursue that agenda in the areas of clinical operations, clinical quality, and privacy and security.

“Our hope for this committee is to emulate the great [hockey player] Wayne Gretsky and skate to where the puck will be,” said Dr. Jonathan Perlin, the committee chairman and chief medical officer of the Healthcare Corp. of America. Perlin is also a former undersecretary for health for the Department of Veterans Affairs.

via Health IT standards panel unveils practical agenda — Government Health IT.

With billions in stimulus dollars available to help doctors and hospitals digitize their health records, it stands to reason that tech companies want to make spending that money as easy as possible.

Several of the players–Allscripts, Cisco, Citrix, Dell, Intel, Intuit, Microsoft, and Nuance Communications–have teamed up in an alliance aimed at educating doctors on the many tools available to help set up electronic health records.

The EHR Stimulus Alliance is pulling out all the stops, with a road tour, Webcasts, telephone hotline, and other tools all aimed at demystifying the technology and showing case studies of where it has worked.

President Obamas stimulus package provides on the order of $20 billion for health care technology, with the central focus being nudging hospitals and doctors to move their records from manila folders to computers. Even with the money, though, its seen as a daunting task.

“The EHR Stimulus Alliance is a unified movement toward turning the national dialogue surrounding the EHR transition into action,” Nuance Healthcare President John Shagoury said in a statement. “Each of the partners involved has unique solutions that are crucial to EHR implementation. In our case, because most doctors speak at least three times faster than they type, speech recognition technology helps increase the meaningful use and efficiency of EHRs by decreasing physician reliance on the keyboard and mouse.”

via Tech giants line up for e-health dollars | Beyond Binary – CNET News.