Telehealth Monitor

100 recycled cell phones. That’s all it took. That, and a donated laptop, a copy of a free computer software which serves as a central text message hub, and a little bit of innovation for a college student to change the way patients receive and obtain treatment in a village in Malawi.

Josh Nesbit, a senior at Stanford University, may be on the cusp of changing healthcare for rural parts of the world forever.

As a result of his project, patients and healthcare workers no longer have to walk up to 100  miles just to receive or provide treatment. Within eight weeks of starting his project in the summer of 2008, Nesbit trained about 75 community health workers in text messaging and provided them with cell phones. At the local hospital in Lilongwe, Malawi,  a laptop running the SMS software, called FrontlineSMS, coordinates the health network’s SMS activities in a 100-mile radius. As a result of the SMS network, the hospital now responds to requests for remote patient care, informs community health workers of proper drug dosages and uses, receives patient updates, and easily facilitates general communication and group mobilization for volunteers and patients.

via Telemedicine 2.0: Who needs Internet when you’ve got a cell phone? | The Morningside Post.

When it comes to swine flu, the Feds are maintaining full online alert.

As news about the epidemic has burned up all corners of the Web, the Centers for Disease Control and Prevention and the Department of Health and Human Services have been using Twitter and YouTube, among other sites, to disseminate information.

Three agency heads — HHS Secretary Kathleen Sebelius, Richard Besser of the CDC and Janet Napolitano of the Department of Homeland Security — will conduct a live question-and-answer online session at 1 p.m. today. The hour-long “town hall” will be streamed on CDC.gov and HHS.gov, and questions can be e-mailed to hhsstudio@hhs.gov. A moderator will choose from the questions submitted; staffers at HHS said they will track such social networking sites as Twitter to monitor public response.

via Government Officials Take to the Web to Address Swine Flu Fears – washingtonpost.com.

President Obamas Cabinet was finally filled yesterday after the Senate, on the eve of President Obamas 100th day in office, voted 65 to 31 to confirm Kathleen Sebelius to head the Department of Health and Human Services. Hours later, the former Kansas governor was sworn in in an Oval Office ceremony.

Democrats had sought a quick vote on Sebelius as Congress moves ahead with health-care reform this summer, but Republicans slowed her advancement because of her support for abortion rights. But GOP procedural objections faded with the recent outbreak of swine flu and the threat of a global pandemic, our colleague Shailagh Murray reported from the Senate.

via Al Kamen – Just Inside 100 Days, Sebelius Completes the Cabinet – washingtonpost.com.

Following similar moves by Intel and General Electric, auto parts and appliance maker Bosch said it will launch a new division today that will focus on remote healthcare monitoring and other “telehealth” technologies.

The division is built around Health Buddy, a monitoring device made by Health Hero Network, which was acquired by Bosch and will now be known as Robert Bosch Healthcare.

via Bosch enters remote healthcare electronics market with Health Buddy » VentureBeat.

President Obama’s ambitious plan to establish a lifetime electronic record for service members and veterans will improve delivery of benefits, speed processing of claims and, over time, open VA health care to any veteran, regardless of their medical condition or income level.

VA Secretary Eric Shinseki first raised the idea of a more sophisticated electronic record system, and linked it to automatic enrollment by all veterans in the VA health system, during a House hearing in February.

This week, through a press spokeswoman, Shinseki confirmed that universal access to VA health care is integral to the administration’s plan to develop as quickly as possible a 21st Century electronic record system.

“Secretary Shinseki and the whole [VA] team believe that ‘uniform registration’ ” in the VA health system “is an essential part of the lifetime virtual record,” said Katie Roberts, his press secretary, in an e-mail.

Shinseki and Defense Secretary Robert Gates were with the president April 9 in the Old Executive Office Building when Obama announced to an audience of veterans a “huge step toward modernizing the way VA health care is delivered and [VA] benefits are administered.”

Obama described a comprehensive electronic record system, to be developed and used jointly by the Department of Defense and VA, which would hold all service-related documents, administrative and medical, on individuals from the time they enter service until “they are laid to rest.”

via Military Update: Health record plan may open VA to all veterans | Stars and Stripes.

GE, Google, and others, in a stimulus-fueled frenzy, are piling into the business. But electronic health records have a dubious history

Neal Patterson likens the current scramble in health information technology to the 19th century land rush that opened his native Oklahoma to homesteaders. Cerner (CERN), the large medical vendor Patterson heads, is jockeying for new business spurred by a $19.6 billion federal initiative to computerize a health system buried in paper. “It’s a beautiful opportunity for us,” the CEO says.

The billions in taxpayer funds—part of the $787 billion economic stimulus—also have energized tech titans General Electric (GE), Intel (INTC), and IBM (IBM), all of which are challenging Cerner and other traditional medical suppliers. Microsoft (MSFT) and Google (GOOG) aim to put medical records in the hands of patients via the Web. Wal-Mart (WMT) is teaming with computer maker Dell (DELL) and digital vendor eClinicalWorks to sell information technology to doctors through Sam’s Club stores.

Under the federal stimulus program enacted in February, hospitals can seek several million dollars apiece for tech purchases over the next five years. Individual physicians can receive up to $44,000. These carrots should encourage the proliferation of technology that will computerize physician orders, automate dispensing of drugs, and digitally store patient records. If providers participate broadly, those files are supposed to be accessible no matter where a consumer goes for treatment. President Barack Obama says the changes will improve care, eliminate errors, and eventually save billions of dollars a year. There’s also a stick: The federal government will cut Medicare reimbursement for hospitals and medical practices that don’t go electronic by 2015.

via The Dubious Promise of Digital Medicine – BusinessWeek.

The Conficker worm infected several hundred machines and critical medical equipment in an undisclosed number of U.S. hospitals recently, a security expert said on Thursday in a panel at the RSA security conference.

“It was not widespread, but it raises the awareness of what we would do if there were millions” of computers infected at hospitals or in critical infrastructure locations, Marcus Sachs told CNET News after the session. Sachs is the director of the SANS Internet Storm Center and a former White House cybersecurity official.

It is unclear how the devices, which control things like heart monitors and MRI machines, and the PCs got infected, he said. The computers are older machines running Windows NT and Windows 2000 in a local area network that was not supposed to have access to the Internet, however, the network was connected to one that has direct Internet access and so they were infected, he said.

Conficker spreads via networked computers as well as through removable storage devices and a hole in Windows that Microsoft patched in October, but these machines were too old to be patched, according to Sachs.

In the U.K., PCs at hospitals in Sheffield were found to be infected with Conficker in January, The Register reported.

The situation illustrates the dangers of connecting critical networks, like in hospitals and in SCADA (Supervisory Control and Data Acquisition) systems used by utilities and other critical infrastructure providers, with networks connected to the Internet, he said during the panel “Securing Critical Infrastructures: Infrastructure Exposed.”

via Conficker infected critical hospital equipment, expert says | Security – CNET News.

Electronic prescribing has seen significant growth in adoption and use of critical components, according to the annual National Progress Report on E-Prescribing.

The report, released by Alexandria, Va.-based Surescripts, documents the status of e-prescribing adoption and use in the United States from 2006 through 2008.

According to the report, more than 100,000 prescribers are now routing prescriptions electronically, and the use of three critical components of e-prescribing – electronic prescription benefit, history and routing – jumped 61 percent in the first quarter of 2009. This jump resulted in more than 134 million e-prescribing messages being exchanged among prescribers, payers and pharmacies.

The report credits three factors for influencing e-prescribing growth in 2008:

the attention e-prescribing received at the federal and state policy level;

national programs that drove e-prescribing and offered practical tools to assist the industry in moving;

and the adoption of e-prescribing by key groups – namely, payers  (including PBMs and Medicaid plans), prescribers and pharmacies.

“In the past two years, the U.S. has gone from 19,000 to 103,000 prescribers routing prescriptions electronically – punctuated by 39 percent sequential growth in prescriber adoption in the first quarter of this year,” said Harry Totonis, president and CEO of Surescripts. “The past two years have also witnessed a sevenfold increase in the use of e-prescribing. And while this growth shows clear evidence that the steps taken by policymakers, prescribers, payers, pharmacies and others are having a positive impact, swift and specific action is required for the U.S. to achieve mainstream adoption and use of e-prescribing.”

via Industry News | Healthcare IT News.

The public holds mixed views when it comes to the use of electronic medical records, with most believing it’s important to adopt EMR technology and that doing so would improve the country’s healthcare system, according to a new survey conducted by National Public Radio, Kaiser Family Foundation and Harvard School of Public Health.

“The Public and the Health Care Delivery System” reveals that Americans also question both the confidentiality of an electronic health record system a system and its potential for cost savings.

Three of every four respondents say it’s important for their healthcare providers to use electronic medical records. A large proportion of the public also sees benefits to nationwide adoption.

A majority of those surveyed also say that with greater adoption of an EMR system in the United States, their own doctors would do a better job coordinating their care (72 percent say this is at least somewhat likely), the overall quality of care in the country would be improved (67 percent) and fewer people would get unnecessary medical care (58 percent.) Just more than half (53 percent) say there would be fewer medical errors.

via Industry News | Healthcare IT News.

Congress moved a step closer Tuesday to filling a critical vacancy in President Obamas Cabinet when a Senate committee approved the nomination of Kansas Gov. Kathleen Sebelius to head the Department of Health and Human Services.

Senate Finance Committee Chairman Max Baucus, Montana Democrat, said he would press for a speedy confirmation for Mrs. Sebelius before the full Senate, although several Republicans are determined to block the vote.

“I congratulate Governor Sebelius and will push for immediate action by the full Senate so that she can finally roll up her sleeves and get down to helping out on this critical work of reforming the health care system,” Mr. Baucus said.

via Sebelius backed by Senate panel – Washington Times.

Rules proposed by the Federal Trade Commission on April 16 on disclosure of breaches of personal health information would greatly expand the number of companies that would be subject to notifying individuals if their personal health data was exposed because records were lost or stolen, or because a hacker broke into a computer health network.

Vendors that offer personal health records and organizations not covered by the Health Insurance Portability and Accountability Act — which requires patient confidentiality — that access or send health information to or from a patient-controlled health record would be required to notify individuals whose personal data was exposed by a breach.

Such a definition would include online applications that allow individuals to connect monitoring devices — like blood pressure cuffs and blood glucose monitors — that send information to an electronic health record, such as Microsoft’s HealthVault or Google Health, the agency said. FTC did not identify specific vendors or products in its proposed rules.

via Nextgov – Proposed breach notification rule would affect more health vendors.

Chicago — Doctors and hospitals could receive as much as $39 billion in economic stimulus funds during the next five years to acquire electronic health record systems, a top Healthcare Information and Management Systems Society official said on the opening day of the organization’s four-day conference here.

Though the Recovery Act provided $17 billion for payments to clinicians and hospitals through the Centers for Medicare and Medicaid Services, actual spending could be more than double that figure, depending on the rate of e-records adoption, said Dave Roberts, HIMSS vice president for government relations, during a press briefing on Saturday.

Roberts said the $17 billion in the stimulus package is an estimate of funding needed to meet the act’s pledge of giving providers that use health information technology systems in a “meaningful way” $44,000 each during a five-year period to defray expenses, starting with an $18,000 payment in 2010. The e-records initiative is an entitlement program like Social Security, he said.

Roberts said his $39 billion estimate was based on a Congressional Budget Office analysis. CBO estimated that information technology could reduce overall health care costs by $15 billion for that same time period as a result of increased efficiencies, he added.

via Nextgov – Adopting e-health records could cost more than anticipated.

When physician Andrew Wiesenthal needs to work out a problem, he runs around Lake Merritt, across the street from his Oakland (Calif.) office at Kaiser Permanente. As one of the main drivers behind Kaiser’s decades-long, multibillion-dollar effort to overhaul the way patient health records are kept, Wiesenthal has had a lot of laps to run.

Doctors and other medical professionals across the country will be working through similar challenges in the coming years. President Barack Obama plans to spend $17.2 billion to induce care providers to maintain patient records electronically, scrapping the current paper-based system. The Obama Administration wants electronic health records for every American by 2014.

via How Kaiser Permanente Went Paperless – BusinessWeek.

CHICAGO – There is a great deal of resistance to healthcare reform because industry players make so much money from the current system, said George Halvorson, chairman and CEO of the Kaiser Foundation Health Plan and Kaiser Foundation Hospitals.

Speaking Monday at HIMSS09, Halvorson said the current fee-for-service payment model generates $2.5 trillion worth of revenue, but merely sells “pieces of care” to consumers because the system is not efficient.

Healthcare is the fastest growing segment of the U.S. economy, moving toward 20 percent of the Gross Domestic Product, but Halvorson said the United States is on a dangerous path and must lower the costs of the system and improve outcomes.

“We need to fix the delivery of healthcare and move to full (health insurance) coverage,” he said.

Halvorson affirmed that only a “systematic” approach to changing U.S. healthcare would succeed. He called for an emphasis on best practices, an increase in coordination between caregivers and a more consistent follow-through on patients.

Halvorson said there is tremendous inconsistency in the quality of healthcare in the United States, citing a study by Dartmouth professor Jack Wennberg that revealed a 40 percent variation by region in cardiac care.

via Industry News | Healthcare IT News.

Dr. David Blumenthal offered this week a first significant glimpse into how he views the policy choices ahead of him as he prepares to take over as national coordinator for health IT. 

In a perspective piece published April 9 by the New England Journal of Medicine, Blumenthal said that to carry out Congress’ intentions in the recently passed health IT stimulus legislation, it will be important not to set the bar too high for providers to qualify for health IT funding. 

The current certification process for health IT needs tightening, he said.

Congress provided $20 billion in health IT incentives in the American Recovery and Reinvestment Act as the means to improve the quality of health care, not as an end in itself, Blumenthal said. 

“Under the pressure to show results, it will be tempting to measure…the payoff from the $787 billion stimulus package in narrow terms — for example, the numbers of computers newly deployed in doctors’ offices and hospital nursing stations,” Blumenthal said. 

“But that does not seem to be Congress’ intent. It wants improvements in health and health care through the use” of health IT.

via Blumenthal signals position on key stimulus policies — Government Health IT.

Breaking into the health-care industry can be daunting. Doctors, hospitals, insurance companies and patients speak different languages and have vastly different needs.

But more than $19 billion in stimulus money intended to revamp the nation’s health system has piqued the interest of some local tech companies that have in the past shied away from the complex industry. And for companies with expertise in the business, stimulus dollars mean new opportunities.

“Health care is thought to be a safer place right now because more money is coming from the government, and it’s not really something anyone can cut back on,” said Michael Slage of Arlington, founder of HealthEngage, a firm that develops applications that help patients manage conditions such as diabetes and asthma. “Everyone senses that there’s all this money out there.”

The Obama administration is pushing to digitize health records; electronic records depend on fast data networks, interoperable software systems and devices to enter and track patient data.

via Kim Hart – Kim Hart’s The Download – washingtonpost.com.

CHICAGO – Consumer appetite for electronic health records, online tools and services continues to grow, according to the results of the 2009 Deloitte Survey of Health Care Consumers.

While only 9 percent of consumers surveyed have an electronic personal health record, 42 percent are interested in establishing PHRs connected online to their physicians.

Fifty-five percent want the ability to communicate with their doctor via e-mail to exchange health information and get answers to questions.

Fifty-seven percent reported they’d be interested in scheduling appointments, buying prescriptions and completing other transactions online if their information is protected.

Technology that can facilitate consumer transactions with providers and health plans, such as integrated billing systems that make bill payment faster and more convenient, appeal to nearly half (47 percent) of consumers surveyed.

The survey of more than 4,000 U.S. consumers 18 and older was released at the Healthcare Information and Management Systems Society’s annual conference in Chicago last week. It’s the second annual study examining healthcare consumers’ attitudes, behaviors and unmet needs conducted by the Deloitte Center for Health Solutions.

via Industry News | Healthcare IT News.

Kansas Gov. Kathleen Sebelius, who is awaiting confirmation as the next secretary of Health and Human Services, has made it clear that she views the widespread use of health information technology as essential to reforming the health care system.

In 137 pages of written answers to questions from members of the Senate Finance Committee after an April 2 confirmation hearing, Sebelius repeatedly cited health IT as a way to lower costs, raise the quality of care and achieve comprehensive health care reform.

“A nationwide interoperable health IT infrastructure is a fundamental building block for broader health reform,” she wrote, adding that the federal government must step in to ensure that “systems are interoperable and that patient privacy is assured.”

via Sebelius sees IT as key to health reform — Government Health IT.

NEW YORK – A new study says hospitals’ efforts to implement “meaningful” EHR systems will be affected more by the federal funding they may lose than what they may receive.

“Rock and a Hard Place: An Analysis of the $36 Billion Impact From Health IT Stimulus Funding,” from the New York-based PricewaterhouseCoopers Health Research Institute, finds that healthcare providers are struggling to find money to implement electronic health record systems, primarily because the sour economy has depleted capital resources and forced them to make cuts in information technology.

And while the federal government is pledging $33 billion in incentives to compel providers to adopt meaningful EMR systems by 2015, that money won’t compensate hospitals enough for the costs they incur in setting up the systems, the report states.

A better motivator, PwC researchers say, is the threat of reduced Medicare reimbursements if those IT goals are not met.

via Industry News | Healthcare IT News.

BANGALORE: Wipro Technologies, India’s third biggest software exporter, has established a new practice for serving healthcare customers, and has also restructured some of its business units in order to focus on recession-proof business segments and ensure sharper focus on its existing business units.

Rajiv Shah, who was heading Wipro’s technology business unit, will now head the newly-created healthcare business unit, and will report to the joint chief executive Suresh Vaswani. Mr Shah will be replaced by GK Prasanna. Mr Prasanna was the head of the technology infrastructure services at the company.

“Healthcare is somewhat recession-proof when compared to other verticals, and Wipro already had assets needed to establish a bigger healthcare practice,” said a person familiar with the development at Wipro. He requested anonymity.

In a communication to Wipro’s leadership team, the company’s joint CEOs Mr Vaswani and Mr Girish Paranjpe, said the newly-created healthcare practice will help Wipro address the big healthcare IT spend being planned by the US government.

via Wipro focuses on crisis-proof biz segments- ITeS-Infotech-The Economic Times.

The top military physician in Iraq blasted the capability and responsiveness of a new system that tracks wounded soldiers who are flown to hospitals in Germany and then to the United States, according to internal e-mails obtained by Nextgov.

The e-mails also revealed an ongoing dispute between medical personnel in the field and program managers with the Military Health System over the new Theater Medical Data Store and the system it replaced, the Joint Patient Tracking Application.

In a March 2 e-mail, Army Brig. Gen. William Gamble, command surgeon for the U.S. Central Command, bluntly told Army Col. Claude Hines, program manager for the Defense Health Information Management System at the Military Health System, that “JPTA worked. The alternative does not. Simple. We need to allow JPTA data entry. I know you are doing your absolute. But as I said a year ago, flick the switch. JPTA is better than what we have now.”

In his e-mail, Gamble detailed myriad problems with the new TMDS system, including a significant delay between the time clinicians in Iraq upload data onto the network and when it is visible to doctors. The delay is particularly frustrating for clinicians at the Landstuhl Army Medical Center in Germany, which is the first stop for wounded soldiers coming from Iraq as they make their way to U.S. hospitals.

He said the minimum time delay to load data into TMDS was three hours and “at times much longer, 48 hours by accounts from [theater] medical providers.”

via Nextgov – Military doctors blast new system to track wounded soldiers in Iraq.

When Dave deBronkart, a tech-savvy kidney cancer survivor, tried to transfer his medical records from Beth Israel Deaconess Medical Center to Google Health, a new free service that lets patients keep all their health records in one place and easily share them with new doctors, he was stunned at what he found.

Google said his cancer had spread to either his brain or spine – a frightening diagnosis deBronkart had never gotten from his doctors – and listed an array of other conditions that he never had, as far as he knew, like chronic lung disease and aortic aneurysm. A warning announced his blood pressure medication required “immediate attention.”

“I wondered, What are they talking about? ” said deBronkart, who is 59 and lives in Nashua.

DeBronkart eventually discovered the problem: Some of the information in his Google Health record was drawn from billing records, which sometimes reflect imprecise information plugged into codes required by insurers. Google Health and others in the fast-growing personal health record business say they are offering a revolutionary tool to help patients navigate a fragmented healthcare system, but some doctors fear that inaccurate information from billing data could lead to improper treatment.

via Electronic health records raise doubt – The Boston Globe.

THE Obama administration’s plan to spend $19 billion on electronic medical records has generated so much buzz you might think it was the biggest thing in health care since penicillin.

“We’ve got a long way to go” before digital health files are widespread, said Dr. Ashish Jha, an associate professor at Harvard who has been involved in several studies on such records.

But while policy makers, hospitals, doctors and technology companies debate the best ways to give every health care provider computer access to patient records, patients can’t help but wonder: What’s in this for me?

There is obvious appeal in the idea of an electronic file controlled by the patient but accessible with his or her permission by doctors, hospitals and insurers — a file that could be continually updated with all new medical procedures, prescriptions and tests. That kind of detailed record and seamless communication could improve the quality of health care and help reduce dangerous medical errors. And by improving the efficiency of medicine, it might also help curb the nation’s skyrocketing health care costs.

Lured by such promises, 4 of every 10 consumers are interested in creating an online personal health record that can be shared with physicians, according to a recent survey conducted by the Deloitte Center for Health Solutions.

via Patient Money – Some Caveats About Personal Digital Health Records – NYTimes.com.

President Obama said yesterday that his administration will create an electronic record for veterans that will “contain their administrative and medical information from the day they first enlist to the day that they are laid to rest.”

Research has shown that the handoff of medical information — between individuals and hospital systems — can be dangerous. Incomplete, incomprehensible or misunderstood data can contribute to medical error or substandard care.

While the Defense Department’s hospitals and the Veterans Affairs medical system have electronic records, they are not seamlessly connected — a problem Obama said he is determined to solve.

“Currently, there is no comprehensive system in place that allows for a streamlined transition of health records between DOD and the VA,” the president said during a briefing at the Eisenhower Executive Office Building that was attended by the secretaries of those two departments as well as patients and practitioners from Washington area hospitals and military and VA facilities.

via Obama Seeks to Create Seamless Transition of Electronic Medical Records Between DOD and VA – washingtonpost.com.

PRESS RELEASE: Bosch adds leading telemedicine innovator, Expands product offering for telehealth market

Stuttgart – The Bosch Group has acquired Visual Telecommunication Network Inc., also known as ViTel Net, a leading innovator in the telehealth – remote patient monitoring – business. Terms of the agreement will not be disclosed.

ViTel Net, headquartered in McLean, Virginia, has developed and sells technologies that allow clinicians to remotely manage patient health regardless of geographic boundaries. The company’s products are designed for home health monitoring of patients with chronic conditions.

“The acquisition of ViTel Net is an outstanding complement to our current, emerging telehealth business in the North American market, and follows our December 2007 acquisition of Health Hero Network, based in Palo Alto, California,” said Sascha Henke, vice president, Healthcare Telemedicine. “Bosch is committed to strengthening its presence in this important market and other dynamic regions around the world.”

The Bosch Group is a leading global supplier of technology and services. In the areas of automotive and industrial technology, consumer goods, and building technology, some 282,000 associates generated sales of 45 billion euros over $63 billion in fiscal 2008. The Bosch Group comprises Robert Bosch GmbH and its more than 300 subsidiaries and regional companies in roughly 50 countries. This worldwide development, manufacturing, and sales network is the foundation for further growth. Each year, Bosch spends more than 3 billion euros for research and development, and applies for over 3,000 patents worldwide. The company was set up in Stuttgart in 1886 by Robert Bosch 1861-1942 as “Workshop for Precision Mechanics and Electrical Engineering.”

In North America, the Bosch Group manufactures and markets automotive original equipment and aftermarket products, industrial automation and mobile products, power tools and accessories, security technology, thermo-technology, packaging equipment and household appliances. Bosch employs approximately 25,000 associates in more than 70 locations throughout the U.S., Canada and Mexico, with reported sales of $9.5 billion in fiscal 2007. For more information on the company, visit www.boschusa.com.