Healthcare IT News

A new web-based tool recently revealed allows providers to gauge their return on investment (ROI) on remote patient monitoring technologies. The tool, developed by The Center for Connected Health (CCH) and the Center for Technology and Aging (CTA) have worked in tandem on the progress of a tool for deciphering the ROI for remote patient monitoring technologies, permitting healthcare providers a means to assess the financial benefit of these technologies for patients with chronic heart disease. Remote patient monitoring (RMP) supplies an ever-growing means of distributing health care in the U.S. improving care delivery, access to care, and quality of life, while cutting health care costs. Typically suppliers and buyers interested in RMP programs usually need evidence, especially financial evidence, that illustrate the proficiency of a RPM program before granting its approval of integration or expansion. Therefore, the ROI tool aids health care suppliers the ability to evaluate the existing ROI of a recognized RPM program, in accordance with determining possible ROI for the coming years. Co-produced with the California HealthCare Foundation, this web-based ROI tool helps construct a sturdy economic case that healthcare organizations require in order to take RPM programs to the next level. “Remote patient monitoring increasingly offers providers new options for improving the care of America’s aging population, particularly those with a chronic disease,” said Director of the Center for Technology and Aging, David Lindeman, PhD. “This new tool not only assists program managers to evaluate financial ROI, but it also identifies potential program efficiencies, making the ROI Tool effective for both evaluation and decision-making,” added Corporate Manager of Research and Innovation for the Center for Connected Health, Kamal Jethwani, MD, MPH. The ROI tool was engineered and tested by a number of different health care companies that participated in the CTA Diffusion Grant Program. HealthCare Partners (HCP) used the tool to measure the worth of its remote patient monitoring program for chronic obtrusive pulmonary disease (COPD). The organization soon found out that through the use of the ROI tool, it garnered a positive ROI of 1.3 to 1 after one year, with numbers expecting to soar to 18.9 to 1 in a period of five years. "The importance of accurate, compelling and relevant health services research cannot be overstated in an evolving care environment,” said Director of the Torrance, Calif., HealthCare Partners Institute for Applied Research and Education, Jeremy Rich. Results from using the ROI tool further cements and promotes the use of RPM as a productive means of lessening unnecessary hospitalization admission ... Read more

Physicians have had difficulty meeting Meaningful Use criteria for electronic health records, according to research published this week in the Annals of Internal Medicine. The research, based on a survey of 1,820 primary care physicians and ... Read more

At a conference held at the Society for Imaging Informatics in Medicine (SIIM)  it was pointed out that computerized physician order-entry (CPOE) technology is not only limited to physicians. CPOE software can be utilized by radiologists to properly call-for the scanner protocols that perform imaging studies. At the MD Anderson Cancer Center, a scanner protocol order-entry process for radiologists that is fixed in the establishment's electronic medical record (EMR) has significantly diminished paper-driven protocol calling for MR and CT studies at five different locations. Presenter, Dr. Kevin McEnery also notes the order-entry system expands a radiologist's position in clinical management. "CPOE provides radiologists with the opportunity for an integral role in the imaging process. In my opinion, radiologist CPOE systems will contribute to redefining the radiologist value proposition,” he said. McEnery went on to add that imaging procedure protocols is a crucial step in decoding the requested imaging study into directions for technologists to use and follow. Traditionally, most radiology departments send-out for imaging protocols through a paper-driven procedure. This strategy however, depends on manual-labor, by going and retrieving clinical information and provides no room for decision support. Additionally, paper-driven methods often involve obscure logistics like faxing and delivery with the slight chance for lost protocols. Moreover, they are not implemented in the digital workflow and offer no data for process re-structuring and overall improvement. By implementing clinical order sets in EMRs gives-way to the regularity care of delivery systems. “These order sets enable efficient clinician ordering of numerous care events. They can also contain multiple instructions for care, covering medications, required tests, nursing instructions, imaging procedures, and consults,” said McEnery. For CT and MRI, order sets would consist of descriptions and specific instructions of medications covering oral contrast, intravenous contrast, allergy mitigation, and anxiety relief. Radiologists using the system can choose from a number of CT protocols with designated presets. They themselves can add options and medications. For MRIs, radiologists can select and highlight areas of interest and the scanning sequences required. The system also has the ability to predict how long a protocol will take to be carried-out. Research studies that focus on the use of CPOE software in radiology are usually assessed EMR order formation by clinicians, with decision-support studies observing clinicians order the proper exam. However, current software doesn’t necessarily identify radiologists as clinicians. The EMR is essentially an order system, while the RIS is a protocol entry system. Protocols determine the technical facets of an examination, while medication order entry and incorporated oversight of historical information focus on the clinical elements of a radiologist's job; since radiologists make sure a patient's scan will be optimized for radiation, medication, and clinical outcome, he/she must be present in both the technical and clinical imaging areas. For now McEnery believes a concept of radiologist CPOE: a system that allows radiologists to perform order entry in regards of patient information will lead to vast improvement. "It will elevate the role of the radiologist in the clinical management process. Radiologists filling out protocols and order sets exactly like clinicians gives the perception and, actually, the reality that the radiologists are participating in the same care-giving process that the clinicians are,” he ... Read more

EHI Intelligence has published detailed research on the strategies that NHS trusts are following to develop electronic patient records. The new report, ‘Routes to EPR’, details how hospital trusts across England are pursuing a range of different strategies to develop electronic patient records and become paper-lite. Analysts from the research arm of EHI conducted in-depth interviews with IT directors and other senior IT managers at 10% of the acute trusts in England. The result is a unique insight into the strategies – or ‘Routes to EPR’ – that are being pursued by trusts, alongside detailed profiles of the progress made to date by the 16 trusts involved in the research. These include trusts taking very different approaches to EPR, from Cambridge University Hospitals NHS Foundation Trust, which has signed a ‘single supplier’ deal with Epic, to Moorfields Eye Hospital NHS Foundation Trust, which is developing its own, open source system, OpenEyes. The research is particularly timely given the launch of the new £260m Digital Innovation Fund, made available by NHS England to help trusts accelerate their development of electronic records and technologies that underpin patient safety, such as e-prescribing. The £260m fund is intended to support health secretary Jeremy Hunt’s commitment for the NHS to become paperless by 2018. As a first step towards that aim, trusts must have plans for implementing electronic records in place by April 2014. NHS England will publish guidance on these plans at the start of next month. The ‘Routes to EPR’ report published today shows that trusts have three routes open to them – to buy all but very specialist systems from a ‘single supplier’, to buy a suite of ‘core’ systems from one supplier, or to pursue a pure ‘best of breed’ strategy, by connecting systems through a portal. It shows that whatever direction they are taking, trusts are looking to create as integrated a suite of systems as possible, and to reduce the number of systems to which this is interfaced. Adding systems to support clinicians in making prescribing and clinical decisions is a priority, as is sharing information with GPs and, eventually, patients. The interviews also explored the additional steps that trusts would need to take to become paperless or paper-lite, and the financial and other costs and benefits of deploying EPR systems. Only one of the trusts involved had set a date for going paperless – 2017 – and only one other interviewee said that their trust would remove all paper in time. The others were aiming to be “as paperless as possible” or paper-lite. Trusts aiming for paper-lite working tended to be looking at electronic document management projects to deal with legacy notes and information on any paper that remained. Lead author, EHI Intelligence senior analyst, SA Mathieson said: “The report provides a unique set of profiles showing the steps that trusts have taken to develop EPRs and the progress they have made. “The strategies outlined in this report would generate many of the benefits that the government has cited, in terms of making healthcare easier to access, more efficient, safer, and better information-based. “However, the IT directors that we spoke to are pragmatists. They have been trying to achieve aims similar to those now being promoted by Hunt and NHS England for several years and have a realistic view of the problems to be overcome; as well as the benefits to be achieved.” The research also confirms that EPR projects are major developments for trusts. Few of the IT directors interviewed expected cash savings from EPR programmes, and most were expecting their budgets to ... Read more

Using an electronic medication management system did not significantly affect the amount of time doctors and nurses in an Australian study spent on direct patient care or medication-related tasks. The Australian research, published in the Journal American Medical Informatics Association, involved time and motion studies of 129 doctors and nurses for 633.2 hours on four wards in a 400-bed hospital in Sydney. It compared a period before the system was implemented and the period after the hospital installed the Cerner Millennium PowerOrders technology into its CPOE system, also comparing wards using the new technology on both computers on wheels and desk PCs with wards that still used paper charts. A study published in in JAMIA in February found that using computerized physician order entry averted 17.4 million medication errors in the United States in a single year. However, ensuring that health IT fits into clinicians' workflow has been central to the effort to introduce new technologies. It found that in the post-period, doctors using paper charts spent 19.7 percent of their time (2 hours out of a 10-hour shift) on direct care and 7.4 percent (44.4 minutes out of a 10-hour shift) on medication tasks. Meanwhile, doctors using the electronic system spent 25.7 percent of the their time (2.6 hours per shift) on direct care and 8.5 percent on medication tasks (51 minutes per shift. Nurses using paper charts in the post-period spent 22.1 percent of their time (1.9 hour per 8.5-hour shift) on direct care and 23.7 percent on medication tasks, while nurses using the computerized system spent 26.1 percent of their time  (2.2 hours per shift) on direct care and and 22.6 percent (1.9 hours per shift) on medication tasks. Over the course of the study, there was an overall increase in time for both spent in direct patient care unrelated to the new system and also an increase for both in time spent on medication tasks. Doctors who used the new system, however, spent less time alone and more time with other doctors and patients, and nurses using the new system spent less time with doctors. Research from Johns Hopkins University School of Medicine found that medical interns spend 12 percent of their time examining and talking to patients, and more than 40 percent of their time behind a computer. It called for better EHRs to reduce the amount of time doctors spend looking up patient histories. With big Medicare penalties for high readmission rates, hospitals are focusing on ways pharmacists can help prevent them. Atlanta Medical Center keeps pharmacists involved during the stay and afterward. Barnes-Jewish Hospital in St. Louis found a link between readmission and patients never filling their prescriptions upon dismissal. It now uses technology that allows patients to fill their prescriptions before they ... Read more

In a recent roundtable discussion focusing on challenges associated with implementing electronic health record systems, several hospital executives pointed to workflow issues as being the most difficult to overcome, Becker's Hospital Review ... Read more

The healthcare IT merger and acquisition space will go through heavy consolidation over the next five years, according to Tom O'Connor, managing director at New York-based Berkery Noyes. In a recent interview with Healthcare Informatics, O'Connor, touting a recently released whitepaper by the investment bank, said that there simply are too many players in the industry, despite the need for constant innovation. "Everyone's under a lot of financial pressure in healthcare to do more with less," O'Connor told Healthcare Informatics. "There will be bigger vendors, but they'll be doing more." According to O'Connor, healthcare, along with education, are more than a decade behind other industries in going digital. Still, he said, the health IT industry a "mixed picture" in which more vendors are fighting for bigger shares of a limited hospital market. "And hospitals want fewer vendors, to make them more efficient … 10 years from now, you'll see a lot fewer companies," he said. According to a Berkery Noyes report published in January, mergers and acquisitions in health IT increased considerably from 2011 to 2012, with smaller deals yielding big returns on investment. The report, which analyzed M&A activity in 2012--comparing the data since 2010--showed that healthcare IT M&A transaction volume increased 21 percent annually, with private equity firms accounting for four of the industry's top-value deals last year. Mercom Capital Group reported in April that health IT companies raised a record $493 million in venture capital during the first quarter of 2013, with 104 deals ... Read more

National Lung Screening Trial (NLST) investigators also conclude that the 20 percent reduction in lung cancer mortality with low-dose computed tomography (LDCT) versus chest X-ray (CXR) screening previously reported in the NLST primary paper is ... Read more

Healthcare providers are swamped in data, leaving them searching for effective storage solutions even as the amount of data continues to explode, according to a story at CIO. For example, 3-D imaging can boost the amount of information by a factor ... Read more

They never said navigating the electronic medical record landscape would be easy — at least not at first. And as new regulations from both federal and state spheres begin to tighten their hold around the industry, the valleys of EHR adoption and EHR mastery are sure to only become more congested and therein, even harder to get a handle on.  Fortunately, current EHR veterans saw it coming and set out early with open minds — ready to note and reroute the process wherever necessary — and are now reporting back at last on the troubles and tricks that arise when dealing with digitized data. Panelists on deck in Boston for the recent Health IT Summit session titled "EHR Data: A Touchstone for Quality Care" had plenty of diverging facets to share on the topic of EHR integration, but one primary point remained: We are all in this together. “For things like this, I think all doctors are created equal,” said Jonathan Leviss, MD, chief medical officer for Rhode Island Quality Institute, a physician for Thunder mist Health Center and a clinical assistant professor for Alpert Medical School and Brown University. “The one thing that I’ve learned most importantly is that these are team-based efforts,” he continued. “We’re talking about getting data out of electronic health records, out of different HIT systems, to drive quality initiatives, which requires us to look at data in a way that an individual person can’t, the individual brain, whether that’s a physician, a nurse or a quality person.” Beyond that need for a pack mentality in the EMR stratosphere, Reid Coleman, MD, chief medical information officer for evidence-based medicine, Nuance Communications, spoke of the importance of roles distributed to people who both know the importance of data and who want to be strictly involved in the pursuit of it. “Unfortunately, we started to lean too far in one direction in turning clinicians into data-entry technicians, which clinicians don’t do well, which I think is important and they don’t like doing, which is equally important,” Coleman said. “One of the big challenges that we face is finding a way to let the clinicians do what they do best, which is tell the patient’s story and explain their understanding of both the patient condition and plans for treatment and then use tools to take that and turn it into usable data. And boy, do we need the data — we need the data for analytics and from my perspective, to trigger workflows, to set people down the right path based on what the clinician has said about the ... Read more

After three years of contraction, the U.S. interventional X-ray equipment market has, as of the end of 2012, begun to veer back into positive growth, according to a report from the market research firm Frost & Sullivan. The change in market ... Read more

Electronic health record technology alone will not be sufficient to implement accountable care, according to a new report from IDC Health Insights. It has released a five-stage Accountable Care Maturity Model designed to help healthcare ... Read more

The healthcare industry has been increasingly under attack, specifically the cyber kind, during the past two years. Cybercriminals have started shifting their target of attack towards healthcare organizations because of many reasons. Healthcare ... Read more

The healthcare industry, like most industries in today’s business world, depends mainly on IT systems to carry out operations, record different data and process financial transactions. And as the reliance on those IT systems increases, the risk of the data stored and processed using these systems to be intercepted by criminals and misused has also increased greatly. In the past three years, many studies have shown that the healthcare industry has faced a major increase in cyber attacks although securing the systems has become the main focus of the efforts of both IT and healthcare providers. However, the percentage and extent of the attacks are on a rise, that is why it is essential for both the healthcare and IT providers to identify the main targets being attacked by the cyber criminals and for ways to secure the entry points of such attacks instead of just increasing the secure measures in general. An annual investigation of security breaches is conducted by Verizon on the systems of various industries to determine the vulnerabilities of such systems and the main areas targeted by the criminals. In 2012, Verizon conducted the investigation on healthcare industry systems. The detailed study can be downloaded here.  It is also to be noted here that the healthcare industry has become one of the highest industries experiencing security breaches and data theft. The study showed that the small to medium-size category of healthcare providers were attacked the most mainly because their systems are usually less secure than the larger organizations. The main concern of the study was that healthcare providers need to understand that the reason criminals attack their systems is not to get patient medical data but rather to obtain information that they can use to make financial gain,like social security numbers and data recorded in financial transactions.The attacks on the healthcare organizations included in the study were mainly caused by external threats, some internal threats occurred due to stolen laptops and mobile devices, but the major security breaches were caused by outside perpetrators.93% of the attacks were carried out using malware and hacking techniques. The attackers gained access to the systems using easily guessable or default passwords, back doors to the organizations’ systems, using brute force attacks (trying out a “dictionary” of possible usernames and passwords), stealing log in information with spyware, tricking employees into installing malware on the computers to use in stealing information and sending it to a remote site. Verizon analyzed the main areas targeted by attackers which may be either the less secure points in a system or the places where the data sought are stored or processed. The most common targets were the Point of Sale (POS) terminals and servers, desktops and workstations and storage systems. The POS terminals and servers were the most common targets, attacked 64% and 48% of the total number of security breaches analyzed, respectively. The reason that these points were attacked the most is that financial and insurance information are entered, processed and stored using these terminals, which the attackers can use to assume medical identities and make financial gain. Desktops and workstations were attacked in 38% of the security breaches,where the criminals trick organization employees into installing malware and spyware on their computers by downloading software or clicking on malicious links.Storage systems are also valuable to criminals,although they were attacked the least, because they contain medical and financial information that could be useful to them. After analyzing the vulnerable points and main points of entry that criminals target to attack healthcare organizations, the study states that although no single set of recommendations can be formulated in order to prevent cyber attacks as each organization is different so its IT team should assess the weaknesses and identify the major threats that could be attacked, the study made some recommendations in order to help healthcare organizations in protecting themselves against potential cyber attacks. Verizon recommended that administrative passwords should be changed constantly on all POS systems as hackers always scan the internet for easy passwords, it is also advisable to avoid using POS computers to access the internet. Another recommendation is to implement a firewall or access control list on remote access / administration services in order to prevent hackers from gaining access into the system and ensure that the POS is a PCI DSS-compliant application which would increase the security around card holder data to reduce credit card fraud via exposure of data. If any of the organization’s security systems or POS terminals and servers are managed by a third party, the healthcare organization should make sure that the appropriate security measures are maintained by the third party. And due to the seriousness of the issue of cyber attacks on the healthcare industry, it is important to mention another study that discusses the vulnerability of the US healthcare system and the recommendations that can help healthcare organizations in guarding themselves against such threats. This paper is published in detail on this page. The authors of the paper, Mr. David Harries and Dr. Peter Yellowless, discussed prevention steps on a more strategic level to be adopted by large as well as small healthcare organizations each according to their needs and security vulnerabilities. The six guidelines mentioned by the authors are performing regular security assessments to determine any security gaps, installing and maintaining intrusion detection and prevention services that can detect and block cyber attackers, installing a data loss prevention solution that checks for leakage of information, keeping audit logs to track access to sensitive patient data, regular testing of web security and mandating encryption of software for mobile devices, laptops, portable storage and backup tapes. As healthcare systems become more complicated with different functionalities and connected to various other systems and related parties, the threats to the financial and medical data going through these channels become more serious, thus it is the duty of every organization to take all precautions and measures to keep its systems and data secure from such malicious ... Read more

While Meaningful Use regulations provide potential bonus payments of $1.5 billion over the next four years, many radiologists have been slow to comply. According to a survey published by Diagnostic Imaging earlier this year, only about four out of ... Read more

NEW YORK, May 7, 2013 – eHealth Technologies announced today that Massachusetts General Hospital has selected the new eHealth Connect® Referral Portal to provide referring physicians easier access to their facility and a clear, single process to submit new referrals. The site also allows the referring provider to receive key updates about their patients’ appointments and the results of the referrals. eHealth Connect® Referral Portal is an easy-to-use “branded” portal that connects referring physicians with hospitals and health systems for convenient two-way communication and streamlined collection of all required patient information. Incoming data can be interfaced directly into existing systems eliminating manual entry. The portal is customizable, allowing organizations to educate their referring physicians about new trials, services, physicians and more. “We continuously strive to improve our service and coordination of care for our patients and referring physicians,” said Alexa Kimball, MD, Senior Vice President, Massachusetts General Physicians Organization. “Facilitating patient referrals can be further streamlined by an online mechanism that offers referring physicians a way to initiate referrals quickly and ensure they are triaged to the appropriate provider.” "We are thrilled to be collaborating with Massachusetts General Hospital to further improve continuity of care and enhance their patient and referring physician satisfaction—by streamlining transitions of care, and by providing the right patient information–when and where it is needed,” said Michael Margiotta, CEO for eHealth Technologies. “The Referral Portal’s template-based web interface provides a fast and easy way for referring physicians to submit specific information needed by our hospital and health system customers. Patient reports, demographics and results are sent along with the referral so that it is instantly available to staff.” About eHealth Technologies™: eHealth Technologies is a leading provider of continuity of care solutions, serving leading health information exchanges (HIEs) and over half of the nation's top 100 hospitals, including 12 of the top 17 U.S. News & World Report Honor roll Hospitals for 2012-2013. The company's eHealth Connect® offering enhances patient and physician satisfaction by streamlining transitions of care, and by providing the right patient information – when and where it is ... Read more

Researchers from the Mayo Clinic have developed a computer-aided electronic warning system to help identify patients at risk for premature death, such as from an abnormality in the heart's electrical system, the institution recently ... Read more

Personal health records represent a faster, more patient-friendly method for health information exchange than actual HIE solutions, according to David Mendelson, a professor of radiology at Mount Sinai Medical Center in New York. Mendelson, speaking at the Information Management Network Hospital Cloud Forum in New York on April 16, said that PHRs are "less cumbersome … for exchanging health information," as they eliminate the need for multiple business association agreements while encouraging patient engagement, according to an article published this week by Health IT Security. "You as the consumer are interested in controlling the flow of your data and expediting that flow when necessary," Mendelson said. ' It actually eliminates a whole set of consent issues out there. Once you put the data into the PHR, you as the patient have the ability to distribute and control the distribution. You don't have to sign consent forms anymore, which just introduces a delay and a bureaucratic step." Mendelson specifically talked about such exchange efforts with regard to image sharing, as he serves as a principal investigator for the Radiological Society of North America's Image Share project. "As much as I would like to believe that the HIE solution can work and will work, I still think if you have a significant illness, you'd like to have your data in your hands just to get it to the doctor you choose to see at any given moment in time," he said. In a recent interview with FierceHealthIT, Laura Mccrary, executive director of the Kansas Health Information Network, talked about her organization's plans for using PHRs to facilitate information exchange. Mccrary said that KHIN is in the process of putting in a state-wide patient portal--a PHR that will connect to the health information exchange. "Patients will be able to have their own information from the health information exchange and over time … we plan to allow patients to see who's accessed their information in their personal health record," she said. Research published in February in the Journal of Medical Internet Research determined that PHR adoption by patients can be influenced by provider ... Read more

The Food and Drug Administration has announced updates to its post-market surveillance of medical devices in order to add more input from physicians and patients. The added updates are designed to create a system capable of "providing ... Read more

While demand for IT talent in healthcare remains high, salaries appear flat according to InformationWeek's 2013 U.S. IT Salary Survey. The demand, however, indicates continuing upward pressure on salaries, the report says. It finds no rise from a year ago in median annual base pay at $83,000, compared with $87,000 for IT pros across all industries. Healthcare IT managers received a slight boost in average base pay to $112,000, up from $109,000 in 2012, more than the industry average of $110,000. However, there tend to be fewer bonuses in healthcare, the report says, and they're smaller for healthcare IT managers. Just 4 percent of healthcare IT manager compensation is beyond base pay, compared with 8 percent in the industry overall. Fifty-three percent of healthcare IT staff  say they will receive bonuses in 2013 and 67 percent of managers. Total compensation for staffers inched up 1.2 percent for staffers to a median of $85,000 and 1.9 percent for managers to $117,000, a slower growth rate that the survey found in the previous two years. Just 18 percent of mangers say they are satisfied with their overall compensation package. The survey polled 711 IT staff and 586 IT managers. The lagging pay can be explained, to some extent, by the number of nonprofit and government organizations included in the sector where salaries are lower, the report says. The median base salary for IT staff in the nonprofit sector is $65,000 and at $70,000 with state and local governments. However, women IT pros in the healthcare are closer to achieving parity with men than in the industry overall. Female IT staffers earn $84,000 in median total compensation, compared with $85,000 for men; for managers, men earn $118,000 and women $117,000. That 1 percent wage gap compares with a 13 percent difference in the industry at large. The sector differs from the wider industry, though, by attracting more physicians into CIO, CMIO and research IT positions, which can boost salaries. High demand continues for talent in data management, business intelligence and as chief technology officers. A recent report from Towers Watson reiterated the difficulty organizations have in IT staffing, recommending the best retention tools are increases in base pay, retention bonuses and additional education. Hospital size makes a big difference in CIO pay, according to the College of Healthcare Information Management Executives. Hospital CIOs averaged $208,000 annually in 2012, while those at facilities with fewer than 25 beds earned as little as ... Read more