Industry Archives

Health-care providers still have a lot of work to do to meet key health IT requirements expected under the government's Stage 2 "meaningful use" standard, a new industry report finds.

CSC, an IT consulting firm based in Falls Church, Va., says the following essential areas require immediate attention:

• Electronic patient access to personal health information.


• Electronic capture of physician notes, including diagnosis and treatment, and rationale for excluding patients from treatment recommendations.


• Electronic exchange of patient information from one provider to another.

Only 12 percent of hospital chief information officers in a survey said they were prepared to allow patients to view and download their information; 24 percent said they couldn't yet transmit summary-of-care records when a patient left the hospital. And only 25 percent said they can meet proposed Stage 2 requirements for electronic physician notes.

The problem is twofold, they said: vendor products and operational readiness.

Expected Stage 2 goals for electronic medication administration (eMar) have been easier to reach, with 86 percent of the survey's respondents saying they are prepared to implement eMar in at least one hospital unit, as required.

The report combines information from early attesters to meaningful use with results of a survey of CIOs belonging to the College of Healthcare Information Management Executives.

Final rules for Stage 2 meaningful use are supposed to be published in July, but a delay is likely because the Centers for Medicare and Medicaid Services missed a December 2011 target date for releasing an early version of the rules.

While health-care professionals seem to love iPads, health IT professionals are less enamored with the consumer-friendly tablet computers, according to a new industry report.

Doctors and others are more likely to use technology they like, which could help chief information officers get everyone on board in using electronic health records and other health IT systems. But iPads in particular are challenging to integrate into existing health IT, according to the report from BizTechReports, "Diagnosis Danger: Governance and Security Issues Cause IT Concerns About iPad in Healthcare Settings."

"There is a sense of concern among healthcare IT executives that pressure to meet the demands of end-users to support consumer-grade computing and communications devices like the iPad is coming at the expense of other important priorities," the researchers reported.

Areas of concern reported by the 100 hospital and clinic CIOs and other health IT executives interviewed by BizTechReports, an independent, Washington, D.C.-based research group, include:

• Compliance with privacy governance requirements.


• The need to manage risk while sharing health information with other users.


• The ability to quickly react to and remediate data breaches.


• Integration with end-to-end productivity systems.

For example, electronic patient records are not meant to be managed on consumer-grade technology like the iPad, according to the report. It's also difficult to enter information from an iPad into an enterprise system like an EHR. Nor do iPads have mechanical keyboards or USB ports that can attach devices such as barcode scanners, severely limiting the number of applications they can support.

Panasonic Solutions Co. teamed with BizTechReports to produce the study.

A population that is on the move will increasingly turn to mobile health applications, predicts a new market study.

The Hampshire, England-based Juniper Research Ltd. projects that mobile networks will monitor 3 million patients by 2016, according to a company news release. The growth will be fueled in part by increasingly more capable smartphones, the company says.

U.S. insurers already offer reimbursement for mobile cardiac monitoring, which makes the monitoring of cardiac outpatients the top remote monitoring field, according to Jupiter. But the analysis projects growth in the monitoring of other chronic diseases, including diabetes and Chronic Obstructive Pulmonary Disease.

Other projections:

• Consumers will download 44 million mHealth and medical applications this year.


• That number will grow to 142 million in 2016.


• Electronic health records will eventually be an important piece of mHealth offerings.


• Smartphone-based patient monitoring will replace expensive specialized remote monitoring systems and drive down mHealth costs.

The nation's health IT czar polished off his crystal ball this week and predicted five major health IT trends for the year. Dr. Farzad Mostashari, national coordinator for health IT, shared the prognostications on his office's Health IT Buzz blog:

• Meaningful use takes off. Mostashari projects that at least 100,000 providers will demonstrate that their electronic health records meet ONC standards for "meaningful use" by the end of the year, enabling them to receive Medicare or Medicaid incentive payments.


• Health information exchanges turn a corner. "ONC efforts are critical," he writes. "Robust policies that protect information and create public trust will galvanize rapid growth and innovation in health information exchange.


• The dots connect between health IT and payment reform. Pay-for-service models lead to higher costs, he argues, just as health IT helps hospitals and practices to move away from traditional pay models. "We are headed toward a virtuous cycle where payment reform improves the business case for using health IT and greater use of health IT improves the chances that new payment models will succeed."


• Consumers take advantage of eHealth resources. Mobile apps and other technological advances make it easier for patients to become more involved in improving their health, Mostashari says.


• Innovation drives improvement. Efforts in 2012 will focus on improving the usability of EHRs, he says.

Venture capitalists continue to view health IT companies favorably.

Investment by VC funds in the health IT sector increased 22 percent last year over the 2010 total, far outpacing the overall 10 percent increase in the amount of capital raised across all industry sectors, according to a Jan. 20 report by Dow Jones VentureSource.

Venture capital firms invested $633 million in 86 health IT deals last year, according to a news release. That's a 26 percent increase in the number of deals done in 2010.

Overall, venture capitalists invested $8.4 billion in the health-care sector in 2011, up only slightly from the $8.3 billion invested in 2010. Biopharmaceuticals led the category, followed by medical devices.

Venture capitalists poured $32.6 billion into 3,209 deals across all industry sectors, according to the release.

The full report is available online for VentureSource subscribers.

Physicians who have an ownership stake in a medical practice are more likely than other doctors to rate EHR implementation as difficult.

That's the finding of a study published this month in the Journal of the American Medical Informatics Association.

"Physicians who own their practice may need more external support for EHR implementation than those who do not," the authors report in an abstract of the article. "Innovative clinical support staff may ease the EHR implementation process and contribute to its success."

In an article about the full report, ModernHealthcare.com said that about 25 percent of physicians who weren't practice owners termed EHR implementation as "very difficult." Among owners, 38 percent rated implementation as very difficult. The authors said financial risk might skew doctors' perceptions, Modern Healthcare reported.

The researchers, from Boston-based Partners HealthCare, interviewed 150 Massachusetts physicians.

The full article is available online to JAMIA subscribers or for purchase.

If you have to sit in traffic, you might as well do something to improve your health.

At the Digital Health Summit during this month's Consumer Electronics Show in Las Vegas, Ford Motor Company promoted mobile health apps enabled by its Sync computer system. Ford announced partnerships with Microsoft HealthVault, Windows Azure and Healthrageous Inc. to develop a prototype system that works with "compatible biometric measurement devices."

Sync "provides easy, voice-controlled access to mobile devices such as smartphones and tablets, and therefore it makes sense to research areas that are important to our customers," said Gary Strumolo, manager of infotainment, interiors, health and wellness at Ford Research and Innovation, in a news release.

Ford thinks cars could be the ultimate mobile-health platform. They're convenient and private, and they can provide "personalized access" to health information, products and services. Accessing health apps will give people something constructive to do when they're stuck in traffic, the automaker says.

BlueMetal Architects of Watertown, Mass., designed the prototype mHealth system. Boston-based Healthrageous compiles information collected from blood-pressure monitors, activity monitors and glucose meters along with "behavioral data" provided by the patient to help people end unhealthy habits, Ford says. Microsoft's programs "translate robotic sensory information" provided by the vehicle into an application with a voice and touch-screen interface.

The system will upload data from the driver to the HealthVault cloud and transfer the information to Windows Azure, which creates graphical reports that the driver can read upon reaching his or her destination.

Health IT appears effective in helping medical practices to keep their patients' high-blood pressure under control, according to a study published in the Archives of Internal Medicine.

The combination of electronic health records and clinical decision support (CDS) systems showed the best results, according to researchers from Boston's Brigham and Women's Hospital and the University of Massachusetts Medical System in Worcester. Practices using health IT reported greater success in keeping patients' blood pressure under control and fewer disparities in outcomes among racial and ethnic groups, according to an article by CMIO.net, a health-care online news site.

According to CMIO, the researchers found:

• Providers using both an EHR and CDS managed to control the blood pressure of 78 percent of non-Hispanic whites and 85 percent of Hispanics.


• Providers using neither health IT system had blood-pressure control rates of 75 percent of non-Hispanic whites and 69 percent of non-Hispanic blacks. A comparable rate for Hispanics was not included in the CMIO article.

The researchers used data from the 2007-2008 National Ambulatory Medical Care Survey, administered by the National Center for Health Statistics. In the study group, 15 percent of providers had EHRs, 27 percent had EHRs and CDS, and 48 percent had neither. The researchers said further study is needed.

The full text of the Jan. 9 Archives of Internal Medicine article, "Impact of Electronic Health Records on Racial and Ethnic Disparities in Blood Pressure Control at U.S. Primary Care Visits," is available online for subscribers and registered users.

Here are the top 10 developments in health IT for 2011, straight from the national coordinator for health IT. Dr. Farzad Mostashari released the month-by-month list Jan. 6 on his Health IT Buzz blog:

• January: Medicare and Medicaid electronic health record incentive programs launched. Since then, "the marketplace of certified products has grown quickly, interest in meaningful use among providers and hospitals is sky-high, and the pace of incentive payments has continued to accelerate," Mostashari said. More than $1.8 billion in incentives had been paid to more than 20,000 health-care providers and 1,200 hospitals as of Nov. 30.


• February: ONC launched Direct Project, providing "a simple, secure, standards-based way for providers and other participants to send encrypted health information directly to trusted recipients over the Internet - a kind of 'health email,'" Mostashari said. Multiple vendors and states are implementing the system.


• March: The Health and Human Services Department, ONC's parent agency, released its National Quality Strategy, a framework to guide efforts to improve health-care, with health IT as a critical component.


• April: The "Summer of Standards" kicked off, a series of standards and interoperability forums to support Stage 2 standards and certification requirements for EHR incentive programs, resulting in consensus being reached on the Consolidated Clinical Document Architecture. Mostashari described the architecture as a "single, broadly supported electronic data standard for patient care transitions."


• June: The Investing in Innovations (i2) program used challenges and prizes to promote innovations in health IT. Several i2 challenges have been launched since, including a call to create applications "activating and empowering patients to improve their heart health."


• July: Health IT training curriculum was released on the open market in July. Employment continued growing in the health IT workforce, which added more than 50,000 jobs between 2008 and 2010, according to the Bureau of Labor Statistics.


• September: HHS' Office for Civil Rights issued its first report to Congress on breaches of protected health information. Breaches now must be reported to HHS, those affected, and in some cases the news media.


• September: ONC formally launched its Consumer e-Health Program, with the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention proposing regulations making it easier for patients to access lab data. More than 250 organizations covering more than 100 million people, including Aetna, the Mayo Clinic and AARP, have "agreed to make health information easily available to consumers," Mostashari said.


• October: ONC's 62 Regional Extension Centers passed their goals to enroll 100,000 "priority" primary-care providers nationwide, and by mid-December had enrolled 116,000 providers requesting help with EHR implementation, including 70 percent of rural primary-care providers.


• November: A CDC survey of office-based physicians showed the percentage of nonhospital-based physicians with a basic EHR doubled from 17 percent in 2008 to 34 percent in 2011, with nearly 40 percent of primary-care physicians adopting an EHR. The proportion of hospitals operating EHRs with the functionality required in the Medicare and Medicaid incentive programs rose from 2 percent to 41 percent, among hospitals eligible for the incentives.

Electronic health records top a list of 10 technologies hospitals need to watch in 2012, according to a report released today by ECRI Institute.

"Technology is increasingly a top management concern, and is no longer confined to clinical and technical decision making. Themes emerging on our 2012 list reflect ongoing impacts of health-care reform initiatives and new technology developments that emphasize patient-centered care," says Jeffrey C. Lerner, president and CEO of ECRI Institute, in a news release. ECRI, based in Plymouth Meeting, Pa., is an independent, not-for-profit organization that focuses on improving health care.

Hospitals need to focus on meeting Stage 2 meaningful-use criteria this year to continue qualifying for federal health IT reimbursements, the organization notes in its report, "ECRI Institute's Top 10 C-Suite Watch List: Hospital Technology Issues for 2012."

The report cites Stage 2 criteria including:

• Increasing the threshold for computerized physician order entry from 30 percent under Stage 1 criteria to 60 percent.


• Requiring that vital signs be recorded electronically for 80 percent of patients, up from 50 percent under Stage 1.


• Recording how the patient prefers to receive communications.


• Enabling Web-based access to inpatient records.

After developing a medical-device integration plan, hospitals will have to determine how they will share the information with health information exchanges, the report notes. "The IT challenges, as well as contractual issues (e.g., with your state or regional health information exchange) related to integration seem unending."

The report is available, with registration, through the ECRI Institute website.