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.

"The importance of these requirements goes beyond meeting the incentives for meaningful use," writes CSC's Erica Drazen, author of "Moving Ahead with Stage 2 of Meaningful Use." Patients need access to their records to become accountable for their care, she writes, and accountability of providers rests on their being able to share patient information with one 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.

Health information exchanges represent a "megachange challenge" that won't be surmounted without breaking down financing, governance and policy barriers, the Washington-based Brookings Institution writes in a new report.

Health information exchanges are intended to allow doctors, hospitals and insurers to share information seamlessly and make health care more cost-effective and efficient. They also will retain insurance information for patients without coverage.

The good news is that HIEs have "made progress in establishing organizational frameworks, building technology-based connections, and bringing relevant groups to the table for discussion," co-authors Allan Friedman and Darrell West write in the introduction to the think tank's Feb. 8 report, "Health Information Exchanges and Megachange."

It's been more difficult for states and regions to agree on how HIEs should operate and how to fund them, the authors say. It's not even clear whether states ought to be operating exchanges because they don't take advantage of regional "natural marketplaces."

"Until those problems are overcome," Friedman and West write, "it will be impossible for HIEs to achieve their full potential."

If HIEs are to work, the authors say, "policymakers must present a clear vision, achieve consensus on key objectives, overcome organizational and market fragmentation, and work effectively with a range of different constituencies." Public and private leaders will need incentives to cooperate "in relationships based on mutual trust," they write, and sustainable business models and financing sources must be developed for the exchanges.

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.

"Products like the iPad ... have derived many of their most attractive features by adopting non-industry-standard components," the researchers said. "Because of this, it is often not possible for these technologies to comprehensively interact or comply with key systems, policies and processes."

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 federal Centers for Disease Control and Prevention now has an app geared toward the iPad generation.

The CDC's leap into mobile health gives iPad users touchpad access to the organization's Facebook, Twitter and YouTube sites, as well as articles about health topics, a health-related blog, updated CDC announcements and news releases, and the CDC's podcast library.

With the ability to quickly update public-health information, the site could become an important mHealth resource during times of a public health crisis, such as a flu pandemic.

Download the free app at the CDC's website.