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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.

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.

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.

2012 will be the year in which health IT "truly comes of age," Mostashari predicts.

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.

A major U.S. Department of Health and Human Services contractor has fallen behind in its efforts to promote electronic health records, concluded the General Accountability Office in a Jan. 13 report.

The contractor, the not-for-profit National Quality Foundation, or NQF, failed to deliver five of eight projects related to electronic health records activity on time, according to the report, "Health Care Quality Measurement: HHS Should Address Contractor Performance and Plan for Needed Measures."

NQF converted existing quality measures to an electronic format compatible with EHRs -- 113 measures, according to the report. The retooling will allow data from EHRs to be exchanged and used for measuring quality of health care. The project deadline was September 2011, but the project was not completed until December, GAO said.

NQF also was required to convene an expert review panel to examine the retooled measures to ensure proper formatting and correct logic. The panel was convened in June, five months later than required.

As of August 2011, NQF had failed to meet timelines on 18 of 26 projects in nine contract categories during the first two years of the four-year HHS contract, the report said.

HHS and NQF officials listed several factors that they said contributed to the extended project timeframes. According to HHS, the first set of 44 retooled measures had errors requiring correction, including errors in electronic coding. Both organizations also said the estimated timeframes were "overly ambitious, given the scope and complexity of the work." HHS officials said "the technical complexity and labor required to complete the project were greater than anticipated."

NQF officials said HHS also modified the scope of work, requiring the company to hire extra staff to handle the work.

HHS officials told the auditors that they rely on NQF to inform them of problems in its monthly progress reports, but the GAO said the agency did not use available monitoring tools required under its contract with NQF. "These tools could have helped to provide an opportunity for HHS to make any appropriate changes to NQF's projects," the GAO said.

The GAO recommended that HHS:

• Use monitoring tools required under the NQF contract to obtain detailed and timely information on the company's performance and use that information to inform changes to timeframes, projects and cost estimates through the remainder of the contract.


• Ensure that testing of the electronic versions of the measures retooled by NQF to be used in the Medicare and Medicaid EHR incentive programs be completed in a timely manner to identify potential errors and address implementation issues.


• Develop a comprehensive plan that identifies the quality-measurement needs of HHS programs and initiatives and provides a strategy for using NQF's work product to meet those needs.

HHS neither agreed nor disagreed with the recommendations, the auditors said. NQF concurred with "many of the findings," clarified several issues and noted challenges the organization faced, including having to develop new software to implement health IT requirements in the contract.

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.

Blood-pressure control improved for patients of all racial and ethnic groups who were cared for by providers using EHRs and CDS, Dr. Lipika Samal of Brigham and Women's Hospital wrote in the report, according to CMIO. Practices that did not use health IT reported disparate outcomes in the hypertension-control rates of non-Hispanic blacks and non-Hispanic whites, CMIO reported.

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.