Patient Portal Explosion Has Major Health Care Implications

Terry, Ken. "Patient Portal Explosion Has Major Health Care Implications." iHealth Beat, February 12, 2013. 

From the article: "A small fraction of physicians use a Web portal to interact and share information with patients today. But meaningful use Stage 2 requires that eligible professionals ensure at least 5% of patients view, download or transmit their electronic health records. As a result, the use of patient portals is likely to skyrocket. If that happens, experts say, the impact on health care could be quite significant." Read more

EHR Adoption Could Exceed 80 Percent by End of 2013, New Study Finds

McCann, Erin. "EHR Adoption Could Exceed 80 Percent by End of 2013, New Study Finds." Healthcare IT News, January 15, 2013. 

From the article: "Family physicians are adopting electronic health records (EHRs) at a much faster rate than previous data suggested, reaching a nearly 70 percent adoption rate nationwide, new study findings reveal. 

The study, published in the January/February issue of the Annals of Family Medicine, shows EHR adoption by family physicians has doubled since 2005, with researchers estimating that the adoption rate will exceed 80 percent by the end of 2013." Read more 

Mining Electronic Records for Revealing Health Data

Jaret, Peter. "Mining Electronic Records for Revealing Health Data." The New York Times, January 14, 2013. 

From the article: "Over the past decade, nudged by new federal regulations, hospitals and medical offices around the country have been converting scribbled doctors’ notes to electronic records. Although the chief goal has been to improve efficiency and cut costs, a disappointing report published last week by the RAND Corp. found that electronic health records actually may beraising the nation’s medical bills.

But the report neglected one powerful incentive for the switch to electronic records: the resulting databases of clinical information are gold mines for medical research. The monitoring and analysis of electronic medical records, some scientists say, have the potential to make every patient a participant in a vast, ongoing clinical trial, pinpointing treatments and side effects that would be hard to discern from anecdotal case reports or expensive clinical trials." Read more 

Why Electronic Health Records Failed

Kliff, Sarah. "Why Electronic Health Records Failed." The Washington Post, January 11, 2013. 

From the article: "Back in 2005, researchers at the influential RAND Corp. made an optimistic prediction: Digitizing electronic medical records could save the health-care system at least $81 billion annually.

The savings were significant but not unreasonable: It would represent less than a 1 percent cut to health-care spending, much smaller than the 1.5 percent efficiency increase the retail sector saw when it went digital.

Seven years later, those savings have not materialized." Read more

ONC Delves into Patients' Privacy Concerns

Conn, Joseph. "ONC Delves into Patients' Privacy Concerns." Modern Healthcare, January 9, 2013.

From the article: "In considering whether to participate in a health information exchange, patients want to know whether their clinical information will be shared with their insurance company and whether their more sensitive information, in addition to routine patient information, will be included.

They also want to know whether, once they have opted into a health information exchange, they can ever opt back out.

These were the findings of a survey of patients at four healthcare organizations in western New York state who participated in the eConsent Trial Project sponsored by HHS' Office of the National Coordinator for Health Information Technology." Read more

Digital Health Funding Rose 45 Percent in 2012

Huessner, Ki Mae. "Digital Health Funding Rose 45 Percent in 2012." GigaOm, January 7, 2013. 

From the article: "According to health tech accelerator Rock Health, investors poured $1.4 billion into digital health companies last year, which is up 45 percent from 2011. The major areas of interest include healthcare purchasing tools for consumers, personal health tracking, Electronic Medical records and hospital administration." Read more

Copying Common in Electronic Medical Records

Stokes, Trevor. "Copying Common in Electronic Medical Records." Reuters. January 4, 2013.

From the article: "Most doctors copy and paste old, potentially out-of-date information into patients' electronic records, according to a new study looking at a shortcut that some experts fear could lead to miscommunication and medical errors…Using plagiarism-detection software, the researchers analyzed five months' worth of progress notes for 135 patients.

They found that 82 percent of residents' notes and 74 percent of attending physicians' notes included 20 percent or more copied and pasted material from the patients' records." Read more

See also 

Thornton, J. Daryl, Schold, Jesse D., Venkateshaiah, Lokesh and Bradley Lander. "Prevalence of Copied Information by Attendings and Residents in Critical Care Progress Notes." Critical Care Medicine, December 20, 2012. 

Health-Care Sector Vulnerable to Hackers, Researchers Say

O'Harrow Jr., Robert. "Health-Care Sector Vulnerable to Hackers, Researchers Say." The Washington Post, December 25, 2012.

From the article: "As the health-care industry rushed onto the Internet in search of efficiencies and improved care in recent years, it has exposed a wide array of vulnerable hospital computers and medical devices to hacking, according to documents and interviews." Read more

EHRs May Turn Small Errors Into Big Ones

Baum, Stephanie. "EHRs May Turn Small Errors Into Big Ones." MedPage Today, December 16, 2012.  

From the article: "As electronic health record systems become more interconnected, errors may propagate much farther than under old paper-based systems, a recent study suggested.

According to a review by the PennsylvaniaPatient Safety Authority, mistakes and near misses involving electronic health records were analogous to those made with paper-based records with one caveat: those made with EHRs tend to be amplified and can affect a larger group of people.

The Authority's study looked at 3,099 reports from Pennsylvania hospitals detailing 3,946 problems. More than 2,700 incidents involved near misses and 15 involved temporary harm to patients.

The study focused on incidents from 2004 to 2012 in which electronic health records were the root cause in the event, as opposed to being incidental.

Electronic health records are designed to be more efficient than paper-based records, but the two systems have one thing in common: they're developed and maintained by people. The most common source of problems identified in the study rested with data entry and, to a much lesser extent, with technical glitches.

Medication errors accounted for about 80% of the cases, or 2,516 reports. Many of the remainder involved lab tests." Read more

Smartphone Use: Good for Healthcare

Manos, Diana. "Smartphone Use: Good for Healthcare." Healthcare IT News, December 10, 2012.  

Electronic tools, including smartphones, can help patients, but the adoption of apps for healthcare is still lagging, according to a new report released by the Bipartisan Policy Center in Washington, D.C.

At a Dec. 10 report-release briefing, Janet Marchabroda, chair of the Health IT Initiative at the Bipartisan Policy Center, said smartphones have changed every aspect of American life, including the way Americans shop, travel and manage their finances. "If we could apply that use of smartphones to healthcare, great things would result, she said.

Barriers on the consumer side often include lack of awareness that the apps are out there, and more innovation is still needed in the marketplace.

See also

"Improving Quality and Reducing Costs in Healthcare: Engaging Consumers Using Electronic Tools." Bipartisan Policy Center Health Information Technology Initiative, December 2012. 

Computerized Health Records Breed Digital Discontent For Some Doctors

Whitney, Eric. "Computerized Health Records Breed Digital Discontent For Some Doctors." NPR, December 4, 2012. 

From the article: "Two years and $8.4 billion into the government's effort to get doctors to take their practices digital, some unintended consequences are starting to emerge.

One is a lot of unhappy doctors. In a big survey by Medscape, an online site for doctors, 38 percent of the doctors polled said they were unhappy with their electronic medical records system." Read more

HHS Publishes Guidance on How to De-Identify Protected Health Information

"HHS Publishes Guidance on How to De-Identify Protected Health Information." Privacy and Security Information Law Blog, November 27, 2012.

From the article: "On November 26, 2012, the Department of Health and Human Services’ Office of Civil Rights (“OCR”) published guidance on the two methods for de-identifying protected health information (“PHI”) in accordance with the HIPAA Privacy Rule. The guidance, which was required by the Health Information Technology for Clinical and Economic Health (“HITECH”) Act, has been developed over several years by OCR in collaboration with healthcare entities and other industry experts and builds upon the discussions from a workshop on de-identification that took place in March 2010.

The guidance covers three main topics: (1) key terms in the HIPAA Privacy Rule, (2) the statistical expert method for de-identifying PHI, and (3) the safe harbor method for de-identifying PHI." Read more

See also

U.S. Department of Health and Human Services. "Guidance Regarding Methods for De-identification of Protected Health Information in Accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule."

Patients Want Granular Privacy Control Over Health Information in Electronic Medical Records

Caine, Kelly and Rima Hanania. "Patients Want Granular Privacy Control Over Health Information in Electronic Medical Records." Journal of the American Medical Informatics Association, November 26, 2012. 

From the report: "Patients expressed sharing preferences consistent with a desire for granular privacy control over which health information should be shared with whom and expressed differences in sharing preferences for sensitive versus less-sensitive EMR data. The pattern of results may be used by designers to generate privacy-preserving EMR systems including interfaces for patients to express privacy and sharing preferences." Read more 

The Impact of Electronic Patient Portals on Patient Care: A Systematic Review of Controlled Trials

Ammenwerth, Elske, Schnell-Inderst, Petra, and Alexander Hoerbst. "The Impact of Electronic Patient Portals on Patient Care: A Systematic Review of Controlled Trials." Journal of Medical Internet Research 14 (2012).

From the report: "Modern information technology is changing and provides new challenges to health care. The emergence of the Internet and the electronic health record (EHR) has brought new opportunities for patients to play a more active role in his/her care. Although in many countries patients have the right to access their clinical information, access to clinical records electronically is not common. Patient portals consist of provider-tethered applications that allow patients to electronically access health information that are documented and managed by a health care institution. Although patient portals are already being implemented, it is still unclear in which ways these technologies can influence patient care." Read more

A Survey of Primary Care Doctors in Ten Countries Shows Progress in Use of Health Information Technology, Less in Other Areas

Schoen, Cathy, et al. "A Survey of Primary Care Doctors in Ten Countries Shows Progress in Use of Health Information Technology, Less in Other Areas." The Common Wealth Fund, November 15, 2012.

From the article:

• Two-thirds (69%) of U.S. primary care physicians reported using EMRs in 2012, up from less than half (46%) in 2009. Both U.S. and Canadian doctors expanded their use of health information technology (HIT), though the two countries lag the U.K., New Zealand, and Australia in EMRs and use of HIT to perform a range of functions, like generating patient information or ordering diagnostic tests. 
• In the U.S.—the only country in the survey without universal health coverage—59 percent of physicians said their patients often have trouble paying for care. Far fewer physicians in Norway (4%), the U.K. (13%), Switzerland (16%), Germany (21%), and Australia (25%) reported affordability was a concern for their patients. 
• More than half (52%) of U.S. doctors said they or their staff spend too much time dealing with insurers’ restrictions on covered treatments or medications—by far the highest rate in the survey.  Read more

Hospitals Use Patient Data to Target Ads

Sutherly, Ben. "Hospitals Use Patient Data to Target Ads." The Columbus Dispatch, November 12, 2012.

From the article: "You might not know it when you seek care from some of central Ohio’s hospital systems, but your health information makes you a potential marketing target.

OhioHealth and Mount Carmel Health System routinely mine health data from their patients’ records to decide who should receive certain mailings. The approach — sometimes called “ customer-relationship management” — has been used for six years by OhioHealth and two years by Mount Carmel. Ohio State University’s Wexner Medical Center hasn’t used it, but it plans to take another look at the tactic soon, a spokesman said." Read more

Despite ONC's Effort, Comparing PHR Privacy Policies Still Challenging

Ackerman, Kate. "Despite ONC's Effort, Comparing PHR Privacy Policies Still Challenging." iHealthBeat, November 12, 2012.  

From the article: "To date, personal health record adoption has been somewhat limited, but the market is expected to get a big boost from Stage 2 of the meaningful use incentive program.

Deven McGraw -- director of the Health Privacy Project at the Center for Democracy & Technology -- said, "The market for those tools has been a little soft I think because people have really had to hand enter in the data or scan [them] in, as opposed to being able to feed [the information] directly from a provider's electronic health record, unless they happen to be a patient at Kaiser or part of a system that already offers them that tool." However, she said, "That's going to change in 2014 when a lot of the early adopters in the HITECH incentive program begin Stage 2 and start actively encouraging patients to view and potentially download and transmit their data."

But is the industry ready when it comes to privacy and security regulations?" Read more

Big Bad Data: Law, Public Health, and Biomedical Databases

Hoffman, Sharona and Andy Podgurski. "Big Bad Data: Law, Public Health, and Biomedical Databases."  Case Western Legal Studies Research paper No. 2012-34, October 30, 2012.

From the report: "The accelerating adoption of electronic health record (EHR) systems will have profound impacts on clinical care. It will also have far-reaching implications for public health research and surveillance, which in turn could lead to changes in public policy, statutes, and regulations. The public health benefits of EHR use can be significant. However, researchers and analysts who rely on EHR data must proceed with caution and understand the potential limitations of EHRs. 

Much has been written about the risk of EHR privacy breaches. This paper focuses on a different set of concerns, those relating to data quality. EHR data can be erroneous, miscoded, fragmented, and incomplete. In addition, if causation is at issue, analysts must grapple with the complexities of causal inference. Public health findings can be tainted by the problems of selection bias, confounding bias, and measurement bias. These and other obstacles can easily lead to invalid conclusions and unsound public health policies.

The paper will highlight the public health uses of EHRs. It will also probe the shortcomings of EHR information and the challenges of collecting and analyzing it. Finally, we outline several regulatory and other interventions to address data analysis difficulties." Read more

CMS: $7.7 Billion in EHR Payments through September

Conn, Jospeh. "CMS: $7.7 Billion in EHR Payments through September." Modern Healthcare, November 6, 2012.

From the article: "More than 300,000 physicians and other eligible professionals have signed up to participate in the federal electronic health-record system incentive payment programs, while more than 4,000 hospitals have enrolled in the Medicare EHR incentive program, the Medicaid incentive program or both, according to the latest CMS data.

In total, $7.7 billion has been paid out in what has been estimated will be $27 billion in incentive payments through the lives of the two programs." Read more 

HHS Questions GOP Calls to Suspend Meaningful Use

Versel, Neil. "HHS Questions GOP Calls to Suspend Meaningful Use." Healthcare IT News, October 23, 2012. 

From the article: "Health and Human Services officials, who spoke this week at the CHIME12 Annual Fall Forum, are pushing back against Republican questions of the appropriateness of the $27 billion meaningful use EHR Incentive Program.

Four GOP senators sent a letter to Health and Human Services Secretary Kathleen Sebelius on Oct. 17 questioning whether government-subsidized EHRs sometimes actually promote higher utilization of diagnostic testing and whether wider EHR adoption so far has increased Medicare billing." Read more