CMS finalizes EHR meaningful-use rule, adds some flexibility

The CMS late Friday finalized a rule allowing hospitals and eligible professionals more flexibility in how they meet meaningful-use requirements for the electronic health-record incentive program. The agency had first proposed the idea in a May draft rule. Friday's final rule left the May proposal unchanged.

The rule would grant providers a longer timeline and more flexibility in meeting the incentive goals laid out by the stimulus program first created in the 2009 HITECH Act. The incentive program provides doctors and hospitals stimulus funding to implement electronic health records. The rule pushes back the beginning of the third stage of meaningful use for the first cohort of adopters until Jan. 1, 2017, as opposed to the old standard of Jan. 1, 2016. Read More

Stroke Rounds: Telestroke Delivers in Germany

A telestroke program in rural Bavaria cut door-to-needle times by half and the lag between symptom onset and first treatment by 20%, researchers said. Read more  "The main findings of 10-year experience of TEMPiS showed that this type of telemedical stroke unit network is sustaining, offers state-of-the-art acute stroke care by increasing access to stroke units and improving thrombolysis service, and is associated with long-term improvement in terms of quality indicators of acute hospital care," Muller-Barna and colleagues wrote.

Medical marijuana laws tied to fewer drug overdose deaths

States that have enacted laws allowing for the medicinal use of marijuana have lower annual rates of drug overdose death than do states without such laws, according to a study.

The link between such laws and lower rates of overdose deaths remains unclear, according to an analysis published online Monday in JAMA Internal Medicine, but the findings showed states with medical marijuana laws in place had a nearly 25% lower average yearly opioid overdose death rate compared with states without those laws. Read More

New Tips for Meeting the Stage 2 Meaningful Use Transition of Care Measure

New Tips for Meeting the Stage 2 Meaningful Use Transition of Care Measure

More support on how to meet the transition of care measure that is required for Stage 2 Meaningful Use? ONC has just released a new brief that provides support. This is a part of one of the ONC Health Information Exchange (HIE) team’s goals – to provide support and direction to grantees.  Recently, ONC released comprehensive interoperability training modules that are geared toward multiple stakeholder audiences and provide guidance from the elementary level to detailed technical guidance for experts involved in implementation. Read More

Telehealth in India: The Apollo contribution and an overview

Click Here to review the article and great bibliography about telemedicine

HIMSS Analytics: Most providers adopt telemedicine to close patient-care gaps

HIMSS Analytics Research Director Brendan FitzGerald told FierceHealthIT. "Because of the ever-evolving technology aspects and being able to deliver that clinical care remotely, that's where our definition of telemedicine is key and may cause some confusion in the market."

HIMSS Analytics: Most providers adopt telemedicine to close patient-care gaps - FierceHealthIT fiercehealthit.com

Provider adoption of telemedicine solutions is largely driven by the need to fill gaps in patient care, particularly among hospitals, according to HIMSS Analytics' 2014 Telemedicine Study, published on Wednesday.

Telemedicine in India might be just what the doctor ordered

Medanta, the multi-specialty hospital where he works, started its free telemedicine service about a year ago as an outreach service for patients who cannot visit the hospital.
“In-person consultation is obviously the gold standard,” Parakh told India Insight. “But if we have a doctor at the patient’s end, especially somebody who he trusts and who he knows, we can be reasonably comfortable about prescribing treatment.”
Medanta is one of several e-health providers that say they want to change how healthcare is delivered in India, and address the industry’s two biggest problems: accessibility and lack of manpower.
India has 0.7 physicians per 1,000 people — BRIC peers Russia (5), Brazil (1.5) and China (1.5) have better ratios — and most Indians travel about 20 kilometres to reach a hospital, according to a 2012 report by accounting firm PricewaterhouseCoopers (PwC).
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RWJF: Strong evidence that home visits help moms make healthy choices, raise healthy children

	As a society, we ought to be doing much more to help families with young children establish a solid foundation for health from day one. The best way to strengthen families is to meet them where they are, writes RWJF Director Kristin Schubert, and help provide them with the tools they need to make healthy choices where they live: at home. Find out how home visits help > Last month, JAMA Pediatrics published new research from on the effects of nurse-home visits on maternal and child health. The randomized, clinical trial followed a group of low-income, primarily African American mothers and children living in disadvantaged, urban neighborhoods of Memphis over a 19-year period. Specifically, they wanted to see whether home visits conducted by the Nurse-Family Partnership before and after a birth influenced whether the mothers and children died prematurely.  Read More

Fixing the EHR Beast

Medscape "First, what is wrong? Most current EMRs were developed by software engineers, primarily to serve the financial interests of healthcare facilities. Clinical usefulness for physicians and nurses was an afterthought. The hardware and software used for most EMRs are still old-style and legacy-based, and this is enterprise-wide." Read More

HealthSpot visits now reimbursed by Medicaid!

HealthSpot and CareSource team up to create value for Medicaid members, increasing access to care through telehealth platform in convenient locations. HealthSpot^® and CareSource, an Ohio nonprofit managed care company announced an agreement to increase access to quality healthcare for CareSource Medicaid, CareSource Just4Me and MyCare Ohio members.
HealthSpot has built a comprehensive healthcare delivery platform that combines cloud-based software with the award-winning HealthSpot station. The stations connect patients to medical providers from a variety of Ohio’s health systems including Cleveland Clinic, MetroHealth and University Hospitals. For the past 18 months, these providers and others have been using the stations for diagnosis of high frequency illnesses, such as the flu and upper respiratory issues.Read More

Microsoft and TracFone collaborate to offer innovative mobile health management solution to the healthcare market

Microsoft Corp. and TracFone Wireless on Thursday announced a collaboration that will bring the benefits of smartphone technology and services to underserved and high-risk populations through a new mobile health management solution offered through providers and insurers. This approach expands on Microsoft’s commitment to healthcare and TracFone’s telecommunications expertise as the largest Lifeline provider and prepaid wireless leader. Microsoft and TracFone will work with Health Choice Network (HCN), a Miami-based company that manages and connects a network of community health centers with more than 760,000 patients in 17 states, to conduct a pilot project where HCN will provide smartphones to diabetes patients to help them better manage their care.

Microsoft and TracFone collaborate to offer innovative mobile health... microsoft.com

Windows Phone and TracFone services will connect data, devices and people to drive better patient engagement and health outcomes in a HIPAA-enabled environment. Read More

Telemedicine Doesn't Define Me, It Enables Me

By Alan Pitt on Aug 21, 2014

 

I hate the word, telemedicine. It conjures visions of technology, not care—something futuristic, expensive, something only for people far away. However, at it’s core, telemedicine is an opportunity to change how we care for each other by bringing people together in time, enabling “reassurance” when we or a loved one is most vulnerable.
 Read More

Privacy by design' not 'disclosure by default' per European Parliamentary Research

Malcolm Fisk CoDirector of Age Research Centre, Coventry University

Security of the Internet, including e-Government, cloud computing and social networks | European Parliamentary Research Service ow.ly

As we become increasingly dependent on the internet for all aspects of our lives, how can Europe on the web work best while ensuring that everyone can trust online services? STOA has examined the latest technological advances with regard to the internet...

Q2 Digital health metrics round-up

This quarter, Manhattan Research’s Taking the Pulse survey found more than a third of US physicians recommended that a patient use a health app. The research group released data that suggested physicians’ awareness and engagement with mobile and digital tools is on the rise, and that this is motivated in some part by the trend toward outcomes-based care models.

Another Manhattan Research study found 80 percent of physicians in China now own or use smartphones for professional purposes.

Read More 

Hackers Directly Targeting Health Care Organizations, FBI Warns

The FBI has issued a flash alert warning that health care organizations are being targeted by hackers for intellectual property, such as equipment development and medical device data. Meanwhile, three lawmakers are calling for legislative action to improve safeguards against cyberattacks. Reuters, Politico's "eMorning Health."Read More

Adopting Simplified EHR Alerts Greatly Reduces UTIs, Study Finds

A University of Pennsylvania study finds that hospitals can significantly reduce their rates of urinary tract infections by using electronic health record alerts that notify physicians about the recommended time to removed catheters. EHR Intelligence, Penn Medicine release. Read More

When Patients Read What Their Doctors Write

"Since I started sharing notes with my patients, they have made dozens of valuable corrections and changes, such as adding medication allergies and telling me when a previous medical problem has been resolved. We come up with treatment plans together... The medical record becomes a collaborative tool for patients, not just a record of what we doctors do to patients.”

After the first year, the results were striking: 80 percent of patients who saw their records reported better understanding of their medical condition and said they were in better control of their health. Two-thirds reported that they were better at sticking with their prescriptions. Ninety-nine percent of the patients wanted OpenNotes to continue, and no doctor withdrew from the pilot. Instead, they shared anecdotes like mine. When patients see their records, there's more trust and more accuracy.

When Patients Read What Their Doctors Write

Patients are more satisfied with their care when doctors share their medical notes. But letting patients see what doctors put in medical records has long been taboo. That's starting to change. Read More

NPR.ORG|BY WEEKEND EDITION SUNDAY

Health IT Security Programs

It’s widely understood throughout the healthcare industry that organizations need better IT security leadership to improve employee awareness and boost compliance efforts. HealthITSecurity.com discussed the need for more IT security leadership talent in healthcare with Stephen Person, Network & Security Engineer at North Valley Hospital. With the need for a strong understanding of both healthcare and IT security technology, organizations can use these programs to improve their internal security knowledge and leadership. The following a rundown of some programs announced within the past year or so by organizations with IT security expertise. Read More

RWJF: Envisioning a healthy future

	The American Indian community of Taos Pueblo, N.M., is more than 1,000 years old, but it has its eyes firmly focused on the future. Through self-governance and culturally sensitive planning, the 2014 RWJF Culture of Health Prize winner is building a healthier future for children, and for people of all ages and generations. http://click.rwjfmail.org/?qs=7da110706dec212488a4399aadf8f50bd07251a59f2a4f8ddc07d7fcf4c1b9dc

Patient Portals Not Yet Go-To Platform for Patients

HDM: A survey by Nashville-based technology consultancy Technology Advice reveals almost half of patients don't even know if their physician has a patient portal--and that patients still prefer a mix of online and telephone communications from their providers.
READ MORE »

Launching a Patient Portal: Best Practices and Lessons Learned at Main Line Health!

In implementing its patient portal, Main Line Health’s goal was to create a one-stop portal for the entire health system. With four acute-care hospitals, several outpatient facilities, a physical medicine and rehab hospital and a drug and alcohol treatment center, Main Line Health needed a solution that could quickly relay information from multiple points of care to thousands of patients. Read More

Barriers to the Adoption of Telemedicine Services

1) a lack of financial support, mainly by social security systems, (2) a lack of adequate measures to assure patient safety and patient information security, as well as (3) a lack of awareness of health professionals and the great public about the possibilities of Telemedecine, However, the industrial push linking human captors, diagnostic tools and at distance operations will most likely be recognized as" life saving" in case of major disasters or lack of local specialists! 

iTriage just did a survey among 2600 consumers to gauge their usage and awareness of telehealth and it's possible the reality of current adoption rates are a deterrent. Similar to what you see in the banking industry, it took a while for consumers to embrace new tech services (paperless checking, mobile banking apps, etc) that add significant convenience and efficiency while reducing cost, and now nearly every bank offers at least one form of consumer mobile app. One of our clinicians blogged about the research on HL7 Standards - here's a link if it's helpful: http://www.hl7standards.com/blog/2014/08/07/telehealth-future/

Berg Insights recently published a report that indicated a current low global adoption of prescribed remote monitoring (as opposed to zillions of useless quantify self solutions) - but forecasted an incredible growth rate the next 3-4 year.
This is also primarily attributed to the growing platform of smartphones.

http://www.berginsight.com/ReportPDF/ProductSheet/bi-mhealth6-ps.pdf 

See Chapter 6 for a literature review which includes this area and also the publication about a grounded theory on the key factor in uptake. The final chapter contains additional commentary on the barriers.

http://digital.library.adelaide.edu.au/dspace/handle/2440/83508

Hospitals and Telehealth Issues

Why Hospitals Still Struggle to Sell Telehealth Yes, the technology can get complicated. Yes, licensure and reimbursement remain a regulatory mess. That said, telehealth is arguably one of healthcare IT's few 'easy wins' for physicians as well as patients. If your organization has yet to see...  Read More

New medical technology poses safety problems if users not trained properly

Staff at MedStar Health's National Center for Human Factors in Healthcare use a simulation lab to demonstrate how a patient-safety event could easily occur with a cardiac defibrillator. The center looks for potential usability and human factor problems with new and current technologies.

Staff at MedStar Health's National Center for Human Factors in Healthcare use a simulation lab to demonstrate how a patient-safety event could easily occur with a cardiac defibrillator. The center looks for potential usability and human factor problems with new and current technologies. Experts say some types of adverse events and near-misses commonly happen when new technology is introduced without adequate analysis of how staff will interact with new devices. (MODERN HEALTHCARE)
FULL STORY »

Health Policy Brief: Interoperability

A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation (RWJF) looks at the issue of health information exchange. The Health Information Technology for Economic and Clinical Health (HITECH) Act was signed into law at the very beginning of the Obama administration, bringing with it significant investments in health information technology (IT) -- $26 billion to date.
While the adoption of electronic health records (EHRs) has increased considerably since 2009, there is very little electronic information sharing among clinicians, hospitals, and other providers. New models of care delivery, designed to improve quality and reduce costs, require both interoperable EHRs and electronic information sharing to be effective. This Health Policy Brief looks at the efforts the federal government has made to improve interoperability and increase the level of electronic information sharing, as well as the barriers to achieving these goals. Read more about the RWJF Brief: Click here

Leveraging HIEs to facilitate care-coordination

Providers  are leveraging their HIEs to help solve care-coordination problems, helping to reduce costs, streamline communication, and improve provider and patient satisfaction.

HIEs: Transforming Clinical Workflows for Care Coordination

‘eVisits’ save $5 billion globally this year–but are they more effective care?

 Deloitte‘s ’21st Century Housecall’ study (short paper) is also worth a read for presenting facts/figures on the global addressable market and for a surprising conclusion–that the ‘greater good (in developing countries) may come from saving tens of millions of lives’. Hat tip to reader Mike Clark. Clinical Innovation + Technology summary.
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Hospitals and Telehealth Technology

As organizations move toward more value-based care and set up ACOs and even HIEs, telemedicine networks are becoming increasingly important in terms of being able to connect all that clinical data together.
Forty-six percent of healthcare providers answering a HIMSS survey used multiple telemedicine technologies in their practice, with the most popular technology by far being two-way video

Read More

Results of the NCSBN National Simulation Study are out

The full report will be out this week on the Journal of Nursing Regulation website in pdf download for free.  NCSBN National Simulation Study
Study Results

Results of Phase I

Results from the National Survey of Simulation Use in Prelicensure Nursing Programs, representing nursing programs in all 50 states, have been published in the Journal of Nursing Regulation. Hayden, J. (2010). Use of Simulation in Nursing Education: National Survey Results. Journal of Nursing Regulation, 1(3): 52-57.
An additional analysis of the survey’s open–ended responses was conducted and these results have been published in Clinical Simulation in Nursing. Kardong-Edgren, S., Willhaus, J., Bennett, D., Hayden, J. (2012). Results of the National Council of State Boards of Nursing (NCSBN) National Simulation Survey: Part II. Clinical Simulation in Nursing, 8(4), e117-e123.

Results of Phases II and III

The results of the study will be presented on August 13, 2014 at the NCSBN Annual Meeting in Chicago, IL.
A full report of the research study and results of the multi-site, randomized study of simulation during the nursing program and the results of the follow-up study on how well the students were prepared for clinical practice will be published in a special supplement of the Journal of Nursing Regulation available August, 2014.
Results from the first year of data collected from the cohort of study participants and clinical faculty were presented for the first time at the NCSBN Scientific Symposium, September 11, 2012 in Arlington, VA.
For additional information on the study, please contact Jennifer Hayden, project director, simulationstudy@ncsbn.org

Simulations: Distance Education-UT Arlington and Pediatrix partner to bring simulation training direct to practice

Judy LeFlore, associate dean at the UT Arlington College of Nursing, can supervise simulation assessments from hundreds of miles away. Credit: UT Arlington College of Nursing

A real-time video feed, a laptop and a computerized manikin baby are key components for a new simulation training initiative that allows UT Arlington College of Nursing educators to put Neonatal Nurse Practitioners (NNPs) and physicians through the paces of an emergency scenario from hundreds of miles away. Read More

Obama Signs VA Health Reform Bill That Leverages Health IT

President Obama has signed into law a bill aimed at improving veterans' access to care in part by leveraging health IT. Among other things, the new law will expand veterans' access to telehealth services and create a special task force to recommend improvements for the Department of Veterans Affairs' scheduling software system. The Hill reports (Matishak, The Hill, 8/7). Read More

CMS: Final Rule for FY 2015 Affects Health IT

ihealthbeat.org

On Monday, CMS released a final rule for the fiscal year 2015 Medicare payment schedule for general acute care and long-term care hospitals that aligns hospital reporting requirements with those of the meaningful use program, Clinical Innovation & Technology reports (Walsh, Clinical Innovation & Technology, 8/5).

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicare and Medicaid incentive payments.

The final rule will be published in the Federal Register on Aug. 22, and a majority of its provisions will take effect on Oct. 1.

Health IT-Related Details of Rule

Among other things, the final rule includes a market basket update of 2.9% for providers that in fiscal year 2013:

• Submitted data related to quality of care measures; and
• Demonstrated meaningful use of electronic health records (AHA News, 8/4). Read More

Report: Tablet-Based App Curbs Readmissions for at-Risk Patients

Health coaches who used tablet-based software to monitor the health of recently discharged, at-risk Medicare beneficiaries were better able to reduce readmission rates than health coaches who did not use the software, according to an Innovations Exchange report by the Agency for Healthcare Research and Quality, Becker's Hospital Review's "Hospital CIO" reports (Jayanthi, "Hospital CIO," 

Program Results

Hospital-generated admissions data from participating hospitals show that incorporating the tablet-based application into the visitation program helped to:

• Cut 30-day readmissions by 39.6% among at-risk patients eligible for the program, compared with a previous visitation program that did not use the software; 
• Reduce all-cause readmissions for all Medicare beneficiaries, including those not assigned a coach, by 5.9%; and
• Save roughly $109 per patient per month over a six-month period, with gross savings of about $600,000 and net savings of roughly $370,000 (Goth, Health Data Management, 8/6). 
•  Read More

Study: E-Reminders Can Boost Adherence to Presurgery Instructions

A new study published in the Journal of the American College of Surgeons finds that sending electronic reminders, such as by email or text message, can lead to an increase in patient adherence to a preadmission shower procedure, which is recommended to reduce the risk of surgical site infections. FierceHealthIT, American College of Surgeons release.Read More

Top 7 Health Care Challenges in 2014

The US healthcare market is evolving rapidly. Hospitals and private practices need to address the various challenges and trends in order to survive. They are expected to reinvent their operations and reevaluate their revenue cycle to maximize cash flow.

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