Health IT Taking Flight–What Is in Store for the Year Ahead
January 25, 2012, 3:34 pm
Dr. Farzad Mostashari / National Coordinator for Health Information Technology
Earlier this month, I wrote about some of the most important and notable highlights in the world of health IT and ONC over the past year. The achievements of 2011 built on hard work and progress, which has been underway for many years.The HITECH Act is helping to accelerate this momentum—like a turbocharger in a racecar.
As we start the New Year, I am excited about what the future holds and want to share what I see as five big health IT trends for the year to come.
Meaningful Use Takes Off. We sometimes refer to the stages of Meaningful Use as an escalator because it will get more rigorous and sophisticated over time. We might equally call it the necessary foundation upon which to build a truly 21st Century health system where care is better coordinated, patient-centered, safer, and where we pay for the right care, not just more care. Successfully attesting to Meaningful Use will not by itself achieve these goals, but it does help ensure providers have the right information at the right time so patients get the right care.
Health Information Exchange Turns a Corner. A key element of the Meaningful Use roadmap is the electronic exchange of important clinical information. With the foundation we have built in Stage 1, increasingly rigorous health information exchange requirements in Stage 2 and payment reform as a constant drumbeat, I think exchange will take off in 2012.Connecting the Dots on Health IT and Payment Reform. It is widely recognized that fee-for-service payment for health care tends to reward volume while providing little incentive to furnish care in ways that drive toward improved health outcomes or efficiency. All that is changing before our eyes as more health systems move away from fee-for-service and toward payment models that incentivize care coordination, quality improvement, prevention, and more efficient use of resources. New payment models, such as accountable care organizations, patient-centered medical homes, bundled payments, and quality measurement/improvement initiatives may seem disconnected from each other, but they all have a common denominator: Success depends on better information about each patient’s health needs than paper records can provide.
Consumers Use eHealth to Get More Involved. I believe this year we will see consumers and patients use information technology to become better informed about their health and more engaged with their own care than ever before. In large part, this will happen because it’s becoming easier for consumers to electronically access their own information. Personal health records are becoming easier to use as more data holders make it possible to download information through tools like Blue Button. Many health care providers are setting up patient portals which are directly connected to their EHRs. The Medicare and Medicaid EHR Incentive Programs already require providers to give patients access to their electronic health information, and I anticipate future stages will build on that notion. And the work that is being done on standards and interoperability will help make consumer access to their health information more seamless and more useful.
Innovation Drives Improvement. Innovation is the lifeblood of technology, whether we are talking about health IT or otherwise. For health IT, innovation is being driven on many fronts, including ways of making EHR systems easier and less expensive to install and maintain, such as software-as-a-service and web-based systems. Mobile devices such as smart phones and tablets are being directly integrated into health IT systems, and I expect this trend will continue to pick up speed as capabilities such as voice recognition are perfected. The growing emphasis on value-based payment models will help fuel innovation around products and services that help providers perform quality measurement/improvement and population health management. There will be increasing emphasis on data analytics and finding ways of using data to support population health management, as well as feed information back into EHRs in ways that support a learning health system.
Top 10 Health IT Predictions For 2012
Healthcare reform, analytics, cloud computing, mobility, and social media will alter the health IT landscape over the next year, forecasts IDC Health Insights.
By Nicole Lewis InformationWeek
December 28, 2011 08:00 AM
In 2012, we will see new and successful accountable care organizations (ACOs), hospital CIOs tackling increasing security risks brought on by clinicians' use of mobile technology, and a majority of providers using electronic health records (EHRs).
These are a few of IDC Health Insights' top 10 predictions for 2012, based on year-long research and conversations with health industry executives. There are five overarching themes impacting the healthcare industry which will affect the future of health IT, according to IDC: health reform, analytics and big data, cloud computing, mobile devices, and social media.
As 2011 draws to a close, the healthcare industry reflects upon a year that saw a number of interesting developments, from Meaningful Use becoming a reality to the activities that will advance ICD-10, ACOs and HIEs. While we have yet to see what new challenges 2012 will bring, one thing is undeniable – the journey toward healthcare reform will continue to be top of mind.
To date, the use of technology has allowed us to tackle some of the most pressing issues in healthcare. Patient records are being transformed for the digital era, and individuals can remotely consult with doctors, nurses and specialists from hundreds of miles away. But new obstacles are cropping up daily, and factors such as an aging population and an explosion in the sheer volume and varieties of patient data are presenting new and increasingly complex challenges for the healthcare system. Reaping the benefits of the investments must be top of mind if we are to healthcare better and more cost-effective.
Monday, December 05, 2011
Despite the health information revolution and health care consumerism that the Web has ignited, many decisions in medicine today are still made without reliable comparative information. The analytics methodology that can address patients' and physicians' needs for comparative information does exist. However, it is not consistently applied and it is not easily accessible at the point of care. Specifically, analytics on comparing hospital quality have primarily focused on experts and have made their way into professional reports that are sold for thousands of dollars to hospital administrators. For the most part, they have not yet been made usable or accessible to patients and their busy physicians.
The Future: 'It's All About Me'
In the course of our NIH-funded research, we found that analytics should not be about the content but about the patient. In their "think out loud" sessions, patients who used an online guide to compare kidney transplant centers trusted and engaged with the system if they perceived it as "empathetic" and easy to use. Their comments expressed a "trust-engage-no-think-no-work" reaction to analytics tools consistent with studies on human-computer interaction. Some of the lessons learned include:
***Healthcare IT News (11/21)
Thursday, November 17, 2011
has released a report detailing the top nine ways IT is transforming the health care industry, Becker's Hospital Review reports (Rodak, Becker's Hospital Review, 11/16).
The report noted that health IT has significant potential to make the U.S. health care system more patient-centered. According to the report, health IT can:
Thursday, November 17, 2011
according to a study published in the Journal of Hospital Medicine, the Wall Street Journal's "Health Blog" reports.
For the study, Harvard University researchers examined data on Medicare beneficiaries treated at 1,017 hospitals that adopted UpToDate -- a clinical decision support system -- between 2004 and 2006. They also looked at data from 2,305 hospitals that did not use the UpToDate system.
Thomas Isaac -- a physician at Beth Israel Deaconess Medical Center and an instructor at Harvard Medical School -- said researchers found that hospitals using the UpToDate system:
Wednesday, November 16, 2011
Physicians who are board-certified in any of the 24 primary medical specialties now can earn secondary certification as informaticians.
In an iHealthBeat Special Report by Mina Kim, experts discussed the new medical subspecialty.
In a New York Times opinion piece, Frank Moss -- an entrepreneur and former director of the Massachusetts Institute of Technology's Media Lab -- writes that the U.S. is in the early stages of the "next big technology-driven revolution, which I call 'consumer health.'"
He adds that the trend "could radically cut health care costs and become a huge global growth market."
Moss writes that in recent years, electronic health records, mobile devices and other health IT tools have started to improve health care delivery. He adds, "But imagine a far more extreme transformation, in which advances in information technology, biology and engineering allow us to move much of health care out of hospitals, clinics and doctors' offices, and into our everyday lives."
IOM is scheduled to release a new report -- titled, "Health IT and Patient Safety: Building Safer Systems for Better Care" -- on Nov. 10, but iWatch News received an advance copy (Daly, Modern Healthcare, 11/8). Findings from the report were presented to HHS and its agencies on Oct. 28.
The report also states that health IT vendors should be required to report adverse events associated with their products. Health care providers could voluntarily report health IT-related safety issues, according to IOM.
IOM also recommends that:
The contest is part of the foundation's Aligning Forces for Quality initiative (Goedert, Health Data Management, 10/28). The initiative is designed to improve the quality of health care in 16 communities around the U.S.
The initiative already has produced information on health care quality. For example, participants of the initiative have developed online reports on diabetes care -- such as whether patients received appropriate tests and procedures -- and the safety of local medical centers (Newport News Daily Press, 10/28).
Data from the Aligning Forces initiative will be used in the apps (Merrill, Healthcare IT News, 10/31).
During Phase 1 of the challenge, competing developers will create applications for various devices, including smartphones and iPads, to allow consumers to access comparative information on the quality of health care in various regions of the country. During Phase 2, the developers will work with communities that are part of the Aligning Forces initiative to refine their products.
by Fred Trotter
Healthcare reform pairs two basic concepts:
The clinical people in this country tend to focus on meaningful use incentives as "how do I get paid to install an EHR" rather than seeing it as deeply connected to the whole process of healthcare reform. But any geek can quickly see the bottom line: all of the other healthcare reform efforts are pointless unless we can get the measurement issue right.
The Office of the National Coordinator for Health IT and Health 2.0 have opened a contest inviting developers to create applications using the popHealth framework, Government Health IT reports (Mosquera, Government Health IT, 10/10).
In February 2010, ONC made the open-source popHealth software available to help health care providers cull data from electronic health record systems to discern trends among patient populations (iHealthBeat, 3/1/10).
October 1, 2011 — 5:43pm ET | By Ken Terry
Is it possible that the Obama Administration is doing something right in its ambitious health IT program? The U.K. National Health Service's failed, decade-long effort to implement a nationwide electronic health record system suggests that, in many ways, the U.S. government is taking a wiser approach to encouraging widespread EHR adoption. On the other hand, it is still possible that the federal government might overreach and hit the same brick wall that the Brits did.
In a recent New York Times piece, reporter Steve Lohr asked three top experts--Dr. David Brailer, Dr. David Blumenthal (both former national health IT coordinators) and Richard Alvarez, who heads Canada's health IT effort--what lessons they drew from the NHS fiasco.
Brailer and Blumenthal stressed the importance of having physicians involved in health IT planning; Brailer went so far as to say that physician resistance to the U.K. National Programme for IT (NPfIT) had "brought [the NHS] to their knees." All three pointed out that a top-down program of this scope cannot work because health IT must be implemented at the local level--which is also the message of the NHS press release about the dismantling of its IT program.
October 2, 2011
In a partnership with other public and private organizations, the U.S. Department of Health and Human Services (HHS) launched a program Sept. 29 that is designed to prevent a million heart attacks and strokes over the next five years. Details of the Million Hearts Initiative appeared in the Sept. 29 issue of the New England Journal of Medicine.
Clinical interventions focus on four components, collectively called ABCS: aspirin for high-risk patients; blood-pressure control; cholesterol management; and smoking cessation. The five-year program will emphasize management of these components through a focused approach, health IT and clinical innovations.
Community interventions will include public health warnings, grants, mass media campaigns, menu-labeling requirements for chain restaurants and data gathering.
***Brian Klein on Sep 26, 2011 • 11:14 am
The Department of Health and Human Services (HHS) hasn’t traditionally been thought of as a bold, risk-taking agency. HHS Chief Technology Officer (CTO) Todd Park has been working hard to change that. Park, who co-founded healthcare technology firm Athenahealth and later Castlight Health, was offered his current position two years ago. HHS asked Park to come work for them as an entrepreneur in residence. “The [CTO] job title is a little bit of a red herring; I actually don’t run technology at HHS. I’m 100% focused on being an internal change agent,” Park said at a recent roundtable meeting with journalists on September 23. His main task is to help the agency figure out how to tap “the power of data and technology in innovative ways to improve the health of the American people.”
“They brought me in as an entrepreneur,” Parks says. “But what I would say is that the most entrepreneurial years of my life have been the last two, because [HHS has been] launching initiatives that behave very much like Silicon Valley startups,” he explains. “There are interdisciplinary teams that work on Silicon Valley time in hyperrapid cycles in a really lean, startup style way. And these incredibly talented groups of HHS-ers have done just incredible things.
Maybe the best example of how it has mushroomed is [...] “Health Data-Palooza.” (I think the formal name was the Health Data Initiative Forum, but I keep calling it the “Health Data-Palooza.”).
Health Data Management Magazine, 10/01/2011
There is growing consensus over the economic imperative cited by Miranda that is driving the formation of ACOs. And there is equal consensus over the sophisticated I.T. that needed to make them work, regardless of the particulars of local structures. Information technology will be needed to plug the many gaps in the industry that stand to impede accountable care, particularly if care is being coordinated across inpatient, outpatient and home care settings.
The grant recipients will use the funding for a variety of projects. For example, San Diego-based Sharp HealthCare is piloting a program to remotely monitor patients with chronic obstructive pulmonary disease.
HHS Text4Health Task Force now has released recommendations calling for HHS to:
CMS innovation center: Federally Qualified Health Center (FQHC) Advanced Primary Care Practice DemonstrationThe Innovation Center is now accepting applications from eligible FQHCs for the FQHC Advanced Primary Care Demonstration project. This demonstration project, operated by CMS in partnership with the Health Resources Services Administration (HRSA), will test the effectiveness of doctors and other health professionals working as teams to improve care for up to 195,000 Medicare patients. The FQHC Advanced Primary Care Practice demonstration will show whether and in what manner the patient-centered medical home model can improve quality of care, promote better health, and lower costs. For more information, please click here.
PHR market generated revenue of $312.2 million in 2010 and estimates that revenue will reach $414.8 million in 2015, representing a compound annual growth rate (CAGR) of 5.8%.
the use of PHRs among Americans was estimated to be around 7% of the population in 2010.
The Department of Veterans Affairs plans to award about $500 million worth of IT contracts over the next five months to support VA Secretary Eric Shinseki's 16 priority projects. Of those funds, the department expects to spend about $70 million to support VA's Virtual Lifetime Electronic Record project. Washington Technology, Federal Computer Week.
Roger Baker -- VA's CIO and assistant secretary for information and technology -- said the department has an $800 million budget for the 16 priority projects this fiscal year and already has obligated about $300 million (Lipowicz, Washington Technology, 5/5).
In total, the agency plans to spend $2.7 billion on IT this fiscal year, Baker said.
A coalition of consumer, labor and patient advocacy groups is urging greater consumer participation in the development of federal health IT standards and initiatives to ensure long-term success of the federal government's efforts to drive electronic health record adoption, Modern Healthcare reports.
On Friday, the Consumer Partnership for eHealth released a report, titled "Consumer Platform for Health IT," that offers recommendations for expanding consumers' role in the development and implementation of health IT standards and programs (Daly, Modern Healthcare, 5/9).
The Consumer Consortium on eHealth is designed to serve as a collaborative forum for sharing best practices, initiatives, tools, resources, ideas, and experience related to effective consumer engagement on health IT. Consortium members will work together to identify obstacles to the adoption of eHealth, brainstorm solutions, and develop effective communication strategies to reach a national audience with messages about the benefits of health IT.
Thus far, RockHealth has received more than 40 applications. It expects more applications from startups working on:
It will accept applications until May 20, and approximately 12 startups will start work in June (Newton, San Francisco Chronicle, 4/11).
More than 70% of U.S. adults think the country's health care system should be completely changed and a large majority want their care to include health IT, according to a survey released by the Commonwealth Fund, CMIO reports (Byers, CMIO, 4/8).
The poll, conducted by Harris Interactive, surveyed 1,011 adults between Feb. 7 and Feb. 11. It found that most adults reported problems with accessing health care services and care coordination (Norman, CQ HealthBeat, 4/6).
By Neil Versel InformationWeek April 11, 2011 11:18 AM
Perhaps to fight conservative critics or perhaps because it's truly what they want, federal health IT officials continue to call on the private sector to solve some of healthcare's most vexing problems.
"We firmly believe that the private marketplace has some of the key answers," Dr. Thomas Tsang, medical director for meaningful use and quality in the Office of the National Coordinator for Health Information Technology (ONC), said Wednesday at a health IT meeting in Atlanta hosted by the New York-based Institute for Health Technology Transformation.
Why? Because healthcare spending accounts for 21% of the Obama administration's proposed 2012 budget, somewhere in the range of $800 billion. "About one-third of that is complete waste," Tsang said.
Wednesday, April 06, 2011
On Wednesday, five medical groups that are considered "pioneers" in electronic health record use announced the launch of the Care Connectivity Consortium, a project to create a health information exchange network that will span several states and include millions of patients, the New York Times' "Bits" reports.
The groups launching the consortium are:
***Dr. David Blumenthal / National Coordinator for Health Information Technology
Providing strategic leadership to public and private sector efforts to improve health and health care through the use of information and technology is a key responsibility of the Office of the National Coordinator for Health Information Technology (ONC). The Federal Health IT Strategic Plan (“the Plan”) is an important tool for guiding national efforts and investments in health IT over the next several years.
Thursday, March 10, 2011
IRVINE -- We are facing big changes in health care -- no matter what happens with efforts to repeal the national health care reform law.
That's the word from an impressive array of health care and economic experts who gathered at the end of February for the 20th Annual Health Care Forecast Conference at UC-Irvine.
The future, they said, is now. The health care system is changing dramatically because health care reform has built a momentum that likely will last for years, despite any legislative, economic and judicial developments aimed at stalling it.
***MedCity News (Cleveland) (3/3)
***Brian Dolan | Mar 4, 2011 8:59am EST
After just four months of launching “Refill by Scan,” Walgreens have found that users of its smartphone application have embraced the feature which enables them to use the camera on their phone to scan the barcode printed on a prescription label to order a refill. Walgreens said half of all refill orders originating from a mobile device are now from Refill by Scan. The feature has been available to users of Walgreens’ iPhone and Android apps since November 2010.
Connected healthcare presents a red-hot opportunity in M2M. This was a point emphasized by Glenn Lurie, AT&T’s president of Emerging Devices, Resale, and Partnerships, during his guest spot on this week’s edition of The Peggy Smedley Show. And this week especially, buzz about new health-and-wellness-related technologies has been swirling thanks in part to the 2011 HIMMS (Healthcare Information and Management Systems) conference in Orlando.
IBM and Nuance, a speech-recognition products vendor, have announced a five-year research agreement to explore ways for the health care industry to tap into the capabilities of IBM's Watson supercomputer, InformationWeek reports.
IBM engineers, along with Columbia and University of Maryland researchers, are seeking to identify how Watson could work with health care professionals (Gaudin, Computerworld, 2/17).
Researchers will use Nuance technology to develop a "physician assistant" that could mine data from health care providers' existing electronic health record systems, medical images and dictated reports to help guide physicians' decisions. Data from other sources -- such as best practices and other evidence-based literature -- also could be factored in to the technology (InformationWeek, 2/17).
HHS has launched a Web portal that allows health IT developers to access health data in an effort to bring about more health care innovations, Modern Healthcare reports.
HHS Secretary Kathleen Sebelius said that the Health Indicators Warehouse portal "provides a new public resource needed to fuel development of innovative IT applications" to improve health care.
***Brian Dolan | Jan 31, 2011 1:47pm EST
Earlier this month PricewaterhouseCoopers published its Innovation Scorecard for the medical device industries in nine countries. The bottomline conclusion was that the US will continue to dominate but emerging markets like China, India and Brazil. In other words: Nothing new here, folks.
***Darrell M. West, Vice President and Director, Governance Studies
The Brookings Institution
This paper outlines the challenges of enabling personalized medicine, as well as the policy and operational changes that would facilitate connectivity, integration, reimbursement reform, and analysis of information. Our health system requires a seamless and rapid flow of digital information, including genomic, clinical outcome, and claims data. Research derived from clinical care must feed back into assessment in order to advance care quality for consumers. There currently are discrete data on diagnosis, treatment, medical claims, and health outcomes that exist in parts of the system, but it is hard to determine what works and how treatments differ across subgroups. Changes in reimbursement practices would better align incentives with effective health care practices.
Three Revolutions and How They Affect Health Care
Policy Challenges and Recommendations
By Marianne Kolbasuk McGee , InformationWeek
January 27, 2011 08:00 AM
Stage 1 & 2 Meaningful Use
While bonuses will become available in 2011 for healthcare providers who comply with Stage 1 meaningful use criteria, providers have until 2012 to meet Stage 1 requirements and still be eligible for the maximum financial rewards set by the federal stimulus Health Information Technology for Economic and Clinical Health (HITECH) Act.
Accountable Care Organizations
If you're still hungry for even more government mandates, stay tuned. Also on the regulatory scene in 2011, more details will emerge from CMS about its requirements for accountable care organizations (ACOs), which got a boost in the healthcare reform legislation that passed in 2010.
Mobile Health IT
Aside from the many mandates healthcare providers will be juggling, another hot area in health IT next year will be the continued evolution of mobile health tools.