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July 18, 2008

More IT in hospitals means happier patients, better quality of care
Information technology makes a major difference in patient experience and quality of care at U.S. hospitals, according to a pair of recently released studies. According to "The 2008 Most Wired Survey and Benchmarking Study," an assessment of patients' views toward hospital technology, the more "wired" a hospital is, the happier the patients will be. A second study, "The 100 Most-Wired Hospitals and Health Systems," notes that technologically up-to-date facilities have better outcomes on numerous quality measures, including risk-adjusted mortality rates. This marks the fifth straight year of increases in these areas. Yet while the studies show that top tech hospitals excel in providing quality, patient-centric care, industrywide progress in adopting clinical IT remains remarkably slow, according to the reports. "We may be measuring a commitment to quality," Press Ganey Research Associate Suzanne Coshow said. http://www.hhnmag.com/hhnmag_app/jsp/articledisplay...

Personal health records could open door to electronic data use by consumers
Efforts by Microsoft, Google and Dossia to develop Web sites where individuals can create personal health records (PHRs) from numerous sources could give automation a push among consumers. The PHR data, designed to be formatted to fit onto a USB drive or DVD that users can easily carry, may encourage the public to use electronic records out of medical convenience, according to proponents. Microsoft's Health Vault project is already online; and Google and Dossia plan to release their programs later this year, exposing them to more than 20 million consumer patients nationwide. But doctors argue that PHRs may be no substitute for the more detailed, institutional health record. They stress that providers may "dumb down" summary data for a PHR, and that users can add or delete information, making the system a potential dud with physicians. http://www.computerworld.com/action/article...

England's HealthSpace project set for major expansion
HealthSpace, the British government's secure online site for patients, plans to expand coverage to include shared records and general practitioner bookings, according to a report by England's Department of Health. Proposed features include the ability for patients to record their treatment preferences, view their Summary Care Record and access a shared record. Other features would include a self-care section where patients could monitor their condition and load the results for GPs to view, access to Summary Care Records, and reminders on tests, appointments and screenings. "The extra information provided by patients via HealthSpace will allow them to jointly manage their health, have access to their care plans, become 'expert patients' and provide a more complete picture on which clinical decisions can be based," the report notes. http://www.ehiprimarycare.com/news/... and http://www.dh.gov.uk/en/Publicationsandstatistics/...

House, Senate override President's veto of Medicare reimbursement bill
A 10.6 percent reduction to Medicare physician fees scheduled to have taken effect as of July 1 will be delayed until January 2010. Legislation delaying the cuts for 18 months became law on Tuesday after both Congressional houses voted to override President Bush's veto of the bill by votes of 383-41 in the House and 70-26 in the Senate. H.R. 6331 (Rep. Charles Rangel, D-NY) will instead replace the fee reduction with a rate freeze for the remainder of 2008 and a 1.1 percent increase in 2009. The law also establishes skilled nursing facilities, in-hospital dialysis centers and community mental health as originating sites for Medicare reimbursement, and implements an electronic prescribing initiative that links physician reimbursement to use of technology. The American Telemedicine Association plans to work with the Centers for Medicare and Medicaid Services over the next few months as it develops regulations on how the far-reaching legislation will be implemented. http://stabenow.senate.gov/... and http://www.californiahealthline.org/...

German insurer Techniker Krankenkasse ventures in glaucoma telemedicine
German health insurer Techniker Krankenkasse (TK) now offers a telemedicine-based glaucoma monitoring program as a mainstream service. It is the first such service offered to glaucoma patients as part of a German health insurance company's routine patient care. The goal is to "better customize medication therapy to the individual needs of the patient and thus prevent irreversible damage to the retina," according to TK spokesperson Harald Kriednau. The contract is between TK and Greifswald University Hospital, which runs a multidisciplinary telemedicine center for patients in rural Western Pomerania and on the Baltic islands. Glaucoma patients are seen at least once by a specialist at Griefswald's department for ophthalmology. After confirmation of the glaucoma diagnosis, the patient receives a small suitcase that contains all necessary equipment for the telemedicine measurement of the intraocular pressure. http://www.ehealtheurope.net/news/...

Nevada turns to telemedicine to reduce ultra-high suicide rate
Nevada is expanding its telemedicine program in hopes of reducing its sky-high suicide rate. Nevadans in 15 rural counties commit suicide at more than twice the national rate, potentially due to a shortage of mental health professionals. Distance between communities and the stigma of seeking treatment all contribute to the problem, which claims the lives of 27 out of every 100,000 people annually. The national rate is 11 per 100,000. The telemedicine program connects patients to a psychiatrist through a Web camera, where the individual may seek treatment in private. The state has also recently enacted a law to license new mental health counselors and partnered with state colleges and universities to create academic programs specific to rural mental health. http://www.rgj.com/apps/pbcs.dll/article?AID=/...

British Web site allows patients to rate doctors on quality of care
A British physician has developed a Web site that allows patients to rate individual general practitioners and hospital doctors on their treatment, and share the information on their healthcare experience with other patients. iWantGreatCare.org is an opportunity for doctors to fine-tune their act, according to site founder Dr. Neil Bacon. "As a clinician, I'm very aware that patients are always looking for recommendations," Bacon said. "This site will allow them to see other people's recommendations and make their own, too." The new site will enable healthcare providers and managers to collect the views of their patients, using real-time dashboards. Patients can use the site anonymously if they wish. The sliding-scale questions should take less than a minute to complete. Moderators will check for posts that may be malicious campaigns against a healthcare provider, Bacon noted. http://www.ehiprimarycare.com/... and http://www.iwantgreatcare.org/

California's emergency department info systems have mixed success with EHRs
More than two-thirds of hospitals in California use an Emergency Department Information System (EDIS), but they are experience varying levels of satisfaction and success, according to a report from the California HealthCare Foundation. An EDIS, being used in conjunction with a hospital's transitions to an electronic medical records (EMR) system, essentially time-stamps patient movements through the system, according to "Adoption of Patient Tracking System Among Hospital Emergency Rooms in California." Sixty-nine percent of hospitals has an EDIS, with just over half of these linked to the hospital's inpatient tracking system. One-third of the hospitals surveyed have an EDIS but do not share data between it and the EHR system, according to the study. For many, the systems remain prohibitively expensive, especially for smaller organizations. And there remains a resistance to the change from paper to electronic systems. http://www.chcf.org/topics/hospitals/index.cfm?itemID=133683

E-health standards should be kept to a minimum to ensure compatibility
Three types of standards - base standards, profiles and interoperability specifications - must be focused on to enable interoperability in e-health, according to a report from eHealth-INTEROP. The sub-group of the European Standardization Organization Alliance notes that meeting these standards could eliminate existing barriers to interoperability across Europe. Keeping the list of standards to a mere three will also speed up the process. "Unintended optionality results in variability of implementation to the extent that interoperability is lost," the report notes. "Development of perfect standards is a long and near-impossible process, imposing delays in delivery and/or unforeseen implementation problems." eHealth-INTEROP's 58-page draft report is available for review and public comment at its Web site at www.ehealth-interop.nen.nl/publicaties/2860; the full report will be issued on Nov. 7. http://www.ehealtheurope.net/news/... and http://www.ehealth-interop.nen.nl/publicaties/2860

BlueCross doctors in Tennessee to get more time to review e-profiles
As of last Tuesday, doctors involved with BlueCross BlueShield of Tennessee will have 45 days to review their electronic profiles and update information on their medical claims. That's 45 more days than they had as of last Monday. The state's largest health insurer is developing an online physician rating system and had planned to launch it in April, but delayed it after doctors raised concerns about the accuracy of their individual information and about the use of claims data, which they argued doesn't best reflect quality of care provided. BlueCross BlueShield now plans to consider the doctors' feedback before the online tool goes live Sept. 15. "It may not be perfect for everyone, but we feel confident this is a good first step," BlueCross spokesperson Scott Wilson said. http://www.tennessean.com/apps/pbcs.dll/...

NDT to deploy WiMAX network across Northern Italy
As part of its original deployment plan for the islands of Fiji, Newport Beach, CA-based Newport Digital Technologies (NDT) has secured a $30 million contract to deploy fixed and mobile WiMAX base stations across Northern Italy. The network will be similar to the company's plans for Fiji, which included introduction of eLearning and telemedicine services, according to WiMAX Program Director Robert Pimentel. "The benefits for WiMAX technology are clear," Pimentel said. "This technology is now able to bring broadband to remote regions of the world that we could not previously service and now serves as a foundation for our eLearning, eHealth and eGovernment platforms, where we can deploy extensive applications for governments and business." As a result, the company expects to expand its operations in Italy to $1 million [USD] per month as of August, Pimentel said. http://www.wimax.com/commentary/blog/...

Widespread EHR adoption held back by lack of incentives for physicians
Widespread adoption of electronic health record (EHR) technology is hindered by a lack of incentives for physicians or hospitals to share data with other healthcare providers, according to the head of a healthcare standards developing firm. Studies show that EHRs and other technology applications can improve healthcare quality, but they are generally not compensated for these improvements, according to Charles Jaffe, chief executive officer of Ann Arbor, MI-based Health Level 7. "The problem we have in this country is a lack of business reasons for integrating," Jaffe said. "What is the business case for two competing hospitals to share data? None." Loose and overlapping technical standards and poor interoperability among the different health information systems are also holding the healthcare industry back, Jaffe said. http://www.computerworld.com/action/...

In the Current Issue of the peer reviewed publication Telemedicine and e-Health

Acceptance of Telemonitoring to Enhance Medication Compliance in Patients with Chronic Heart Failure
Silke Schmidt, Sarah Sheikzadeh, Britta Beil, Monica Patten, Jürgen Stettin
Telemedicine and e-Health. June 2008, 14(5): 426-433.
Sixty-two congestive heart failure patients participated in a controlled, longitudinal study at two ambulatory medical centers in Hamburg, Germany. Two groups, a control (no telemedicine intervention) and the study group (telemedicine) were evaluated for medication intake. A medication box, networked to the patient's electronic health record, was used for the telemedicine group. The main objective was to evaluate noncompliance of medication intake. The research showed that the system was effective. However, nearly 50% felt it was not necessary to continue the reporting after the study. Full Article

Published 10 times a year in print and online, Telemedicine and e-health covers all aspects of clinical telemedicine practice, technical advances, enabling technologies, education, health policy and regulation and biomedical and health services research dealing with clinical effectiveness, efficacy and safety of telemedicine and its effects on quality, cost and accessibility of care, medical records and transmission of same.

Telemedicine and e-Health is the Official journal of the American Telemedicine Association.
To learn more, click here.

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