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November 18, 2008

Healthcare industry could save $21 billion by 2019 through use of PHRs
Using personal health records (PHRs) could save the U.S. healthcare system more than $21 billion annually, according to a study by the Boston-based Center for Information Technology Leadership (CITL). The savings, based on PHR usage by 80 percent of the U.S. population over a 10-year period, illustrate how PHRs can add value to the healthcare system through reduced waste and error, and decreased administrative and clinical costs, according to Blackford Middleton, M.D., CITL chairperson and senior author of "The Latest New Frontier in Healthcare IT." In compiling the report, CITL examined the financial value of four emerging PHR architectures-provider-tethered, payer-tethered, third-party, and interoperable PHR systems-all providing the functions of information collection and sharing, information for self-management, and healthcare information exchange. "PHRs have the potential to dramatically improve efficiencies in our healthcare system," Middleton said. "As more individuals actively participate in the management of their healthcare, we can realize enormous savings and enhanced quality of care." http://www.citl.org/research/pdf/CITL_PHR_Press_Release.pdf

Nine nations launch first-ever joint effort against illegal Internet medicine sales
Regulatory agencies in nine countries have launched an unprecedented operation to tackle the illegal sale and supply of medicines over the Internet. The action, codenamed "Pangea," involved locations in the United States, Canada, Britain, Germany, Ireland, Israel, New Zealand, Singapore and Switzerland, according to the London-based Medicines and Healthcare products Regulatory Agency (MHRA). MHRA investigators have already seized more than 1,000 packs of unlicensed medicines, as well as computers and related documentation, and are working on closing down infringing Web sites, according to MHRA Head of Operations Danny Lee-Frost. "People can be at considerable risk if they buy medicines from illegal Web sites," he said. "Our messages are simple - do not buy prescription-only medicines over the Internet without a prescription. And if you are illegally selling or supplying medicines, we will use all appropriate measures available to stop you, including prosecution and confiscation." http://www.mhra.gov.uk/NewsCentre/Pressreleases/CON030988

Online peer review could hasten medical community's adoption of IT
A new online peer review process that is about to go public could speed up the adoption of information technology, including electronic health records, according to officials who are currently testing or marketing the system at medical facilities. Physician peer review is a standard, mandated - and paper-based - form of quality control, according to Kevin Chesney, Chief Executive Officer of Acesis, maker of a Web-based clinical review software suite making the rounds at several hospitals nationwide. Paper-based peer review is "historically time-consuming and inefficient," said Daniel LeGrand, Chief Medical Officer at St. Vincent Hospital in Indianapolis. "But that's definitely not the case with this system." Physicians who weren't impressed or involved with IT have become more interested once they get more comfortable with the online peer review process, LeGrand added. http://www.ihealthbeat.org/features/2008/...

HHS releases first-ever online quality measures database
The Department of Health and Human Services (HHS) has released its first-ever database, or "inventory," of quality measures used for reporting, payment or quality improvement by its agencies and operating divisions. The inventory is available on the National Quality Measures Clearinghouse™ Web site at www.qualitymeasures.ahrq.gov. Contributors include the Administration on Aging, Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, Health Resources and Services Administration, Indian Health Service, Office of Public Health and Science, National Institutes of Health, Substance Abuse and Mental Health Services Administration, and Office of the National Coordinator for Health Information Technology. According to HHS Secretary Mike Leavitt, the measures can be sorted by agency or operating division and can be downloaded in their entirety. In the next several months, the inventory will be enhanced so the measure can be sorted by condition, setting, or measure domain. http://www.ahrq.gov/news/press/pr2008/qualmeaspr.htm

University of Puerto Rico researchers test multi-hospital telemedicine procedure
Researchers at the University of Puerto Rico (UPR) and other member universities of the Internet2 consortium are testing a telemedicine procedure in which several hospitals may simultaneously collaborate on a surgery through advanced networking. UPR researchers recently broadcast an endoscopic procedure to colleagues at multiple sites across the United States. The procedure included a multipoint videoconference connected to the video stream, allowing live interaction between participants. "Being isolated geographically from major research centers, we need to use information technology to foster research collaborations with scientists around the world," UPR Medical Director Jose Conde said. Internet2 team members include Johns Hopkins Hospital, the Rochester Institute of Technology and the University of Michigan School of Medicine. UPR plans to conduct further tests with different surgical procedures and an expanded number of remote locations, Conde added. http://www.rit.edu/news/?v=46432

Consolidating HIE systems can speed doctors' adoption of EHRs
If federal agencies work together to reduce the number of health information systems that doctors and insurers need to access to provide care, more of them will want to adopt electronic health record systems, according to Medicare's Chief Technology Officer. CTO Henry Chao said the Centers for Medicare and Medicaid Services (CMS) needs to "figure out how to streamline the way frontline clinicians deal with multiple payers and insurers so they can reduce their workload." CMS works with more than 700 healthcare plan providers, which in turn process payments to clinicians. Many of these clinicians don't want to access multiple systems when billing, according to Chao. http://www.nextgov.com/nextgov/ng_20081113_1406.php

IT adoption-based medical education to have largest impact on healthcare in future
Four in 10 health information technology professionals believe IT adoption-based medical education will have the biggest impact on future healthcare delivery, according to a new survey by the Healthcare Information and Management Systems Society. The survey "Quality of Care, Patient Safety and Information Technology" also notes that 36 percent of the survey's nearly 500 respondents thought educational advances in clinical outcomes were the most important factor in improving healthcare, while 19 percent gave priority to quality measures. http://www.himss.org/content/files/vantagepoint/...

E-health success lies in planning flexibility, ability to learn from failure
Following a few basic rules might not be the most profitable ventures, but they can dramatically improve an e-health project's chance of success, according to the head of German technology research firm empirica. During the recent EHTEL/EUROEC symposium at the World of Health IT conference, Dr. Karl Stroetman said the No. 1 key to e-health success is to be flexible. "You should have a vision, but don't be too rigid," Stroetman said. "Be pragmatic, but be prepared to fail." Failure, as long as lessons are learned, can actually be healthy, he noted. He also said "big bang" approaches should be avoided in favor of "small, iterative steps." Clinical leadership is also a critical element, as is an expectation that regular return on investment calculations won't work. "E-health will not save money," Stroetman said. "It will cost money." http://ehealtheurope.net/comment_and_analysis/...

Local community health crisis response hampered by IT shortage
Local communities are in dire need of additional information technologies to support them during public health emergencies, according to officials from the Department of Homeland Security (DHS). Much of the problem exists in local emergency information management, which has "serious health communications and IT infrastructure issues to deal with," Health and Human Services (HHS) Office of Preparedness and Emergency Operations Deputy Director Maribeth Love said. Right now, according to Love, her office is trying to conduct "gap analysis," so that after an incident the federal government understands what the local area needs before the federal responders get there. According to DHS Acting Assistant Secretary for Health Affairs John Krohmer, local disaster support is "an area where we really have to continue to push for more tools and for more seamless communication between federal, state, tribal and local officials." http://www.govhealthit.com/online/news/350680-1.html

Despite its benefits and drawbacks, new coding system is viewed as necessity
Making a transition to ICD-10 code sets is a necessary but challenging prospect as the government overhauls the coding system for healthcare claims, according to the Centers for Medicare and Medicaid Services (CMS). Hospitals, insurance companies and many doctors say the planned coding system is needed to keep up with the new medical developments that emerge every year. The ICD-10 system would increase the number of codes used to define various ailments and procedures to 155,000, nearly 10 times as many codes as are currently in use. CMS believes the coding system, due in place by October 2011, will help physicians include more information on patients' health records, but it will also cost the medical industry $1.6 billion over 15 years. There could also be an initial increase in billing errors as people adapt to the new system, according to CMS. http://online.wsj.com/article/SB122636897819516185.html

CCHIT^® grants certification to new e-health record products; still seeks more
The Certification Commission for Healthcare Information Technology (CCHIT^® ) has certified a series of new Inpatient (hospital-based) and Emergency Department electronic health record (EHR) products, as well as a special Enterprise EHR certification for vendors that provide comprehensive Ambulatory, Inpatient, and Emergency Department EHRs that are interoperable. Receiving certification were the Epic Systems' Spring 2008 version of its EpicCare Inpatient Clinical System, as well as its ASAP Emergency Department Information System and EpicCare Enterprise Clinical System; Emergisoft's EmergisoftED 5.1; and Wellsoft's Wellsoft v11. The commission is also accepting applications for 2008 certification for ambulatory EHRs with optional certification in child health and cardiovascular medicine, inpatient EHRS, emergency department EHRs and enterprise EHRs. Applications will be accepted through March 31, 2009. CCHIT^® will also accept applications for health information exchange certification through Aug. 16, 2009. http://www.cchit.org/about/news/releases/2008/...

Few U.S. hospitals have complete EHR systems, but most have gotten off to start
Only 2 percent to 12 percent of American hospitals use comprehensive electronic health record (EHR) systems, according to a report by the American Health Information Community (AHIC). But the Health and Human Services Department advisory committee noted that three-fourths of the 3,000 non-federal U.S. hospitals surveyed do use some EHRs at their facilities. "This is somewhat sobering," said Dr. Ashish Jha of the Harvard University School of Public Health. "But I do think we've got a good start on automating hospitals' medical record keeping." E-prescribing is the biggest hurdle currently facing most hospitals, with cost keeping most facilities from installing EHR systems, AHIC noted. http://www.govhealthit.com/online/news/350667-1.html

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  April 26-28, 2009 - Las Vegas, NV
  Recognized throughout the world as the primary forum for the telemedicine industry, ATA's peer-reviewed oral and poster presentations and certificate courses set the standard for medical education on the topics of telemedicine and telehealth. The ATA Expo offers over 100,000 square feet of the latest in telemedicine products and services.

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

A Study on Intrabody Communication for Personal Healthcare Monitoring System
Abdullah Alshehab, Nao Kobayashi, Jordi Ruiz, Ryosuke Kikuchi, Shigeru Shimamoto, Hiroshi Ishibashi Telemedicine and e-Health. October 2008, 14(8): 851-857.
The body itself can be used to conduct sensor data to a central hub. In this report, electrocardiogram data were sent from the chest region to the left wrist for subsequent transmission in a telehealth configuration. Two modulation schemes (Quadrative Phase Shift Keying [QPSK] and Binary Phase Shift Keying [BPSK]) could be used for the intrabody communication. With the body as a conductor of signal up to 2.4G Hz and a decrease in transmission power, the optimal carrier frequency shifted to a lower range of 75 MHz-150 MHz. Both QPSK and BPSK performed well. 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.

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