Review of the Personally Controlled Electronic Health Record – December 2013

Posted on May 19, 2014. Filed under: Health Informatics | Tags: , , |

Review of the Personally Controlled Electronic Health Record – December 2013

This section of the site contains information relating to eHealth.

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European Hospital Survey – Benchmarking Deployment of eHealth services (2012-2013) – European Commission – 24 March 2014

Posted on April 3, 2014. Filed under: Health Economics | Tags: |

European Hospital Survey – Benchmarking Deployment of eHealth services (2012-2013) – European Commission – 24 March 2014

“A survey carried out in about 1,800 hospitals in the 28 EU countries plus Iceland and Norway measures the level of deployment and take-up of ICT and eHealth applications in acute care hospitals in Europe.

The survey, carried out by PwC EU Services in cooperation with Global Data Collection Company, covered i) ICT Infrastructure, ii) ICT Applications, iii) Health Information Exchange and iv) Security and Privacy. Based on the survey results, the Joint Research Centre IPTS developed two composite indicators on eHealth deployment and eHealth availability & use and made a comparison with a previous survey carried out in 2010. The results suggest that the deployment of eHealth in European acute care hospitals has increased over the period 2010-2013 (from an average of 0.39 to 0.42 in a range of 0 to 1). Moreover, the gap between best performers (mostly Nordic countries) and less advanced countries (mostly Eastern European and Greece) in hospital eHealth deployment has narrowed. Advanced eHealth functionalities are not widely used across hospitals, however, when available, they are quite popular. For example, digital archiving of radiology images is available in just 53% of EU hospitals, but in almost all of these (92%) it is fully used.

The results also suggest that connectivity is still lagging behind, as most of the hospitals do not share electronically medical information that they produce/store in this format. Finally, the vast majority of hospitals do not allow patients to access their complete health records online thus preventing more involvement in their healthcare.
Top performing countries for eHealth deployment among hospitals are Denmark (66%), Estonia (63%), Sweden and Finland (both 62%). Full country profiles are available (see below).

The study “European Hospital Survey- Benchmarking Deployment of eHealth services (2012-2013)” is composed of the following reports:”

… continues on the site

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SAFER Guides – Safety Assurance Factors for EHR Resilience – Office of the National Coordinator for Health Information Technology – 15 January 2014

Posted on January 16, 2014. Filed under: Health Informatics, Patient Safety | Tags: , , |

SAFER Guides – Safety Assurance Factors for EHR Resilience – Office of the National Coordinator for Health Information Technology – 15 January 2014

“The SAFER guides consist of nine guides organized into three broad groups. These guides enable healthcare organizations to address EHR safety in a variety of areas. Most organizations will want to start with the Foundational Guides, and proceed from there to address their areas of greatest interest or concern. The guides identify recommended practices to optimize the safety and safe use of EHRs. The content of the guides can be explored here, at the links below, or interactive PDF versions of the guides can be downloaded and completed locally for self-assessment of an organization’s degree of conformance to the Recommended Practices. The downloaded guides can be filled out, saved, and transmitted between team members.”

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A Blueprint for eHealth in NSW – NSW Health – 18 December 2013

Posted on December 19, 2013. Filed under: Health Informatics | Tags: |

A Blueprint for eHealth in NSW – NSW Health – 18 December 2013

“A Blueprint for eHealth in NSW sets out the NSW Government’s principles and directions for using information and communication technology (ICT) to drive improvements in health and medical care in NSW over the next five years.”

Media release

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ICTs and the Health Sector: Towards Smarter Health and Wellness Models – OECD – October 2013

Posted on October 16, 2013. Filed under: Health Informatics | Tags: , , |

ICTs and the Health Sector: Towards Smarter Health and Wellness Models – OECD – October 2013

“The future sustainability of health systems will depend on how well governments are able to anticipate and respond to efficiency and quality of care challenges. Bold action is required, as well as willingness to test innovative care delivery approaches.

The greatest promise for transformational change is in applications that encourage new, ubiquitous, participatory preventive and personalised smart models of care. A whole new world of possibilities in using mobiles and the Internet to address healthcare challenges has opened up. The potential of mobile devices, services and applications to support self-management, behavioural modification and “participatory healthcare” is greater than ever before.

A key hurdle is, however, the big data challenge, dealing with the exponentially accelerating accumulation of patient data – all of which must be mined, stored securely and accurately, and converted to meaningful information at the point of care. In order to fully exploit the new smart approaches to care, acceptance, privacy and usability issues will also have to be carefully considered.”

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Opportunities for Action: A Pan-Canadian Digital Health Strategic Plan – Canada Health Infoway – 26 June 2013

Posted on June 28, 2013. Filed under: Health Informatics | Tags: , |

Opportunities for Action: A Pan-Canadian Digital Health Strategic Plan – Canada Health Infoway – 26 June 2013

“Refreshed Strategic Plan Focuses on Next Steps in Canada’s Digital Health Journey

Canada Health Infoway (Infoway) today released Opportunities for Action: A Pan-Canadian Digital Health Strategic Plan. The plan, which details the health care priorities that digital health solutions can best support over the coming years, has identified key opportunities for action.

“This refreshed strategic plan was developed by Canadians, for Canadians,” said Richard Alvarez, President and CEO of Infoway. “It represents how digital health is evolving in step with the health care system to meet the needs of Canadians, and sets out how Infoway and our jurisdictional partners can focus on improving the patient experience through digital health solutions.”

The strategic plan was developed in consultation with more than 500 Canadians, clinicians, government and health care administrators, national associations and digital health vendors, who were asked to identify priorities that health IT could best support. Six broad themes emerged describing health care priorities over the next several years, and from these themes, five opportunities for action were developed:

■Bring care closer to home
■Provide easier access
■Support new models of care
■Improve patient safety
■Enable a high-performing health system

Much of Infoway’s work over the past decade has concentrated on digital health investments in electronic health records and point-of-care systems for clinicians. These include solutions that securely house critical data including patient drug information, diagnostic images and lab test results, resulting in billions of dollars in health system efficiencies, improvements in access, and gains in quality of care.”

… continues on the site

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A review of the potential benefits from the better use of information and technology in health and social care’ – NHS – 16 January 2013

Posted on January 21, 2013. Filed under: Health Informatics | Tags: |

A review of the potential benefits from the better use of information and technology in health and social care’ – NHS – 16 January 2013

“The potential benefits to staff and patients of greater use of information and digital technology in the NHS and social care are shown in a new study, published today.

The study, commissioned by the Department of Health from Price Waterhouse Coopers, found that measures such as more use of text messages for negative test results, electronic prescribing and electronic patient records could improve care, allow health professionals to spend more time with patients and save billions of pounds.

The report says that a potential £4.4billion per year could be reinvested in improving care by making better use of information and technology.”

… continues on the site

Media on this in eHealth Insider – 16 January 2013: Hunt wants paperless NHS in five years

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Improving Quality and Reducing Costs in Health Care: Engaging Consumers Using Electronic Tools – Bipartisan Policy Center Health Information Technology Initiative – December 2012

Posted on January 10, 2013. Filed under: Health Informatics, Patient Participation | Tags: |

Improving Quality and Reducing Costs in Health Care: Engaging Consumers Using Electronic Tools – Bipartisan Policy  Center Health Information Technology Initiative – December 2012

“Engaging consumers more fully in their own health and health care not only improves the experience of care for patients and their families, it also improves the quality and costeffectiveness of care. Research shows that more engaged patients have better outcomes in terms of both cost and quality, which is why consumer engagement is such an essential element of new delivery system and payment reforms now emerging to address the significant challenges facing the U.S. health care system. Online and electronic tools that play such key roles in many other aspects of American life—from how people manage their finances to how they shop for goods and services—can be leveraged to accelerate and support patient engagement efforts in health care.

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Patient Engagement Framework – National eHealth Collaborative [US] – 19 November 2012

Posted on January 10, 2013. Filed under: Health Economics, Patient Participation | Tags: |

Patient Engagement Framework – National eHealth Collaborative [US] – 19 November 2012

“The Patient Engagement Framework is a model created to guide healthcare organizations in developing and strengthening their patient engagement strategies through the use of eHealth tools and resources.”

Media release

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Digital Health Digital guidance and best practice for the health and care system – Department of Health [England] – 20 December 2012

Posted on January 4, 2013. Filed under: Health Informatics | Tags: , |

Digital Health Digital guidance and best practice for the health and care system – Department of Health [England] – 20 December 2012

Media release

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Digital hospitals: debunking the myths surrounding the technology journey – Deloitte – July 2012

Posted on January 4, 2013. Filed under: Health Informatics | Tags: , , |

Untangling the truth: debunking the myths surrounding the technology journey for digital hospitals – Deloitte – July 2012

“Do you believe that a digital hospital and a paperless hospital are the same thing? That a single data governance approach is all your hospital needs? That clinical requirements should dictate the hospital’s technology capabilities? Or that mobility is a ‘nice to have’?

If you do, you are not alone. So whether you are building a new digital hospital from the ground up, or digitising an existing hospital, views like these can make your journey more complex, risky and expensive than it really needs to be.

This paper details 12 myths surrounding the technology journey to digitisation that, if left unchanged, can limit the value that can be realised from digital hospital initiatives.”

… continues

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eHealth Action Plan 2012-2020 – Innovative healthcare for the 21st century – European Commission – 7 December 2012

Posted on January 3, 2013. Filed under: Health Informatics | Tags: , , |

eHealth Action Plan 2012-2020 – Innovative healthcare for the 21st century – European Commission – 7 December 2012

Media release

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Putting patients in the driving seat: A digital future for healthcare – European Commission – 7 December 2012

Posted on January 3, 2013. Filed under: Health Informatics | Tags: , , |

Putting patients in the driving seat: A digital future for healthcare – European Commission – 7 December 2012

Extract:

“The European Commission has unveiled an Action Plan to address barriers to the full use of digital solutions in Europe’s healthcare systems. The goal is to improve healthcare for the benefit of patients, give patients more control of their care and bring down costs. While patients and health professionals are enthusiastically using telehealth solutions and millions of Europeans have downloaded smartphone apps to keep track of their health and wellbeing, digital healthcare has yet to reap its great potential to improve healthcare and generate efficiency savings.

The Action Plan (full list of actions in MEMO/12/959) attempts to increase the pace of change and improvement in healthcare by:

•clarifying areas of legal uncertainty;

•improving interoperability between systems;

•increasing awareness and skills among patients and healthcare professionals;

•putting patients at the centre with initiatives related to personal health management and supporting research into personalised medicine;

•ensuring free legal advice for start-up eHealth businesses.

The Commission also commits to issue a mHealth (Mobile Health) Green Paper by 2014 addressing quality and transparency issues.”

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Guidelines on Hardware-Rooted Security in Mobile Devices – Draft – National Institute of Standards and Technology (NIST) – 31 October 2012

Posted on November 2, 2012. Filed under: Health Informatics | Tags: , , |

Guidelines on Hardware-Rooted Security in Mobile Devices – Draft – National Institute of Standards and Technology (NIST) – 31 October 2012

“The National Institute of Standards and Technology (NIST) has published draft guidelines that outline the baseline security technologies mobile devices should include to protect the information they handle. Smart phones, tablets and other mobile devices, whether personal or “organization-issued,” are increasingly used in business and government. NIST’s goal in issuing the new guidelines is to accelerate industry efforts to implement these technologies for more cyber-secure mobile devices.

Securing these tools, especially employee-owned products, is becoming increasingly important for companies and government agencies with the growing popularity—and capability—of the devices. Many organizations allow employees to use their own smart phones and tablets, even though their use increases cybersecurity risks to the organization’s networks, data and resources.”

… continues

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Providing Clinical Summaries to Patients after Each Office Visit: A Technical Guide – July 2012

Posted on September 10, 2012. Filed under: Health Informatics, Patient Participation | Tags: , |

Providing Clinical Summaries to Patients after Each Office Visit: A Technical Guide – July 2012

“Executive Summary

The Centers for Medicare and Medicaid Services (CMS) include the practice of giving a clinical summary to patients after each office visit as an element of Meaningful Use of an electronic health record (EHR) Stage One.

Giving every patient a clinical summary after each office visit is one of the most challenging of all meaningful use elements because of the complexity of both the information flow and the workflows involved.

This document is a guide to help eligible professionals and their organizations gain a better grasp of how to successfully meet the criteria of giving clinical summaries to patients after each office visit. It discusses the two requirements to accomplishing these goals and assists organizations in meeting them.”

… continues

“Clinical Summary—Defined
CMS has defined the clinical summary as “an after-visit summary (AVS) that provides a patient with relevant and actionable information and instructions containing the patient name, provider’s office contact information, date and location of visit, an updated medication list, updated vitals, reason(s) for visit, procedures and other instructions based on clinical discussions that took place during the office visit, any updates to a problem list, immunizations or medications administered during visit, summary of topics covered/considered during visit, time and location of next appointment/testing if scheduled, or a recommended appointment time if not scheduled, list of other appointments and tests that the patient needs to schedule with contact information, recommended patient decision aids, laboratory and other diagnostic test orders, test/laboratory results (if received before 24 hours after visit), and symptoms.”

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Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition Draft Test Procedures – Office of the National Coordinator for Health Information Technology – September 2012

Posted on September 10, 2012. Filed under: Health Informatics, Medical Records | Tags: , |

Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition Draft Test Procedures – Office of the National Coordinator for Health Information Technology – September 2012

“The Office of the National Coordinator for Health Information Technology (ONC) has posted the first wave of draft Test Procedures and applicable test data files for the 2014 Edition EHR certification criteria. The Test Procedures, once finalized and approved by the National Coordinator, will be used for testing and certifying EHR technology under the ONC HIT Certification Program (formerly referred to as the Permanent Certification Program or PCP). The Test Procedures are being developed in collaboration with the National Institute of Standards and Technology (NIST).

General Purpose

The Test Procedures will be used by testing laboratories and certification bodies to evaluate conformance and functionality of Complete Electronic Health Records (EHRs) or EHR Modules against the standards, implementation specifications, and certification criteria adopted by the HHS Secretary for 2014 certification. The Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology, Final Rule [PDF – 1.25MB], published September 4, 2012, establishes the 2014 Edition EHR Certification Criteria used to develop draft Test Procedures.”

… continues

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PALANTE: PAtient Leading and mANaging their healThcare through EHealth – European Commission

Posted on August 30, 2012. Filed under: Health Informatics, Patient Participation | Tags: |

PALANTE: PAtient Leading and mANaging their healThcare through EHealth – European Commission

“Patient empowerment is considered a potential tool to reduce healthcare costs and improve efficiency of the health systems, reinforcing healthcare quality. Patient empowerment has become an element of high priority in the EU health strategy, supported by national and regional health authorities. Building on already existing e-health platforms and services in the participating regions, the PALANTE project focuses on the implementation, scaling up and optimisation of 7 demonstration pilots based on the concept of secure and user friendly online access by citizens to their medical/health data. The main goal of this proposal is to empower patients so they will be able to make informed decisions about their health, take an active role in their care and collaborate effectively with their healthcare team thanks to the use of information and communication technologies. The PALANTE Project considers 7 new pilots in 6 countries (7 regions) and 2 additional on-going pilots in 2 other countries. The pilots have been carefully selected to cover different levels of patient empowerment. Globally, the project mobilizes 21 partners in 10 different countries, and 69.550 new users. Pilot teams include public and private partnerships ensuring all the key stakeholders involved in eHealth provision. All the pilots address the issue of patient’s secure access to their own health information. Additionally, 5 of these pilots deal with integrated chronic disease management support, including comprehensive self-learning, education and monitoring systems that will be validated for diabetes, chronic heart failure, severe arthritis and respiratory diseases. They cover a wide range of services with different grade of complexity and thus different number of patients according to each service. The Project also takes into account the challenge of patients’ mobility by addressing interoperability among pilots. Some partners of PALANTE consortium are directly involved in EpSOS project.”

http://www.palante-project.eu – Note, site not working as at 30 August 2012

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A Human Factors Guide to Enhance EHR Usability of Critical User Interactions when Supporting Pediatric Patient Care – National Institute of Standards and Technology – June 2012

Posted on July 20, 2012. Filed under: Child Health / Paediatrics, Health Informatics, Medical Records | Tags: , , , , |

A Human Factors Guide to Enhance EHR Usability of Critical User Interactions when Supporting Pediatric Patient Care – National Institute of Standards and Technology – June 2012 NIST

“Executive Summary

Adoption of electronic health record (EHR) systems in hospitals and physician practices is accelerating. Usability of EHRs has been identified as an important factor impacting patient safety, and recommendations for improvement have been provided. Pediatric patients have unique characteristics that translate into unique EHR usability challenges. It is not surprising, then, that the adoption of EHRs by pediatric care providers has lagged behind adoption for adult care providers. In this document, we highlight important user interactions that are especially salient for pediatric care and hence to the EHR user-centered design process. These interactions and associated usability recommendations were identified by consensus during a series of teleconferences with experts representing the disciplines of human factors engineering, usability, informatics, and pediatrics in ambulatory care and pediatric intensive care. In addition, extensive peer review was provided by experts in pediatric informatics, emergency medicine, neonatology, pediatrics, human factors engineering, usability engineering,and software development and implementation.

This report details recommendations to enhance EHR usability when supporting pediatric patient care and also identifies promising areas for EHR innovation. Finally, we illustrate unique pediatric considerations in the context of representative clinical scenarios which may be helpful for formative user-centered design approaches and summative usability evaluations.”

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National eHealth Strategy Toolkit- WHO and the International Telecommunication Union – 2012

Posted on July 17, 2012. Filed under: Health Informatics | Tags: , , |

National eHealth Strategy Toolkit- WHO and the International Telecommunication Union – 2012

ISBN 978 92 4 154846 5 (WHO)
ISBN 978 92 61 14051 9 (ITU)

“Worldwide, the application of information and communication technologies to support national health-care services is rapidly expanding and increasingly important. This is especially so at a time when all health systems face stringent economic challenges and greater demands to provide more and better care, especially to those most in need.

The National eHealth Strategy Toolkit is an expert, practical guide that provides governments, their ministries and stakeholders with a solid foundation and method for the development and implementation of a national eHealth vision, action plan and monitoring framework. All countries, whatever their level of development, can adapt the Toolkit to suit their own circumstances.

Representing one of the most significant collaborations in recent years between the World Health Organization and the International Telecommunication Union, the Toolkit is a landmark in understanding what eHealth is, what it can do, and why and how it should be applied to health care today.”

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Using Electronic Health Records to Improve Quality and Efficiency: The Experiences of Leading Hospitals – The Commonwealth Fund – 2 July 2012

Posted on July 3, 2012. Filed under: Health Informatics, Medical Records | Tags: , , |

Using Electronic Health Records to Improve Quality and Efficiency: The Experiences of Leading Hospitals – The Commonwealth Fund – 2 July 2012

Authors: Sharon Silow-Carroll et al

“Overview

An examination of nine hospitals that recently implemented a comprehensive electronic health record (EHR) system finds that clinical and administrative leaders built EHR adoption into their strategic plans to integrate inpatient and outpatient care and provide a continuum of coordinated services. Successful implementation depended on: strong leadership, full involvement of clinical staff in design and implementation, mandatory staff training, and strict adherence to timeline and budget. The EHR systems facilitate patient safety and quality improvement through: use of checklists, alerts, and predictive tools; embedded clinical guidelines that promote standardized, evidence-based practices; electronic prescribing and test-ordering that reduces errors and redundancy; and discrete data fields that foster use of performance dashboards and compliance reports. Faster, more accurate communication and streamlined processes have led to improved patient flow, fewer duplicative tests, faster responses to patient inquiries, redeployment of transcription and claims staff, more complete capture of charges, and federal incentive payments.”

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New eHealth “learning centre” goes live – 11 May 2012

Posted on May 11, 2012. Filed under: Educ for Hlth Professions, Health Informatics | Tags: , |

New eHealth “learning centre” goes live – 11 May 2012

“Health Minister Tanya Plibersek today launched an online “learning centre” which details how the Gillard Government’s new electronic health record system will work for patients and practitioners.

Ms Plibersek said the launch of the website came after the Government made a $233.7 million investment in the Budget to continue the rollout of the eHealth record system, which is being designed to modernise the way health services are delivered, making them safer and more efficient.
“eHealth will deliver benefits to Australian patients as it will ensure health practitioners are able to access their medical histories in one convenient location, reducing errors and making diagnosis and treatment quicker and easier,” said Ms Plibersek.

From 1 July 2012, interested Australians will be able to register to create a personal eHealth record. The website explains how eHealth will be further developed over time.

Ms Plibersek said the new learning centre will inform and educate the public and healthcare professionals about eHealth and the personally controlled electronic health record system in the lead up to the July launch.

“This website will help people discover how eHealth can help streamline their interactions with the health system, as well as assist doctors and nurses learn about the new system, saving them time and effort once it is up and running.”

“The learning centre includes click-through modules tailored for the public and healthcare professionals, and case studies illustrating how eHealth records will benefit people in a variety of settings.”

Ms Plibersek said content will progressively be added to the site and encouraged patients and practitioners to continue to check for updates.

“Patients and practitioners can also register via the site to be kept up to date on all the eHealth news.”

Go to http://www.ehealth.gov.au and follow the link to the learning centre.

For all media inquiries, please contact Simon Crittle on 0466 773 531″

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Bulletin of the World Health Organization Special Theme: e-health – May 2012

Posted on May 2, 2012. Filed under: Health Informatics | Tags: , |

Bulletin of the World Health Organization Special Theme: e-health – May 2012

“This theme issue has three main objectives, as explained in a call for papers published in June 2011:
• to provide an authoritative, critical and independent overview of current knowledge about appropriate, trans-disciplinary methods and applications in e-health;
• to include contributors from developing countries, who seldom have the opportunity to publish in international journals;
• to strengthen the commitment of high-level decision-makers to address e-health interoperability issues and seek to widened the application of e-health.”

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Embedding Privacy Into the Design of Electronic Health Records to Enable Multiple Functionalities – Win/Win – Canada Health Infoway – 2 March 2012

Posted on March 6, 2012. Filed under: Health Informatics, Medical Records | Tags: , , |

Embedding Privacy Into the Design of Electronic Health Records to Enable Multiple Functionalities – Win/Win – Canada Health Infoway – 2 March 2012

full text

Co-authored by Dr. Ann Cavoukian, and Richard C. Alvarez, President & CEO, Canada Health Infoway

“Embedding and implementing Privacy by Design (PbD) into electronic health record (EHR) systems being built across Canada will enable us to benefit from the wealth of health information stored on these systems, while protecting patient privacy, according to a new paper released today at the Toronto Board of Trade.

“By incorporating the principles of Privacy by Design into the EHR environment, you can accommodate both individual privacy and access to health information for purposes that benefit society as a whole, such as research purposes – a win-win scenario,” said Dr. Ann Cavoukian, Information and Privacy Commissioner of Ontario.”

… continues on the site

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Why National eHealth Programs Need Dead Philosophers: Wittgensteinian Reflections on Policymakers’ Reluctance to Learn from History

Posted on January 16, 2012. Filed under: Health Informatics | Tags: |

Why National eHealth Programs Need Dead Philosophers: Wittgensteinian Reflections on Policymakers’ Reluctance to Learn from History
Trisha Greenhalgh, Jill Russell, Richard E. Ashcroft, and Wayne Parsons
Queen Mary University of London
Milbank Quarterly 2001  v.89 (4)

“Context: Policymakers seeking to introduce expensive national eHealth programs would be advised to study lessons from elsewhere. But these lessons are unclear, partly because a paradigm war (controlled experiment versus interpretive case study) is raging. England’s $20.6 billion National Programme for Information Technology (NPfIT) ran from 2003 to 2010, but its overall success was limited. Although case study evaluations were published, policymakers appeared to overlook many of their recommendations and persisted with some of the NPfIT’s most criticized components and implementation methods.

Methods: In this reflective analysis, illustrated by a case fragment from the NPfIT, we apply ideas from Ludwig Wittgenstein’s postanalytic philosophy to justify the place of the “n of 1” case study and consider why those in charge of national eHealth programs appear reluctant to learn from such studies.

Findings: National eHealth programs unfold as they do partly because no one fully understands what is going on. They fail when this lack of understanding becomes critical to the programs’ mission. Detailed analyses of the fortunes of individual programs, articulated in such a way as to illuminate the contextualized talk and action (“language games”) of multiple stakeholders, offer unique and important insights. Such accounts, portrayals rather than models, deliver neither statistical generalization (as with experiments) nor theoretical generalization (as with multisite case comparisons or realist evaluations). But they do provide the facility for heuristic generalization (i.e., to achieve a clearer understanding of what is going on), thereby enabling more productive debate about eHealth programs’ complex, interdependent social practices. A national eHealth program is best conceptualized not as a blueprint and implementation plan for a state-of-the-art technical system but as a series of overlapping, conflicting, and mutually misunderstood language games that combine to produce a situation of ambiguity, paradox, incompleteness, and confusion. But going beyond technical “solutions” and engaging with these language games would clash with the bounded rationality that policymakers typically employ to make their eHealth programs manageable. This may explain their limited and contained response to the nuanced messages of in-depth case study reports.

Conclusion: The complexity of contemporary health care, combined with the multiple stakeholders in large technology initiatives, means that national eHealth programs require considerably more thinking through than has sometimes occurred. We need fewer grand plans and more learning communities. The onus, therefore, is on academics to develop ways of drawing judiciously on the richness of case studies to inform and influence eHealth policy, which necessarily occurs in a simplified decision environment.”

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Guide to Reducing Unintended Consequences of Electronic Health Records – AHRQ – 14 December 2011

Posted on December 16, 2011. Filed under: Health Informatics, Medical Records | Tags: , |

Guide to Reducing Unintended Consequences of Electronic Health Records – AHRQ – 14 December 2011

“The Guide to Reducing Unintended Consequences of Electronic Health Records is an online resource designed to help you and your organization anticipate, avoid, and address problems that can occur when implementing and using an electronic health record (EHR). Our purpose in developing the Guide was to provide practical, troubleshooting knowledge and resources.

The Guide was developed with all types of health care organizations in mind — from large hospital systems to solo physician practices. We anticipate that the primary users will be EHR implementers such as Regional Extension Centers, chief information officers, directors of clinical informatics, EHR champions or “super users,” administrators, information technology specialists, and clinicians involved in the implementation of an EHR. Frontline EHR users (such as physicians and nurses) may also find the Guide useful.

The Guide is based on the research literature, other practice-oriented guides for EHR implementation and use, research by its authors, and interviews with organizations that have recently implemented EHR. The Guide represents a compilation of the known best practices for anticipating, avoiding, and addressing EHR-related unintended consequences. However, this area of research is still in its infancy. Therefore, the Guide is a work in progress. We invite you to revise its tools and recommendations in keeping with your own experience and in response to emerging research findings.”

The RAND Corporation prepared the Guide for the Agency for Healthcare Research and Quality

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Technical Evaluation, Testing and Validation of the Usability of Electronic Health Records [draft] – National Institute of Standards and Technology [US] – October 2011

Posted on November 3, 2011. Filed under: Health Informatics, Medical Records | Tags: , |

Technical Evaluation, Testing and Validation of the Usability of Electronic Health Records [draft] – National Institute of Standards and Technology [US] – October 2011

“Executive Summary

This document summarizes the rationale for an Electronic Health Record (EHR) Usability Protocol (EUP) that encompasses procedures for (1) expert evaluation of an EHR user interface from a clinical perspective and a human factors best practices perspective, and (2) validation studies of EHR user interfaces with representative user groups on realistic EHR tasks.

This document begins with a brief overview of the problem at hand: Why is EHR usability critical? There is a sentiment among clinical users that EHRs are harder to use than they need to be and can introduce “use error” that could have potential negative implications on patient care. This document centers on improving user performance of EHRs through system developer demonstration of application of human factors best practices and user-centered design principles.

Within this document there is a detailed description of research findings relating to the usability issues and their potential impact on patient care. These findings resulted in the development of a model for understanding usability and patient safety outcomes. As a backdrop, these findings motivate and guide the clinical aspects of the expert evaluation procedure.

Another intent of the EUP is to provide detailed systematic steps for conducting validation studies (that is, summative usability tests). The validation study procedure guides the reader to help insure that the application’s user interface is free from critical usability issues and supports error-free user interaction with the EHR. The sample forms for data collection and test scenarios provided in the appendices are guidance only; the development teams can choose other scenarios or modify these examples as necessary for their medical context.

This document presents a three-step process — that incorporates both the evaluation and validation procedures — for design evaluation and human user performance testing for an EHR, see Figure 1. This process is focused on increasing safe use of the EHR and increasing ease of use of the EHR by users. The steps are as follows:

1. Usability/Human Factors Analysis of the application during EHR user interface development,
2. Expert Review/Analysis of the EHR user interface after it is designed/developed, and
3. Testing of the EHR user interface with users.”

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The Correlation of Training Duration With EHR Usability and Satisfaction: Implications For Meaningful Use – AmericanEHR Partners – 20 October 2011

Posted on October 25, 2011. Filed under: Educ for Hlth Professions, Health Informatics, Medical Records | Tags: |

The Correlation of Training Duration With EHR Usability and Satisfaction: Implications For Meaningful Use – AmericanEHR Partners – 20 October 2011

“New Report Highlights Relationship Between EHR Training and Satisfaction As well as the Usability of Features Important for Achieving Meaningful Use

Washington –  A report released today by AmericanEHR Partners highlights physicians’ experiences with the usability of EHRs to achieve some Meaningful Use requirements. The survey data, from more than 2,300 physicians, was collected from April 2010 to July 2011 on satisfaction with their use of EHR systems.  It also provides strong evidence that clinicians do not receive adequate training to effectively use their EHRs. 

The survey was conducted collaboratively with the American Academy of Allergy Asthma & Immunology, the American College of Physicians, the American Osteopathic Association of Medical Informatics, the Infectious Disease Society of America, and the Renal Physicians Association. Key findings from the report include:”

… continues on the site

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A Framework and Toolkit for Managing eHealth Change: People and Processes – Canada Health Infoway – October 2011

Posted on October 19, 2011. Filed under: Health Informatics | Tags: , |

A Framework and Toolkit for Managing eHealth Change: People and Processes – Canada Health Infoway – October 2011

“The Pan-Canadian Change Management Network has concluded that ICT for health projects should incorporate the following six core change management elements:

Governance & Leadership
Stakeholder Engagement
Communications
Workflow Analysis & Integration
Training & Education
Monitoring & Evaluation”

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The eHealth readiness of Australia’s medical specialists and allied health sector – Dept of Health and Ageing – 30 May 2011

Posted on October 17, 2011. Filed under: Allied Health, Health Informatics, Health Professions, Medicine | Tags: |

The eHealth readiness of Australia’s medical specialists – Dept of Health and Ageing – 30 May 2011
ISBN: 978-1-74241-537-6   Online ISBN: 978-1-74241-538-3

The eHealth Readiness of Australia’s Allied Health Sector – Dept of Health and Ageing – 30 May 2011

ISBN: 978-1-74241-537-6   Online ISBN: 978-1-74241-538-3

These reports set out research on the use of and attitudes towards ‘eHealth’ (the combined use of electronic communication and technology in healthcare) among:

 the full range of licensed medical specialists in eight different segments–anaesthesia, diagnostics (radiology and pathology), internal medicine, emergency medicine, obstetrics and gynaecology (including neonatology), ophthalmology and dermatology, psychiatry and surgery

the 15 major sectors of allied health practitioners prioritised by the Department – Aboriginal and Torres Strait Islander health workers, audiologists, chiropractors, dental allied health professionals, dietitians, exercise physiologists, occupational therapists, optometrists, osteopaths,  physiotherapists, podiatrists, psychologists, radiographers and sonographers, social workers and speech pathologists

The research has been framed around three ’anchor’ questions:
1. Are Australian medical specialists and allied health professionals ready to adopt and use eHealth technologies and solutions, today and in a way consistent with policy direction in the future?
2. What are the barriers impacting eHealth readiness and adoption and how can we minimise them?
3. What are the eHealth enablers and how can we apply them to drive adoption and effective usage?

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Incorporating Occupational Information in Electronic Health Records: Letter Report – Institute of Medicine – 30 September 2011

Posted on October 3, 2011. Filed under: Health Informatics, Medical Records, Occupational Hlth Safety | Tags: , |

Incorporating Occupational Information in Electronic Health Records: Letter Report – Institute of Medicine – 30 September 2011

“Each year in the United States, more than 4,000 occupational fatalities and more than 3 million occupational injuries occur along with more than 160,000 cases of occupational illnesses. The use of electronic health records (EHRs) has increased rapidly since the passage of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act. Incorporating patients’ occupational information into EHRs could lead to more informed clinical diagnosis and treatment plans as well as more effective policies, interventions, and prevention strategies to improve the overall health of the working population.

At the request of the National Institute for Occupational Safety and Health, the IOM appointed a committee to examine the rationale and feasibility of incorporating occupational information in patients’ EHRs. The committee focused on the potential benefits of the inclusion of occupational information to individual and public health, current systems that use this information, and technical barriers to incorporating occupational information into the EHR. The IOM concluded that three data elements – occupation, industry, and work-relatedness – were ready for immediate focus. To incorporate these data into EHRs, recommendations were made that include assessment of data collection and incorporation, requirements for storing and communicating occupational information, development of metrics and performance measures, and assessment of privacy concerns, among others.”

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eHealth Strategy 2011-2017 – Scotland – 12 September 2011

Posted on September 23, 2011. Filed under: Health Informatics | Tags: , |

eHealth Strategy 2011-2017 – Scotland – 12 September 2011
The second eHealth Strategy for NHS Scotland

ISBN 978 1 78045 376 7

Contents

Ministerial Foreword

1. Introduction

2. How eHealth is making a difference to healthcare in Scotland
2.1 Working in collaboration
2.2 Sharing technology and services
2.3 National systems and solutions

3. Our new policy context
3.1 Quality Strategy
3.2 Health and Social Care

4. Technical, Governance and financial context
4.1 A New eHealth Finance Strategy
4.2 Our New delivery model: outcomes based approach
4.3 Governance

5. How we are responding to the challenges – our Strategic Aims for eHealth

Annexe 1 Summary of our performance against actions for eHealth Strategy 2008-11

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Guide to Reducing Unintended Consequences of Electronic Health Records – Agency for Healthcare Research and Quality [US] – August 2011

Posted on September 21, 2011. Filed under: Health Informatics, Medical Records | Tags: , |

Guide to Reducing Unintended Consequences of Electronic Health Records – Agency for Healthcare Research and Quality [US] – August 2011

S.S. Jones, R. Koppel, M.S. Ridgely, T.E. Palen, S. Wu, and M.I. Harrison. Guide to Reducing Unintended Consequences of Electronic Health Records Prepared by RAND Corporation under Contract No. HHSA290200600017I, Task Order #5. Agency for Healthcare Research and Quality (AHRQ). Rockville, MD. August, 2011.
 
“The Guide to Reducing Unintended Consequences of Electronic Health Records is an online resource designed to help you and your organization anticipate, avoid, and address problems that can occur when implementing and using an electronic health record (EHR). Our purpose in developing the Guide was to provide practical, troubleshooting knowledge and resources.

The Guide was developed with all types of health care organizations in mind — from large hospital systems to solo physician practices. We anticipate that the primary users will be EHR implementers such as Regional Extension Centers, chief information officers, directors of clinical informatics, EHR champions or “super users,” administrators, information technology specialists, and clinicians involved in the implementation of an EHR. Frontline EHR users (such as physicians and nurses) may also find the Guide useful.

The Guide is based on the research literature, other practice-oriented guides for EHR implementation and use, research by its authors, and interviews with organizations that have recently implemented EHR. The Guide represents a compilation of the known best practices for anticipating, avoiding, and addressing EHR-related unintended consequences. However, this area of research is still in its infancy. Therefore, the Guide is a work in progress. We invite you to revise its tools and recommendations in keeping with your own experience and in response to emerging research findings.”

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The National Programme for IT in the NHS: An update on the delivery of detailed care records systems – Public Accounts Committee [UK] – 3 August 2011

Posted on August 3, 2011. Filed under: Health Informatics | Tags: , |

The National Programme for IT in the NHS: An update on the delivery of detailed care records systems – Public Accounts Committee [UK] – 3 August 2011

The Commons Public Accounts Committee publishes a report today which, on the basis of evidence from the Department of Health and its contractors BT and Computer Sciences Corporation (CSC), examines the delivery of care records systems under the National Programme for IT in the NHS.

The report

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Secrets of HIE Success Revealed: Lessons from the Leaders – National eHealth Collaborative [US] – July 2011

Posted on August 3, 2011. Filed under: Health Informatics | Tags: |

Secrets of HIE Success Revealed: Lessons from the Leaders – National eHealth Collaborative [US] – July 2011
Funded by the Office of the National Coordinator for Health IT

Extract from the executive summary:

“The environment for building and growing a health information exchange (HIE) organization has never been better. Government funds are flowing, HIE is a key component of electronic health record (EHR) meaningful use requirements, and information communication technologies are becoming increasingly more powerful and less expensive. However, concerns about the long-term sustainability of HIE organizations persist, and questions remain about the impact and value of exchanging health information. To help the healthcare community better understand these issues, and work together towards common solutions, National eHealth Collaborative (NeHC) recently conducted a study of 12 fully operational HIEs that demonstrate through their innovative strategies and business models that HIEs can benefit multiple stakeholder groups, and can, in the process, become growing, self-sustaining business enterprises.”  … continues

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A composite index for the benchmarking of eHealth Deployment in European acute Hospitals. Distilling reality in manageable form for evidence based policy – European Commission Joint Research Centre – May 2011

Posted on May 25, 2011. Filed under: Evidence Based Practice, Health Informatics | Tags: , |

A composite index for the benchmarking of eHealth Deployment in European acute Hospitals. Distilling reality in manageable form for evidence based policy – European Commission Joint Research Centre – May 2011

Authors: Cristiano Codagnone and Francisco Lupiañez-Villanueva

“Abstract
Benchmarking is an important pillar of European policy making and has acquired a ‘quasi-regulatory’ role within the Open Method of Coordination in that it helps the Commission and MS to set target and monitor their achievement. After at least a decade of policy efforts and investments of public money to digitalise healthcare delivery it is a good time to take stock of where we stand in terms of take up, usage and impact. Applying state of the art multivariate statistical analysis to the data of survey of eHealth deployment in Acute European Hospitals funded by Unit C4 of DG INFSO, JRC-IPTS researchers have constructed a composite indicator of take up and usage of eHealth in European hospitals, as well as a typology of impacts. This combined analysis clearly show how, if methodology and substantive policy issues are rightly integrated, benchmarking can really contribute to the policy process and help decision makers fill existing gaps and invest into promising directions.”

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Digital Agenda: eHealth survey shows most hospitals online but telemedicine services not fully deployed – Europa – 10 May 2011

Posted on May 20, 2011. Filed under: Health Informatics, Telehealth | Tags: |

Digital Agenda: eHealth survey shows most hospitals online but telemedicine services not fully deployed – Europa – 10 May 2011

“More than 90% of European hospitals are connected to broadband, 80% have electronic patient record systems, but only 4% of hospitals grant patients online access to their electronic records, according to the results of a survey conducted for the European Commission. European hospitals are more advanced than US hospitals in terms of external medical exchange, but they lag behind in using eHealth to view laboratory reports or radiology images. The survey provides useful data for the work of the EU eHealth Task Force on assessing the role of information and communications technologies (ICT) in health and social care, which is due to suggest ways for ICT to speed up innovation in healthcare to the benefit of patients, carers and the healthcare sector. ”  … continues on the site

For more information
The survey’s final report and related annexes are available

Digital Agenda website

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Medication Management & Health IT – AHRQ – April 2011

Posted on May 6, 2011. Filed under: Health Informatics, Medications, Pharmacy | Tags: , |

Medication Management & Health IT – AHRQ – April 2011

U.S. Agency for Healthcare Research and Quality

“Structured Abstract
Objective: The objective of the report was to review the evidence on the impact of health information technology (IT) on all phases of the medication management process (prescribing and ordering, order communication, dispensing, administration and monitoring as well as education and reconciliation), to identify the gaps in the literature and to make recommendations for future research.

Data sources: We searched peer-reviewed electronic databases, grey literature, and performed hand searches. Databases searched included MEDLINE®, Embase, CINAHL (Cumulated Index to Nursing and Allied Health Literature), Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts, Compendex, Inspec (which includes IEEE Xplore), Library and Information Science Abstracts, E-Prints in Library and Information Science, PsycINFO, Sociological Abstracts, and Business Source Complete. Grey literature searching involved Internet searching, reviewing relevant Web sites, and searching electronic databases of grey literatures. AHRQ also provided all references in their e-Prescribing, bar coding, and CPOE knowledge libraries.

Methods: Paired reviewers looked at citations to identify studies on a range of health IT used to assist in the medication management process (MMIT) during multiple levels of screening (titles and abstracts, full text and final review for assignment of questions and data abstrction). Randomized controlled trials and cohort, case-control, and case series studies were independently assessed for quality. All data were abstracted by one reviewer and examined by one of two different reviewers with content and methods expertise.

Results: 40,582 articles were retrieved. After duplicates were removed, 32,785 articles were screened at the title and abstract phase. 4,578 full text articles were assessed and 789 articles were included in the final report. Of these, 361 met only content criteria and were listed without further abstraction. The final report included data from 428 articles across the seven key questions. Study quality varied according to phase of medication management. Substantially more studies, and studies with stronger comparative methods, evaluated prescribing and monitoring. Clinical decision support systems (CDSS) and computerized provider order entry (CPOE) systems were studied more than any other application of MMIT. Physicians were more often the subject of evaluation than other participants. Other health care professionals, patients, and families are important but not studied as thoroughly as physicians. These nonphysicians groups often value different aspects of MMIT, have diverse needs, and use systems differently. Hospitals and ambulatory clinics were well-represented in the literature with less emphasis placed on long-term care facilities, communities, homes, and nonhospital pharmacies. Most studies evaluated changes in process and outcomes of use, usability, and knowledge, skills, and attitudes. Most showed moderate to substantial improvement with implementation of MMIT. Economics studies and those with clinical outcomes were less frequently studied. Those articles that did address economics and clinical outcomes often showed equivocal findings on the effectiveness and cost-effectiveness of MMIT systems. Qualitative studies provided evidence of strong perceptions, both positive and negative, of the effects of MMIT and unintended consequences. We found little data on the effects of forms of medications, conformity, standards, and open source status. Much descriptive literature discusses implementation issues but little strong evidence exists. Interest is strong in MMIT and more groups and institutions will implement systems in the next decades, especially with the Federal Government’s push toward more health IT to support better and more cost-effective health care.

Conclusions: MMIT is well-studied, although on closer examination of the literature the evidence is not uniform across phases of medication management, groups of people involved, or types of MMIT. MMIT holds the promise of improved processes; clinical and economics studies and the understanding of sustainability issues are lacking.”

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Physician Practices, E-Prescribing and Accessing Information to Improve Prescribing Decisions – Center for Studying Health System Change Research Brief No 20 – May 2011

Posted on May 6, 2011. Filed under: Health Informatics, Knowledge Translation, Pharmacy | Tags: |

Physician Practices, E-Prescribing and Accessing Information to Improve Prescribing Decisions – Center for Studying Health System Change Research Brief No 20 – May 2011

By Joy M. Grossman, Ellyn R. Boukus, Dori A. Cross and Genna R. Cohen

Abstract:
“Hoping to reduce medication errors and contain health care costs, policy makers are promoting electronic prescribing through Medicare and Medicaid financial incentives. Many e-prescribing systems provide electronic access to important information—for example, medications prescribed by physicians in other practices, patient formularies and generic alternatives—when physicians are deciding what medications to prescribe. However, physician practices with e-prescribing face challenges using these features effectively, according to a new qualitative study by the Center for Studying Health System Change (HSC) funded by the Agency for Healthcare Research and Quality (AHRQ).

While most of the 24 practices studied reported that physicians had access to patient formulary information, only slightly more than half reported physician access to patient medication histories, and many physicians did not routinely review these sources of information when making prescribing decisions. Study respondents highlighted two barriers to use: 1) tools to view and import the data into patient records were  cumbersome to use in some systems; and 2) the data were not always perceived as useful enough to warrant the additional time to access and review them, particularly during time-pressed patient visits. To support generic prescribing, practices typically set their system defaults to permit pharmacist substitution of generics; many practices also used other tools to more proactively identify and select generic alternatives at the point of prescribing. Overall, physicians who more strongly perceived the need for third-party data, those in practices with greater access to complete and accurate data, and those with easier-to-use e-prescribing systems were more likely to use these features consistently.”

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NeHC to consumers: Take charge of your health – from Governemnt Health IT – 28 April 2011

Posted on April 29, 2011. Filed under: Health Informatics, Patient Participation | Tags: |

NeHC to consumers: Take charge of your health
April 28, 2011 | Mary Mosquera

“The Consumer Consortium on eHealth has launched from dozens of organizations that serve consumers in a variety of ways to encourage participation by individuals in their health care through the use of health information technology.
The National eHealth Collaborative, a public/private partnership that promotes secure health information exchange, brought together representatives from 65 consumer groups, patient advocates and government agencies to start sharing their most effective practices, communication strategies and tools to encourage consumers to become more involved in their health.

Groups included the National Partnership for Women and Families, AARP and the Medical Group Management Association.

Consumers need to be involved in the innovations and investments of health IT to improve the quality and coordination of health care, according to participants.”

…continues on the Government Health IT site

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eHealth Action Plan 2012-2020 public consultation – European Commission

Posted on April 14, 2011. Filed under: Health Informatics | Tags: , |

eHealth Action Plan 2012-2020 public consultation – European Commission 

“The public consultation is open for 8 weeks (from 31st March to 25th May 2011 16:00 Brussels time). Following this, the results of the consultation will be analysed, published on this page, and taken into consideration in drafting a policy document setting out an Action plan for eHealth, which is planned to be adopted by the Commission in 4Q 2011.”

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NQF Posts Specifications for Electronic Measures that will Reward Meaningful Use of HIT – 15 February 2011

Posted on February 16, 2011. Filed under: Health Informatics | Tags: , |

NQF Posts Specifications for Electronic Measures that will Reward Meaningful Use of HIT

“Washington, DC – The National Quality Forum (NQF) announces the conversion of 113 NQF-endorsed measures from a paper-based format to an electronic “eMeasure” format. The conversion, requested by the Department of Health and Human Services (HHS) in compliance with the Health Information Technology for Economic and Clinical Health (HITECH) Act, will allow the measures to be more easily readable by electronic health record (EHR) systems. The converted measures will be available for public and member comment through April 1, 2011.

The use of eMeasures offers many benefits and efficiencies including: greater consistency in measure development and in measuring and comparing performance results; providing more exact requirements or “specifications” about where information should be collected; greater standardization across the measures; and greater confidence in comparing outcomes and provider performance. This conversion should ensure that performance measure data are consistently defined, implemented, and usable in the context of an EHR and support the meaningful use requirements.” …continues on the site

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Will Adoption of Electronic Health Records Improve Quality in U.S. Hospitals? – RAND – 2011

Posted on February 10, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Informatics | Tags: , |

Will Adoption of Electronic Health Records Improve Quality in U.S. Hospitals? – RAND – 2011

by Spencer S. Jones, John L. Adams, Eric Schneider, Jeanne S. Ringel, Elizabeth A. McGlynn, Mary E. Vaiana

“Shares findings on the potential effects of electronic health records (EHRs) on health care quality, based on analysis of extensive data from 2003 and 2006 on EHR adoption, hospital characteristics, and hospital quality in nearly 2,100 hospitals.”

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Secrets of CIO Success on the EMR Journey to Meaningful Use – Accenture – 4 January 2011

Posted on January 28, 2011. Filed under: Health Informatics | Tags: , |

Secrets of CIO Success on the EMR Journey to Meaningful Use – Accenture – 4 January 2011

“The government mandate to demonstrate meaningful use of electronic medical records (EMRs) by 2015 or face stiff penalties has only heightened these pressures.

Healthcare providers must update their IT infrastructure to adhere not only to these new government regulations, but also to requirements coming from the World Health Organization (such as the new ICD-10 coding). Given that a small percentage of providers are currently in compliance with the meaningful use requirements, the transition to EMR will represent a watershed moment for the industry.

To prepare for that transition, Accenture conducted in-depth interviews with 15 CIOs of leading US health systems. Each organization in our study is evaluating options for achieving meaningful use.

The results of Accenture’s 2010 EMR study, Secrets of Success on the EMR Journey to Meaningful Use: Leading Hospital CIOs Reveal Key Lessons Learned, reveal six best practices that can help health systems implement EMR and optimize their investment. Ranging from the basic (such as securing commitment from top leadership and managing rising IT costs) to the surprising (including strategies for winning buy-in from clinicians), these best practices can make the EMR terrain easier to navigate. Result? Health systems capture valuable incentives while avoiding painful penalties.”

…continues on the site

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Standards and eHealth – ITU-T Technology Watch Report – January 2011

Posted on January 28, 2011. Filed under: Health Informatics | Tags: |

Standards and eHealth – ITU-T Technology Watch Report – January 2011

International Telecommunication Union, ITU Telecommunication Standardization Bureau, Policy & Technology Watch Division

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Electronic Health Record Usability: Vendor Practices and Perspectives – AHRQ – May 2010

Posted on May 27, 2010. Filed under: Health Informatics | Tags: , |

Electronic Health Record Usability: Vendor Practices and Perspectives – AHRQ – May 2010

McDonnell C, Werner K, Wendel L. Electronic Health Record Usability: Vendor Practices and Perspectives. AHRQ Publication No. 09(10)-0091-3-EF. Rockville, MD: Agency for Healthcare Research and Quality. May 2010.

“One of the key factors driving the adoption and appropriate utilization of electronic health record (EHR) systems is their usability. However, a recent study funded by the Agency for Healthcare Research and Quality (AHRQ) identified information about current EHR vendor usability processes and practices during the different phases of product development and deployment as a key research gap.

To address this gap and identify actionable recommendations to move the field forward, AHRQ contracted with James Bell Associates and the Altarum Institute to conduct a series of structured discussions with selected certified EHR vendors and to solicit recommendations based on these findings from a panel of multidisciplinary experts in this area.

The objectives of the project were to understand processes and practices by these vendors with regard to:

• The existence and use of standards and “best practices” in designing, developing, and deploying products.
• Testing and evaluating usability throughout the product life cycle.
• Supporting postdeployment monitoring to ensure patient safety and effective use.”

…continues

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Optimising E-Health Value Using an Investment Model to Build a Foundation for Program Success – booz&co – 6 May 2010

Posted on May 12, 2010. Filed under: Health Informatics | Tags: , |

Optimising E-Health Value Using an Investment Model to Build a Foundation for Program Success – booz&co – 6 May 2010

Media release

“Sydney, 6 May 2010 — A report released today by leading global management consultancy, Booz & Company, has revealed Government investment in a comprehensive e-health system may generate more than $7.6 billion in annual healthcare savings by 2020.
 
The Booz & Company report, Optimising E-Health Value, outlines a comprehensive case for national investment in e-health to better connect GPs, hospitals and other points of care, so as to improve sharing of patient information.”

…continues
 

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Evaluating the Value and Impact of an Electronic Health Record in a Complex Health System – article – 2010

Posted on April 13, 2010. Filed under: Health Informatics, Medical Records | Tags: |

ElectronicHealthcare, 8(4) 2010: e3-e14
Evaluating the Value and Impact of an Electronic Health Record in a Complex Health System
Damon C. Mayes and David R. Mador
pdf

 “Abstract:
NetCARE is Canada’s first region-wide electronic health record (EHR) (Hospital News 2004). It is a clinical, web-based, view-only record of an individual’s key health information drawn from multiple sources. NetCARE is available in both hospital and community settings and is accessed by a variety of clinical users. A systematic evaluation showed that an average of 88% of respondents agreed or strongly agreed that netCARE provided valuable lab test results, event history, diagnostic imaging and transcribed reports. Seventy-six per cent indicated that it helped provide quality patient care, and 82% felt it integrated easily into their clinical workflow. A 15-fold increase in EHR use over two and a half years was accompanied by a 56% decrease in physician use of a major legacy system (p=.004) and an average decrease of 24% in requests for paper-based records (p=.03). The average time for netCARE to decrease both legacy system use and patient-chart requests to desired levels was two years.”

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Conference Declaration: European Co-operation on eHealth – 15 March 2010

Posted on March 18, 2010. Filed under: Health Informatics | Tags: |

Conference Declaration: European Co-operation on eHealth
Adopted  on 15/03/2010

“Following the adoption by the EPSCO Council of the Conclusions on safe and efficient healthcare through eHealth, we[1] acknowledge

That ICT for Health (eHealth) is a tool to improve quality and patient safety, to modernise national healthcare systems, to increase their efficiency and make them better adapted to the individual needs of citizens, patients, health professionals, and the challenges of an   ageing society.

The importance of ensuring that the deployment of ICT in healthcare, to be successful has to be accompanied by the necessary organisational reforms, driven by leadership and supported by adequate skills.

Therefore we welcome

Recent efforts by Member States to reform the governance arrangements for eHealth in Europe  through a new mechanism of cooperation – the European eHealth Governance Initiative,
The forthcoming update of the Commission Communication on the “eHealth Action Plan”
The Commission Consultation on the European Digital Agenda
The Council Conclusions on the”Post-i2010 Strategy”
The agreed programme of priorities of the TRIO Presidencies[2]

To build on these developments and achieve the overall objective of enhancing quality and sustainability of healthcare systems, to make them to benefit from ICT deployment in the best interest of patients, healthcare professionals and society,

we consider that the following points should be addressed:”

…continues

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Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method – article – 2009

Posted on December 15, 2009. Filed under: Health Informatics, Medical Records | Tags: , |

Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method
Trisha Greenhalgh, Henry W.W. Potts, Geoff Wong, Pippa Bark, and Deborah Swinglehurst
University College London
The Milbank Quarterly, Vol. 87, No. 4, 2009 (pp. 729–788)

Context: The extensive research literature on electronic patient records (EPRs) presents challenges to systematic reviewers because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches.

Methods: Using the meta-narrative method and searching beyond the Medline-indexed literature, this review used “conflicting” findings to address higher-order questions about how researchers had differently conceptualized and studied the EPR and its implementation.

Findings: Twenty-four previous systematic reviews and ninety-four further primary studies were considered. Key tensions in the literature centered on (1) the EPR (“container” or “itinerary”); (2) the EPR user (“information-processer” or “member of socio-technical network”); (3) organizational context (“the setting within which the EPR is implemented” or “the EPR-in-use”); (4) clinical work (“decision making” or “situated practice”); (5) the process of change (“the logic of determinism” or “the logic of opposition”); (6) implementation success (“objectively defined” or “socially negotiated”); and (7) complexity and scale (“the bigger the better” or “small is beautiful”).

Conclusions: The findings suggest that EPR use will always require human input to recontextualize knowledge; that even though secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper may offer a unique degree of ecological flexibility; and that smaller EPR systems may sometimes be more efficient and effective than larger ones. We suggest an agenda for further research.

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Accomplishing EHR / HIE (eHealth): lessons from Europe – July 2009

Posted on August 4, 2009. Filed under: Health Informatics | Tags: , |

Accomplishing EHR / HIE (eHealth): lessons from Europe – July 2009 – CSC – Authors: Dr. Harald Deutsch, Fran Turisco

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Electronic Health Records in Hospitals – NEJM letter to the editor – 23 July 2009

Posted on July 23, 2009. Filed under: Health Informatics, Medical Records | Tags: , , |

Electronic Health Records in Hospitals

Recommends using the VHA’s Computerized Patient Record System

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First step taken towards national e-health system – consultation – Australia – 13 July 2009

Posted on July 14, 2009. Filed under: Health Informatics | Tags: , , |

First step taken towards national e-health system 13 July 2009

“In an out-of-session communique, the Australian Health Ministers’ Conference has announced that the first step has been taken towards a national e-health system. National consultations are set to begin on the legislative framework to underpin the governance, privacy and agreed uses for national healthcare identifier numbers essential to a secure national e-health system.

National consultations are set to begin on the legislative framework to underpin the governance, privacy and agreed uses for national healthcare identifier numbers essential to a secure national e-health system.

Healthcare Identifiers are unique numbers that will be given to all healthcare providers, healthcare centres and healthcare consumers. These unique numbers will provide a new level of confidence when communicating patient information between the myriad of private and government healthcare providers and systems.”   … continues on the website

Discussion paper

COAG Communique from 13 July 2009

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NHHRC Backs Person-controlled Electronic Health Records – 30 April 2009

Posted on May 1, 2009. Filed under: Health Informatics, Nat Hlth & Hosps Reform Comm | Tags: |

NHHRC Backs Person-controlled Electronic Health Records  –  information taken from an NHHRC Media Release – 30 April 2009

The National Health and Hospitals Reform Commission (NHHRC) today released a supplementary paper to its Interim Report, which outlines the Commission’s support for person-controlled electronic health records for every Australian.

NHHRC Chair, Dr Christine Bennett, said today that the supplementary paper spells out the Commission’s position that an electronic health record is arguably the single most important enabler of truly person-centred care.

“The timely and accurate communication of pertinent, up-to-date health details of an individual can enhance the quality, safety and continuity of health care,” Dr Bennett said.

“A person-controlled electronic health record would enable people to take a more active role in managing their health and making informed health care decisions.”

According to recent research commissioned by the National Electronic Health Transition Authority (NEHTA), 82 per cent of consumers in Australia support the establishment of an electronic health record.

The Commission has made seven recommendations to make person-controlled electronic health records a reality. These include:

o By 2012, every Australian should be able to have a personal electronic health record that will at all times be owned and controlled by that person;
o The Commonwealth Government must legislate to ensure the privacy of a person’s electronic health data, while enabling secure access to the data by the person’s authorised health providers;
o The Commonwealth Government must introduce unique personal identifiers for health care by 1 July 2010;
o The Commonwealth Government must develop and implement an appropriate national social marketing strategy to inform consumers and health professionals about the significant benefits and safeguards of the proposed e-health approach; and
o The Commonwealth Government must mandate that the payment of public and private benefits for all health and aged care services be dependent upon the provision of data to patients, their authorised carers, and their authorised health providers, in a format that can be integrated into a personal electronic health record.

The NHHRC supplementary paper, Person-controlled Electronic Health Records, is available on the NHHRC website at http://www.nhhrc.org.au under Interim Report of the NHHRC. Feedback can be sent to talkhealth@nhhrc.org.au but must be received by Friday 8 May.

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Critical issues for electronic health records: considerations from an expert workshop – UK

Posted on April 17, 2009. Filed under: Health Informatics, Medical Records | Tags: |

Critical issues for electronic health records: considerations from an expert workshop – UK

This report is based on the Electronic Health Records Symposium – an expert seminar hosted by the Nuffield Trust and Wellcome Trust. This seminar brought together health leaders, policy-makers and academics to identify the key priorities involved in research, strategy and implementation of electronic health record systems (EHR). The report augments the workshop findings with further comment from the authors and identifies the key requirements for successful EHR systems implementation, integration and maintenance worldwide

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eHealth Intelligence Report

Posted on April 16, 2009. Filed under: Health Informatics | Tags: , |

eHealth Intelligence Report

Covers eHealth developments worldwide offering readers a wide range of information on publications, reviews, standards, major events as well as the latest news from countries.

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Ontario’s eHealth Strategy

Posted on April 16, 2009. Filed under: Health Informatics | Tags: |

On February 5, 2009, eHealth Ontario published Ontario’s three year eHealth Strategy. It is a working draft created by eHealth Ontario’s leadership and Board of Directors with input from the healthcare sector. The document is intended to guide investments and operations during the Strategy time frame of 2009-2012, enable/fulfill the government’s strategic healthcare priorities and provide a framework for measuring and reporting progress and results. The feedback received from February 5 to 19 will be used to finalize the plan.

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Informatics Planning 2009 to 2010 – UK Department of Health Dec 2008

Posted on April 7, 2009. Filed under: Health Informatics | Tags: |

Report published 8 December 2008

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E-Health: enabler for Australia’s Health Reform 27 Nov 2008

Posted on April 7, 2009. Filed under: Health Informatics | Tags: |

Discussion paper by booz&co.  Prepared for the National Health and Hospitals Reform Commission.   69p.

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A Pebble in the Pond: A Vision for E-Health Enabled Healthcare Transformation

Posted on April 7, 2009. Filed under: Health Informatics | Tags: |

Report by Sally Glass, Louise Schaper & John Glass November 2008    CHIK Services Pty Ltd    15 p.

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