medical information

NQF endorses national technology standards

Anne Zieger — Mon, 01 Sep 2008 22:59:13 -0400

The National Quality Forum has endorsed a group of nine health IT standards under its new national voluntary consensus program. The standards address electronic prescribing, EMR interoperability, care management, quality registries and the medical home. Details include the following:

* E-prescribing: The two e-prescribing measures encourage adoption of either a standalone e-prescribing tool for providers without EMRs, or enhanced use of e-prescribing within an EMR.

* Interoperable EMRs: NQF has two standards for EMRs, one of which measures adoption of an EMR to manage clinical data within a practice, and the second measuring receipt of external data within an EMR.

* Care management: The NQF standards measure the use of HIT to identify specific patients in need of care, track preferences and lab results, and help the clinician in providing evidence-based care.

The standards are intended to help reduce medical errors by increasing clinicians' access to medical information. For example, the standards are intended to improve response times to abnormal lab results, eliminate repetitive testing and and provide decision-support tools to foster the use of evidence-based care.

To learn more about the standards:
- read this NQF press release

SPOTLIGHT: Should patients have broader health data access?

Mon, 21 Apr 2008 06:59:52 -0400

As Dr. Ted Eytan sees it, patients have far too little access to their own medical information, thanks largely to a medical and societal culture that encourages keeping records close to the vest. (For example, many medical offices tell patients that they'll only get test results if something of concern is found.) In his mind, however, it's important to change this norm; in fact, in his view, patients should get any and all information, preferably delivered to them as soon as it's available. Article

Are your PHRs safe?

Mon, 31 Mar 2008 07:59:54 -0400

We've said it before and we'll say it again: The fact that several of the PHR initiatives launched by bigger companies such as Google and Microsoft don't fall under HIPAA medical privacy rules is a little bit scary. While some states have passed "additional privacy standards" to try to keep the Googles and the Microsofts in check by allowing users to control how much access others have to their information, patients ultimately need to understand each individual company's privacy policies and terms of use. I don't know about you, but it seems that with all the recent leaks in medical information, thinking twice about which route you choose for your PHRs wouldn't necessarily be a bad thing at all.

For more:
- read iHealthBeat's article

HIMSS08: Google unveils details of PHR

Mon, 03 Mar 2008 06:59:57 -0500

So, the Google boys have marched into town with their own PHR, which they demonstrated last week for a marveling crowd at HIMSS08. At a modest booth on a side alley at the exhibition, Google was premiering a simple PHR interface consisting of only few text links, including a link to a feature allowing users to search for doctors, and another accessing Google Scholar to search for medical information. The PHR's key function was a link to a utility allowing users to import records from varied provider systems, then store the records online. Of course, Google CEO Eric Schmidt has been making the rounds assuring privacy advocates that the search giant won't share these records without the patient's consent, but as I understand it, since Google's not a provider they're not required to meet HIPAA standards unless they feel like it. How long that will last, particularly if competitors like Microsoft and Revolution Health begin to loosen their standards?

As we've previously noted, the records will be accessible through the same name/password combination consumers use to access other Google features, such as Calendar and Gmail. OK, readers, I'm sure you know far more than me on this front, but isn't that a fairly weak security method to store extremely private information? When I asked one of the young Google-ites manning the booth this question, he brushed it away. I don't know about you, but that didn't impress me much.

To get more background on the Google PHR:
- read this iHealthBeat piece

Related Article:
Google begins storing medical records. Article

Marriott rolls out Web-based PHR to employees

Mon, 04 Feb 2008 06:59:58 -0500

Hotel operator Marriott has rolled out a Web-based PHR to 50,000 employees across the U.S. Marriott is doing the rollout after conducting a small pilot test with the PHR system, developed by ActiveHealth Management. To participate, patients fill out a Web-based health risk assessment, answering such question as whether they smoke, as well as other basic medical information. ActiveHealth, which is owned by Aetna, then combines patient data with medical and pharmacy claims data and lab results, comparing patient data with its repository of evidence-based clinical rules.

In addition to a data bank, the PHR includes a clinical rules engine that's designed to help providers avoid medical mistakes. When the system uncovers potential mistakes--or gaps in care--it alerts doctors by phone, fax or letter, recommending an alternative course of action, as well as letting the patient know what's going on.

To learn more about this PHR rollout:
- read this Information Week piece

Related Articles:
Medicare tests PHRs in South Carolina. Report
Insurers create PHR model. Report
Wal-Mart, partners pilot Dossia PHR. Report

You tell me: What's a PHR?

Mon, 12 Nov 2007 06:59:59 -0500

OK, maybe some of you are sick of hearing me harp on this subject, but I'll ask again--what the heck is a personal health record?

One view comes from America's Health Insurance Plans: "The industry model personal health record (PHR) is a private, secure web-based tool maintained by an insurer that contains claims and administrative information." Makes sense if you're a health plan, definitely.

Or what about AHIMA's take: "[A PHR is]an electronic, universally available, lifelong resource of health information maintained and owned by the individual." Should calm the nerves of the privacy advocates, no?

The HIMSS definition takes us in a slightly different direction: "To enable the goals of reducing medical errors, improving quality of care, and improving the validity of information available to care providers, Personal Health Records (PHRs) function to consolidate an individual's medical information in one place." This one doesn't dwell on a patient's rights so much as the comprehensiveness of the data, which is of course a wrinkle worth considering.

Yes, I think it's pretty clear what the intent of various employer- and healthplan-driven PHRs is (cheaper, better care), but that's not enough. You can know that you want to ride from Phoenix to Denver without knowing what parts are needed to build a car.

I'm taking up this issue again, in part, because that the indefatigable folks at HL7 are voting on a functional PHR model over the next few weeks. While I'm delighted to see some consensus building on key PHR functions (such as wellness reminders or prompts to look at lab results), that still begs the question of what the ultimate goal of a PHR is. Quick: tell me in one sentence what your PHR effort is trying to accomplish. Not so easy, is it?

When it comes to PHR content, some key unanswered questions include:

* What is the core clinical data set a PHR must contain to deserve the name? Patient medical history, drug allergies, care plans, genetic data, what?
* Does the name "personal health record" imply that it's largely or entirely maintained by consumers, or are consumers merely its custodians?
* What's the benefit of maintaining a PHR? (No, I don't agree that the answer to this is obvious.)
* What is the minimum amount of data a PHR must contain to be useful?

Yes, I realize that health plans, employers, software vendors, standards groups and even consumers will have to do a lot more talking before they arrive at a shared conclusion on these issues--and that technology never moves ahead without some fuzzy logic in between--but in my view things are still too fuzzy. As I see it, it's critical to get bit more clarity on core issues like, say, whether a PHR should be populated by claims data, consumer self-reporting, EMR data or a mix before more dollars are spent. In the mean time, let's not put the cart before the horse, shall we? - Anne

HIT group offers medical data security standards

Mon, 29 Oct 2007 07:59:57 -0400

The Healthcare Information Technology Standards Panel (HITSP) has issued a new set of standards designed to keep digital medical information secure. HITSP is operating under contract to HHS, and is administered by the American National Standards Institute (usually known as ANSI). The standards, which it dubbed the "security and privacy constructs," address key data security issues in a number of areas, including e-delivery of lab results to clinicians, medication workflow, quality improvement and consumer health data access. Ultimately, the security and privacy constructs are intended to help foster a more robust health information networking system in the U.S. These standards come as part of a larger project, in which the group is working establish standards for EMR interoperability.

To learn more about the standards:
- read this Healthcare IT News piece

Related Articles:
Federal agency offers standards for improving EMRs. Report
Report: RHIOs need governance, technical standards. Report

SPOTLIGHT: The emergence of the CMIO

Mon, 24 Sep 2007 06:59:52 -0400

As demands for healthcare quality data increase, and the role of IT in improving quality has grown, there's been an increasing demand for hospitals to employ a chief medical information officer. While the position is still a new one--and providers are still struggling to refine the job description--it seems clear that there's a rapidly-expanding need for an intermediary that understands both clinical and IT issues. Article

ALSO NOTED: Oregon HIE hits the rocks; CMIOs at 'tipping point' for health IT investment; and much more...

Mon, 13 Aug 2007 06:59:50 -0400

> Like their peers in communities across the U.S., Portland, Ore. physicians and hospitals were psyched to get together plans for a health information exchange. But then things started to fall apart. Article

> A new study suggests most chief medical information officers are now actively investing in IT for acute care, despite low uptake of EMRs in ambulatory settings. Article

> The Department of Defense has awarded $1.6 million to a university research centers to help it develop an implantable biochip that could transmit medical information. Article

> EDS has won a $100.8 million contract to install a Medicaid IT system for Ohio. EDS previously won a $308 million contract for Medicaid IT in Florida. Article

> A Vermont medical center has begun offering EMRs to medical group practices affiliated with the hospital. Article

And Finally... Can't get comfortable at night? This gadget may help. Release

SPOTLIGHT: Henry Ford saves with eROI

Sun, 01 Jul 2007 20:01:32 -0400

Managing releases of medical information (ROI) can be a major drain on a health organization. Nowhere is that more true than at Henry Ford Hospital and Health Network, which gets more than 42,000 ROI requests every year. To tame this problem, Henry Ford has re-engineered its entire process, using a new work flow management tool which controls access to both paper and electronic medical records. The new, affordable system has generated some remarkable benefits, including a 50 to 60 percent reduction in phone calls and a substantial savings on copy services. Article