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Filed under: Information Technology | Tagged: EHRs, EMRs, HIT, National Health Information Technology Week |















National HIT Jobs Week
If you are a HIPAA covered entity with a voluntary (but permanent) NPI number, you are more than likely unaware that this is National HIT (jobs) Week.
Even though shy electronic dental record stakeholders inside and outside the ADA have been suspiciously silent about this week’s celebration of the half-baked, parasite-infested HIT mandate, President Obama has proclaimed this week as “National Health Information Technology Week.”
http://www.whitehouse.gov/the-press-office/2011/09/12/presidential-proclamation-national-health-information-technology-week
Not long ago, privacy attorney Jim Pyles suggested that HITECH under Obama isn’t so much a healthcare bill as a jobs creation bill. I now see what he means. The White House chose to roll out Obama’s proclamation not through the Department of Health and Human Resources, but rather under the banner of his American Jobs Act.
That’s actually not surprising. Since the mandate-driven EHRs are naturally so lousy that physicians have to be paid just to use them, Obama is trying to create a consumer demand for his bad idea by calling Health IT a panacea for unemployment – magically converting illness into a renewable national resource.
On Monday, President Obama said, “I urge all Americans to learn more about the benefits of Health IT by visiting HealthIT.gov, take action to increase adoption and meaningful use of Health IT, and utilize the information Health IT provides to improve the quality, safety, and cost effectiveness of health care in the United States.”
Not in dentistry. If there were tangible advantages of electronic dental records over paper, dentists would purchase them. And if vetted ADA leaders were transparent with common ADA members, they’d confess that EDRs are not only more expensive than paper, but also more dangerous for both dentists and patients. However, ADA leaders are too deeply involved in the effort to be honest with membership.
Misled dentists and patients are clearly heading for trouble, and it still looks like I’m the only dentist in the nation who has the courage to mention the blunder. Any arguments?
D. Kellus Pruitt DDS
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CMS to Delay Enforcing 5010 Compliance
The CMS has backed off—a bit—from its January 1, 2012 deadline for enforcement of a rule requiring adoption of a more-robust set of claims transmission standards. The CMS announced today it will hold off until March 31, 2012, on enforcing its rule requiring hospitals, physician practices, health plans, and claims clearinghouses to switch to using the ASC X12 Version 5010 standards for the electronic transmission of healthcare claims and other administrative communications.
The agency said its decision to bend a little on enforcement was “based on industry feedback revealing that, with only about 45 days remaining before the Jan. 1, 2012 compliance date, testing between some covered entities and their trading partners has not yet reached a threshold whereby a majority of covered entities would be able to be in compliance by January 1.”
Source: Joseph Conn, Modern Healthcare [11/17/11]
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Ambulances turned away as computer virus infects Gwinnett Medical Center computers
As I awoke this Sunday morning I was alerted to the following breaking-news event from The Atlanta Journal-Constitution.
“Gwinnett Medical Center on Friday confirmed it has instructed ambulances to take patients to other area hospitals when possible after discovering a system-wide computer virus that slowed patient registration and other operations at its campuses in Lawrenceville and Duluth, Georgia”.
After working in the Pennsylvania Hospital ER as a medical student in Philadelphia, back in the day, and then covering local ERs for more than a decade, I can not recall a similar incident.
Think about it!
Dr. David Edward Marcinko FACFAS, MBA
[Publisher-in-Chief]
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This is an isolated incident affecting only one hospital. Imagine how easy it would be for a terrorist to shut down our healthcare system nation wide. It’s no secret that we’re vulnerable.
D. Kellus Pruitt DDS
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It’s a tough week for the EHR industry
According to a recent Accenture study, only 47% of U.S. physicians think EHRs have helped improve the quality of treatment decisions and only 45% think they lead to improved health outcomes for patients. (See: “American Docs Question Health IT’s Benefits,” by Nicole Lewis for InformationWeek).
http://www.informationweek.com/news/healthcare/EMR/232500067
So what do dentists think? Who knows? They certainly aren’t bragging about their EDR purchases.
Don’t you agree that American dentists’ shy behavior is really suspicious for adults with post-grad degrees? I’m certain many who blame me for putting them on the spot would like for you in the community to think it’s their respect for measured “professionalism” that restricts them from publicly discussing important topics with this dentist – as if they are too good to come down to my level.
Don’t be fooled. Theirs is hardly professional behavior. The ADA has been unresponsive to me for 6 years. That’s not even common decency.
Since dental practices have even less need for interoperability than physicians’, and since there is almost no internet conversations about EDRs, that can only mean that dentists are disappointed in the cost and safety of EDRs. Perhaps shy, HIPAA-covered dentists are not unlike scam victims who are too embarrassed to admit that unethical characters they trusted tricked them into making bad decisions – like volunteering for NPI numbers.
D. Kellus Pruitt DDS
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FDA Sued By Employees Over Email Privacy
In one of the more troubling episodes to place the FDA in an unflattering light, the agency has been accused by a group of current and former employees that their personal e-mails were exposed, after they warned Congress the agency was forcing employees to approve medical devices they maintained posed unacceptable risks, according to a lawsuit filed last week.
http://www.pharmalot.com/2012/01/fda-sued-by-employees-over-email-privacy/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Pharmalot+%28Pharmalot%29
So, let’s call it “National Snoop on Citizens Week.”
Chase
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Disappointing news in HIT world
I received an email today containing breaking, but not surprising, news: HIT industry can’t deliver on promises after all.
“[Findings] emphasize the importance of establishing the benefits of computerization rather than estimating them in the absence of data, or generalizing from small studies at a few atypical institutions.”
————————————
For Immediate Release
Contrary To Conventional Wisdom, Doctors’ Ready Access Via Computer-to-Patient Test Results Does Not Reduce Costs or Curtail Test Ordering, Says Study – Having Computerized Images at Hand Linked to 40-70 Percent Increase in Testing
Bethesda, MD — Despite the widely held assumption that having computer access to patients’ test results will reduce testing, a new study shows that doctors who have such access to tests in the ambulatory care setting are more likely to order imaging and lab tests.
Researchers writing in the March issue of the journal Health Affairs say their findings challenge one premise of the nation’s multibillion-dollar effort to promote widespread adoption of health information technology (HIT). They warn that the effort “may not yield anticipated cost savings from reductions in duplicative or inappropriate diagnostic testing” and, in fact, could drive costs up.
“Our findings should at a minimum raise questions about the whole idea that computerization decreases test ordering and therefore costs in the real world of outpatient practice,” says lead author Danny McCormick, a physician and assistant professor of medicine at Harvard Medical School. Referring to better access to results with computerization, McCormick says, “As with many other things, if you make things easier to do, people will do them more often.”
McCormick co-wrote the paper with David Bor, chief of medicine at Cambridge Health Alliance, and Stephanie Woolhandler and David Himmelstein, both professors of public health at the City University of New York.
For their study, McCormick and colleagues analyzed data from the 2008 National Ambulatory Medical Care Survey, which includes 28,741 patient visits to a national sample of 1,187 physician-based offices. The survey excludes hospital outpatient departments and offices of radiologists, anesthesiologists, and pathologists.
They found that:
• Point-of-care electronic access to electronic imaging results, sometimes through an electronic health record, was associated with a 40-70 percent greater likelihood of an imaging test being ordered. Physicians without such access ordered imaging in 12.9 percent of visits, while physicians with access ordered imaging in 18.0 percent of visits.
• Women received more imaging studies overall than men, perhaps reflecting their use of mammograms and ultrasound studies–but not more advanced imaging.
• Surgeons and other specialists were more likely to order imaging tests than primary care physicians.
Several studies have estimated that computerization in physician offices would save as much as $8.3 billion a year on imaging and lab testing. But McCormick and colleagues say the predicted savings from this technology were based on incomplete data, relying on a few “flagship” health care institutions with cutting-edge systems, and not generalizable to current medical practice, where computer technology is commonly an “off-the-shelf” product.
-The authors say that office-based computerization may not yet reduce imaging use because current systems are cumbersome, insufficiently interoperable, or lack effective decision-support software. Although savings on imaging may emerge in the future if there is greater interoperability, the authors caution that high rates of testing were also identified in hospital-owned practices with the highest levels of interoperability and decision support. They add that curbing self-referral to imaging facilities in which doctors have a financial stake would have more impact.
The study does not examine the reasons for physician behavior when it comes to test ordering. And although the authors say that they are not criticizing investments in HIT, they contend that their findings “emphasize the importance of establishing the benefits of computerization rather than estimating them in the absence of data, or generalizing from small studies at a few atypical institutions.”
—————————–
Contact:
Jemma Weymouth
(301) 652-1558
jweymouth@burnesscommunications.com
Sue Ducat
Director of Communications
(301) 841-9962
sducat@projecthope.org
About Health Affairs: Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically and health policy briefs published twice monthly at http://www.healthaffairs.org . Read daily perspectives on Health Affairs Blog. Download weekly Narrative Matters podcasts on iTunes.
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The HIT hits keep coming
[Will it pull Wall Street down with it?]
“Health IT lawyer decries ‘epidemic’ of privacy breaches,” by Jessica Zigmond was posted a couple of hours ago, featuring patients’ privacy rights attorney James Pyles.
http://www.modernhealthcare.com/article/20120305/NEWS/303059949/health-it-lawyer-decries-epidemic-of-privacy-breaches
Zigmond writes: “The U.S. healthcare system faces an ‘untenable situation’ as less than half of the country’s providers and practitioners use electronic health information systems but there exists an ‘epidemic’ of electronic privacy breaches, according to a member of the team that produced The Financial Impact of Breached Protected Health Information, a report from the American National Standards Institute.”
http://www.modernhealthcare.com/article/20120305/NEWS/303059988/report-spotlights-data-breach-costs-concerns
James Pyles, a principal at Washington law firm Powers Pyles Sutter & Verville and former general counsel at the U.S. Health, Education and Welfare Department (an HHS predecessor), tells ModernHealthcare.com:
“We have a healthcare delivery system right now that we cannot afford—there is going to be no new money coming into it in the foreseeable future, so we have downward pressure on healthcare spending at the very time when we have upward pressure on privacy breaches. Those are two forces on a collision course. So what we hope with this report … is that we would help those involved in security make the case in the boardroom that it is a whole lot cheaper to avoid a privacy breach or privacy violation than it is to react to one.”
Mr. Pyles adds that cases surrounding healthcare security generally settle for about $20 million and that “almost every privacy breach is now followed by a class-action lawsuit.”
You heard it, sports fans. Healthcare is in an “untenable situation.” Until there is transparency about the costs and dangers of HIT, interoperability will not move forward from here. That’s a fact. But we knew all about that long ago, didn’t we.
Wall Street isn’t going to like this news a bit. I expect Allscripts (MDRX) stock to tumble.
D. Kellus Pruitt DDS
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Now – Researchers want more access to personal health information
HIPAA was instrumental in preserving the privacy of patients since 1996. Just this week, in fact, Blue Cross Blue Shield of Tennessee became the first health insurer to receive a fine for violating the security rule after 57 hard drives with protected health information on one million Blue Cross members were stolen from a leased facility in the state.
However, debates continue to rage about its enforcement. Some researchers believe that some medical records should be open for public viewing and use, especially if it means unlocking information that could potentially help future populations.
http://articles.philly.com/2012-03-13/news/31160163_1_medical-research-medical-history-controls
So – It’s just a matter of time – isn’t it – until Uncle Sam knows all about us! Privacy? Forgetaboutit!
Maurice
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Why the U.N. Tax Proposal Could Seriously Harm the Web
The United Nations is considering a proposal that could significantly impact some of the world’s largest online content providers.
http://redir.ientry.com/04-27937-2069565-14193238-0-20
According to some leaked documents, which are being made available at http://www.WCITleaks.org, the European Telecommunications Network Operators’ Association (ETNO) is lobbying the U.N. to amend an existing treaty, the International Telecommunications Regulations, that would put a global Internet tax on companies such as Google, Facebook, and Apple.
Lancaster
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