IT for Healthcare

Democrats to Push HIT Legislation

The next congress is expected to take up some of the issues impacting HIT adoption in 2007, according to an article at GovernmentHealthIT.com.

Four themes are likely to emerge among the Democrats’ talking points: funding, privacy, systems interoperability and personal health records. Funding and privacy are potential sticking points.

Democrats will likely target funding to encourage small medical practices in underserved communities to adopt health IT. But Dave Roberts, vice president of government relations at the Healthcare Information and Management Systems Society, said they will have to be creative, because the Democrats have already committed to using a pay-as-you-go budgeting approach.

Anti-Fraud Recommendations for EHR

There is ongoing debate and discussion about fraud, privacy, and security as it pertains to EHR adoption.  Scientific R&D institute RTI International, partnering with AHIMA, SAS, and SPSS, has put together a list of recommended anti-fraud measures and posted them here for public comment.  The purpose of this exercise, according to the site, is:

[T]o develop model anti-fraud requirements for electronic health records (EHRs) based on the Guiding Pricinples set forth in the FY2005 project.  Further, the model anti-fraud requirements will be submitted to the Certification Commission for Health Information Technology (CCHIT) as potential EHR anti-fraud certification criteria.

Take a look at the recommendations (free registration required) and use your voice.  These are important considerations that are going to need to be sorted out before we see significant advancement in adoption rates.

Shocking Headline: Patients Lie to Doctors!!

Anyone who's ever gone to a doctor probably knew this one, but this article underlines the importance of doctors getting all the facts about a patients medical history and current medications.  Without belaboring the point, this dovetails nicely with something we said here last week about Dossia specifically and PHR in general:

Another point being addressed is the accuracy of patient controlled information.  According to internist and vice president for the American College of Physicians, Michael Barr, physicians "will always have a question of whether that information is complete information" because patients are allowed to change/exclude certain information:

[J.D.] Kleinke [Chair and CEO of Omnimedix Institute] said patients can request that changes be made on incorrect information, but they cannot change or tamper with what is in the health record. However, patients can choose to exclude certain medical details, such as a prescription or drunken-driving incident, from their PHR, according to [Intel spokesperson Jennifer] Gresson.

If people lie about their medical history, current medications, lifestyle, and adherence to recommended treatments now, imagine how much dissembling will take place when you can sit in the comfort of your home and "manage" your record via the internet. That isn't to say we're against PHR, just for taking them with a grain of salt.  They will not replace functional, interoperable EHR in every doctor's office.

EHR and Medical Device Connectivity

Some thoughts on how EHR adoption and its growing influence on physicians' choice of medical device.

Link

GMR Making a Splash

Everyone's talking about this so we thought we'd give it a link, too.  Frankly, we're not overwhelmed by what we see but there seems to be some (reserved) praise for the work.  Take a look and see what you think.  One stipulation - this is not an actual EHR.  It is, currently, just a proof of concept-type user interface.  There's a brief "screencast" demo and also a demo interface that users can play with.  Take a look.

Free E-Prescribing For America's Physicians

EHR vendor Allscripts has partnered with Wolters-Kluwer Health and Surescripts to provide a web-based e-prescribing application called eRx NOW.  Dell, Fujitsu, Microsoft, Cisco, Sprint Nextel, Aetna, WellPoint, and Blue Cross Blue Shield (whew! that's a serious list).  I wonder out loud if the latest spate of free EHR/PMS, PHR, and now this is the first onslaught of serious competition to the big (read: pricey) EHR vendors.  As one commentator on this particular matter pointed out, you get what you pay for.  While I agree with that in principle, we'll be watching with interest as these various programs unfold.

Official Press Release

FutureHIT: Insider Security Threats Come in Many Forms

Dale Hunscher at FutureHIT puts together a few thoughts on IT security in an increasingly tech-oriented society.

The teenage hacker and the identity thief from some country in the former Soviet bloc get a lot of traction in the press as villains.

However, what I have come to understand gradually is expressed in the title of this article from last November on SearchSecurity.com: Insider security threats come in many forms. The most likely candidates for identity theft in your organization are the people working alongside you.

Exactly.  The laptop with sensitive data on it (which it shouldn't have) left in the car (where it shouldn't be) by an employee (who should know better) is a serious threat that has to do with the way security is approached culturally in the workplace.  There need to be security best-practices in place and they need to be enforced:

Companies must also be prepared to deal with people who create security risks without necessarily meaning to. If the network suffers a security breach because an employee was visiting seedy Web sites on company machinery, for example, there must be a plan for punishment.

"People need to understand that their computers are for business only and that they can be disciplined or even fired for using them for anything that isn't business related," Anderson said.

Or, you know, letting them get stolen with sensitive patient/client information in tow.  There are some other valuable insights, as well.  Click through and take a look.

Link

 

Post-Gazette.com: Spread of Records Stirs Fears of Privacy Erosion

We've had our share of cordial difference of opinion on this subject in the past; stolen laptops and the like are unpleasant but should be easily avoidable and we can't find the motivation to attack technology itself for the flaws of its users.  This article, posted at post-gazette.com, however, highlights the very real scariness of privacy violations through bureaucracy.  Patricia Galvin, whose tribulations are the article's focus, was denied claims for disability benefits based on information found in what should have been confidential psychotherapy session notes.  Shockingly, Stanford  Hospital and the insurance company, UnumProvident, deny any wrongdoing, stating the notes were taken and filed according to all legal guidelines and that UnumProvident obtained the records legally.  Meanwhile, Ms. Galvin is suing everyone involved for the records leak and the disability claim denial.

[Galvin] continues to worry, she says, that "any time anybody asks for my medical records, my psychotherapy notes are going to be turned over." In therapy, she adds, "all kinds of things come up -- they want you to go into detail about your feelings about your mother and your father and your sister and your brother and your dead fiance and how all of that affects you."

A very real concern that highlighs privacy issues that need to be addressed as we move towards pervasive electronic medial records technology.