InformationWeek Stories by Mitch Wagner

InformationWeek Stories by Mitch Wagnerhttp://www.informationweek.comInformationWeeken-usCopyright 2012, UBM LLC.2009-12-23T13:47:00ZHospitals Cut Costs With BI SoftwareTwo hospitals in Florida and California are using business intelligence and analytic software to corral costs and aid clinical reporting. http://www.informationweek.com/news/222100066?cid=RSSfeed_IWK_AuthorsTwo healthcare providers on opposite coasts are improving their bottom lines by implementing business intelligence software from different vendors. Watson Clinic, in Lakeland, Fla., is implementing business analytics software from Dimensional Insight, while, on the other side of the country, the Community Hospital of the Monterey Peninsula (CHOMP) is benefiting from a seven-year-old McKesson implementation. Watson Clinic implemented the Dimensional Insight software to get rapid information access on financial metrics and clinical reporting to organization users. Watson Clinic implemented Dimensional Insight's The Diver Solution, which includes a dashboard, reporting, and analytics software to integrate data from different systems, including GE Healthcare and billing and accounts receivable. Watson Clinic has more than 1,500 employees and 200 physicians at 16 locations. The clinic is creating multiple views into data for users, including monitoring available appointments, viewing daily charges versus actual and forecast, analyzing monthly forecasts by department and service line reporting. Meanwhile, CHOMP improved profits and cut costs with document management software from McKesson. CHOMP deployed McKesson's Horizon Patient Folder software to aid cash flow, regulatory compliance, expense cutting, and patient care. CHOMP installed the software seven years ago, replacing paper-based health information management processes across the 15-facility healthcare system, reducing days not final billed from six days to two and a half days. The software also accelerated reimbursement and generated cash flow benefit of more than $4 million. CHOMP credits the document management solution with more than $250,000 in annual staffing and supply cost savings. CHOMP later integrated the software with a clinical system installed in 2004. "With Horizon Patient Folder, our medical and administrative teams can access and manage the full legal medical record across our enterprise from a single system, which means more efficient processes and complete access to critical information," said Madelyn Burke, CHOMP's director of HIM, in a statement. "The system also gives us confidence that we can successfully handle the demands of increasingly complex regulations and requirements presented by dynamics such as HIPAA, CMS audits and the economic stimulus." Formerly, physicians had to sort through stacks of paper records to sign patient charts, but now they can access documents, including deficiency work lists and wound photos, securely through the clinical system viewer or on a laptop at home. CHOMP is located in Monterey, California. It is a nonprofit healthcare provider with 205 staffed acute-care hospital beds and 28 skilled-nursing bed. It has 15 locations on the Monterey Peninsula, including hospital, outpatient facilities, satellite laboratories, a mental health clinic, short-term skilled nursing facility, hospice, and business offices. 2009-12-23T09:30:00Z3D Printer Builds Artificial Blood VesselsThe goal is to custom-build tissues and organs for transplant, using the patient's own cells and 3D medical printers.http://www.informationweek.com/news/222003031?cid=RSSfeed_IWK_Authors<div style="margin:0; padding:0 0 10px 10px; float:right; width:185px; text-align:center;"> <a href="http://www.informationweek.com/galleries/showImage.jhtml?galleryID=326&imageID=150&articleID=222003031"><img src="http://twimgs.com/infoweek/galleries/automated/326/Invetech_Organovo_HumanTissuePrinter_tn.jpg" width="175" height="175" alt="Invetech Orgonovo 3D Medical Printer" title="Invetech Orgonovo 3D Medical Printer" hspace="0" vspace="0" border="0" style="margin:0 0 3px 0; padding:0;" /></a> (click image for larger view) <div style="margin:5px 0 0 0; padding:0;font-weight:bold; font-size:1.2em; color:#990000;">Invetech Orgonovo 3D Medical Printer</div> </div> A San Diego company is developing technology to "print" artificial blood vessels for transplant. The initial goal: Create an arterial graft for use in coronary bypass surgery. The long-term goal is to solve problems in medical therapy that can't be solved otherwise, especially in organ transplants, where tens of thousands of people are waiting for donated organs, said Keith Murphy, CEO of the company, Organovo. Invetech, a design and contract manufacturing company with offices in Australia and San Diego, built Orgonovo's first 3D medical printer, in conjunction with Organovo. "Building human organs cell-by-cell was considered science fiction not that long ago," said Fred Davis, president of Invetech, in a statement. "Through this clever combination of technology and science we have helped Organovo develop an instrument that will improve people’s lives, making the regenerative medicine that Organovo provides accessible to people around the world.” Murphy said in a statement, "Scientists and engineers can use the 3D bio printers to enable placing cells of almost any type into a desired pattern in 3D.” He added, "Researchers can place liver cells on a preformed scaffold, support kidney cells with a co-printed scaffold, or form adjacent layers of epithelial and stromal soft tissue that grow into a mature tooth. Ultimately the idea would be for surgeons to have tissue-on-demand for various uses, and the best way to do that is get a number of bio-printers into the hands of researchers and give them the ability to make three dimensional tissues on demand.” The technology works by using a robot to lay down cells in precise positions in three dimensions, accurate to within 20 microns. "It's similar to the way a laser printer prints by putting solid particles in place," Murphy told InformationWeek. The 3D medical printer puts down objects on 2D layers, one on top of the other. The particles used in the construction are made up of stem cells, formed into tiny spheres and cylinders. The stem cells are available for research purposes from companies including Life Technologies and Invitrogen. When the device is used for treatment, cells will come from the patient, such as bone marrow, or fatty adipose tissues, where stem cells can be harvested. "Because they come from the patient, there's no risk of having a rejection," Murphy said. These are adult stem cells, not the fetal stem cells that have been politically controversial. Researchers take a cross-section picture of the object they want to build, such as an artery. "We use that as a map to paint by numbers," he said. Objects take about an hour to build, and then the cells fuse together on their own in the course of 24-48 hours, locking the object in shape. 3D printers are an emerging technology with a wide variety of applications. Like Organovo's equipment, they build 3D objects by laying down two-dimensional layers one on top of the other. They typically use plaster, cornstarch or resins to create objects, and are most often used in rapid prototoyping, for footwear, jewelry, industrial design, architecture, automotive, aerospace, dental, and medical industries. Organovo is not alone finding medical applications for 3D printing; researches at the University of Tokyo hospital and venture company Next 21 are using 3D printers to create <a href="http://pinktentacle.com/2007/08/artificial-bones-made-with-3d-inkjet-printers/">artificial bones</a> for reconstructive surgery. Organovo is starting simple, building blood vessels at first, including an arterial structure meant for use in coronary bypass surgery. That involves creating an object with three different cell types in it: Endothelium cells on the inside, smooth muscle in the middle, and an exterior layer of fibroblasts, which are similar to skin cells. The arterial segments are 5-20 centimeters long, with an interior diameter of 0.5 to 5 mm. Arteries with larger interior diameters can be built with Teflon or Dacron, but the smaller diameters clot when built using synthetic materials. A next step will be to make a branched structure of blood vessels, which will allow putting the artificially grown vasculature inside living tissue. "Sure, I can make a one-inch cube of liver tissue now, but they'll all die because they can't get nutrients," Murphy said. With a branched structure, scientists can make larger, thicker pieces of tissue and keep them alive with blood vessels inside. The printed blood vessels should be in clinical trials in three to five years, with thicker, and more complex types of tissues further out. In the long run, researchers hope to build a kidney or heart or other organ. "That's certainly within the long-term capabilities. But we're focused as a company on what works short-term from a commercial standpoint, and that allows us to move forward and consider longer-term things," Murphy said. "The printer fits inside a standard biosafety cabinet for sterile use," Invetech said. "It includes two print heads, one for placing human cells, and the other for placing a hydrogel, scaffold, or support matrix. One of the most complex challenges in the development of the printer was being able to repeatedly position the capillary tip, attached to the print head, to within microns. This was essential to ensure that the cells are placed in exactly the right position. Invetech developed a computer controlled, laser-based calibration system to achieve the required repeatability." Invetech plans to ship multiple 3D bio-printers to Organovo in 2010 and 2011. Organovo will place the printers globally with researchers in centers for excellence for medical research. Orgonovo was co-founded by Gabor Forgacs, a professor of biophysics at the University of Missouri, who studied chicken embryo development to determine how cells in the embryo move around to form tissues--for example, a wing--from a small number of cells in the beginning. "That study enabled him to get a good handle on how clumps of cells grow into tissues," Murphy said. Forgacs' research was funded by a $5 million grant from the National Science Foundation, and the technology is licensed by by Orgonovo from the University of Missouri. The company is angel-funded, and will be seeking venture funding in 2010. 2009-12-21T16:30:00ZFeds Grant $60M For Health IT ResearchThe grant program is focused on areas, including security, where breakthroughs are needed to drive adoption and meaningful use of health IT.http://www.informationweek.com/news/222002851?cid=RSSfeed_IWK_AuthorsThe federal Department of Health and Human Services is planning to make $60 million in stimulus funds available for health information technology research, specifically focused on areas where breakthrough advances are needed to address existing barriers to the adoption and meaningful use of health IT. The Strategic Health IT Advanced Research Projects (SHARP) program, announced Friday, uses funding from the U.S. American Recovery and Reinvestment Act of 2009 (ARRA). It focuses on four areas: <ol><li>Security and risk mitigation to build and preserve public trust in health IT;</li> <li>Patient-centered cognitive support, to align health IT with the daily practice of medicine to support clinician care of patients; </li> <li>Health care application and network platform architectures necessary to achieve electronic exchange and use of health information in a secure, private, and accurate manner;</li> <li>Secondary use of electronic health record data for improving overall quality of health care, population health, and clinical research while maintaining patient privacy.</ol></li> Each agreement will last four years, and will require recipients to implement a collaborative, interdisciplinary program. HHS expects the projects will implement cooperative programs between researchers, health care providers, and other health IT stakeholders. The agreements are part of a series of grants to help strengthen and support use of health information technology to improve quality and efficiency of care for all Americans. "The SHARP program will bring together some of the best and brightest minds in the nation to find breakthrough solutions and innovations that will eliminate barriers to adoption and, over time, increase the meaningful use of health IT to improve the health and care of all Americans," said Dr. David Blumenthal, the HHS national coordinator for health information technology, in a statement. Applications are due on Jan. 25, 2010, with awards anticipated in March 2010. Information about the SHARP program and the cooperative agreement applications can be found at <a href="http://www.healthit.gov/">HealthIT.gov</a> and at <a href="http://www.grants.gov">grants.gov</a>. 2009-12-18T18:00:00ZToshiba Intros Healthcare Response SystemsThe nurse call and emergency response systems provide alerts to caregivers via e-mail, pagers, or text messaging.http://www.informationweek.com/news/222002732?cid=RSSfeed_IWK_AuthorsToshiba America Information Systems has introduced a nurse call system and emergency response system as part of its business communications platform for healthcare providers. The company's Telecommunications Systems Division announced availability Wednesday of the Cornell Series 4000 Ton/Visual Nurse Call System and AURA 2.0 Emergency Response System from Cornell Communications, which can be integrated with Toshiba's Strata CIX IP business communication system. They're designed to be used by small and medium-sized healthcare facilities. The nurse call system includes bedside stations, bath and emergency pull cords, and annunciator panels that give tone and visual notification to the nurse or caregiver in case of emergency. The emergency response system provides both wired and wireless support for the nurse call system, including alert display, notifications, and reporting. The alert display shows patient and resident information including room number, name, and how long it's been since the patient pushed the nurse call button. When the emergency response system is integrated with the Toshiba Strata CIX VoIP system, the combined communication system can initiate a "telephone knock-off alarm," which automatically routes calls to a nurse's station telephone when a patient cannot dial a phone or has dropped it during an emergency. It also integrates with AURA 2.0 to notify the caregiver of a knock-off alarm. The emergency response system can be integrated with the nurse-call system. Once an emergency situation is detected through wireless peripherals, the nurse call system, or knock-off alarm, the system alerts the caregiver through e-mail, pagers, or text messaging. Also, audio notifications can be sent to cell, wireless or desk phone, including Toshiba phones using the standard SIP technology. Notifications can be customized. The reporting function generates usage reports, to help improve management of the facility for staff, patients, and families. The reporting function also shows caregiver response time, which can be used as one measure of a healthcare organizations' performance. The emergency response system can also be integrated with some existing nurse call solutions. The nurse call system is UL1069 listed, which is mandatory for skilled nursing facilities in many states. 2009-12-18T09:30:00ZH1N1 Hotline Spreads Flu InfoHealthcare providers may use the phone and online service to provide H1N1 information while preserving medical resources for truly urgent care.http://www.informationweek.com/news/222002644?cid=RSSfeed_IWK_AuthorsThe Beryl Companies, which provides outsourced call center services for the healthcare industry, has launched a new service to help hospitals provide hotlines for useful information for people with questions and concerns about H1N1. H1N1 Risk Assessment lets healthcare providers make phone connections between members of their communities and trained medical advisors who can provide information about the virus and walk callers through a three-minute self-assessment to determine their risk of contracting H1N1, or whether they already have the virus. The service is also available online, Beryl said. The self-assessment was developed by A.D.A.M., a provider of health information solutions. The service is designed to build consumer confidence in the healthcare provider, preserve emergency department resources for truly urgent care, build relationships with community physicians by offering the services as a tool, speed patient access to medical services by connecting with Beryl's patient scheduling or physician referral services, and build traffic to hospital Web sites. "Since 2008, the public has been bombarded with stories about H1N1 deaths, leading some normally timid consumers of healthcare to become more eager to seek professional medical care at the slightest sign of illness, even when they may simply have a cold and need over-the-counter medicines," said Paul Spiegelman, founder and CEO of Beryl, in a statement. "Often, consumers just want medical professionals to help them assess their condition, or to have access to reliable information about this virus." The service lets hospitals provide people with information on H1N1 and makes it easier for consumers to access healthcare services they need. The service also helps consumers save time and money by helping determine when they don't need to see a doctor, which allows providers to save time and resources for patients with immediate needs. The service provides a unique 800-number to connect consumers to advisors who are equipment with relevant and factual H1N1 information based on CDC guidelines. The advisors walk callers through self-assessment. Hospitals can also use their existing patient care phone number, offering prompts that will connect callers to the H1N1 hotline. The online component lets consumers gauge their risk of infection and get a personal action plan, along with up-to-date links to articles and news about the virus. Beryl provides support around-the-clock and services can be branded to support hospital marketing. Healthcare organizations are harnessing information technology to provide information about H1N1. The U.S. Department of Health and Human Services is <a href="http://www.informationweek.com/news/healthcare/policy/showArticle.jhtml?articleID=222001374">getting the word out</a> on YouTube. And Google launched a service to <a href="http://www.informationweek.com/news/healthcare/patient/showArticle.jhtml?articleID=221601515">help people find where they can get flu shots</a>. 2009-12-17T13:44:00Z'Beacon' Communities Need Track Record For Feds' IT FundsCommunities will need a proven track record if they're looking to receive funding to become health IT "beacons" under a federal program to set up models of meaningful health information usage. Communities qualifying for inclusion in the program must demonstrate that they're already embracing e-health records an electronic health information sharing.http://www.iweek-interim.com/news/229204066?cid=RSSfeed_IWK_AuthorsCommunities will need a proven track record if they're looking to receive funding to become health IT "beacons" under a federal program to set up models of meaningful health information usage. Communities qualifying for inclusion in the program must demonstrate that they're already embracing e-health records an electronic health information sharing.The Obama administration said earlier this month it will offer 15 communities grants of up to $20 million to support healthcare IT for meaningful use projects, such as clinical decision support, <a href="http://www.govhealthit.com/newsitem.aspx?nid=72723">according to Government Health IT</a>. <blockquote>To become a "beacon" community, applicants must have an established track record of using health IT to improve health care in at least one category -- cost efficiency, quality of care or population health, said Dr. Farzad Mostashari, senior advisor to the Office of the National Coordinator for health IT during a Dec. 14 teleconference. ONC said it would like the program to get on a fast track. "We want to see what is possible in a relatively short time period, within 30 months," he said in giving more details of the grants, applications for which are due Feb. 1.</blockquote> ONC wants to demonstrate that hospitals, clinicians and patients can act together as a community to achieve measurable improvements in healthcare quality, safety, efficiency and population health, Mostashari told Government Health IT. But communities that win the funding need to have a proven track record implementing healthcare IT. "You must convincingly demonstrate that you're a community that with past success has a credible shot at showing future success," Mostashari said. InformationWeek has published an in-depth report on e-health and the federal stimulus package. <a href="http://informationweekreports.com/shared/download.jhtml?id=177700002&cat=iwkr_compliance&doc_id=InformationWeek_Analytics_Alert_hcstimulus&k=bxxe&cid=blog_bxxe">Download the report here</a> (registration required). Follow InformationWeek on Twitter, Facebook, and LinkedIn: <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_70jph8rxfg_b"> Twitter: <a href="http://twitter.com/informationweek">@InformationWeek</a> <a href="http://twitter.com/iwpremium">@IWpremium</a> <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_73fmvzv6cb_b"> Facebook: <a href="http://www.facebook.com/pages/InformationWeek/10228569831">InformationWeek</a> <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_75cxkqqxdg_b"> LinkedIn: <a href="http://www.linkedin.com/groupInvitation?groupID=102562&sharedKey=0A7330708165">InformationWeek</a>2009-12-17T13:30:00ZGovernment Grapples With EMR Security, PrivacyHealthcare providers aren't stepping up to protect privacy of electronic medical records. Can the government provide adequate data security?http://www.informationweek.com/news/222002134?cid=RSSfeed_IWK_AuthorsWhile electronic medical records promise massive opportunities for health benefits, the privacy and security risks are equally enormous. The Obama administration has set an ambitious goal -- to get electronic medical records on file for every American by 2014. The administration is offering powerful incentives: $20 billion for EMRs included in the American Recovery and Reinvestment Act of 2009, and stiff Medicare penalties for healthcare providers that fail to implement EMRs after 2014. EMRs offer huge benefits: Improved efficiency by eliminating tons of paper files in every doctor's office, and improved medical care using the same kinds of database and data mining technologies that are now routine in other industries. EMR systems can flag symptoms and potentially harmful drug interactions that busy doctors might otherwise miss. But the privacy and security threats are massive as well. When completed, the nation's EMR infrastructure will be a massive store of every American's most personal, private information, potentially abused by marketers, identity thieves, and unscrupulous employers and insurance companies. Unlocking Benefits, Minimizing Risks Regulators are attempting to craft rules that would unlock the benefits of EMRs while protecting Americans from the security risks. Healthcare IT pros will be required to implement systems and business processes that conform to these regulations or face lost funding, institutional fines, and even -- in some cases -- personal criminal penalties. The new regulations come as the healthcare industry faces big privacy problems, going back years. In 2003, a medical transcriptionist in Pakistan threatened to post patient records from the University of California San Francisco's Medical Center on the Internet unless she was paid for her work for a transcription service company hired by the university. The dispute was resolved but many patients were shocked to learn that their records were being sent overseas. In another breach, two computers that held a disc containing the confidential records of close to 200,000 patients of a medical group in San Jose, Calif., were posted for sale on Craigslist.org. The FBI recovered the information and the medical group informed current and former patients of the theft, <a href="http://www.hipaabulletin.com/articles/80" target="_blank">according to</a> a 2006 report in the HIPAA Bulletin. Celebrities aren't immune. Last year, more than a dozen staff at the UCLA Medical Center faced disciplinary charges for prying into the medical records of <a href="http://www.informationweek.com/news/global-cio/compliance/showArticle.jhtml?articleID=206904141">Britney Spears</a>. The same hospital got in trouble again when employees accessed Farrah Fawcett's medical records after she went there for cancer treatments.Healthcare providers and other health businesses aren't stepping up to protect privacy, according to a recent study. Some 80% of healthcare organizations have experienced at least one incident of lost or stolen health information in the past year, according to <a href="http://www.informationweek.com/news/healthcare/security-privacy/showArticle.jhtml?articleID=220700395">the study</a>, released this month from security management company LogLogic and the Ponemon Institute, which conducts privacy and information management research. Also, some 70% of IT managers surveyed said senior management doesn't view privacy and data security as a priority, and 53% say their organizations don't take appropriate steps to protect patient privacy. Less than half judge their existing security measures as "effective or very effective." Unauthorized use of medical records has created a new kind of crime: Medical identity theft, where a criminal poses as another person to obtain medical treatments using another person's insurance. This is a crime with multiple victims: The actual person with insurance coverage, whose medical records now have incorrect information, potentially leading to medical risk and financial harm, and the insurance company, which is paying for the criminal's medical procedure. Seeking Solutions John Halamka, CIO of Harvard Medical School and Beth Israel Deaconess Medical Center, is one of the people trying to solve the privacy problem. Halamka is chair of the U.S. Healthcare Information Technology Standards Panel and co-chair of the HIT Standards Committee for the U.S. Department of Health and Human Services. HITSP is developing standards for EMRs that balance patients' right to control their information and keep it confidential against the needs of healthcare providers, insurers, and other businesses to share information to improve patient care and do business. "You want to protect the patient's preferences for confidentiality," Halamka said. But you also need to get information where it's needed. "If you come to the emergency department in a coma, and you have a record that includes psychiatric treatment, HIV, drug abuse, and other information, would you share part of it or all of it? My preference would be all of it, with the hope that emergency workers would use it discreetly, to save my life." But other people may feel differently, Halamka said, and healthcare policy needs to serve all those needs. Privacy conditions include access logs and encryption requirements for data that reside on mobile devices. Healthcare providers and other health businesses will be required to keep records of everyone who has access to a file, and the patient has a right to know who saw the record, who accessed it, and why, Halamka said. The Carrot And The Stick The Office of Civil Rights enforces standards and the Federal Trade Commission has the authority to process consumer complaints. ARRA also permits states' attorneys general to prosecute violations of the Health Insurance Portability and Accountability Act of 1996. Money is a major incentive for healthcare companies to protect patient privacy. ARRA provides financial incentives for healthcare businesses to meet privacy guidelines, and punishment for people and businesses that fail. Between 2011 and 2015, every doctor in American can claim $44,000 for health IT implementations that meet federal privacy, security, and other standards. Every hospital can claim $2 million for four years under the same conditions. Organizations that fail the ARRA tests get nothing. The regulations have a zero-tolerance policy for data breaches. If authorized people access records inappropriately, they are terminated, and can face criminal charges and fines, Halamka said. "There is also a requirement to notify prominent media. If there are more than 500 records compromised, you have to notify the prominent media of the region. I would have to call the New York Times to say, 'look what we did.' Of course I respect federal law, but I'm more afraid of the Boston Globe and New York Times because if I lose the trust of my patients, I'm not going to be given a second chance," said Halamka.But the ARRA regulations aren't enough, said Deborah Peel, founder and chair of the political group Patient Privacy Rights. "Hospitals let thousands and thousands of employees see millions of patients' data," she said. Hospitals have rules-based systems governing who gets to see patient data -- for example, doctors and nurses get to see data, but not clerks and office workers. If someone is accessing records inappropriately, often the only barrier is a pop-up warning -- and often not even that. "That's why people looked at the Octomom's records," Peel said. Fifteen hospital workers were fired and another eight disciplined in March for unauthorized access to the medical records of octuplet mother <a href="http://www.foxnews.com/story/0,2933,511780,00.html" target="_blank"> Nadya Suleman</a>. "And a hospital employee was able to get into Farrah Fawcett's records and leak the story before she even told her own family. Typically, the nurses get fired and the doctors don't." Monitoring Privacy Breaches Policing medical records is difficult. Developers are working on algorithms to search for potential data breaches. For example, software searches for healthcare workers accessing medical records of people with the same last name, or living at addresses near their own home, based on the possibility that they might be snooping on family members or neighbors. "Suppose a woman's partner is an abuser, she's left him, she goes to the hospital for treatment. If the abuser is an employee of the hospital, how is her privacy going to be protected?" Amendments to the HIPAA Privacy Rule in 2002 removed earlier privacy protections. "In the paper world, you were told by your doctor's office every time he got a request to release information. You were asked to sign off on that. But in the electronic world, your ability to do that has been taken away," she said. "This is very important, because once health information is out there, you can't put it back in the bottle." Earlier, the Gramm-Leach-Bliley Act, also known as the Financial Services Modernization Act of 1999, permitted companies to share medical records the way they share financial records, Peel said. However, medical privacy regulations have been getting new teeth, said Lisa Gallagher, senior director of privacy and security for the Healthcare Information and Management Systems Society. Under the Bush administration, the U.S. Justice Department said that HIPAA could not be applied against individual employees of healthcare providers, but ARRA now says that individuals can be prosecuted. HIPAA now provides criminal penalties of fines up to $250,000 and up to 10 years in prison for disclosing or obtaining health information with the intent to sell, transfer, or use it for commercial advantage, personal gain, or malicious harm, Gallagher said. The law now requires that patients must have access to their medical records in electronic form. Providers are required to give an accounting to the patient any time medical information is disclosed. "All in all, what you're seeing here is that there are significant privacy rules that have been put in place now," Gallagher said. Consent And Control But Peel said more is needed. Patients need to have complete control over their own medical records. Patients' consent should be required to release medical records -- to anyone. "We're still, essentially, voyeurs into our own medical records," she said. "Now, with audit trails, we're going to be able to see who's gotten into our medical records, but voyeurism isn't the same as control." But it's not that simple, Gallager said. "Consent puts most of the burden on the patient. The patient has to be involved in every transaction, and the patient needs to be knowledgeable enough to make the consent, and aware that they're not leaving out things through inaction that might hurt them later on," she said. Some people -- like Peel -- believe that's essential to privacy; others believe the issues are too complex to leave to patients. "In my view, Congress weeded out consent as a solution to the privacy problem," Gallagher said. For Further Reading: <a href="http://www.informationweek.com/news/healthcare/security-privacy/showArticle.jhtml?articleID=220700395"> E-Health Records Put Patient Privacy At Risk</a> <a href="http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=221601440">Can Electronic Medical Records Be Secured? </a> <a href="http://www.informationweek.com/news/software/database/showArticle.jhtml?articleID=220300617">E-Health Records Could Flag Domestic Abuse</a> 2009-12-17T08:40:00ZMicrosoft Amalga Unifies Health RecordsA post-acute care facility is using Microsoft Amalga to build internal apps that coordinate healthcare information between multiple internal organizations.http://www.informationweek.com/news/222002454?cid=RSSfeed_IWK_AuthorsA Washington, D.C., post-acute care center is building an Internet-based electronic health records system to allow patients and their families to better manage their health after patients leave the hospital. Golden Living and Microsoft are collaborating on building the enterprise application using Microsoft Amalga Unified Intelligence System (UIS) to bridge disparate internal and external systems storing data in otherwise incompatible formats, including hospitals, public and private payers, independent physicians, and post-acute services. Golden Living is the first post-acute care organization to adopt Amalga UIS, the companies said in a joint statement. The goal is to do a better job managing chronic diseases, improve clinical outcomes, and substitute early intervention and prevention for costly hospitalization. "The potential is there for significant improvements in healthcare quality and cost efficiency -- exactly the kind of results that are being sought in the healthcare reform," said Golden Living president and CEO Neil Kurtz, M.D., in a statement. Acute care facilities like Golden Living, which include nursing homes, are different from other healthcare providers in that the patient is frequently not managing his or her own care, said Brad Savage, senior vice president and chief information officer for Golden Living, in a phone interview with InformationWeek. Often, the patient is a senior citizen, and the person managing care is family member. People seeking ongoing care after hospitalizations use multiple healthcare providers for recovery and for treating chronic conditions. Few of them see the hospital patient record, and fewer still are linked electronically to provide coordinated, high-quality care, Golden Living said. "Golden Living selected Amalga UIS in part for the ability to link a patient's personal health information stored in Microsoft HealthVault with the patient's data stored in Golden Living systems. <a href="http://www.healthvault.com">HealthVault</a> is an online personal health application platform that lets people gather, store and share health information online," Golden Living said. Patients control their HealthVault accounts, and can authorize Golden Living to augment existing information with additional personal health data from post-acute providers. Post-acute patients are often learning to live differently than they did before, either coping with chronic conditions or making lifestyle changes to prevent recurrence of the condition that prompted hospitalization. Many need to share information with multiple healthcare providers and family members, and that need to change becomes more important as the patient gets older. Amalga and HealthVault facilitate those kinds of information exchanges, Golden Living said. Golden Living will also use Amalga UIS to help integrate patient care across its own businesses, including skilled nursing, long-term care, rehabilitation therapy, assisted living, home health, and hospice. Patients moving between Golden Living facilities will have their health information following them, without needing to be redone, the company said. "The use of Microsoft Amalga allows us to bridge the information between these various care settings and build a robust view of the patient across the enterprise no matter where they've been seen," Savage said. Amalga UIS is in use at more than 100 hospitals, including New York-Presbyterian Hospital, and the Johns Hopkins Health System. Golden Living plans to complete the first phase of its Amalga implementation, its in-house deployment, in the second quarter of 2010. The patient- and caregiver-facing applications are still being evaluated. 2009-12-16T08:50:00ZAbbott To Buy LIMS Firm For $123 MillionThe acquisition of Starlims, a provider of laboratory information management systems, aims to boost Abbott's position in the global diagnostics market.http://www.informationweek.com/news/222002151?cid=RSSfeed_IWK_AuthorsAbbott plans tobuy Starlims Technologies, a vendor of laboratory information management systems, for about $123 million in cash. "The acquisition strengthens Abbott's competitive position in the global diagnostics market, providing advanced web-based applications to help laboratories efficiently store, retrieve and analyze a significantly increasing volume of clinical, managerial and administrative data," Abbott said in statement. Abbott plans to continue serving the non-clinical market segments currently served by Starlims. Abbott discovers, develops, manufactures and markets pharmaceuticals and medical products, including nutritionals, devices and diagnostics. The company employs more than 72,000 people and has products in more than 130 countries. Starlims has 160 employees worldwide and more than 20 years of Laboratory Information Management Systems (LIMS) experience. Starlims' main product, also called Starlims, is designed to improve reliability of laboratory sampling, support compliance with regulations and standards, and provide comprehensive reporting, monitoring and analysis. The company's products are used in government, manufacturing, and life sciences organizations for quality assurance and control, testing and monitoring, and research and development. Starlims is headquartered in Israel, with operations in the United States, Canada, the United Kingdom, and Hong Kong, and serves more than 500 organizations in 40 countries. Abbott will acquire all outstanding equity of Starlims for $14 per share, for a total purchase price of about $123 million. Starlims now has about $18 million cash on hand. Abbott expects the transaction to close in the first quarter of 2010, and will not effect 2009 results. The acquisition is one of several healthcare IT acquisitions announced this month. Microsoft said it <a href="http://www.informationweek.com/news/infrastructure/management/showArticle.jhtml?articleID=222001574">plans to acquire Sentillion</a>, a privately held developer of software tools for healthcare. Sentillion offers identity and access management systems for healthcare environments. Financial terms were not disclosed. And <a href="http://www.informationweek.com/news/healthcare/mobile-wireless/showArticle.jhtml?articleID=222000145">GE Healthcare bought Living Independently Group</a>, which makes wireless technology to track seniors' daily activities, watching for changes that could signify a medical problem or emergency. The terms of both deals were not disclosed. 2009-12-15T09:05:00ZSMS Project Fights Malaria In Africa IBM, Vodafone, and Novartis are using text messages to manage supplies of anti-malarial drugs in Tanzania.http://www.informationweek.com/news/222001998?cid=RSSfeed_IWK_AuthorsIBM interns are teaming up with Novartis and Vodafone to use text messaging and the Web to fight malaria in Africa. The three companies, along with the Roll Back Malaria Partnership, are piloting a project called SMS for Life to use text messaging and Web sites built with Lotus Live collaboration tools to track and manage supplies of anti-malarial drugs, IBM said. The program is running a five-month pilot in 135 villages in Tanzania, where healthcare staff receive automated text messages that prompt them to check remaining stock of anti-malarial drugs each week. Then, staff reply to a database in the UK with current stock levels via text messages sent through a toll-free number, so deliveries can be made before supplies run out. During the first few weeks of the program, the number of health clinics that ran out of drugs was reduced by as much as 75%. Vodafone developed the SMS technology in conjunction with technology partner MatsSoft. The technology is used to track supplies of Artemisinin-based Combination Therapy (ACT) drugs and Quinine injectables, both of which are key to reducing the number of deaths from malaria. "The mosquito-borne disease causes nearly one million deaths in Africa each year, mostly among pregnant women and young children, and many people die because they simply lack quick access to vital medication," IBM said. The program was developed by pharmaceutical company Novartis and a team of international students in IBM's Extreme Blue internship program. SMS for Life "relies on simple technology and fosters self-sufficiency," IBM said. IBM managed the overall project. Despite millions of dollars spent by governments and aid organizations distributing effective anti-malarial drugs to local health centers, more than a million people in Africa die every year from the disease, which strikes particularly hard at pregnant women and young children, IBM said. "This is an example of a truly innovative solution helping solve a humanitarian problem," said Peter Ward of IBM, SMS for Life Project Manager. "After spending time on the ground, we created a project plan, developed the application with Vodafone and Novartis and established the best way to deliver the pilot, working with the Tanzanian Ministry of Health. We expect other countries will also be able to benefit in the future." "The early success of the SMS for Life pilot project has the Tanzanian authorities interested in implementing the solution across the rest of the country," IBM said. Tanzania has about 5,000 clinics, hospitals and dispensaries, and up to half of them might be out of stock of anti-malarial drugs at any given time. 2009-12-11T17:00:00ZCalifornia Health Provider Tackles EHRsCommunity Health System expects to improve quality of care, patient communications, and cost management using Allscripts electronic health record software.http://www.informationweek.com/news/222001783?cid=RSSfeed_IWK_AuthorsCommunity Memorial Health System, a Ventura, Calif. healthcare provider, selected Allscripts software to manage health records, medical practices, and revenue cycles for 150 physicians. The healthcare provider expects to improve quality of care, patient communications, and cost management. Specifically, Community Memorial plans to implement AllScripts Electronic Health Record, Practice Management, and Revenue Cycle Management software, according to a statement from Allscripts. "With Allscripts, the electronic health record has finally become so user friendly that it has tipped the scale from being a burden to becoming a benefit," said Stanley Frochtzwajg, M.D., chief medical officer of Community Memorial Health System. "National quality measures and the reimbursement tied to those measures are impacting physicians and hospitals alike. The only real way to comply with those measures and compete successfully with other health systems is by collecting and collating that data with an EHR." Community Memorial Health System is a not-for-profit with two hospitals and nine family health centers in Ventura County, an affluent coastal area of California adjacent to Los Angeles. Community Memorial was established in 2005 by the merger of the 240-bed Community Memorial Hospital and 103-bed Ojai Valley Community Hospital. Community Memorial will host the Allscripts software for 70 contracted physicians in its nine clinics, along with a pilot group of 12 community physicians, before offering it to other affiliated physicians in the community. Community Memorial is taking advantage of recent changes to Stark federal regulations that allow hospitals to provide assistance to non-employed physicians in purchasing healthcare IT. Community Memorial physicians will be able to use the electronic health record to access a "virtual patient record" that aggregates clinical information about a patient from all the information systems in use across the organization. Community Memorial will also deploy Allscripts Clinical Quality Solutions, which draws data from the Electronic Health Record and Practice Management system to automate quality reporting requirements for government and payer-funded pay-for-performance programs. CQS is provided by Allscripts in partnership with TeamPraxis, and delivers real-time clinical decision support information to improve the quality of patient care. Community Memorial acted now to be eligible for incentive payments of $44,000 to $64,000 per physician that first become available from the Centers for Medicare and Medicaid Services in 2011, under provisions of the U.S. American Recovery and Reinvestment Act of 2009. The incentives will be paid over five years to physicians who adopt and demonstrate "meaningful use" of EHRs.2009-12-11T09:30:00ZWeb Portal Links Doctors To Patient InfoButler Health System is rolling out PatientKeeper software to make it easier for physicians to access medical information.http://www.informationweek.com/news/222001647?cid=RSSfeed_IWK_AuthorsPittsburgh healthcare provider Butler Health System is implementing portal software from PatientKeeper to give physicians access to patient information and improve care. Butler is rolling out PatientKeeper Platform and Physician Portal to more than 200 physicians, aiming to significantly increase patient quality of care. Butler chose PatientKeeper because of its high adoption rate, reputation, ability to exchange information with other systems, and the ease of use of its mobile and client desktop applications. Butler wants to improve clinical and documentation workflow for physicians and build a foundation for connecting its various information systems. Using the PatientKeeper software, the 300-bed health system in north Pittsburgh will be able to integrate information across the enterprise, let physicians access the information on the Web and mobile devices, provide business continuity, and automate the sign-out process. Physicians will be able to review, edit, and sign charts, including transcribed reports, orders, and scanned documents, from any Web browser. "One of our primary goals is to provide a much friendlier front end to our healthcare system," said Peter Schogel, Butler's director of the program management office. PatientKeeper is available on various smart devices, including BlackBerrys and iPhones, he said. The healthcare provider started rolling out the system in late September, and expects it to go live in February. Connectivity and bringing up the system is pretty seamless, Schogel said. "I've implemented several dozens of systems and this was one of the smoothest I've done," he said. "Now we're just in the process of tweaking the front end to make it more customized for our end users." Butler is initially rolling it out to doctors who work full time at its hospital. The cost of implementation is about $300,000. Butler expects reimbursement from the U.S. American Recovery and Reinvestment Act of 2009, which has set aside funds for hospitals and doctors who provide "meaningful use" of healthcare IT. The Department of Health and Human Services, which is overseeing the healthcare IT portion of the funding, has yet to define the criteria by which meaningful use is judged. Butler Health System is undergoing a $175 million building program, opening 75 new beds, a new operating room, intensive care unit, and more, in a seven-story tower. Its operation includes a hospital, regional lab, and about 20 physician practices. 2009-12-10T12:31:45ZObama Allocating $600M To Health CentersPresident Barack Obama allocated almost $600 million to build community health centers and implement electronic medical records, part of the $787 billion stimulus bill. The White House framed the funding as means of adding jobs to the economy, and overhaul the nation's health system.http://www.iweek-interim.com/news/229203990?cid=RSSfeed_IWK_AuthorsPresident Barack Obama allocated almost $600 million to build community health centers and implement electronic medical records, part of the $787 billion stimulus bill. The White House framed the funding as means of adding jobs to the economy, and overhaul the nation's health system.Vice President Joe Biden <a href="http://www.boston.com/business/healthcare/articles/2009/12/09/obama_announcing_600m_for_health/">commented on the allocation</a>: <blockquote>"One of the first investments we made through the Recovery Act was in supporting our nation's community health centers, and today we build on that progress by funding new construction and improvement projects at more than 80 facilities nationwide," Vice President Joe Biden said in remarks prepared for delivery Wednesday. "This is what the Recovery Act is all about: providing immediate assistance for hard-hit families, improving our nation's infrastructure and creating new opportunities for stable, well-paid work." The administration plans to give almost $509 million to repair, rebuild or replace federally designated community health centers. From coast to coast, the centers serve more than 17 million patients -- about 40 percent of whom have no health insurance.</blockquote> The administration allocated $88 million to upgrade information technology, including EMR implementation. And Obama also asked Health and Human Services Secretary Kathleen Sebelius to begin a three-year trial on how to improve care for Medicare patients at community health centers, anticipating as many as 500 health centers will participate. The $600 million allocation is designed to <a href="http://www.reuters.com/article/idUSTRE5B81H920091209?type=politicsNews">help create jobs at 85 community health centers.</a> <blockquote>"Taken together, these three initiatives -- funding for construction, technology and a medical home demonstration -- they won't just save money over the long term and create more jobs," Obama said in remarks just before signing the memo authorizing the demonstration project. "They're also going to give more people the peace of mind of knowing that healthcare will be there for them and their families when they need it and ultimately that's what health insurance reform is really about," he said. "That's what the members of Congress here today will be voting on in the coming weeks."</blockquote> InformationWeek has published an in-depth report on e-health and the federal stimulus package. <a href="http://informationweekreports.com/shared/download.jhtml?id=177700002&cat=iwkr_compliance&doc_id=InformationWeek_Analytics_Alert_hcstimulus&k=bxxe&cid=blog_bxxe">Download the report here</a> (registration required). Follow InformationWeek on Twitter, Facebook, and LinkedIn: <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_70jph8rxfg_b"> Twitter: <a href="http://twitter.com/informationweek">@InformationWeek</a> <a href="http://twitter.com/iwpremium">@IWpremium</a> <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_73fmvzv6cb_b"> Facebook: <a href="http://www.facebook.com/pages/InformationWeek/10228569831">InformationWeek</a> <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_75cxkqqxdg_b"> LinkedIn: <a href="http://www.linkedin.com/groupInvitation?groupID=102562&sharedKey=0A7330708165">InformationWeek</a>2009-12-10T08:00:00ZFeds Launch Internet Healthcare InitiativesDepartment of Health and Human Services programs promote research data sharing, employee collaboration, and flu safety.http://www.informationweek.com/news/222001374?cid=RSSfeed_IWK_AuthorsThe U.S. Department of Health and Human Services launched three Internet initiatives designed to promote the sharing of research information, improve collaboration, and encourage swine flu prevention. The programs are an implementation of President Barack Obama's principles for promoting open government through transparency, participation, and collaboration, said HHS Secretary Kathleen Sebelius in a statement. HHS will stream information about biomedical research innovations as part of the National Assets for High-Tech Economic Growth program. The agency will provide real-time access to information on technologies available for licensing from the National Institutes of Health and Food and Drug Administration intramural laboratories and the NIH's Cooperative Research and Development Agreement. The information will be available on <a href="http://www.data.gov">data.gov</a>. Several agencies are collaborating on the information streaming project, including NIH and FDA, and parts of the Departments of Agriculture and Commerce. In the second initiative, HHS is launching IdeaLab, a collaboration Web project for employees of the Centers for Disease Control and Prevention. Anyone working at CDC can post an idea or request help with a project, and other CDC employees can post their comments, solutions, and similar experiences, according to HHS. "IdeaLab does not, however, allow anonymous postings or comments as doing so would be contrary to the intent of creating the site--which is to promote transparency, participation, and collaboration." And HHS is running the YouTube Know What to Do About the Flu and Prevention Contest, to reach the population most vulnerable to H1N1--teens and young adults--and encourage them to take proactive actions such as washing hands and getting flu shots. More than 250 videos were submitted. Ten finalists were selected and put to a public vote to determine the overall winner, which was featured on national television. Runner-up videos were shown on national media outlets and on <a href="http://www.flu.gov">www.flu.gov</a>. "These examples illustrate our commitment to the President's vision of promoting accountability, collaboration, and public engagement," Sebelius said. "By working together in a transparent manner, we have developed programs that are making real contributions to creating and adopting impactful solutions that protect and improve people's health." InformationWeek has published an in-depth report on e-health and the federal stimulus package. <a href="http://informationweekreports.com/shared/download.jhtml?id=177700002&cat=iwkr_compliance&doc_id=InformationWeek_Analytics_Alert_hcstimulus&k=axxe&cid=article_axxe">Download the report here</a> (registration required). 2009-12-08T12:25:00ZMcKesson Unveils Pharmacy Automation SystemThe system is designed to improve dosage accuracy and patient safety while saving pharmacists' time. http://www.informationweek.com/news/222000954?cid=RSSfeed_IWK_Authors<div style="margin:0; padding:0 0 10px 10px; float:right; width:185px; text-align:center;"> <a href="http://www.informationweek.com/galleries/showImage.jhtml?galleryID=326&imageID=143&articleID=222000954"><img src="http://twimgs.com/infoweek/galleries/automated/326/PROmanagerRx_SideViewWithConveyor_tn2.jpg" width="175" height="135" alt="McKesson PROmanager-Rx" title="McKesson PROmanager-Rx" hspace="0" vspace="0" border="0" style="margin:0 0 3px 0; padding:0;" /></a> (click image for larger view) <div style="margin:5px 0 0 0; padding:0;font-weight:bold; font-size:1.2em; color:#990000;">McKesson PROmanager-Rx</div> </div> McKesson introduced a system to allow hospitals to automate dispensing tablets, capsules, and other oral solid medications that come pre-packaged from drug manufacturers. By retaining original manufacturer packaging, PROmanager-Rx helps hospital pharmacies increase accuracy and improve safety. The system also frees pharmacists from packaging and dispensing, so they can play more integral roles on the clinical care team, McKesson said. The system dispenses medications in unit-dose barcoded form. The system, announced Sunday, is installed at Riverside Methodist Hospital in Columbus, Ohio. "Automation of the picking process, improved safety, and increased staff satisfaction make PROmanager-Rx a big win for us," said Charles McCluskey, director of pharmacy and pulmonary services at Riverside, in a statement from McKesson. "On the front end, we can order a pre-packaged product directly from a wholesaler, receive it, and immediately put it into our medication-use process with no need for repackaging. Because we have a check waiver in place from the Ohio Board of Pharmacy, we can improve patient safety at the same time we're minimizing pharmacist involvement in cart fill." The system supports barcode medication administration operations, with barcode driven robotics scanning every dose for safety and accuracy. The system features order processing and inventory management software to increase inventory turns, manage expired and returned medications, and streamline wholesale ordering. "PROmanager-RX accommodates more than 90% of oral solid medications in use and available from U.S. drug manufacturers today, including a wide variety of shapes and sizes," McKesson said. "Unit-dose packages produced by Sky Packaging, a McKesson company, are certified for use in PROmanager-Rx. The Sky product line includes the most widely prescribed dosages and strengths in generic oral solid medications used by acute care, long-term care, and institutional pharmacies." The system has a "sleek design and small footprint," making it easy to install and support. It works with McKesson's Connect-Rx software and other barcode-driven medication-use process systems. Fulfill-RX software lets PROmanager-RX interface with McKesson's pharmaceutical distribution system. "Fulfill-Rx is designed to reduce drug inventory costs and associated labor with a two-way electronic data interchange between McKesson's pharmaceutical distribution centers and hospital automation solutions," McKesson said. McKesson also introduced the CytoCare Robot for improving safety, accuracy, and cost-effectiveness of oncology IV admixtures in hospital pharmacies. McKesson became the exclusive North American distributor of CytoCare, made by Health Robotics, in August. McKesson also demonstrated its Anesthesia-Rx medication dispensing cart, which provides anesthesiologists and certified registered nurse anesthetists with greater medication and control in the operating room, the company said.2009-12-05T07:00:00ZCan Electronic Medical Records Be Secured?Federal regulators are crafting rules that would unlock the benefits of electronic medical records while protecting Americans from privacy risks.http://www.informationweek.com/news/221601440?cid=RSSfeed_IWK_AuthorsWhile electronic medical records promise massive opportunities for patient health benefits and reductions in administrative costs, the privacy and security risks are equally huge. The Obama administration has set an ambitious goal--to get electronic medical records on file for every American by 2014. The administration is offering powerful incentives: $20 billion in stimulus funds as per the American Recovery and Reinvestment Act (ARRA) of 2009, and stiff Medicare penalties for healthcare providers that fail to implement EMRs after 2014. EMRs offer tantalizing benefits: Improved efficiency via the elimination of tons of paper files in doctors' offices, and better medical care through the use of the same kinds of database and data mining technologies that are now routine in other industries. One example: EMR systems can flag symptoms and potentially harmful drug interactions that busy doctors might otherwise miss. But the accompanying privacy and security threats are significant. When completed, the nation's EMR infrastructure will be a massive store of every American's most personal, private information, and a potential target of abuse by marketers, identity thieves, and unscrupulous employers and insurance companies. Regulators are attempting to craft rules that would unlock the benefits of EMRs while protecting Americans from the security risks. Healthcare IT pros will be required to implement systems and business processes that conform to these regulations, or face lost funding, institutional fines -- and, in some cases, personal criminal penalties. The new regulations come as the healthcare industry faces big privacy problems, going back years. In 2003, a medical transcriptionist in Pakistan threatened to post patient records from the University of California San Francisco's Medical Center on the Internet unless she was paid for her work for a transcription service company hired by the university. The dispute was resolved, but in the meantime, patients had no idea their records were being sent overseas. In another breach, two computers that held the confidential records of close to 200,000 patients of a medical group in San Jose, California, were posted for sale on Craigslist.org. The FBI recovered the information and the medical group informed current and former patients of the theft, <a href="http://www.hipaabulletin.com/articles/80">according to a 2006</a> report in the HIPAA Bulletin. Celebrities aren't immune. Last year, more than a dozen staff at the UCLA Medical Center faced disciplinary charges for <a href="http://www.informationweek.com/news/global-cio/compliance/showArticle.jhtml?articleID=206904141">prying into the medical records of Britney Spears</a>. The same hospital got in trouble again when employees accessed Farrah Fawcett's medical records after she went there for cancer treatments. Healthcare providers and other health businesses <a href="http://www.informationweek.com/news/healthcare/security-privacy/showArticle.jhtml?articleID=220700395">aren't stepping up to protect privacy</a>, according to a recent study. Some 80% of healthcare organizations have experienced at least one incident of lost or stolen health information in the past year, according to a study released this month from security management company LogLogic and the Ponemon Institute, which conducts privacy and information management research. Furthermore, some 70% of IT managers surveyed said senior management doesn't view privacy and data security as a priority, and 53% say their organizations don't take appropriate steps t protect patient privacy. Less than half judge their existing security measures as "effective or very effective." Unauthorized use of medical records has created a new kind of crime: medical identity theft, where a criminal poses as another person to obtain medical treatments using another person's insurance. This is a crime with multiple victims: The actual person with insurance coverage, whose medical records are updated with incorrect information, and the insurance company, which is paying for the criminal's medical procedure. Medical identity theft cuts twice, causing both potential medical risk and financial harm to its victims. <a href="http://geekdoctor.blogspot.com/">John Halamka</a>, CIO of Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, is one of the people trying to solve the privacy problem. Halamka is chair of the US Healthcare Information Technology Standards Panel (HITSP) and co-chair of the HIT Standards Committee, for the U.S. Department of Health and Human Services. HITSP is developing standards for EMRs that balance patients' right to control their information and keep it confidential against healthcare providers', insurers, and other businesses' needs to share information to improve patient care and do business. "You want to protect the patient's preferences for confidentiality," Halamka said. But you also need to get information where it's needed. "If you come to the emergency department in a coma, and you have a record that includes psychiatric treatment, HIV, drug abuse, and other information, would you share part of it or all of it? My preference would be all of it, with the hope that emergency workers would use it discreetly, to save my life." But other people may feel differently, Halamka said, and healthcare policy needs to serve all those needs.Privacy conditions include access logs, and encryption requirements for data that resides on mobile devices. Healthcare providers and other health businesses will be required to keep records of everyone who has access to a file, and the patient has a right to who saw the record, who accessed it, and why, Halamka said. The Office of Civil Rights enforces standards, and the Federal Trade Commission has the authority to process consumer complaints. ARRA also permits states' attorneys general to prosecute HIPAA violations. Money is a major incentive for healthcare companies to protect patient privacy. ARRA provides financial incentives for healthcare businesses to meet its privacy guidelines, and punishment for people and businesses that fail. Every doctor in American can claim $44,000 for health IT implementations that meet federal privacy, security, and other standards, between 2011 and 2015. Every hospital can claim $2 million for four years under the same conditions. Organizations that fail the ARRA tests get nothing. The regulations have a zero-tolerance policy for data breaches. If authorized people access records inappropriately, they are terminated, and can face criminal charges and fines, Halamka said. "There is also a requirement to notify prominent media. If there are more than 500 records compromised, you have to notify the prominent media of the region. I would have to call the New York Times to say, 'look what we did.' Of course I respect federal law, but I'm more afraid of the Boston Globe and New York Times because if I lose the trust of my patients, I'm not going to be given a second chance." But the ARRA regulations aren't enough, said Deborah Peel, founder and chair of the political group Patient Privacy Rights. "Hospitals let thousands and thousands of employees see millions of patients' data," she said. Hospitals have rules-based systems governing who gets to see patient data -- for example, doctors and nurses get to see data, but not clerks and office workers. If someone is accessing records inappropriately, often the only barrier is a pop-up warning--and often not even that. "That's why people looked at the Octomom's records," Peel said. Fifteen hospital workers were fired and another eight disciplined in March for unauthorized access to the medical records of octuplet mother <a href="http://www.foxnews.com/story/0,2933,511780,00.html">Nadya Suleman</a>. "And a hospital employee was able to get into Farrah Fawcett's records and leak the story before she even told her own family. Typically, the nurses get fired and the doctors don't." Policing medical records is difficult. Developers are working on algorithms to search for potential data breaches. For example, software searchers for healthcare workers accessing medical records of people with the same last name, or living at addresses near their own home, based on the possibility that they might be snooping on family members or neighbors. "Suppose a woman's partner is an abuser, she's left him, she goes to the hospital for treatment. If the abuser is an employee of the hospital, how is her privacy going to be protected?" Amendments to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule in 2002 removed earlier privacy protections. "In the paper world, you were told by your doctor's office every time he got a request to release information. You were asked to sign off on that. But in the electronic world, your ability to do that has been taken away," she said. "This is very important, because once health information is out there, you can't put it back in the bottle." Earlier, the Gramm-Leach-Bliley Act (GLBA), also known as the Financial Services Modernization Act of 1999 (a major contributor to the current financial meltdown) permitted companies to share medical records the way they share financial records, Peel said. Medical privacy regulations, however, have been getting new teeth, said Lisa Gallagher, senior director of privacy and security for the Healthcare Information and Management Systems Society (HIMSS). Under the Bush administration, the U.S. Justice Department said that HIPAA could not be applied against individual employees of healthcare providers, but ARRA said individuals can be prosecuted. HIPAA now provides criminal penalties of fines up to $250,000 and up to 10 years in prison for disclosing or obtaining health information with the intent to sell, transfer or use it for commercial advantage, personal gain, or malicious harm, Gallagher said. The law now requires patients must have access to their medical records, in electronic form. Providers are required to give an accounting to the patient any time medical information is disclosed. "All in all, what you're seeing here is that there are significant privacy rules that have been put in place now," Gallagher said. But Peel said more is needed. Patients need to have complete control over their own medical records. Patients' consent should be required to release medical records--to anyone. "We're still, essentially, voyeurs into our own medical records," she said. "Now, with audit trails, we're going to be able to see who's gotten into our medical records, but voyeurism isn't the same as control." But it's not that simple, Gallagher said. "Consent puts most of the burden on the patient. The patient has to be involved in every transaction, and the patient needs to be knowledgeable enough to make the consent, and aware that they're not leaving out things through inaction that might hurt them later on," she said. Some people--like Peel--believe that's essential to privacy; others believe the issues are too complex to leave to patients. "In my view, Congress weeded out consent as a solution to the privacy problem," Gallagher said. For Further Reading: <a href="http://www.informationweek.com/news/healthcare/security-privacy/showArticle.jhtml?articleID=220700395">E-Health Records Put Patient Privacy At Risk</a> <a href="http://www.informationweek.com/news/software/database/showArticle.jhtml?articleID=220300617">E-Health Records Could Flag Domestic Abuse</a> <a href="http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=220700404">Why Your Next IT Job Will Be In Healthcare</a> <a href="http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=221600861">Healthcare IT Career Tips</a> 2009-12-04T13:33:00ZCIGNA Launches Healthcare PodcastsThe audio podcasts, available on the iTunes store, are designed to help Americans take care of themselves while on business overseas. http://www.informationweek.com/news/222000717?cid=RSSfeed_IWK_AuthorsCIGNA International Expatriate Benefits launched a series of health, wellness, and benefits podcasts on iTunes and on its company Web site. CIEB provides healthcare benefits to expatriates around the world. The new series of podcasts, also available on the company <a href="http://www.cignaexpats.com/">Web site</a>, is designed to help ease the transition to expatriate life, and prepare expatriates for accessing healthcare in other countries. The podcasts contain practical information on getting ready for overseas assignments. iTunes users can access the podcasts by searching "CIEB" in the iTunes Store, or following <a href="http://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?id=331321273">this iTunes Store link</a>. The podcasts run two to four minutes in length, and include subjects such as, "First Steps To Take Upon Arrival to Your Expatriate Assignment," "Travel Risks," "Options and Resources Available During A Crisis," and "How to Prepare for Your International Assignment." CIGNA joins other healthcare providers using podcasts and other social media to reach out to the communities they serve. Organizations such as the University of California San Francisco Medical Center and the Mayo Clinic are using Facebook, Twitter, and YouTube <a href="http://www.informationweek.com/news/healthcare/patient/showArticle.jhtml?articleID=219200127">to connect</a> with medical students and the communities those organizations serve. The U.S. Centers for Disease Control is also using Twitter, YouTube, and even games to spread information about the H1N1 virus, or <a href="http://www.informationweek.com/news/healthcare/patient/showArticle.jhtml?articleID=219401216">swine flu</a>. And <a href="http://www.informationweek.com/news/healthcare/patient/showArticle.jhtml?articleID=220300671">Second Life has</a> a following among healthcare providers, as Chicago Children's Hospital is using Second Life for disaster preparedness, while disabled people turn to the virtual world for peer support. And a startup called Mental Health Social recently launched a new social network designed to let <a href="http://www.informationweek.com/news/healthcare/patient/showArticle.jhtml?articleID=222000340">people with mental health conditions</a>, or those interested in those conditions, connect in a comfortable online environment. 2009-12-04T10:00:00ZU.S. Health IT Office ReorganizesThe Office of the National Coordinator for Health Information Technology has reorganized into groups including a Chief Privacy Officer. http://www.informationweek.com/news/222000598?cid=RSSfeed_IWK_AuthorsThe U.S. federal government office which handles the nationwide transition to electronic medical records reorganized into several groups, including creating a Chief Privacy Officer. The National Coordinator for Health Information Technology's new organizational structure is designed to more effectively meet the mission outlined by the U.S. American Recovery and Reinvestment Act of 2009 (ARRA). The changes were <a href="http://edocket.access.gpo.gov/2009/E9-28755.htm">published in the Federal Register, effective Dec. 1.</a> The office is now composed of five smaller offices with direct reporting capability to National Coordinator for Health Information Technology David Blumenthal, who reports to Kathleen Sebelius, secretary of the Department of Health and Human Services, who reports to President Barack Obama. The new groups are the Office of Economic Modeling and Analysis; the Office of the Chief Scientist; the Office of the Deputy National Coordinator for Programs & Policy; the Office of the Deputy National Coordinator for Operations, and the Office of the Chief Privacy Officer. The Office of the Chief Privacy Officer, appointed by the Sebelius, will advise on privacy, security, and data stewardship of health information, coordinating with privacy officers in other federal agencies, state and regional agencies, and foreign countries. The Office of Economic Modeling and Analysis studies the economic effects of investing in health IT, and provides policy analysis. The Office of Chief Scientist has a wide range of responsibilities, including applying research methodologies to perform evaluations of health IT grant programs, supporting innovation in health IT, leading research activities mandated by ARRA, and promoting application of health IT to support basic and clinical research. The Office of Chief Scientist also shares information on health IT with international audiences, collaborates with other agencies and departments, and develops education programs. The Office of the Deputy National Coordinator for Programs and Policy implements and oversees grant programs that advance the nation toward universal meaningful use of health IT, develops and implements standards for national health information exchange, and maintains the Federal Health IT Strategic Plan. And the Office of the Deputy National Coordinator for Operations is responsible for budget, contracts, grants management, and other operational needs of the Office of the National Coordinator for Health Information Technology. The Health Information Technology for Economic and Clinical Health Act (HITECH) portion of ARRA sets, signed into law by Obama in February, sets aside $19 billion for healthcare providers to upgrade their IT infrastructure, provided that the the healthcare providers put the IT to "meaningful use." Blumenthal expects to put out a preliminary definition of the phrase this month. The office set aside <a href="http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=221901412">$80 million in grants for workforce training programs</a> Monday. 2009-12-02T15:26:00ZMental Health Social Network LaunchedThe online environment allows people with mental health problems, as well as their caregivers, connect in a safe and anonymous environment.http://www.informationweek.com/news/222000340?cid=RSSfeed_IWK_AuthorsMental Health Social launched a new social network designed to let people with mental health conditions or those interested in those conditions to connect in a comfortable online environment. <a href="http://MentalHealthSocial.com" target="_blank">MentalHealthSocial.com</a> is designed to allow people to share experiences anonymously, reach out to others with similar problems, and connect caregivers assisting loved ones facing mental health problems, the Naples, Fla., company said. Colin Spencer Wood, the company president and CEO, was diagnosed with bipolar disorder in 1999. "When people suffer from mental health conditions, they can sometimes feel isolated," Wood said in a statement. "There might not be anyone else in a patient's life that has experienced their condition, which can make it difficult for family and friends to relate or understand what they're going through. MentalHealthSocial.com eliminates those feelings of isolation by bringing people with similar experiences together. Sometimes people just need someone to talk to who really understands whatever mental health condition they're dealing with." The service has the same major features as Facebook and other social networks. Users can share information about themselves, post videos, upload audio or photos, and offer help. It supports e-mail style messaging, instant messaging, chat, blogging, status updates, commenting, and forums, as well as free classifieds and events. Users can create private areas for peers with similar conditions. The service will also work to raise money for mental health related nonprofit organizations. Social networking has emerged as both a tool and a source of problems for healthcare providers. Organizations like the University of California San Francisco Medical Center and Mayo Clinic are using Facebook, Twitter, and YouTube <a href="http://www.informationweek.com/news/healthcare/patient/showArticle.jhtml?articleID=219200127">to connect</a> with med students and the communities those organizations serve. The U.S. Centers for Disease Control is using Twitter, YouTube, and even games to spread information <a href="http://www.informationweek.com/news/healthcare/patient/showArticle.jhtml?articleID=219401216">about swine flu</a>. And <a href="http://www.informationweek.com/news/healthcare/patient/showArticle.jhtml?articleID=220300671">Second Life has</a> a following among healthcare providers, as Chicago Children's Hospital is using Second Life for disaster preparedness, while disabled people turn to the virtual world for peer support. On the other hand, a study by the Journal of the American Medical Association shows med students often <a href="http://www.informationweek.com/news/healthcare/security-privacy/showArticle.jhtml?articleID=220101000">behave unprofessionally</a> on social networks, even violating patient confidentiality.2009-12-02T12:43:01ZTexas Hospital District Fires 16 For HIPAA ViolationsThe Harris County Hospital District of Houston, Texas, fired 16 employees, accusing them of violating patient privacy laws by inappropriately accessing the records of a medical resident who'd been admitted to the hospital after she was shot in a grocery store parking lot.http://www.iweek-interim.com/news/229203906?cid=RSSfeed_IWK_AuthorsThe Harris County Hospital District of Houston, Texas, fired 16 employees, accusing them of violating patient privacy laws by inappropriately accessing the records of a medical resident who'd been admitted to the hospital after she was shot in a grocery store parking lot.A spokeswoman for the hospital district confirmed in an e-mail exchange with InformationWeekthat 16 employees were fired November 20 for violating Health Insurance Portability and Accountability Act (HIPAA), but declined to provide specifics. However, the <a href="http://www.chron.com/disp/story.mpl/headline/metro/6738856.html">Houston Chronicle provides more detail</a>: <blockquote>A county employee who asked not to be identified told the Houston Chronicle that two high-ranking administrators told him the fired employees had looked at the medical records of Dr. Stephanie Wuest, a first-year Baylor College of Medicine resident assigned to Ben Taub General Hospital. Wuest became a patient at Ben Taub on Oct. 29, after she was shot in a grocery store parking lot. She is expected to make a full recovery, her mother said [Nov. 25]. Most of the fired employees worked at Ben Taub. They include managers, nurses, clerks and other employees.</blockquote> HIPAA requires healthcare providers to sanction employees for violations, but leaves the level of sanction to the healthcare provider's discretion. <blockquote>"It could be that the district wants to draw a hard line against any violations of the law in order to discourage the federal Office of Civil Rights from imposing large civil or criminal financial penalties," said Stacey Tovino, a professor of health law at Drake University who writes frequently on HIPAA. She noted that many institutions fire employees for that reason. Still, Tovino said the level of sanction could be considered harsh given HIPAA's standards requiring institutions to report violations to the federal government. She said the law defines such breaches as those posing "a significant risk of financial, reputational or other harm to the individual." Tovino questioned whether employees accessing a colleague's record out of concern about her prognosis would meet that threshold.</blockquote> Wuest was described as <a href="http://www.39online.com/news/local/kiah-kroger-blood-drive-story,0,2526420.story">"still slowly recovering"</a> in a Nov. 28 report. InformationWeek has published an in-depth report on e-health and the federal stimulus package. <a href="http://informationweekreports.com/shared/download.jhtml?id=177700002&cat=iwkr_compliance&doc_id=InformationWeek_Analytics_Alert_hcstimulus&k=bxxe&cid=blog_bxxe">Download the report here</a> (registration required). Follow InformationWeek on Twitter, Facebook, and LinkedIn: <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_70jph8rxfg_b"> Twitter: <a href="http://twitter.com/informationweek">@InformationWeek</a> <a href="http://twitter.com/iwpremium">@IWpremium</a> <a href="http://twitter.com/mitchwagner">@MitchWagner</a> <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_73fmvzv6cb_b"> Facebook: <a href="http://www.facebook.com/pages/InformationWeek/10228569831">InformationWeek</a> <a href="http://www.facebook.com/home.php#/pages/Mitch-Wagner/266359020183?ref=ts">Mitch Wagner</a> <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_75cxkqqxdg_b"> LinkedIn: <a href="http://www.linkedin.com/groupInvitation?groupID=102562&sharedKey=0A7330708165">InformationWeek</a> <a href="http://www.linkedin.com/in/mitchwagner">Mitch Wagner</a>2009-12-02T11:31:13ZTaking Another Look At TweetDeckWhat Twitter client do you use? TweetDeck is a favorite of many people who use Twitter for professional purposes. I've been an enthusiastic user of Tweetie for the Mac since it came out more than seven months ago, because I love its powerful, simple, and easy-to-use interface. However, TweetDeck now supports Twitter features that Tweetie doesn't, so I figured I'd give TweetDeck another try. And I'm liking it.http://www.iweek-interim.com/news/229204030?cid=RSSfeed_IWK_AuthorsWhat Twitter client do you use? TweetDeck is a favorite of many people who use Twitter for professional purposes. I've been an enthusiastic user of Tweetie for the Mac since it came out more than seven months ago, because I love its powerful, simple, and easy-to-use interface. However, TweetDeck now supports Twitter features that Tweetie doesn't, so I figured I'd give TweetDeck another try. And I'm liking it.This isn't my first time with <a href="http://www.tweetdeck.com/beta/">TweetDeck</a>; I used it regularly before <a href="http://www.atebits.com/tweetie-mac/">Tweetie</a>. But after I <a href="http://www.informationweek.com/news/personal_tech/reviews/showArticle.jhtml?articleID=217100164">gave Tweetie a whirl</a> in April, I couldn't bear to use TweetDeck anymore, because TweetDeck looked ugly and cluttered. However, Twitter recently came out with some powerful new features: Lists and a new way of handling retweets. Tweetie for the Mac doesn't support those features (although I expect it will soon), but TweetDeck does. So I figured I'd give TweetDeck another try. I instantly started enjoying a feature of TweetDeck that I'd been missing since I switched to Tweetie: The TwitScoop "buzzing right now" cloud. It's a word-cloud of the top trending topics on Twitter. Keeping an eye on the TwitScoop cloud is a great way of checking to see if there's any breaking news you should be aware of, either world news or technology news. As I wrote this post late Tuesday afternoon, the top keywords were <code>fil fotonauts fotopedia</code> and <code>nationwide</code>. This tells me there is nothing happening in the world that requires my immediate attention. On the other hand, a few hours later, during President Barack Obama's address, this was what the TwitScoop pane of TweetDeck looked like. <a href="http://www.flickr.com/photos/mwagner/4152424398/" title="TweetDeck TwitScoop tag cloud during Obama address by Mitch Wagner, on Flickr"><img src="http://farm3.static.flickr.com/2627/4152424398_0d80c5a3b1.jpg" width="273" height="500" alt="TweetDeck TwitScoop tag cloud during Obama address" /></a> And this is what the TwitScoop pane looked like when I got to my desk a few minutes ago: <a href="http://www.flickr.com/photos/mwagner/4152654625/" title="TweetDeck TwitScoop cloud by Mitch Wagner, on Flickr"><img src="http://farm3.static.flickr.com/2550/4152654625_214ca83b84.jpg" width="258" height="500" alt="TweetDeck TwitScoop cloud" /></a> Look at something like that and you know there's a breaking story, and you can even get a general idea what it is. When I worked for a daily newspaper in the 1980s, we had a police scanner going all the time--you could hear it everywhere in the newsroom--TwitScoop is like that, but it covers the whole world. The integration with lists and retweets are where TweetDeck stands out. You can view and manage your lists from within TweetDeck. And retweeting works about the way you'd expect--click a button next to the tweet, select whether you want to retweet immediately or edit it first, and you're done. TweetDeck's stand-out feature is that you can set it up to view Twitter in multiple columns across your monitor. Columns can include saved searches, lists, multiple Twitter accounts, or your status messages on Facebook and LinkedIn. You can also use TweetDeck to access status messages on LinkedIn, Facebook, or Twitter, as well as MySpace and the 12Seconds video microblogging service. I have three major complaints about TweetDeck: - The caption line on individual tweets, where it states the name of the person who posted the tweet and the time it was posted, is a bit gray and hard to read by default. Fortunately, it's easy to go into the settings and beef the font up a bit. - The caption on re-tweets doesn't contain the name of the person doing the retweeting (although it does name the original tweeter). That's annoying. It's doubly annoying because the caption does contain the name of the Twitter client the Twitter user is using, which is virtually useless. - TweetDeck hasn't gotten any prettier in the past seven months. I expect to give Tweetie another whirl when it upgrades to support lists and new-style retweets. Tweetie also has an iPhone app, it's my favorite Twitter app for the iPhone (<a href="http://www.atebits.com/tweetie-iphone/">App Store link</a>.) The iPhone version supports new-style retweets and lists. By the way, what do you think of the new-style retweets? It seems most professional Twitter users hate them, but I like them. It's now easier for me to share content with my friends, and see content shared by other people. Loren Brichter, who developed Tweetie, <a href="http://support.atebits.com/faqs/tweetie/new-retweets">defends the new-style retweets</a>. The big complaint about the new-style retweets is that it's harder to make a comment on the tweet you're retweeting. My solution: use old-style retweets for those tweets, and use the new-style retweets where you have nothing to add to what the original person said. They can co-exist. Unified computing platforms promise to consolidate everything and anything into a single chassis. Read about that and more in Network Computing's second all-digital issue. <a href="http://www.informationweek.com/nwcdigital/nov09/index.jhtml?k=iwkblog&cid=blog_bxxe_ds_onblog">Download the issue here</a> (registration required). Follow InformationWeek on Twitter, Facebook, and LinkedIn: <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_70jph8rxfg_b"> Twitter: <a href="http://twitter.com/informationweek">@InformationWeek</a> <a href="http://twitter.com/iwpremium">@IWpremium</a> <a href="http://twitter.com/mitchwagner">@MitchWagner</a> <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_73fmvzv6cb_b"> Facebook: <a href="http://www.facebook.com/pages/InformationWeek/10228569831">InformationWeek</a> <a href="http://www.facebook.com/home.php#/pages/Mitch-Wagner/266359020183?ref=ts">Mitch Wagner</a> <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_75cxkqqxdg_b"> LinkedIn: <a href="http://www.linkedin.com/groupInvitation?groupID=102562&sharedKey=0A7330708165">InformationWeek</a> <a href="http://www.linkedin.com/in/mitchwagner">Mitch Wagner</a>2009-12-02T08:00:00ZGE Healthcare Buys Wireless Monitoring Device MakerLiving Independently Group's wireless technology tracks seniors' daily activities, watching for changes that could signify a medical problem or emergency. http://www.informationweek.com/news/222000145?cid=RSSfeed_IWK_AuthorsGE Healthcare has acquired Living Independently Group, a provider of a passive monitoring system used to assist in the care of seniors. Living Independently's product, QuietCare, uses wireless sensors to non-intrusively track the daily patterns of seniors' activities. QuietCare alerts caregivers to behavioral changes that may signal potential health problems and emergencies, allowing for fast intervention. The technology is used in many leading assisted living facilities and senior communities across the country, the companies said. GE Healthcare, a subsidiary of General Electric, provides technology for patient monitoring and diagnosis of disease. Terms of the acquisition weren't disclosed. The acquisition follows a September 2008 announcement that GE Healthcare had taken a minority ownership stake in Living Independently, and that the two companies had agreed to market and co-develop QuietCare globally. In September of this year, QuietCare was named as a "Healthymagination" product under GE's Healthymagination initiative to increase access to healthcare while reducing cost and increasing quality. "Increasing pressure on healthcare budgets worldwide, coupled with demographic changes such as the growing aging population, present enormous healthcare challenges in the care of seniors and the management of patients with chronic disease," said Agnes Berzsenyi, general manager of GE Healthcare's Home Health business, in a statement. GE Healthcare has made significant investments in its Home Health business over the past year, the company said. In November 2008, GE Healthcare announced it was leading a consortium of Hungarian companies and universities to develop remote monitoring technologies for seniors and patients with chronic diseases. In April, it joined with Intel in announcing an alliance to invest $250 million in the development of new technologies to assist independent living for seniors and patients with chronic diseases. Several companies are using wireless technologies to <a href="http://www.informationweek.com/blog/main/archives/2009/09/wireless_techno.html">track Alzheimer's patients</a>, including <a href="http://www.informationweek.com/news/healthcare/mobile-wireless/showArticle.jhtml?articleID=220900410">a service produced in partnership with the Alzheimer's Association</a>. EmFinders' EmSeeQ is a watch-like wearable device integrated nationally with 911 systems to quickly locate adults and children with cognitive disabilities, such as Alzheimer's and autism, in emergencies. 2009-12-01T12:50:22ZIT Is 'Pillar' Of White House Healthcare StrategyHealthcare IT adoption is one of four pillars on which the Obama administration is basing its healthcare strategy, and is key to containing costs, administration healthcare officials said. Healthcare IT should be combined with a budget-neutral healthcare reform bill, establishing a Medicare Commission to improve quality, and an excise tax on expensive private healthcare plans, all of which are included in the Senate healthcare reform bill.http://www.iweek-interim.com/news/229203925?cid=RSSfeed_IWK_AuthorsHealthcare IT adoption is one of four pillars on which the Obama administration is basing its healthcare strategy, and is key to containing costs, administration healthcare officials said. Healthcare IT should be combined with a budget-neutral healthcare reform bill, establishing a Medicare Commission to improve quality, and an excise tax on expensive private healthcare plans, all of which are included in the Senate healthcare reform bill.Administration officials <a href="http://www.healthcareitnews.com/news/white-house-officials-hold-healthcare-cost-containment-press-conference-today">discussed healthcare reform</a> in a conference call with reporters last week, according to HealthcareIT News. Nancy-Ann DeParle, director of the White House Office of Health Reform, told reporters she is "very pleased with the way the bill is shaping up for cost containment." <blockquote>Included in that bill are elements of delivery system reform such as funding to research and establish evidence-based care and changing incentives so that providers provide services based on quality over quantity of care.</blockquote> The officials signaled Obama's support for the <a href="http://www.nytimes.com/2009/11/26/health/policy/26health.html">Senate version of healthcare reform</a>, which differs from House legislation in key respects, according to The New York Times: <blockquote>The health care legislation that the House adopted on Nov. 7 did not include the excise tax on the so-called Cadillac insurance plans. But the Senate majority leader, Harry Reid of Nevada, included the levy in the bill that the Senate will begin debating in earnest next week, and many health economists say it is vital to slowing long-term costs. The House legislation also did not include the proposed Medicare commission, a central component of the Senate measure.</blockquote> My colleague Marianne Kolbasuk McGee has <a href="http://www.informationweek.com/blog/main/archives/2009/11/senate_healthca.html">more details</a> on the IT provisions of the Senate bill. These include the call to develop standards for data interoperability, reduce paperwork, beef up IT for skilled nursing homes, and more. InformationWeek has published an in-depth report on e-health and the federal stimulus package. <a href="http://informationweekreports.com/shared/download.jhtml?id=177700002&cat=iwkr_compliance&doc_id=InformationWeek_Analytics_Alert_hcstimulus&k=bxxe&cid=blog_bxxe">Download the report here</a> (registration required). Follow InformationWeek on Twitter, Facebook, and LinkedIn: <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_70jph8rxfg_b"> Twitter: <a href="http://twitter.com/informationweek">@InformationWeek</a> <a href="http://twitter.com/iwpremium">@IWpremium</a> <a href="http://twitter.com/mitchwagner">@MitchWagner</a> <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_73fmvzv6cb_b"> Facebook: <a href="http://www.facebook.com/pages/InformationWeek/10228569831">InformationWeek</a> <a href="http://www.facebook.com/home.php#/pages/Mitch-Wagner/266359020183?ref=ts">Mitch Wagner</a> <img style="width: 16px; height: 16px;" src="https://docs.google.com/a/masseventslabs.com/File?id=dhms4dtk_75cxkqqxdg_b"> LinkedIn: <a href="http://www.linkedin.com/groupInvitation?groupID=102562&sharedKey=0A7330708165">InformationWeek</a> <a href="http://www.linkedin.com/in/mitchwagner">Mitch Wagner</a>2009-12-01T08:40:00ZColorado Healthcare Providers Launch Information ExchangeChildren's Hospital, Exempla Healthcare, and Kaiser Permanente Colorado say they're improving patient care and cutting costs by sharing electronic medical records.http://www.informationweek.com/news/221901513?cid=RSSfeed_IWK_AuthorsThree Colorado hospitals have tied themselves in an information exchange, sharing medical records to improve patient care and reduce unnecessary redundant tests. The program unites the Children's Hospital, Exempla Healthcare, and Kaiser Permanente Colorado, to share complete medical records, including medications, discharge results, lab results, radiology reports, and more. All three hospitals use EMR software from Epic Systems, which simplifies the process. "They've standardized the content so we can exchange and have interoperability with health records," said Mary Anne Leach, vice president and CIO of the Children's Hospital. "Eventually, we will be able to exchange information with other vendors." The exchange started in June with portions of the three healthcare providers, and went live in phases until it is now in full production. The exchange is a first step toward creating a statewide Health Information Exchange, as prescribed in the U.S. American Recovery and Reinvestment Act of 2009 (ARRA), which set aside $19 billion toward implementing e-health records nationwide, said David Pecoraro, senior vice resident and CIO of Exempla Healthcare. The three organizations are working with the Colorado Regional Health Information Organization (CORHIO) to contribute their work toward building a health information exchange, said Lynn Fischer, vice president and business information officer for Kaiser. The three-hospital exchange gives physicians and clinicians access to complete records on patients, so they don't have to re-order lab tests or re-image patients, Leach said. "They're making better clinical decisions, and it's reducing the cost of care to the community by not repeating tests and procedures," she said. Previously, health data was exchanged with faxes, e-mails, and charts being hand-carried from one healthcare provider to another, which was inefficient and not timely. "Patients were literally handed paper and told to take it to their doctors," Pecoraro said. The biggest problem setting up the exchange wasn't technical; it was setting up a process to get patient consent to share records. This required training healthcare provider staff and educating the community. "Patients appreciate overall continuity of care, and in order to do that, people ahve to be more cognizant of the consent process," Pecoraro said. Leach said parents can see the benefits, "Parents don't have to have their children stuck again for lab tests, or exposed to radiation again for another X-Ray," she said. But parents also want to know that their privacy is protected. " We have to assure them that all of this is HIPAA-compliant, private, and secure," Leach said. The healthcare providers made obtaining consent part of the initial registration process. At first they were concerned it might be too time-consuming, but they found it could be made efficient by training admissions personnel and giving them good scripts to follow. E-health record sharing has to be embedded in the physicians' workflow to get them to use it, Leach said. "If you ask them to sign out and sign in to another application, they don't have time for that. But if you have another tab or link in their EHR, they'll use it. As we move forward on CORHIO, we'll use that knowledge." The project was funded internally, with no government grants. All three organizations had made significant investments in implementing Epic EMR, adding a server to allow information sharing cost $50,000 for the server at each healthcare provider, plus about 1,000 staff hours from each organization to implement. The healthcare providers are working on quantifying the benefits. "It's hard to quantify the benefits of improved clinical decisions," Leach said. "This is something we struggle with in the industry, to quantify the ROI of electronic health records. But when we see physicians saying they're making better clinical decisions, and families saying they're getting better care, the value proposition is evident." Using EHRs internally, even without sharing, brought financial benefits to Exempla, said Pecoraro. For example, the healthcare provider used to spend $3 million t $4 million annually transcribing dictated notes. Instead, they now use voice recognition to replace dictation and transcription. InformationWeek has published an in-depth report on e-health and the federal stimulus package. <a href="http://informationweekreports.com/shared/download.jhtml?id=177700002&cat=iwkr_compliance&doc_id=InformationWeek_Analytics_Alert_hcstimulus&k=axxe&cid=article_axxe">Download the report here</a> (registration required). 2009-12-01T08:20:00ZMicrosoft, Google Face Off On HealthcareMicrosoft HealthVault and Google Health want to be the repository of choice for millions of personal health records. Are they up to the task?http://www.informationweek.com/news/221901566?cid=RSSfeed_IWK_AuthorsMicrosoft and Google are taking their rivalry to the doctor's office, running competing services that allow people to store their medical records online for access by family members and healthcare providers. Google Health and Microsoft HealthVault are similar approaches: They let patients input their own medical data either by typing it in or by giving permission for the vendor to get the information from a healthcare provider or insurer with which it's partnering. Google Health and Microsoft HealthVault then provide tools for those partners to give the patient personalized health advice and other services built around the person's records. These "personal health records"--PHRs for short--complement electronic medical records. Both types of records contain a lot of the same information on the patient's conditions, test results, prescriptions, and other medical data. But PHRs are compiled and controlled by the patient, while EMRs are compiled and, for the most part, controlled by the doctors, hospitals, and other healthcare organizations. Google's Approach Google Health aims to let consumers "get more directly involved in their healthcare," said Roni Zeiger, product manager for Google Health. "Medicine continues to become more complicated, doctors have less and less time to spend with patients in the exam room, and each of us as a patient has greater responsibility to take care of ourselves and our loved ones." Google has been a leading player in e-health simply because searches on healthcare topics have always been popular. When people get sick--or think they getting sick--one of the first things they do is go online for information. "What I hear from a lot of my doctor friends is that people are often coming in with a pretty big pile of questions that they've gotten from reading online or elsewhere," said Zeiger, who's a practicing doctor. "Sometimes those are well-informed questions, sometimes less so. Part of our mission is to narrow down the 20 pages worth of questions to perhaps one page of more informed questions." That's good for the patient, and it also lets doctors see patients more quickly without compromising quality of care. And sometimes patients find treatments in their research that their own doctors aren't aware of. Google Health, which was launched last year, provides an interface where users can type in data. Users can also give Google Health permission to access data held by various healthcare companies. For example, more than 100 million people in the U.S. can give Google Health access to electronic copies of their prescription histories at a pharmacy or pharmacy benefit manager, such as CVS Caremark, Walgreens, and Medco Health Solutions. Google Health lets people organize all relevant health information in one safe place, Zieger said. Partnering Up Google is teaming with other organizations that can use its PHRs to offer personalized information and services. For example, the American Heart Association--with your permission--will check your blood tests imported from another partner, Quest Diagnostics, to find out your cholesterol level, blood pressure readings, and correlate those with other health data, such as whether you have diabetes. It then can compile all the information to determine your ten-year risk for a heart attack, and what you can do to lower the risk. Another example: Google Health partner MDLiveCare, which offers video consultations with doctors, let a patient click a button on the MDLiveCare site to import all of his or her medical history from Google Health. That way the doctor has some background on the patient's medical condition. Cleveland Clinic, a not-for-profit academic medical center, lets patients export their records into Google Health. Beth Israel Deaconess Medical Center, a Harvard Medical School teaching hospital, has linked its PatientSite patient portal to Google Health. Other partners that are letting Google import medical and drug prescription information, with a patient's permission, include Allscripts, and Blue Cross Blue Shield of Massachusetts. Google Health is free to consumers and partner organizations. Google expects that, as more people use Google Health services, they'll do more searches, which will increase the company's ad revenue. Microsoft HealthVault's mission is similar to Google Health. "Your health information is fragmented," said George Scriban, senior global strategist at Microsoft Health Services Group. An person's medical records are scattered among every doctor who's ever seen them, every pharmacy that's filled a prescription, labs, employers--even devices, like diabetics' glucometers, for people managing chronic conditions. The situation is exponentially complicated for parents managing health records for their entire families. "All of these are records you need on a reasonably frequent basis, if not every day. You need a place to keep it all," Scriban said. Like Google, Microsoft HealthVault is partnering with other companies. It has created a set of APIs and interfaces to HealthVault data repositories that let third parties communicate with HealthVault. Some of these third parties are just engaged in data exchange. But in a lot of cases, organizations like the Mayo Clinic, American Heart Association, and American Cancer Society have written applications using HealthVault medical records. "It's a storage service, but it's also a platform," Scriban said. "It provides personalized and individualized guidance just for you." New York Presbyterian Hospital links HealthVault with its patient portal, and Johns Hopkins University's School of Medicine, EMR provider Allscripts, and others are partnering with Microsoft for Internet services. HealthVault offers the same channels for inputting health records as Google Health: If healthcare providers are partners with Microsoft, then individuals can give HealthVault permission to access the records. Alternately, patients can type in the information themselves. Compatible devices such as glucose meters, blood pressure cuffs, and pedometers can send information to HealthVault. Also, Unival, which provides EMR services, lets healthcare providers fax records to them, and then Unival transmits those faxes to HealthVault, where they're stored digitally. "It's not machine-readable, but at least it's in one place," Scriban said. Big Differences So far, Microsoft and Google's health offerings look pretty much the same, offering the same types of services, and in some cases even with the same partners, such as the American Heart Association. But they're really very different, said John Moore, analyst at Chilmark Research. "Microsoft has been putting enormous investment into HealthVault and into its health solutions group," he said. "The same cannot be said of Google. Google has been more of a hands-off approach, letting it grow organically. Every now and then they announce a partnership and someone who has joined the ecosystem." Microsoft is also ahead on allowing biometric devices to feed into HealthVault, using its Connection Center software for Windows. Google has partnered with the Continua Health Alliance to achieve the same goal, but so far with fewer compatible devices, Moore said. "Right now, I think there's one device on the market," he said. Likewise, staffing levels are different. Microsoft has more than 550 people in its Health Solutions Group. "If you look at Google it's not more than 18 people, I bet," Moore said. "Microsoft is taking more of a structured and clinical approach. Google Health is more of a loose-knit health and wellness platform," Moore said. Microsoft and Google are both going after the big pot of stimulus money set aside for healthcare spending, in the U.S. American Recovery and Reinvestment Act of 2009 and elsewhere, which totals $44 billion, Moore said. Some of that money is targeted at getting physicians, practices, and hospitals to provide personal health records by 2013, and healthcare providers may be able to qualify for that money by partnering with Microsoft or Google. Dossia, a consortium of employers offering PHRs for their employees as part of health benefits is a potential competitor to Microsoft and Google, but it's taking a very different approach. Dossia performs the same function as HealthVault and Google Health--but only if you're an employee or family member of one of the companies in the alliance. So far, only Wal-Mart is live on Dossia. Other members, like Intel, Pitney Bowes, and Vanguard Health, are likely to go live in 2010. All told, Dossia covers 8 million employees and family members. "It can be a fairly substantial platform if employees sign onto it," Moore said. The biggest obstacle to PHR adoption is consumer and healthcare provider resistance, said Dr. Paul Abramson, a San Francisco doctor. "Patients are confused, they don't see how this relates to healthcare," Abramson said. "If you go into an ER, they're not going to log into Google Health to get your records. There's no integration to any live, real-time health systems that are used clinically." In hospitals "no one thinks to ask the patient if they have a Microsoft HealthVault account when we access records," he adds. PHRs will take off when they're better integrated with medical practitioner systems, Abramson said. "Right now, it's pretty much a novelty." HealhVault is the more flexible solution, said Abramson, who is also a former professional programmer. He's consulting on developing Hello Health a Web-based medical practice app that will synch with Microsoft HealthVault and Google Health. HealthVault stores any kind of XML-based patient data in its Repositories, Abramson said, letting you import an XML file, store it, and then retrieve it from elsewhere. The service can be used as a data repository and pipeline between e-health systems, even if it doesn't understand all the data it's storing, he said. Google Health, on the other hand, takes the XML files, strips out the subset of data it can understand, and discards the rest. It stores basic information like diagnoses, medications, and allergies, but it doesn't understand or store a broad range of additional information that might be useful to a medical practitioner, including family medical, social, and psychological histories, Abramson said. The Mayo Clinic is partnering with Microsoft on its PHR system, the Mayo Clinic Health Manager. Launched in April, it integrates with HealthVault, storing medical records, immunizations, and information on conditions being managed such as allergies. It also makes recommendations for health based on the patient's personal medical history. Mayo Clinic partnered with Microsoft because of Microsoft's reputation and expertise. "They tend to be frontrunners in the things that we do," said Michael Greenhalgh, senior manager of product management for Mayo Clinic Global Products and Solutions. "We had a shared vision. We were looking to make things better in the health field." Mayo is looking to improve the service by increasing the range of conditions it covers. Mayo is also looking to partner with Google Health on a future project, the details of which haven't been worked out yet, Greenhalgh said. Privacy Concerns Neither Google Health nor Microsoft HealthVault is covered by the U.S.'s chief health privacy regulations, Health Insurance Portability and Accountability Act (HIPAA). "This is because Google doesn't store data on behalf of health care providers. Instead, our primary relationship is with the user," according to an e-mailed statement from a Google spokesman. But both companies say that patient privacy is paramount. "Although Google Health is not covered by HIPAA, we are committed to user privacy and have in place strict data security policies and measures, and ensure that users control access to their information," Google said. Google explained its privacy policy with regard to Google Health in a <a href="http://googlepublicpolicy.blogspot.com/2008/05/google-health-privacy-and-hipaa.html">May, 2008 blog post</a>. The company said it doesn't sell health user information, and has "strict data security policies and measures in place to limit access to sensitive information and to protect against data breaches." The <a href="http://www.google.com/intl/en-US/health/privacy.html">Google Health Privacy Policy</a>, on the company's Web site, is short and in plain English. It gives users control of their information, says that the user is by default the only person who can view and edit information, but can choose to share with others. Users can completely delete their information at any time, and immediately. Users can also revoke sharing privileges at any time. Microsoft uses four privacy principles for HealthVault: The user owns and controls information they create. The user gets to decide what goes into the records, and what leaves it. And "Microsoft is just the steward of this information. We work on your behalf. We won't commercialize it unless we ask and you consent," Scriban said. The company won't use the information to deliver targeted advertisements, and consent to share information must be given on an individual basis; users can't give permission to share information to a whole class of entities, like all doctors, for example. But Phil Cox, principal consultant at SystemExperts, a network security consultancy, said security at both Google Health and HealthVault is lousy. For starters, both services use generic credentials, the Windows Live ID and Google ID, which have had security violations in the past. Also, the data being protected in a PHR repository is much more sensitive than the e-mail and calendaring information the Windows and Google credentials mainly protect, Cox said. Both companies "place the security burden on the user, and have specific language in their respective use agreements that hold them harmless for any breach of data caused by a compromise of a user account," Cox said in an e-mail. Given the security issues with generic credentials, "I worry that individual users will have little recourse if their information is compromised. I do think this will cause some very interesting legal challenges." He said he believes that both services will eventually be brought under HIPAA rules, which might cause Google and Microsoft to drop the services rather than bring them up to regulatory standards. Google and Microsoft plan to evolve their services to a complete data repository of health information, which would be a "HUGE collection of highly sensitive data" with "inadequate" protection, Cox said. He added, "One last concern I have is over the language that basically states there is no guarantee of accuracy or timeliness of information, and that they can drop the service at any time. With those two 'stipulations,' I do not see how any user will take them seriously. I certainly would not rely on the service, and if I can't rely on it, why use it." But analyst Moore said he believes the privacy and security concerns for services like HealthVault and Google Health are overblown. Sure, a major security breach of either of those services, should they become popular, would be a disaster. But the companies will use top-of-the-line security to protect data. And right now the data is scattered around small physician practices and hospitals, which have data breaches regularly. "I am of the opinion that your records will actually be safer and more secure than what is happening today," Moore said. Both Microsoft HealthVault and Google Health are vying to become the chief repository for personal health information. They appear similar on the surface, but have differences underneath, and privacy and security are ongoing issues for both. Individuals will have to take the pulse of both services and decide for themselves.