InformationWeek Stories by Nicole Lewis

InformationWeek Stories by Nicole Lewishttp://www.informationweek.comInformationWeeken-usCopyright 2012, UBM LLC.2012-10-15T08:36:00ZPittsburgh Healthcare System Invests $100M In Big DataUniversity of Pittsburgh Medical Center's data warehouse and sophisticated analytics engine will foster personalized medicine, population health management, and administrative efficiencies.http://www.informationweek.com/news/240008989?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/admin-systems/240001004"><img src="http://twimgs.com/informationweek/galleries/automated/798/01_Intro_tn.jpg" alt="11 Healthcare-Focused Business Intelligence Tools" title="11 Healthcare-Focused Business Intelligence Tools" class="img175" /></a> <div class="storyImageTitle">11 Healthcare-Focused Business Intelligence Tools</div> (click image for larger view and for slideshow)</div>  The University of Pittsburgh Medical Center (UPMC) is taking its big data initiative a step further by announcing <a href="http://www.upmc.com/media/NewsReleases/2012/Pages/UPMC-Personalized-Medicine-Investment.aspx">a five-year $100 million investment</a> to create a comprehensive data warehouse that brings together clinical, financial, administrative, genomic, and other information from more than 200 sources across UPMC, UPMC Health Plan, and other affiliated entities. To collect, store, manage, and analyze the information maintained in the data warehouse, UPMC will use the Oracle Exadata Database Machine, a high-performance database platform; IBM's Cognos software for business intelligence and financial management; Informatica's data integration platform; and dbMotion's SOA-based interoperability platform that integrates patient records from healthcare organizations and health information exchanges. These tools will manage the 3.2 petabytes of data that flows across UPMC's business divisions. Officials at the Pittsburgh, Penn.-based integrated health enterprise said its big data strategy will boost clinical and financial analytics, which will complement the data physicians already have in an electronic health record (EHR). The goal is to help physicians, for example, take an intelligent EHR and flag patients at risk for kidney failure based on subtle changes in lab results, or predict the most effective, least toxic treatment plan for an individual breast cancer patient based on her genetic and clinical information. In the case of breast cancer, much of this work will be done through analyzing groups of patients so that researchers and physicians can follow their reaction to treatments and their health status over time. [ Is it time to re-engineer your clinical decision support system? See <a href="http://www.informationweek.com/news/galleries/healthcare/clinical-systems/232300511?itc=edit_in_body_cross">10 Innovative Clinical Decision Support Programs</a>. ] Officials at UPMC explained that they will begin using their new analytical tools on data gathered from a group of 140 breast cancer patients that were previously studied. Researchers already have both genomic and EHR data for these patients, which will give researchers a head start in their quest to understand the nuances of individuals and their response to medical treatment. Another bonus of upgrading to more <a href="http://www.informationweek.com/healthcare/clinical-systems/supercomputer-speeds-up-cancer-analysis/240008817">sophisticated analytical tools</a>, officials at UPMC said, will be to help research clinicians compare and share a deluge of medical data while reducing their reliance on Excel spreadsheets, paper forms, and proprietary data systems that manually process information. Lisa Khorey, VP of enterprise systems and data management at UPMC, said in an interview with InformationWeek Healthcare: "It's a lot of information. The typical clinician has <a href="http://www.informationweek.com/big-data/news/big-data-analytics/240008980/how-to-bridge-big-datas-information-gap">more information coming at him</a> than he has the cognitive capacity to really comprehend and react to and that's where the intelligence layer between the computer and the digital data and the human being has to be." Neil de Crescenzo, senior VP and general manager of Oracle Health Sciences, said the initiative is important both for <a href="http://www.informationweek.com/big-data/news/healthcare/clinical-systems/240004286/poor-data-management-costs-healthcare-providers">Oracle</a> and UPMC because the enterprise healthcare analytics platform they're developing integrates data from clinical, genomics, financial, administrative, and operations across the organization. These are all areas that need to drive greater efficiency into their workflows as UPMC tackles the challenges of coping with the exponential growth in data. With regard to UPMC's operational data, the organization may realize previously untapped benefits as analytical tools enhance the collection of data and translate it into actionable insights. One instance of this is identifying the utilization rates of operating rooms. According to de Crescenzo, operating room utilization data "does not sit in the financial system or in the EHR, it sits either in other systems or frankly in a few systems where the data needs to be integrated." To sort through its data challenges, UPMC will use a wide range of Oracle tools, including Oracle Health Sciences applications like Oracle Enterprise Healthcare Analytics and Oracle Health Sciences Network. UPMC will also implement Oracle Fusion Analytics, as well as multiple components of Oracle Fusion Middleware such as Oracle Hyperion Profitability and Cost Management to support cost-based accounting and Oracle Identity and Access Management Suite Plus for regulatory compliance and data protection.2012-10-11T10:16:00ZSupercomputer Speeds Up Cancer AnalysisSupercomputer dramatically reduces time required to analyze tumor cells, promising to bring genomic medicine to the bedside.http://www.informationweek.com/news/240008817?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/leadership/iw-500-10-healthcare-it-innovators/240006527"><img src="http://twimgs.com/informationweek/galleries/automated/859/01_dreamstime_tn.jpg" alt="IW 500: 10 Healthcare IT Innovators" title="IW 500: 10 Healthcare IT Innovators" class="img175" /></a> <div class="storyImageTitle">IW 500: 10 Healthcare IT Innovators</div> (click image for larger view and for slideshow)</div>By marrying good science to a supercomputer, researchers have found a way to do the genomic analysis of a cancer tumor, a process that once took 8 weeks, in just 47 seconds per patient. The <a href="http://doctorshelpingdoctorstransformhealthcare.org/wp-content/uploads/2012/09/Press-Release-October-3-Genomic-Supercomputing.pdf">news</a> could for the first time give oncologists critical information about the cancer they are going to treat before they begin treatment. "We have quietly amassed the largest collection of cancer genomes in the nation," Dr. Patrick Soon-Shiong, chairman of NantHealth and the Chan Soon-Shiong Institute for Advanced Health, said at a press event held recently at The Newseum in Washington D.C. Based in Phoenix, Ariz., NantHealth built the supercomputer-based high-speed fiber network with technology from Verizon and AT&T, as well as Intel and HP. Soon-Shiong told the audience that the supercomputer took approximately six years to develop and will provide thousands of oncology practices with life-saving information. [ Is it time to re-engineer your clinical decision support system? See <a href="http://www.informationweek.com/news/galleries/healthcare/clinical-systems/232300511?itc=edit_in_body_cross"> 10 Innovative Clinical Decision Support Programs</a>. ] Another partner is <a href="http://www.eviti.com/">Eviti, Inc.</a>, which provides an oncology clinical decision support platform that connects and shares cancer patient information with physicians and payers. Using this platform, a scientific team from <a href="http://www.nantworks.com/">Nantworks </a> streamed data into the supercomputer that consisted of 6,000 genomes representing over 3,000 patients, with 19 cancer tumor types. The data took up 96,000 GB, and the network is now one of the fastest genomic platforms, with connectivity to over 8,000 practicing oncologists and nurses. Soon-Shiong estimates that this new infrastructure is capable of analyzing 5,000 patients per day. It currently takes approximately two months and tens of thousands of dollars to conduct sequencing and analysis of a single cancer patient's genome. Today, most oncologists prescribe a course of treatment for cancer patients based on the anatomical location of the cancer. However, a patient with breast cancer might benefit from positive results discovered from a patient with lung cancer if the underlying molecular pathways involving both cancers are similar. Part of the difficulty in applying genomic sequencing to guide treatment has been due to the inability to convert a patient's DNA into actionable information in a timely manner. The supercomputer also tackles barriers such as matching patients with their medical records, which Dr. Peter Tippett, chief medical officer, Verizon, described as "a huge problem." During his remarks, Tippett mentioned that Verizon's recent initiatives around universal identity will help the healthcare ecosystem "get the right patient hooked up with the right medical record and the right electronic labels." Tippett also said Verizon is focused on building an infrastructure for health delivery organizations that is <a href="http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html">HIPAA</a>-compliant, and the company is developing a system that can handle 150 million concurrent patients and 400,000 transactions per second. Looking ahead, Soon-Shiong said his team is focused on connecting genomic analysis from the supercomputer with <a href="http://www.informationweek.com/healthcare/electronic-medical-records/cancer-researchers-call-for-ehr-standard/232200424">electronic health records</a>, which he described as disparate systems that are "basically medical bridges to nowhere." Soon-Shiong asserts that if a grid is built that could connect EHRs to the supercomputer's platform, then up-to-date information on cancer patients, including the genomic analysis of their tumor and the treatments they've received could follow the patient wherever they reside. A network of major cancer centers, including those at City of Hope, John Wayne Cancer Institute, and Methodist Hospital in Houston, have contributed to this collection of over 6,000 genomes. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-10-09T14:06:00ZMobile Health Technology Experiences Growing PainsRapid growth of mobile health technology means stakeholders must cope with security issues and integration into the existing IT infrastructure.http://www.informationweek.com/news/240008717?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/mobile-wireless/uncle-sam-shares-12-top-health-apps/240007545"><img src="http://twimgs.com/informationweek/galleries/automated/871/01_Extra2_tn.jpg" alt="Uncle Sam Shares 12 Top Health Apps" title="Uncle Sam Shares 12 Top Health Apps" class="img175" /></a> <div class="storyImageTitle">Uncle Sam Shares 12 Top Health Apps</div> (click image for larger view and for slideshow)</div> Mobile health tools used to manage chronic and acute conditions will become more ubiquitous across healthcare settings, a new report from Frost & Sullivan concludes. But security concerns, problems integrating the technology into providers' monitoring systems, and a lack of best practices remain barriers. The report, <a href="http://www.frost.com/prod/servlet/press-release.pag?docid=267265445">Advances in mHealth Technologies</a>, relies on approximately 60 executives at healthcare organizations, academic research institutions, software development firms, and mobile device companies. These executives operate mobile health platforms in the USA, Canada, the Asian Pacific region, and Europe. Frost & Sullivan industry analyst Prasanna Kannan told InformationWeek Healthcare, "As the care system shifts to a personalized disease management system, mHealth can help physicians and other clinicians remotely manage predictive symptoms of chronic illness, as well as episodes of acute conditions in hospital settings." Kannan, the report's author, said cardiovascular disease and diabetes are the leading chronic conditions that are seeing the greatest adoption rates of mobile health technology, which is used to monitor patients' vital signs and manage their care. [ Which mobile medical apps are doctors and patients turning to most? See <a href="http://www.informationweek.com/news/galleries/healthcare/mobile-wireless/232200263?itc=edit_in_body_cross">9 Mobile Health Apps Worth A Closer Look</a>. ] Furthermore, the report cites six key areas where the use of mobile devices can improve research and care coordination: --Long-term disease management. As patients get older and live longer, the need for mobile devices that monitor their condition will increase and the geriatric market segment will grow. --Primary diagnosis. This is enabled through telehealth systems such as mobile video consultations. By exchanging clinical information, doctors can make diagnostic predictions and improve patient outcomes. --Emergency response systems. Text messaging, personal digital assistant (PDA) devices, and other mobile communications systems can help medical teams coordinate the care of patients in transition from one setting to another. --Health and wellness information. Health-related tools and apps are gaining popularity. These include personalized fitness tools such as <a href="http://www.informationweek.com/healthcare/mobile-wireless/unitedhealth-group-promotes-mobile-healt/232400290">Fitbit</a>, Adidas miCoach, and WiScale, which monitor exercise regimens and track everything from how many calories you burn to your weight and body mass index (BMI). --Mobile-enhanced RFID-based tracking of drugs.Mobile devices can help track medications and other medical supplies. --Public health research.The data collected from monitoring patients can contribute to population health research and surveillance of groups of individuals with similar medical conditions. According to Kannan, within the next three to four years, mobile device developers will gain a better understanding of the nature of security breach concerns and will improve their systems to shield against these threats. She also predicts that as <a href="http://www.informationweek.com/healthcare/mobile-wireless/wearable-medical-technology-set-to-take/240006647">wireless vital sign monitoring</a>, telehealth networks, and Bluetooth-enabled health trackers become more ubiquitous, every hospital facility will eventually need to acquire a full enterprise wireless system. This will be spurred on by an emerging market approach that entails collaboration between <a href="http://www.informationweek.com/healthcare/mobile-wireless/fcc-unleashes-mobile-health-innovation-i/240008136">regulatory agencies</a> and medical device companies to develop mobile health apps that will be adopted widely across healthcare systems. One area of concern, according to executives interviewed for the report, is that doctors need to do more to highlight the features and benefits of mHealth services and applications so patients appreciate their value. Finally, the report offers key strategies to move mobile health forward. One example is urging hospitals and healthcare networks to focus on capturing data generated by apps in specific areas of care, such as diabetes, cancer, or cardiovascular disease. Another strategy is to integrate mHealth systems with existing hospitals and academic research centers to raise the level of research, improve preventative medicine strategies, and lower the cost of care. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)2012-10-03T14:12:00ZHealth Insurance Exchange Spending Hits $2 BillionLatest round of grant awards will go toward building the IT infrastructure necessary to make state exchange websites operational.http://www.informationweek.com/news/240008389?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/leadership/iw-500-10-healthcare-it-innovators/240006527"><img src="http://twimgs.com/informationweek/galleries/automated/859/01_dreamstime_tn.jpg" alt="IW 500: 10 Healthcare IT Innovators" title="IW 500: 10 Healthcare IT Innovators" class="img175" /></a> <div class="storyImageTitle">IW 500: 10 Healthcare IT Innovators</div> (click image for larger view and for slideshow)</div>The federal government has spent $2.2 billion to help states establish their health insurance exchanges, which require creating websites to let millions of small businesses and individuals in every state buy health insurance from qualified health plans. Spending to establish these state exchanges, which must be operational by Jan. 1, 2014, exceeded the $2 billion mark with the <a href="http://www.hhs.gov/news/press/2012pres/09/20120927a.html">announcement</a> last week that Arkansas, Colorado, Kentucky, Massachusetts, Minnesota, and the District of Columbia will receive a new round of Exchange Establishment grants totaling $224 million. The total amount awarded to date in both Level One and Level Two Exchange Establishment grants is $1,899,469,108. The amount awarded to date in Exchange Innovator grants is $249 million, and the total awarded in Exchange Planning grants is $49 million. In May, the <a href="http://www.hhs.gov/news/press/2012pres/05/20120516a.html">U.S. Department of Health and Human Services</a> (HHS) said it had spent $1 billion over a two-year period toward establishing state insurance exchanges. Since then, grants totaling nearly $1 billion were announced after a U.S. Supreme Court decision in June upheld the constitutionality of the Patient Protection and Affordable Care Act. In August, <a href="http://www.hhs.gov/news/press/2012pres/08/20120823a.html">HHS announced</a> that California, Connecticut, Hawaii, Iowa, Maryland, Nevada, New York, and Vermont would receive a total of <a href="http://www.informationweek.com/healthcare/admin-systems/federal-money-boosts-it-investment-in-in/240007356">$765 million</a> in grant funds for their exchanges. The additional $224 million announced last week means that federal spending on HIXs this year nearly equals the amount spent in the previous two years. [ Read <a href=http://www.informationweek.com/healthcare/admin-systems/5-it-tips-for-state-health-insurance-exc/240007916?itc=edit_in_body_cross">5 IT Tips For State Health Insurance Exchanges</a>. ] "I think the support the federal government has shown is indicative of the opportunity and the challenges of updating, redesigning and rebuilding entire technology systems to facilitate healthcare reform," said Dr. Jay Himmelstein, professor in the department of family medicine and community health at the University of Massachusetts Medical School (UMMS), and co-author of the report, <a href="http://www.nasi.org/sites/default/files/research/Establishing_the_Technology_Infrastructure_for_Health_Insurance_Exchanges.pdf">Establishing the Technology Infrastructure for Health Insurance Exchanges Under the Affordable Care Act</a>. Several states have indicated that the latest round of grant awards will go toward building the IT infrastructure necessary to make their exchange websites operational. For example, Arkansas will use its $18.6 million to continue work to design and implement automation to connect Arkansas Medicaid, and appropriate state-run exchange functions, with the federally-facilitated Exchange Eligibility and Enrollment portal. Funds also will go toward the design, development, and implementation of operations and information systems to support state-operated federally-facilitated Exchange Consumer Assistance functions including outreach, education, and the Navigator Program. Minnesota’s $42.5 million grant will help the state continue to fund development of its exchange information technology infrastructure, which includes establishing a governance structure within the Minnesota Department of Commerce with full-time staff dedicated to the development of Minnesota's exchange. State officials said the funds will pay for financial management and consulting for financial system development, third-party assessment of internal controls, and consultation contracts for program integrity, as well as IT security assessment and hardware and software requirements. Colorado will use its $43 million grant to continue efforts to establish the services and systems to launch Colorado’s new health insurance exchange. Specifically, resources from this grant will provide the Colorado Health Benefit Exchange the resources to meet deadlines for certification, testing, and deployment of systems and operations. In the latest round of funding, Arkansas, Colorado, Kentucky, Massachusetts, and Minnesota received awards for Level One Exchange Establishment Grants, which are one-year grants awarded to states to build Exchanges. The District of Columbia received a Level Two Exchange Establishment Grant, which is a multi-year grant awarded to states further along in building their exchanges. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-10-01T08:05:00ZTelemedicine Improves Health Of Diabetics, Research SaysNonprofit group eHealth Initiative says clinics in poor neighborhoods can improve patients' health and cut hospitalizations by using mobile devices, patient Web portals, and social networks to monitor and inform. http://www.informationweek.com/news/240008169?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/mobile-wireless/uncle-sam-shares-12-top-health-apps/240007545"><img src="http://twimgs.com/informationweek/galleries/automated/871/01_Extra2_tn.jpg" alt="Uncle Sam Shares 12 Top Health Apps" title="Uncle Sam Shares 12 Top Health Apps" class="img175" /></a> <div class="storyImageTitle">Uncle Sam Shares 12 Top Health Apps</div> (click image for larger view and for slideshow)</div>Diabetics in low-income communities can improve their blood glucose, lipids, and blood pressure readings by using telemedicine--mobile devices and Web-based portals--according to a new report from nonprofit eHealth Initiative (eHI). These improvements in turn can lead to reductions in emergency room visits and hospital readmissions. <a href="http://www.ehealthinitiative.org/resources/viewdownload/39/551.html">An Issue Brief on eHealth Tools and Diabetes Care for Socially Disadvantaged Populations</a> says "e-health" tools can assist clinics that have limited resources and personnel, are often the only center of care within a large geographic area, and are not connected to a large health system. The new research shows that e-health technologies can reduce healthcare costs, said Jennifer Covich Bordenick, chief executive officer of eHI, an independent group that seeks to improve the quality, safety, and efficiency of healthcare through technology. Bordenick noted that, for instance, as more affordable smartphones get into the hands of consumers, they will increasingly use them to access apps to count calories and obtain nutrition information; log fitness workouts; monitor vital signs; calculate disease risks; and monitor adherence to medications. These tasks can have a significant impact on diabetic care. [ Wearable devices equipped with sensors and Web connections help consumers track health and fitness. Take a look at what's possible now. <a href="http://www.informationweek.com/news/galleries/healthcare/mobile-wireless/240000353?itc=edit_in_body_cross"> 10 Wearable Devices To Keep Patients Healthy</a>. ] "Diabetes costs the nation almost $100 billion per year," Bordenick said in an interview with InformationWeek Healthcare. "The research shows that using e-health technologies to help patients prevent a deterioration of their health condition, as well as reduce costly emergency room visits, validates the pursuit of using these tools, especially among economically disadvantaged patients." The report cites several examples in which technology has improved the health of diabetic patients. Take the Veterans Administration (VA) Care Coordination Home Telemedicine (CCHT) program, for example. Under this initiative, a group of over 400 veterans with Type II diabetes used a device to answer questions about their symptoms and health status every day for 24 months. The group was at high risk for multiple inpatient and outpatient visits, including those to an emergency department. After 24 months, the results showed significant decreases in diabetes-related hospitalizations as well as emergency room and outpatient visits. Similarly, the Informatics for Diabetes Education and Telemedicine Study (IDEATel) used a randomized trial designed to compare telemedicine-based case management with usual care in older, ethnically diverse, Medicare beneficiaries with Type II diabetes residing in medically underserved areas of New York state. After five years, the researchers saw sustained reductions in glycohemoglobin (HgbA1C)--a measure of long-term blood glucose control--LDL cholesterol, and blood pressure for patients using telemedicine when compared to those receiving usual care. <a href="http://slie.dyndns.org/projects/DiaBetNet/webpage/">DiaBetNet</a>, developed by the MIT Media Lab, uses a wireless personal digital assistant with diabetes management software and an integrated motivational game to help youths between the ages of 8 and 18 manage their Type II diabetes. Patients enter their vital signs for transmission to a physician, and are encouraged to play the interactive game to educate themselves about blood glucose levels, blood pressure, diet, and exercise. Using this tool, over 70 patients improved their overall knowledge of diabetes and maintenance of HgbA1C levels, and lowered their overall carbohydrate intake. Patient Web portals also play an important role in improving health, according to the eHI report. It cited <a href="http://xnet.kp.org/newscenter/aboutkp/healthconnect/index.html">Kaiser Permanente HealthConnect</a>, MyGroupHealth, and Patient Gateway as three portals that show technology helps patients access and manage their health data, communicate with their providers, and improve their medical condition. On the social media front, the report cited TuDiabetes.com as an example of an effective online community. Its 15,000-plus members share their experiences with diabetes through blogs, forums, events and news. Another example is <a href="http://www.dlife.com/?gclid=CJqa76zF07ICFQioPAodx2UACA"> dLife</a>, a social networking site that offers more than 25,000 members information on Type II diabetes symptoms; healthy diet tips and exercise suggestions; medications for diabetes control; and an online forum for sharing personal experiences. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-28T13:23:00ZFCC Unleashes Mobile Health Innovation InitiativesFederal Communications Commission announces new measures to promote mobile technology in healthcare industry, including hiring its own healthcare czar.http://www.informationweek.com/news/240008136?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/mobile-wireless/uncle-sam-shares-12-top-health-apps/240007545"><img src="http://twimgs.com/informationweek/galleries/automated/871/01_Extra2_tn.jpg" alt="Uncle Sam Shares 12 Top Health Apps" title="Uncle Sam Shares 12 Top Health Apps" class="img175" /></a> <div class="storyImageTitle">Uncle Sam Shares 12 Top Health Apps</div> (click image for larger view and for slideshow)</div>The Federal Communications Commission chairman, Julius Genachowski, says his agency will create the position of Health Care Director, who will function as the central contact for external groups on all health-related issues. The move is one of several steps designed to pave the way to making mobile health technology an integral part of medical care within five years. Genachowski outlined the FCC's plans this week at a press event held at the Washington D.C. headquarters of the Information Technology and Innovation Foundation, where a <a href="http://www2.itif.org/2012-mhealth-taskforce-recommendations.pdf">report</a> by the mHealth Task Force was unveiled. The report includes a list of recommendations calling on government, academia, and industry to expand their collaboration and adopt policies aimed at enabling and proliferating mobile health technologies. The FCC's latest initiatives come at a time of unprecedented innovation in the field, Genachowski said, including the recent development by Stanford University researchers of a pacemaker that can fit on the head of a pin. Instead of using batteries for power, the device is charged by a wireless transmitter outside the body. Another example comes from the West Health Institute, which recently announced that it is licensing technology to wirelessly monitor high-risk pregnancies in remote clinics. "Wireless remote monitoring increases independence, mobility, and comfort for patients within the hospital or at home--and companies are innovating to create smaller, better, more reliable monitors every day," Genachowski said. Recognizing the potential to transform healthcare through these burgeoning technologies, the FCC plans to expand broadband connectivity and advance the use of mobile devices, wireless health technology, and medical body area network (MBAN) devices, which will accelerate opportunities to use mobile technology in patient care. MBANs are used to monitor patients wirelessly, providing physicians with real-time patient data while giving patients mobility and greater independence. [ Wearable devices equipped with sensors and Web connections help consumers track health and fitness. Take a look at what's possible now. <a href="http://www.informationweek.com/news/galleries/healthcare/mobile-wireless/240000353?itc=edit_in_body_cross"> 10 Wearable Devices To Keep Patients Healthy</a>. ] Genachowski said the work ahead requires a collaborative effort involving the public and private sector, doctors, and other healthcare stakeholders. He also suggested that as America competes with other countries in developing technology that can overcome barriers to adoption such as interoperability, reliability, connectivity, privacy and security, America's leadership role in mobile health innovation is at stake. "It's up to us whether we are the first country in the world to figure it out...." The FCC also is considering a plan to streamline the agency's experimental licensing rules to promote the development of wireless health "test beds" that facilitate easier testing of mobile health devices. Another FCC initiative involves reforming and modernizing the <a href="http://www.informationweek.com/healthcare/policy/fcc-criticized-for-not-spending-on-telem/231002124">Rural Health Care Program</a>, which has been criticized for its inability to allocate more resources to improve telecommunications services for rural health facilities. The FCC said it will consider authorizing networks of hospitals and healthcare facilities to jointly apply for program funds to boost broadband capacity and encourage the adoption of electronic health records. The FCC also plans to address the task force's recommendation to collect richer data on broadband and telehealth. Another initiative the FCC will pursue is developing an outreach plan to promote greater collaboration between it and the healthcare sector on policies at the intersection of communications and health. Genachowski will direct the FCC's international bureau to work with its counterparts in other countries to encourage them to make spectrum available for MBANs. Regulators also will be asked to accelerate spectrum harmonization for medically safe cross-border patient travel and better economies of scale for device makers. This plan advances earlier discussions with regulators in Europe and Mexico on these topics. The FCC has taken several steps in recent years to take advantage of mobile technology in healthcare, including the release of the country's first <a href="http://www.informationweek.com/healthcare/policy/fcc-broadband-key-to-healthcare-it-initi/223900199">National Broadband Plan</a> in 2010. The plan identified ways in which the expansion of broadband technology could foster innovation and a better healthcare system. The <a href="http://www.informationweek.com/healthcare/leadership/fcc-fda-partner-to-advance-telehealth/226300045">FCC and the U.S. Food and Drug Administration</a> also entered into an unprecedented partnership in 2010 to collaborate on communications-related medical innovations and to help advance innovation and investment in wireless-enabled telehealth devices. Recently, the FCC adopted new rules that made the U.S. the first country in the world to allocate spectrum for <a href="http://www.informationweek.com/healthcare/mobile-wireless/emerging-wireless-medical-technology-get/240000836">MBAN</a> devices. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-26T08:38:00Z5 IT Tips For State Health Insurance ExchangesStates confront huge technology challenges and opportunities with federally mandated HIXs. A new report offers guidance to ease the transition.http://www.informationweek.com/news/240007916?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/leadership/iw-500-10-healthcare-it-innovators/240006527"><img src="http://twimgs.com/informationweek/galleries/automated/859/01_dreamstime_tn.jpg" alt="IW 500: 10 Healthcare IT Innovators" title="IW 500: 10 Healthcare IT Innovators" class="img175" /></a> <div class="storyImageTitle">IW 500: 10 Healthcare IT Innovators</div> (click image for larger view and for slideshow)</div>  Building health insurance exchange (HIX) websites where millions of small businesses and individuals can enroll in health plans promises to be one of the most time-consuming IT infrastructure endeavors that states have confronted in recent years. So says a new report from the University of Massachusetts Medical School (UMMS). Not only will health plans have to link their systems to these exchanges, but linking exchange technology with individual eligibility and enrollment data at Medicaid, the Children's Health Insurance Program (CHIP), and other federal government databases will create new opportunities to upgrade or replace systems. That, however, increases the scope and complexity of the work ahead, the report said. <a href="http://www.nasi.org/sites/default/files/research/Establishing_the_Technology_Infrastructure_for_Health_Insurance_Exchanges.pdf">Establishing the Technology Infrastructure for Health Insurance Exchanges Under the Affordable Care Act</a> (ACA), developed in collaboration with the National Academy of Social Insurance, is based on interviews with policy and technology leaders from the "early innovator" states that are developing HIX IT models that can be adopted and tailored by other states. Executives at other state exchanges that have made significant progress in designing and developing exchanges, and others that are modernizing Medicaid and CHIP eligibility systems, were also interviewed. Earlier this year the federal government announced it had disbursed <a href="http://www.informationweek.com/healthcare/policy/web-based-insurance-exchanges-attract-1/240000731">more than $1 billion</a> to develop state HIXs. In August the U.S. Department of Health and Human Services announced another <a href="http://www.informationweek.com/healthcare/admin-systems/federal-money-boosts-it-investment-in-in/240007356">$765 million</a> in grant money to help states conduct major upgrades to their legacy IT systems. [ Looking for a PACS platform to replace an outdated system? See <a href="http://www.informationweek.com/healthcare/clinical-systems/9-must-see-picture-archivingcommunicatio/240006960?itc=edit_in_body_cross">9 Must-See Picture Archiving/Communication Systems</a>. ] Part of the process of integrating systems, the report notes, requires states to "rely heavily on the federal data service hub (DSH) to obtain access to key functions and connectivity to federal data sources that will verify citizenship, immigration status, and tax information." To successfully achieve these goals, states and the federal government must collaborate on DSH technical requirements and allow for transparency in business processes and data collection. Dr. Jay Himmelstein, professor in the department of family medicine and community health at UMMS and co-author of the report, told InformationWeek Healthcare: "The state-based health insurance exchanges will need to connect to a federal data service hub to confirm income and citizenship, and this functionality will require new systems to be built, as well as major upgrades to the current federal systems." According to Himmelstein and his colleagues, states have some flexibility to help them implement their exchanges. These options include (1) establishing and operating their own state-based exchange (SBE); (2) operating an exchange in partnership with the federal government (partnership exchange); or (3) defaulting to a federally facilitated exchange (FFE) run by the federal government. Himmelstein, who is also a senior advisor in the Office of Health Policy and Technology, which is part of the UMMS's Center for Health Policy and Research, said there's not enough time or money for states to fully custom-build a system for themselves. Time constraints, Himmelstein said, threaten the ability of states to meet the summer 2013 deadline, at which point IT systems that determine an individual's eligibility for health coverage must be operational and fully tested. The other looming deadline is January 1, 2014, when state exchanges must be fully operational. "There does come a point at which no amount of reuse or resources--whether human or fiscal--will enable the establishment of an SBE or ACA-compliant Medicaid and CHIP eligibility systems for 2014, given the timelines for procurement and development," the report said. Based on interviews with policy and technology leaders, the authors developed five recommendations for state exchanges to follow: 1. Agree upon a common vision, strategy, and plan for IT development. That's essential for meeting fast-approaching ACA deadlines; 2. Perform a careful assessment of the state's internal and external IT resources; 3. Integrate policy and technology between an exchange and the state's Medicaid program; 4. Leverage federal resources, reuse technologies developed by other states and federal agencies, and participate in multi-state collaborations; 5. Proceed with development, despite federal and state policy, technology, and political uncertainties, to meet aggressive federal implementation deadlines.2012-09-21T09:02:00ZXerox Wins Contract For Nevada Health Insurance ExchangeNevada awards $72 million to Xerox to build its health insurance exchange system--and to prepare the state for the onslaught of users.http://www.informationweek.com/news/240007738?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/mobile-wireless/uncle-sam-shares-12-top-health-apps/240007545"><img src="http://twimgs.com/informationweek/galleries/automated/871/01_Extra2_tn.jpg" alt="Uncle Sam Shares 12 Top Health Apps" title="Uncle Sam Shares 12 Top Health Apps" class="img175" /></a> <div class="storyImageTitle">Uncle Sam Shares 12 Top Health Apps</div> (click image for larger view and for slideshow)</div>Nevada has awarded Xerox a contract worth $72 million to provide the technology and services to design and build the state's health insurance exchange (HIX). Under the agreement, Nevada's Silver State Health Insurance Exchange will use Xerox's cloud-based technology and Web portal to support the HIX website, where individuals and small business employers will compare and buy health insurance plans that meet their needs. Officials at Xerox said the company's technology and services will support premium billing, processing, collection, aggregation and remittance, data analytics and actuarial support, health plan quality review and compliance reporting, and incorporation of tax credits and subsidies in cost calculations. The company also will establish a call center in Las Vegas that will answer customer questions. According to Jon Hager, executive director of the Silver State Health Insurance Exchange, Xerox's technology and service allows Nevada to improve its management of the exchange. "There is very little margin for error in getting an exchange fully operational by 2014 and self-sustainable by 2015," Hager said in a <a href="http://news.xerox.com/pr/xerox/Xerox-Awarded-HIX-Contract-with-Nevada.aspx">statement</a>. <a href="http://www.healthcare.gov/news/factsheets/2011/05/exchanges/nv.html">Nevada's Exchange</a> recently received a Level Two Establishment grant from the <a href="http://www.informationweek.com/healthcare/admin-systems/federal-money-boosts-it-investment-in-in/240007356">federal government</a> worth $50 million, which will go toward building the exchange's IT infrastructure and services to meet certification requirements in January 2013, provide coverage to enrollees by Jan. 1, 2014, and achieve self-sustainability by January 2015. "States need to bear in mind that consumers coming to use these exchanges already have a lot of experience using websites in other markets, such as retail or financial services," said Janice Young, program director at IDC Health Insights. [ Looking for a PACS platform to replace an outdated system? See <a href="http://www.informationweek.com/healthcare/clinical-systems/9-must-see-picture-archivingcommunicatio/240006960?itc=edit_in_body_cross">9 Must-See Picture Archiving/Communication Systems</a>. ] In an interview with InformationWeek Healthcare, Young said states need to create user-friendly websites that are simple, and relatively intuitive, and that give individuals opportunity to easily identify their benefits, look at their options, and enroll without difficulty. She added that health plans are looking for partners to help them build a technological infrastructure to support the millions of individuals expected to purchase health insurance through the exchanges. "Many health plans expect HIX activity to increase online volume, but few have the online capacity to support the level of complexity and responsiveness needed for product selection, enrollment, etc. that these and any high-volume online presence would require," she noted. "Many are looking to solutions partners to create or enhance their capabilities in this regard." In a separate <a href="http://news.xerox.com/pr/xerox/Xerox-and-HealthPlan-Services-Team-Up-on-HIX-solution.aspx">announcement</a> earlier this week, Xerox said it will partner with HealthPlan Services (HPS), to provide technology that will help health plans enroll and participate in state insurance exchanges. Under the agreement between Xerox and HPS, health plans will use HPS's Go-To-Exchange, which offers specific tools that help health plans connect with exchanges. These include: -- The ExchangeLink, which integrates the HIX platform with health plans' existing core systems and business processes. -- The ServiceLink, which manages members' accounts, including calculating and billing member contributions, applying premium tax credits, and reconciling membership and tax credits across state and federal agencies. The partnership also calls for Xerox to provide health plans with technology and services to support customer care for existing members, new enrollees, and prospects; a full suite of third-party administration services; and payment recovery to prevent waste, fraud, and abuse. It also will provide customer communication services. Those services will include a summary of benefits and coverage statements, explanation of benefits, and correspondence. Jeff Bak, president and CEO at HPS, said two of the most significant challenges confronting health plans and their participation in state insurance exchanges are unpredictable volumes, and steep ramp-up requirements during open enrollment. Both are difficult to accurately predict and problematic when trying to decide on how many resources are required. Bak recalls that this was a lesson the industry learned during the first year of Medicare Advantage, when participating carriers struggled to meet enrollment demand. "To avoid repeating that history, carriers need a highly flexible and rapidly scalable HIX framework. That framework can best be provided when vendors team up to deliver a multi-solution approach," Bak told InformationWeek Healthcare. "The reality is that individual solutions, no matter how superior, have limited capacity, while a partnership such as HPS and Xerox enables resources to be scaled in response to fluctuating demands." InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-19T10:00:00ZAnalytics Can Expand Health Insurers' RoleInsurers can help solve problems such as medication errors and duplication of services if providers share clinical and financial data, says new PricewaterhouseCoopers report. http://www.informationweek.com/news/240007563?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/leadership/iw-500-10-healthcare-it-innovators/240006527"><img src="http://twimgs.com/informationweek/galleries/automated/859/01_dreamstime_tn.jpg" alt="IW 500: 10 Healthcare IT Innovators" title="IW 500: 10 Healthcare IT Innovators" class="img175" /></a> <div class="storyImageTitle">IW 500: 10 Healthcare IT Innovators</div> (click image for larger view and for slideshow)</div>As the healthcare industry increasingly relies on analytical tools to provide care metrics, insurers that identify the right data and incorporate informatics into their organizations are likely to transform healthcare, concludes a new report from PricewaterhouseCoopers. According to the report, by creating actionable information, insurers can make a valuable contribution to healthcare that can have a positive impact on healthcare providers and health plan members. Despite that potential, PwC found that three-quarters of healthcare providers surveyed by its Health Research Institute say that they are not effectively aggregating, integrating, or developing performance measures, or acting on clinical data. "Working together, providers and insurers can use informatics to tackle problems such as medication compliance, duplication of services, improved outcomes, and a reduction in medical errors," the report states. <a href="http://www.pwc.com/us/en/health-industries/health-research-institute/index.jhtml">Advancing healthcare informatics: The power of partnerships</a> summed up interviews with 14 executives at health plans and industry organizations, and also relied on previous surveys with more than 600 provider, health insurer, and pharmaceutical and life sciences professionals. [ Related: <a href="http://www.informationweek.com/healthcare/electronic-medical-records/when-medical-informatics-clashes-with-me/240003990?itc=edit_in_body_cross">When Medical Informatics Clashes With Medical Culture</a>. ] The research suggests that health plans are undergoing monumental change in their relationships with providers, health plan members, pharmacies, and other stakeholders. According to John Edwards, a director at PwC and co-author of the report, much of the change has been brought on by the Patient Protection and Affordable Care Act as well as the HITECH Act. "There is going to be a sea change in the use of informatics within payer organizations, partially due to health reform," Edwards told InformationWeek Healthcare. "Payers can no longer deny coverage based on pre-existing conditions so they have to manage the risk rather than avoid it." Insurers can overcome some of that risk through collaborating with health providers in an <a href="http://www.informationweek.com/healthcare/clinical-systems/banner-health-aetna-reach-for-aco-gold/240000516">accountable care organization</a>, in which health insurers can use informatics to improve the health outcomes of a large population. "Insurers bring strong actuarial skills to the table that can help providers calculate the cost of current and future business risk. They can also provide physicians with financial strategies for managing costs and metrics for driving quality improvements on a large scale," the report said. <a href="http://www.informationweek.com/healthcare/patient/health-insurers-customer-communications/232900707">Health plans</a> also are in a position to expand data components that include demographics, community health, and social media, which the report says are examples of rich consumer information. These resources present untold opportunities for health plans to learn from, as well as to use as vehicles to do a better job of communicating with members. Already, there are real-world examples of health plans using data to improve care, according to the report. For instance, United Healthcare, Kaiser Permanente, and the Geisinger Health Plan all have collaborated with health providers to analyze patient data and uncover actionable insights leading to improved care and cost reductions, it says. Still, researchers say there are obstacles that could hamper health insurers' ability to become data partners with providers and other stakeholders, including: -- Lack of trust between insurers and providers. In some cases, they don't even trust the quality of each other's data. -- Insufficient funding. Forty-three percent of providers surveyed by HRI said lack of funding was an organizational barrier in developing informatics programs. -- Absence of technology and business tools for personalized care. The industry is moving away from individual care, which uses medical claims data to provide targeted single services, to personalized care, which aims to integrate the member's unique clinical, social, genetic, and environmental information to maximize overall health. The industry has yet to build technology required to support this level of advanced knowledge and scale it operationally. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-18T13:35:00ZHealth Information Exchanges Struggle To Prove ROITo survive, HIEs need to implement performance metrics to show they can improve quality of care and reduce costs.http://www.informationweek.com/news/240007531?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"> <a href="http://www.informationweek.com/news/galleries/healthcare/interoperabil ity/240001675"><img src="http://twimgs.com/informationweek/galleries/automated/805/Maine_Healath _infonet_tn.jpg" alt="8 Health Information Exchanges Lead The Way" title="8 Health Information Exchanges Lead The Way" class="img175" /></a> <div class="storyImageTitle">8 Health Information Exchanges Lead The Way</div> (click image for larger for slideshow) </div> To convince investors that health information exchanges (HIEs) are a worthwhile investment, organizers need to develop performance metrics that show HIEs can improve quality of care and generate a return on investment (ROI). A study published in the latest issue of <a href="http://perspectives.ahima.org/index.php?option=com_content&view=article&id=256:health-information-exchange-metrics-to-address-quality-of-care-and-return-on-investment&catid=43:him-operations">Perspectives in Health Information Management</a>, however, reveals that only 50% of surveyed HIE executives say they use or plan to use metrics to measure the impact of their exchange. Amid doubts about the <a href="http://www.informationweek.com/healthcare/interoperability/health-information-exchanges-need-a-bett/231700227">sustainability of HIEs</a>, the results of the survey are disconcerting, lead author, Anjum Khurshid, director of the health systems division at the Louisiana Public Health Institute, and his colleagues conclude, because without incorporating quality of care and ROI metrics into their business model, many HIEs may not survive. "The transformational changes that HIEs promise come much later and require trust, evidence-based approaches, perseverance, and collaboration among all healthcare stakeholders. It would be disappointing if the already high rate of HIE failures increased in the next few years as federal funds are exhausted," the report stated. Bill Rudman, executive director at the <a href="http://www.ahimafoundation.org/">American Health Information Management Association (AHIMA) Foundation</a>, told InformationWeek Healthcare that the report is a wake-up call for healthcare stakeholders. [ Looking for a PACS platform to replace an outdated system? See <a href="http://www.informationweek.com/healthcare/clinical-systems/9-must-see-picture-archivingcommunicatio/240006960?itc=edit_in_body_cross">9 Must-See Picture Archiving/Communication Systems</a>. ] "I absolutely think it's irresponsible for healthcare provider organizations and leaders not to develop and utilize outcome metrics to measure the efficacy and efficiency of the health information exchange," Rudman said. The report's authors note that HIEs are a key part of the Nationwide Health Information Network (NHIN) infrastructure that will electronically exchange patient data among providers in different locations. To help HIEs along, approximately $2 billion from the HITECH Act will go toward the development of HIE infrastructure and services. To help NHIN succeed, state, regional, and local HIEs must develop an effective business model that financially supports HIEs well into the future, long after these exchanges stop receiving government funds. "This means that to convert the stimulus funding into a transformational long-term regional strategy, a case has to be made to private-sector, local, and regional stakeholders to invest in HIE initiatives. While most experts agree with the transformational potential of HIEs to support a system that delivers coordinated, affordable, and quality healthcare services, we lack robust empirical evidence of HIEs improving quality of care and providing value to patients and to participating entities," the report said. Researchers sought to find out how many fully functional <a href="http://www.informationweek.com/healthcare/clinical-systems/how-one-health-information-exchange-cut/231600512">HIEs</a> are using metrics to gauge the impact of HIEs on quality improvement and ROI. With that goal in mind, they identified 96 fully operational exchanges across the country that are transmitting data used by healthcare stakeholders, and that also have sustainable business models. Responses were received from 21 organizations, of which 18 HIEs met the survey criteria of actually exchanging data as of January 1, 2010. Among the key findings for the 18 HIEs: -- Fifty percent of the HIEs reported using metrics for quality improvement. Of these, most organizations tracked quality improvement in a number of different areas related to clinical outcomes and some preventive measures, including readmissions, vaccination rates, diabetes management, and cancer screening. -- More than half of the organizations have used or plan to see reduction in duplicative tests or procedures, improved communication among providers, and improved health outcomes to measure the impact on ROI. Thirty-nine percent of respondents listed specific metrics currently being used to determine ROI. Forty percent of the organizations that were using some ROI metrics also believed more evidence was needed to show a positive impact of HIEs. -- Ten respondents (56%) said that based on the performance of their own HIE, they believed that HIEs show positive ROI, while eight respondents (44%) felt more evidence was needed to make such a determination. Two respondents who believed HIEs show positive ROI stated that they have not used metrics to calculate ROI but are in the process of developing ROI metrics. Seventeen respondents (94%) believed that HIEs improve quality of care. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-17T09:00:00ZFederal Money Boosts IT Investment In Insurance ExchangesMany states will use their portion of the $765 million grant to grow the IT capabilities of their health insurance exchanges.http://www.informationweek.com/news/240007356?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/leadership/iw-500-10-healthcare-it-innovators/240006527"><img src="http://twimgs.com/informationweek/galleries/automated/859/01_dreamstime_tn.jpg" alt="IW 500: 10 Healthcare IT Innovators" title="IW 500: 10 Healthcare IT Innovators" class="img175" /></a> <div class="storyImageTitle">IW 500: 10 Healthcare IT Innovators</div> (click image for larger view and for slideshow)</div>The Department of Health and Human Services (HHS) <a href="http://www.hhs.gov/news/press/2012pres/08/20120823a.html">announced</a> that California, Connecticut, Hawaii, Iowa, Maryland, Nevada, New York, and Vermont received in total more than $765 million in new grants to support the establishment of state health insurance exchanges. These grants give states additional resources and flexibility to invest in technology services and skills that they need to establish online exchanges, which must be operational by Jan. 1, 2014. The <a href="http://www.informationweek.com/healthcare/policy/web-based-insurance-exchanges-attract-1/240000731">federal government</a> has already provided more than $1 billion to assist with state insurance exchange development. Developing <a href=" http://www.informationweek.com/healthcare/admin-systems/minnesota-taps-ibm-for-health-insurance/240004532">state exchange websites</a> presents complex technological considerations as the exchanges aggregate data from federal and state agencies as well as from health plans, consumers, and employers, noted Janice Young, program director for analyst firm IDC's health research. "Building state insurance exchanges is one of the most significant new initiatives in healthcare insurance in recent decades. Exchanges support entirely new programs, processes, customers, information and data, much of which has yet to be clarified," Young said. "The integration issues can't be understated because a lot of information, including eligibility and financial data, needs to be available as individuals participate in these programs." Several states have outlined how they intend to use their funds to bolster their technological capabilities. Iowa, for example, will use its $27 million grant to conduct focus groups and stakeholder outreach regarding user interface design and program development, and continue to plan and develop an integrated, automated eligibility system. [ Looking for a PACS platform to replace an outdated system? See <a href="http://www.informationweek.com/healthcare/clinical-systems/9-must-see-picture-archivingcommunicatio/240006960?itc=edit_in_body_cross"> 9 Must-See Picture Archiving/Communication Systems</a>. ] The resulting Iowa Health Benefit Exchange (IHBE) will offer one-stop shopping both for individuals and employers looking to purchase and enroll in healthcare plans. Specifically, Iowa will use its grant money to: -- Redesign the current database and Web application to develop an intuitive website for residents and businesses. -- Implement an enterprise service bus, a software model used for interacting between software applications. -- Integrate the eligibility system into the state's system for Medicaid and Children's Health Insurance Program. -- Integrate the eligibility system into the IHBE to facilitate the determination of Medicaid and CHIP eligibility, as well as tax credit subsidies or other eligibility for qualified health plan participation. -- Further automate eligibility business processes and incorporate expanding populations into online enrollment. New York will use its $95 million grant to hire executive leadership that will work toward developing the exchange in several areas. The state expects to: -- Further improve the IT systems needed to operate the exchange -- Continue work to establish New York's All Payer Claims Database and develop the back-end operations of the exchange call center to provide customer support and other consumer assistance activities. -- Design a campaign to educate prospective users in preparation for open enrollment in October. Vermont will use the $104 million it is receiving mainly to develop IT systems that can run its state exchange and ensure interoperability with other state healthcare systems built as part of the greater eligibility modernization project. It will hire additional IT staff, implement an outreach and training program, and review its organizational structure to make sure the enrollment process is easy both for consumers and employers. According to the HHS, California, Hawaii, Iowa, and New York were awarded Level One Exchange Establishment grants, which provide one year of funding to states that have begun the process of building their exchange. Connecticut, Maryland, Nevada, and Vermont were awarded Level Two Establishment grants, which HHS awards to states that are further along in building their exchanges. These grants provide funding over multiple years. Through state exchanges, consumers are able to apply for health insurance online and learn if they are eligible for tax credits, cost-sharing reductions, or other healthcare programs such as the Children's Health Insurance Program. Small businesses become eligible to receive tax credits for coverage purchased for employees through the exchange. These competitive marketplaces make purchasing health insurance easier and more understandable and offer consumers and small businesses the benefits of increased competition and choice. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-12T14:00:00ZProviders Seek Consulting Firms For Smaller EHR ProjectsWith EHR installation a done deal, many health providers look to consulting firms for smaller Meaningful Use projects, KLAS study shows. http://www.informationweek.com/news/240007215?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/clinical-systems/9-must-see-picture-archivingcommunicatio/240006960"><img src="http://twimgs.com/informationweek/galleries/automated/864/01a_Agfa2_tn.jpg" alt="9 Must-See Picture Archiving/Communication Systems" title="9 Must-See Picture Archiving/Communication Systems" class="img175" /></a> <div class="storyImageTitle">9 Must-See Picture Archiving/Communication Systems</div> (click image for larger view and for slideshow)</div>  Healthcare organizations seeking to meet Meaningful Use Stage 1 requirements are much less inclined to hire consulting firms to fully install an electronic health record (EHR) and more likely to turn to these firms to help with smaller projects that enhance the features and functionality of their EHRs, a new KLAS report reveals. <a href="http://www.klasresearch.com/KLASReports/?ProductID=732&PR_MUC">Rapid Growth of Meaningful Use Consulting: Why Providers Are Reaching Out</a> examines the performance of third-party firms during the last two years. These firms are involved in preparing providers to attest to Meaningful Use Stage 1 requirements, which health providers must meet before they can qualify to receive payments under the federal EHR Incentive Programs. The report identified 51 firms that have conducted at least one Meaningful Use related project, offering a variety of services. The research shows, for instance, that in 2010 there were 40 large EHR installation projects that consulting firms were engaged in, which rose to 63 projects in 2012. By comparison, smaller projects, including adding functionality to EHRs or providing additional IT staff, moved from 33 engagements in 2010 to 147 in 2012. According to the report, providers who thought they could implement an EHR on their own have found themselves to be "overstretched and overwhelmed and are scrambling for third-party assistance." However, the type of consulting work being sought by providers is changing. And fewer sales of EHR systems convey only part of the story, said Erik Westerlind, KLAS analyst and author of the report, in an interview with InformationWeek Healthcare. [ What is the role of EHRs in clinical research? Read <a href="http://www.informationweek.com/healthcare/clinical-systems/health-its-next-big-challenge-comparativ/240005790?itc=edit_in_body_cross">Health IT's next challenge: Comparative Effectiveness Research</a>. ] The report identified four areas that providers say present the greatest challenge to their efforts to attest for Meaningful Use Stage 1: --Quality measures and reporting --User adoption, which consists of go-live support, training, computerized physician order entry (CPOE) assistance, and clinical transformation --Software upgrades --Understanding Meaningful Use requirements, which involves using a consulting firm's advisory services. The data also revealed that only two firms--<a href="http://www.deloitte.com/view/en_US/us/index.htm">Deloitte</a> and Impact Advisors--are seeing increases in the number of engagements since 2010. The report notes that this is primarily due to their focus on Epic implementations, the EHR vendor that continues to dominate new EHR sales. All other firms, including Dell Services, CSC, Accenture, CTG, and Xerox, have seen a decrease in the number of large EHR implementations since 2010, and in the case of IBM and Coastal, these firms have "virtually disappeared from the market," according to the report. The top-rated companies competing for smaller EHR-related projects include Cumberland, Innovative Healthcare Solutions, and Peer Consulting Dearborn. These firms offer mainly advisory support, as well as significant implementation expertise. The research cited Navin, Haffty & Associates, ESD, and Beacon Partners as the top three firms offering staff augmentation support. KLAS researchers predict that providers will continue to rely on third-party firms to help them navigate the rules and regulations of <a href=" http://www.informationweek.com/healthcare/policy/meaningful-use-stage-2-are-you-ready/240006670">Meaningful Use Stage 2</a> and beyond, which will require more detailed reporting requirements, greater interoperability between systems, and more internal collaboration. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-11T12:07:00ZIT Critical To New Health Learning SystemU.S. healthcare system needs to transform itself into a "continuous learning machine" that uses technology to provide doctors with timely information, says Institute of Medicine report.http://www.informationweek.com/news/240007100?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/policy/240005118"><img src="http://twimgs.com/informationweek/galleries/automated/848/SS_ACO_dreamstime_01_tn.jpg" alt="8 Accountable Care Organizations Worth Closer Examination" title="8 Accountable Care Organizations Worth Closer Examination" class="img175" /></a> <div class="storyImageTitle">8 Accountable Care Organizations Worth Closer Examination</div> (click image for larger view and for slideshow)</div>For America to consistently deliver reliable performance and improve patient outcomes, providers must apply computing capabilities and analytical tools that allow clinicians to share real-time insights from routine patient care. In short, the entire U.S. healthcare system must transform itself into a continuous learning machine that drives efficiency and curbs costs, a new study released by the Institute of Medicine (IOM) concludes. <a href="http://iom.edu/Reports/2012/Best-Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America.aspx">Best Care at Lower Cost: The Path to Continuously Learning Health Care in America</a> says the healthcare industry, unlike the banking, airline, and auto industries, lags far behind in its ability to establish the practices and procedures that raise its performance level. Furthermore, the report said the industry has not done enough to provide patients and clinicians with timely, relevant, and useful information, and added that inefficiencies in healthcare have cost the nation in lives and treasure. "If the care in every state were of the quality delivered by the highest-performing state, an estimated 75,000 fewer deaths would have occurred across the country in 2005. Current waste diverts resources from productive use, resulting in an estimated $750 billion loss in 2009," says the report. [ For another point of view on PHRs, see <a href="http://www.informationweek.com/news/healthcare/patient/232400272 ?itc=edit_in_body_cross">Why Personal Health Records Have Flopped</a>. ] The report urges healthcare leaders to structure incentives to reward the best outcomes for patients and suggests that a cultural change needs to occur in which health organizations are continuously learning from the transfer of knowledge at every patient interaction. This will require "systematic problem solving; the application of systems engineering techniques; operational models that encourage and reward sustained quality and improved patient outcomes; <a href="http://www.informationweek.com/healthcare/leadership/acos-need-better-data-transparency-manag/232901612">transparency</a> on cost and outcomes; and strong leadership and governance that define, disseminate, and support a vision of continuous improvement," the report asserts. According to Dr. Paul Tang, VP and chief innovation and technology officer at Palo Alto Medical Foundation, "We are not tying our information systems to the full extent [they] could be used to generate real knowledge and to make sure that new knowledge is applied." Tang also serves on the IOM's Committee on the Learning Health Care System in America, which produced the report. The report recognizes the opportunities that mobile technologies and EHRs offer in capturing and exchanging data among healthcare providers and urges the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations to develop robust and <a href="http://www.informationweek.com/healthcare/interoperability/ehr-interoperability-key-for-meaningful/240006244">interoperable systems</a>. The report also suggests that initiatives be developed to encourage patients to become more actively engaged in their care by adopting technology tools such as <a href="http://www.informationweek.com/healthcare/patient/cancer-care-portal-connects-docs-to-pati/240006937">personal health information portals</a>. Along with the report, IOM published several recommendations, including: -- Improve the capacity to capture clinical, care delivery process, and financial data. -- Accelerate integration of the best clinical knowledge into care decisions. -- Promote community-clinical partnerships and services aimed at managing and improving health at the community level. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-07T12:49:00ZCancer Care Portal Connects Docs To PatientsOncologists can use the tool to help meet Meaningful Use regulations on patient engagement.http://www.informationweek.com/news/240006937?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"> <a href="http://www.informationweek.com/news/galleries/healthcare/patient/232901341"><img src="http://twimgs.com/informationweek/galleries/automated/790/01_NYPPortal_tn.jpg" alt="9 Health IT Tools Patients Should Understand" title="9 Health IT Tools Patients Should Understand" class="img175" /></a> <div class="storyImageTitle">9 Health IT Tools Patients Should Understand</div> (click image for larger view and for slideshow)</div>  Oncologists are looking for ways to meet Meaningful Use requirements that call for them to facilitate patients' access to their medical information online. <a href="https://www.navigatingcancer.com/">Navigating Cancer</a> has announced a tool to help accomplish that goal. Its patient portal has signed up more than 500 oncology providers across the country, enabling them to provide a more coordinated, patient-centered approach to care. At the same time, the Seattle-based company's product, the Patient Engagement Portal, will help patients build their own online personal health records (PHRs) to manage their care and access medical information from their providers. Company officials said Navigating Cancer hit the milestone of <a href="http://www.prnewswire.com/news-releases/500-oncology-providers-sign-up-for-navigating-cancers-patient-engagement-portal-168447546.html">adding 500 oncology providers</a> to the patient portal in mid-August and has signed up several large practices including Advanced Medical Specialties in Miami, Michiana Hematology Oncology in Northern Indiana, and the Center for Cancer and Blood Disorders in Fort Worth, Texas. [ Wearable devices equipped with sensors and Web connections help consumers track health and fitness. Take a look at what's possible now. <a href="http://www.informationweek.com/news/galleries/healthcare/mobile-wireless/240000353?itc=edit_in_body_cross">10 Wearable Devices To Keep Patients Healthy</a>. ] Navigating Cancer CEO Gena Cook said the company began offering its cloud-based and electronic health record (EHR)-agnostic patient portal to oncologists two years ago, and currently there are 20,000 patients and around 200 oncology providers using the system. Cook expects that number to grow as practices that have recently signed on begin to integrate their EHRs with the Patient Engagement Portal tool. Through the system, new patients are invited electronically to register via their clinic's website prior to their first appointment. Once they've signed up and logged into the system, patients can enter their name, their medication list, their insurance information, and all relevant information from home before the doctor's visit. For patients scheduled for a return visit, the system allows them to update any changes to their condition that might have occurred between visits, such as information about how they felt during the course of a treatment or new medication prescribed by another doctor. The system allows oncologists to add information such as lab results, diagnosis, and references to resource materials for the patients' <a href="http://www.informationweek.com/healthcare/patient/interactive-phrs-make-patients-more-proa/240003784">PHRs</a>. Cook stressed that oncologists will manage each patient's complete medical record stored in their office EHR; that won't be posted on the cloud. "What we are trying to do is help physicians adhere to the standards outlined in the American College of Surgeons 2012 Commission on Cancer report and the requirements for patient-centered medical home and Accountable Care Organization models of care," Cook said. "We are also preparing patients and physicians to meet Meaningful Use stage 2 requirements that call for greater electronic exchange of health information between a physician and their patients." The recently released final rules for <a href="http://www.informationweek.com/healthcare/policy/meaningful-use-stage-2-are-you-ready/240006670">Meaningful Use stage 2</a> call for physicians applying for EHR incentive payments to provide patients with electronic copies of their health information so that patients can view, download, and transmit their health information online. Stage 2 also requires that more than 5% of patients send secure messages to their healthcare provider. As these requirements put more pressure on healthcare providers to offer PHRs to their patients, Nancy Fabozzi, principal analyst at Frost & Sullivan, said disease-specific patient engagement tools like the patient portal being offered by Navigating Cancer can motivate patients to establish and continually use a PHR. "There needs to be a reason [to open a PHR] and that reason usually pertains to the need to manage a specific chronic or acute health condition," Fabozzi said. "For patients, cancer is clearly one of the most difficult conditions to manage in terms of understanding various treatment options, coordinating appointments with various providers, tracking treatments and medications, and keeping up with the latest research." InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-06T15:16:00ZEHRs May Shortchange Depression PatientsElectronic health records may focus a doctor's attention on certain medical conditions, leading to undertreatment for depression, researchers suggest.http://www.informationweek.com/news/240006895?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"> <a href="http://www.informationweek.com/news/galleries/healthcare/EMR/232300279"><img src="http://twimgs.com/informationweek/galleries/automated/700/01_Allscripts_RemoteforHDM_175.jpg" alt="12 EHR Vendors That Stand Out" title="12 EHR Vendors That Stand Out" class="img175" /></a> <div class="storyImageTitle">12 EHR Vendors That Stand Out</div> (click image for larger view and for slideshow)</div>  Patients with three or more chronic conditions are half as likely to receive treatment for their depression during a visit to a doctor's office that uses electronic health records (EHRs) when compared with patients who visited paper-based practices. At least that's the conclusion of an investigation recently published in the Journal of General Internal Medicine. The <a href="http://link.springer.com/article/10.1007%2Fs11606-012-2001-0">study</a>, conducted by researchers at the University of Florida and the University of South Florida, analyzed the odds of receiving treatment for depression during a doctor's visit by examining data from the National Ambulatory Medical Care Surveys (NAMCS) of 3,467 physician office visits by patients from 2006 to 2008. Researchers focused on visits to primary care providers by patients ages 18 and older with physician-identified depression. The 3,467 visits were divided into two groups: 2,584 visits to practices without EHRs, and 883 visits to practices with EHRs. The EHRs showed that patients were receiving either mental health counseling or one or more antidepressants, such as amitriptyline, amoxapine, and bupropion. The study revealed that 1,092 patients had one chronic condition, 916 had two, and 1,459 had three or more chronic conditions, including arthritis, asthma, cancer, and congestive heart failure. [ Practice management software keeps the medical office running smoothly. For a closer look at KLAS' top-ranked systems, see <a href="http://www.informationweek.com/news/galleries/healthcare/admin-systems/232602435?itc=edit_in_body_cross"> 10 Top Medical Practice Management Software Systems</a>. ] The report found that for patients with three or more chronic conditions, EHRs "appear to have an unintended negative association with depression care provided during visits made by primary care patients with multiple chronic conditions." On the other hand, researchers also found that patients with depression combined with two or fewer chronic conditions who visited a <a href="http://www.informationweek.com/healthcare/electronic-medical-records/ehr-adoption-grows-as-docs-bid-for-incen/240006440">physician with an EHR</a> had the same probability of being treated for depression as those patients whose physician practice operated without an EHR. Dr. Jeffrey Harman and his colleagues can't explain why patients who have three or more chronic conditions and visited a physician using an EHR were significantly less likely to be treated for their depression, but in an interview with InformationWeek Healthcare, he said that the study does offer a warning for EHR-enabled physicians. "The study suggests two things ... when physicians are working with an EHR they may end up being engaged with the computer instead of the patient," Harman said. "Second, EHRs are often designed to focus physicians' attention on biomedical conditions, and the more medical conditions that exist, the greater the attention is toward addressing, for example, diabetes, high blood pressure, or congestive heart failure" rather than depression. According to Harman, whatever the underlying cause, <a href="http://www.informationweek.com/healthcare/electronic-medical-records/ehr-innovation-gap-threatens-healthcare/240002283">EHR vendors</a> need to address how they design these systems in the future. "EHRs are tools meant to assist physicians in the delivery of care and to improve patient outcomes," Harman said. "Primary care physicians only have about 15 minutes per patient. Therefore vendors need to think about workflow--how the physician works with these computers, and how to make EHRs easier to access and enter information related to mental illness and other chronic conditions." InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-04T13:24:00ZWearable Medical Technology Set To Take OffMobile health devices that monitor vital signs will become more standard, pushing market to $6 billion by 2016, says IMS Research.http://www.informationweek.com/news/240006647?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"> <a href="http://www.informationweek.com/news/galleries/healthcare/mobile-wireless/240000353"><img src="http://twimgs.com/informationweek/galleries/automated/796/01_Intro_full.jpg" alt="10 Wearable Devices To Keep Patients Healthy" title="10 Wearable Devices To Keep Patients Healthy" class="img175" /></a> <div class="storyImageTitle">10 Wearable Devices To Keep Patients Healthy</div> (click image for larger view and for slideshow)</div>  Mobile health devices that track vital signs are ready to take off, IMS Research predicts. According to a report on wearable technology, which includes devices such as glucose and heart monitors, the market was worth $2 billion in 2011 and will reach $6 billion by 2016. Correspondingly, 14 million wearable devices were shipped in 2011, and that number will likely rise to 171 million in 2016. <a href="http://imsresearch.com/press-release/Wearable_Technology_Market_to_Exceed_6_Billion_by_2016">World Market for Wearable Technology--A Quantitative Market Assessment--2012</a> examines wearable electronic devices used in professional and consumer environments. IMS Research defines these devices as products that are worn on the user's body for an extended period of time and that contain advanced circuitry, wireless connectivity, and can process data. According to the report, several shifts in the market will occur during the next four years that will increase demand for these products among patients as well as healthy individuals. As baby boomers age, they'll become a primary market for health devices such as blood pressure and glucose monitors that upload up-to-date information to caregivers. Researchers also found that in 2011, glucose monitors accounted for most of the revenue in the health device segment of the market, reflecting the need for continuous data on blood glucose levels, particularly in Type I diabetes patients. The dominant wearable products in this category include continuous glucose monitors from Abbott and Medtronic. [ There's almost no end to the amount of useful medical information available online. For seven valuable resources, see <a href="http://www.informationweek.com/news/galleries/healthcare/patient/231903173?itc=edit_in_body_cross"> 7 Health Education Tools For Patients</a>. ] Activity monitors from <a href="http://www.fitbit.com/product">Fitbit</a>, <a href="http://www.adidas.com/us/micoach/">Adidas miCoach</a>, and <a href="http://store.nike.com/us/en_us/?l=shop,fuelband&cp=USNS_KW_0611081618">Nike Fuelband</a> are also popular with consumers, as are fitness and heart-rate monitors such as those from Garmin, Polar, and Suunto. Wearable technology helps clinicians work more efficiently and extend care outside the hospital environment. When clinicians can collect information on patients anywhere and anytime, the increased knowledge can lead to earlier detection of problems, preventing readmission and resulting in better clinical outcomes, Theo Ahadome, senior analyst at IMS Research, said in an interview with InformationWeek Healthcare. "This will decrease the cost of healthcare in the long run," Ahadome predicts. "However, these benefits will need to be clearly proven in order for providers to adopt them and for payers to pay for them." Another consideration is the deluge of data that these devices generate. For payers and providers, while these devices give better insights on a patient's medical condition, more data brings greater risk of data breaches and more responsibility to implement tighter security and access controls. In addition to tighter data security, Ahadome foresees a change in clinical workflow as providers seek to accommodate a new way of tracking patients' health. "Physicians need this data to be integrated into their IT systems, and [they] will have to change their workflow to accept and use this external data," Ahadome said. "There will be internal resistance from physicians who are used to standard patient visits. In the long run, once these issues are dealt with, it will lead to greater competition in the hospital and payer markets as patients begin to seek out those health organizations that deploy extended systems of care incorporating wearable technology." InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-09-04T13:15:00ZMeaningful Use Stage 2: Are You Ready?Final stage 2 MU rule offers healthcare providers some compromises and EHR tweaks, and also requires greater patient engagement.http://www.informationweek.com/news/240006670?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/policy/240005118"><img src="http://twimgs.com/informationweek/galleries/automated/848/SS_ACO_dreamstime_01_tn.jpg" alt="8 Accountable Care Organizations Worth Closer Examination" title="8 Accountable Care Organizations Worth Closer Examination" class="img175" /></a> <div class="storyImageTitle">8 Accountable Care Organizations Worth Closer Examination</div> (click image for larger view and for slideshow)</div>  Under the Meaningful Use stage 2 final rule, eligible professionals (EPs) working in a hospital can apply for incentive payments if they can demonstrate that they've acquired a certified electronic health record (EHR), and are using it in lieu of the hospital's EHR. To qualify, EPs must show that they implemented the EHR and maintain the system, including supporting hardware and interfaces needed to achieve meaningful use, without receiving reimbursements from the hospital. "We know that there are EPs who work within certain areas or unit of hospitals--for example, neonatal care--but use entirely separate systems, and this application process will allow those EPs to ask for a redetermination of their hospital-based status based on those factors," a spokesman for the Centers for Medicare & Medicaid Services (CMS) told InformationWeek Healthcare. Expanding the criteria for EPs to apply for incentive payments is one of the many changes incorporated into the <a href="http://www.ofr.gov/(X(1)S(bu4homm0jme3rdlfa1vumenp))/OFRUpload/OFRData/2012-21050_PI.pdf">Meaningful Use stage 2 final rule</a>, a 672-page document recently published by CMS. Many of the changes address real-world concerns that healthcare providers face as they prepare their systems to meet Meaningful Use criteria, said Dr. Farzad Mostashari, National Coordinator for Health IT at the Office of the National Coordinator for Health Information Technology. [ For more on Meaningful Use stage 2, see <a href=" http://www.informationweek.com/healthcare/policy/meaningful-use-stage-2-rules-finalized/240006128?itc=edit_in_body_cross">Meaningful Use Stage 2 Rules Finalized</a>. ] "What you will see [in the stage 2 final rule] is some compromises frankly between the aspirational goals and the realities of where the market is and the pressures on providers and vendors in terms of timeline," Mostashari said during a webcast August 24 hosted by the National eHealth Collaborative. Extending the timeline to meet Meaningful Use stage 1 deadlines is one area of compromise. In the stage 1 Meaningful Use regulations, CMS established a timeline that required providers to progress to stage 2 criteria after completing two years in the incentive program. This original timeline would have required Medicare providers who first demonstrated Meaningful Use in 2011 to meet the stage 2 criteria in 2013. However, CMS pushed back the timeline by one year. The earliest that the stage 2 criteria will be effective is fiscal year 2014 for eligible hospitals and critical access hospitals (CAH), or calendar year 2014 for EPs. Hospitals and physicians must also keep in mind that many of the stage 1 requirements that have been carried forward to stage 2 have a concomitant rise in threshold levels, according to Rob Anthony, a health specialist in the Office of eHealth Standards and Services at CMS. Explaining the new requirements during the webcast, Anthony said health providers must show that more than 50% of prescriptions are completed through electronic prescribing, up from the stage 1 threshold of 40%. Reporting of demographic information, vital signs, and smoking status has moved from 50% in stage 1 to more than 80% in stage 2. CMS also raised the requirement for reporting instances of clinical decision support and intervention from one to five. These interventions include reporting on drug-to-drug interactions and drug allergy interaction alerts. Turning to clinical quality measure (CQM) reporting in stage 2, beginning in 2014 EPs must report on nine out of 64 total CQMs, and eligible hospitals and CAHs must report on 16 out of 29 total CQMs. In addition, all providers must select CQMs from at least three of the six key healthcare policy domains recommended by the Department of Health and Human Services' National Quality Strategy. These are: 1. Patient and Family Engagement; 2. Patient Safety; 3. Care Coordination; 4. Population and Public Health; 5. Efficient Use of Healthcare Resources; and 6. Clinical Processes/Effectiveness. Stage 2 will also focus more intensely on facilitating patients' access to their records, and replaces stage 1 objectives that call for clinicians to provide electronic copies of health information or discharge instructions, with the stage 2 objectives that allow patients to access their health information online. For EPs, stage 2 requires that patients have the ability to view online, download, and transmit their health information within four business days of the information being available to the EP. Eligible hospitals and CAHs are required to provide patients the ability to view online, download, and transmit their health information within 36 hours after discharge from the hospital. Patients must also do their part in stage 2, which calls for more than 5% of patients to send secure messages to their EP, and more than 5% of patients to access their health information online. CMS is introducing exclusions based on broadband availability in the provider's county. Stage 2 also facilitates batch reporting. Starting in 2014, groups can submit attestation information for all of their individual EPs in one file for upload to the attestation system, rather than having each EP individually enter data. In the stage 2 criteria, the feds emphasized the need to exchange health information between providers to <a href="http://www.informationweek.com/healthcare/electronic-medical-records/hospitals-look-to-ehrs-to-reduce-readmis/240005621">improve care coordination</a> for patients. One of the core objectives requires EPs, eligible hospitals, and CAHs who transition or refer a patient to another care setting or provider to furnish a summary of care record for more than 50% of those transitions of care and referrals. Additionally, there are new requirements for the electronic exchange of summary of care documents: EPs, eligible hospitals, and CAHs that transition or refer their patient to another care setting or provider must electronically provide a summary of care record for more than 10% of transitions and referrals. The EP, eligible hospital, or CAH that transitions or refers a patient to another care setting or provider must either: a) conduct one or more successful electronic exchanges of a summary of care record with a recipient using technology that was designed by a <a href="http://www.informationweek.com/healthcare/interoperability/ehr-interoperability-key-for-meaningful/240006244">different EHR developer</a> than the sender's, or b) conduct one or more successful tests with the CMS-designated test EHR during the EHR reporting period. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-08-31T12:45:00ZEHRs Feed Clinical Research MachineOne-million-patient study provides further evidence that EHRs and analytics tools can advance clinical research.http://www.informationweek.com/news/240006570?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/policy/240005118"><img src="http://twimgs.com/informationweek/galleries/automated/848/SS_ACO_dreamstime_01_tn.jpg" alt="8 Accountable Care Organizations Worth Closer Examination" title="8 Accountable Care Organizations Worth Closer Examination" class="img175" /></a> <div class="storyImageTitle">8 Accountable Care Organizations Worth Closer Examination</div> (click image for larger view and for slideshow)</div>  A major medical study that used EHR data to comb through the clinical records of nearly one million patients shows that advanced technology can have a significant impact on clinical research. <a href="http://jamia.bmj.com/content/early/2012/07/01/amiajnl-2011-000782.abstract?sid=ca4ab6ad-4ff3-4ade-9213-ecf6f36f819b">The study</a>, which was recently published in the online edition of the Journal of the American Medical Informatics Association, involved a team of data experts at MetroHealth Medical Center and <a href="http://www.explorys.com/">Explorys Inc.</a>, a Cleveland Clinic spinoff company that provides a health data analytics platform. The study tried to find out whether height and/or weight can make a person more susceptible to blood clots in the lung or leg. Using the Explorys tool, which standardized the data and de-identified patient information, researchers analyzed the clinical records of 959,030 patients, pooled from multiple healthcare organizations that use different <a href="http://www.informationweek.com/healthcare/interoperability/ehr-interoperability-key-for-meaningful/240006244">EHR systems</a>. Researchers examined the records of patients 26 years or older, going as far back as 1999. The study found that a combination of obesity and height significantly increases the risk of blood clots. In fact, tall obese women were twice as likely to suffer from a blood clot in the lung or leg as shorter women of normal weight. Similarly, tall obese men are 20% more likely to get a blood clot than shorter men of normal weight. [ To read about the role of EHRs in clinical research, see <a href="http://www.informationweek.com/healthcare/clinical-systems/health-its-next-big-challenge-comparativ/240005790?itc=edit_in_body_cross"> Health IT's next challenge: Comparative Effectiveness Research</a>. ] With regard to the racial makeup of patients, the study revealed that Hispanic women are about 50% less likely than white women to contract a blood clot. African-American women, the research shows, were twice as likely to develop a blood clot as white women. In the male group, Hispanic men were about 20% less likely to get a blood clot than white men. However, black males have a 50% greater chance of contracting a blood clot compared to their white counterparts. Unlike previous studies that have spent months or even years to complete research of this magnitude, the MetroHealth/Explorys data analysis took 11 weeks and involved only five people working part time, with no direct costs. "With the right clinical research informatics tools and EHR data, some types of very large cohort studies can be completed with minimal resources," the study states. "This is a paradigm shift that can now occur for certain types of clinical research because we have all of this electronic data and we are starting to develop the tools to aggregate and analyze the data," said Dr. David Kaelber, chief medical informatics officer at MetroHealth. "This is a one-million-patient study--just imagine the resources that would be needed if we were going to try to recruit one million patients to a study and follow them for 13 years." Kaelber, who is the lead author of the report, also said researchers can take advantage of analytics tools to circumvent the thorny issue of data privacy by de-identifying the data to make sure the information contains none of the privacy information that is protected by the Health Insurance Portability and Accountability Act. As a result, researchers do not need to go through the time-consuming human subjects' approval process with their institutions. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-08-27T11:53:00ZEHR Interoperability Key For Meaningful Use Stage 2Farzad Mostashari, national coordinator for health information technology, stresses EHR-to-EHR communication in webcast.http://www.informationweek.com/news/240006244?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/policy/240005118"><img src="http://twimgs.com/informationweek/galleries/automated/848/SS_ACO_dreamstime_01_tn.jpg" alt="8 Accountable Care Organizations Worth Closer Examination" title="8 Accountable Care Organizations Worth Closer Examination" class="img175" /></a> <div class="storyImageTitle">8 Accountable Care Organizations Worth Closer Examination</div> (click image for larger view and for slideshow)</div>Interoperability between different electronic health record (EHR) systems is one of the most important requirements that hospitals and physicians must meet as they prepare their systems for attestation in Meaningful Use Stage 2, Dr. Farzad Mostashari, the national coordinator for health information technology, said Friday. Sharing his assessment of the <a href=" http://www.ofr.gov/(X(1)S(bu4homm0jme3rdlfa1vumenp))/OFRUpload/OFRData/2012-21050_PI.pdf">Meaningful Use Stage 2 Final Rule</a>, which was published Thursday, Mostashari said the goal of a national health IT system is to make sure "information follows the patient regardless of geographic, organizational, or vendor boundaries." He also emphasized that there has to be at least one instance in which providers exchange an electronic summary of care with all the clinical data elements between different EHRs. Speaking during a webcast hosted by the National eHealth Collaborative, Mostashari read a section in the final rule that illustrates the importance of interoperability between EHRs: "We continue to believe that making vendor-to-vendor standards-based exchange attainable for all meaningful EHR users is of paramount importance. In that regard, and as we look toward meaningful use Stage 3, we will monitor the ease with which EPs [eligible professionals], eligible hospitals, and CAHs [critical access hospitals] engage in electronic exchange, especially across different vendors EHRs." The document continues: "If we do not see sufficient progress or that continued impediments exist such that our policy goals for standards-based exchange are not being met, we will revisit these more specific measurement limitations and consider other policies to strengthen the interoperability requirements..." Mostashari went on to emphasize, "I want there to be no question about the seriousness of our intent on this issue. [The] bottom line is it's what's right for the patient and it's what we have to do as a country to get to better healthcare and lower costs." [ Practice management software keeps the medical office running smoothly. For a closer look at KLAS' top-ranked systems, see <a href="http://www.informationweek.com/news/galleries/healthcare/admin-systems/232602435?itc=edit_in_body_cross"> 10 Top Medical Practice Management Software Systems.</a> ] To help health providers working in environments that have a high concentration of one particular vendor's EHR, or others who work in areas where there might be low adoption of EHRs, Rob Anthony, a health specialist in the Office of eHealth Standards and Services at the Centers for Medicare and Medicaid Services (CMS), said CMS will provide a test EHR that will allow providers the opportunity to successfully exchange clinical data electronically between their EHR and the one provided by CMS, as they seek to meet Meaningful Use Stage 2 requirements. "We do remain dedicated to the idea of health information exchange without borders, across different ….areas of care, but also across different technologies, and that is why we have this third measure that we've introduced here in the final [rule] that at least one of the electronically exchanged summaries of care have to be sent to a recipient with a different EHR vendor,” Anthony said during the webcast. The issue of EHR interoperability has been top of mind among healthcare leaders who assert that the smooth flow of clinical data across secure IT systems will advance the quality of patient care. In June, a New England Journal of Medicine editorial fiercely <a href="http://www.informationweek.com/healthcare/electronic-medical-records/ehr-innovation-gap-threatens-healthcare/240002283">attacked EHR vendors</a> for their lack of innovation and resistance to sharing patient information outside of their own closed systems. The authors cited the need to protect market share and reap huge financial rewards as the reasons why vendors retain their proprietary EHR systems. In the meantime, <a href="http://www.informationweek.com/healthcare/electronic-medical-records/mostashari-ehrs-will-help-most-patients/232601626">Mostashari </a> pointed to several significant achievements that will raise the quality of clinical data exchange in 2014, the year when providers participating in the EHR Incentive Programs who have met Stage 1 for two or three years will need to meet Meaningful Use Stage 2 criteria. Mostashari says ONC has defined a common Meaningful Use data set that facilitates reporting for all summary of care records, care transitions, discharges, and patient access. He also pointed to an impressive array of data elements that are associated with standardized formats and vocabularies that include everything from lab test results, vital signs, and blood pressure readings, to patient demographic information, discharge instructions for hospitals, and provider contact information. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-08-23T15:22:00ZPublic Health Reporting Rethought By Pilot ProjectStandardization effort aims to make patient health data in EHRs easier for public health agencies to access, so they can respond more quickly to infectious disease outbreaks.http://www.informationweek.com/news/240006097?cid=RSSfeed_IWK_Authors<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/policy/240005118"><img src="http://twimgs.com/informationweek/galleries/automated/848/SS_ACO_dreamstime_01_tn.jpg" alt="8 Accountable Care Organizations Worth Closer Examination" title="8 Accountable Care Organizations Worth Closer Examination" class="img175" /></a> <div class="storyImageTitle">8 Accountable Care Organizations Worth Closer Examination</div> (click image for larger view and for slideshow)</div>Preliminary results of a pilot project testing standardized reporting of public health information from electronic health records (EHRs) reveals that by using templates for clinical data, public health officials can improve the quality and coordination of care as they try to contain problems such as <a href="http://www.cdc.gov/media/releases/2012/t0822_west_nile_update.html">West Nile Virus</a>, or outbreaks of whooping cough or flu. "This was the first pilot implementation of clinical document architecture for the purposes of public health reporting from clinical care providers specifically in the area of communicable diseases," Dr. Nikolay Lipskiy, health IT standards and interoperability lead for the Centers for Disease Control and Prevention (CDC), said in an interview with InformationWeek Healthcare. The pilot project is part of a three-year program in which IBM, the CDC, and the Public Health Data Standards Consortium (PHDSC) are collaborating on ways to make patient health data in EHRs quicker and easier for health officials to access. The initiative involves creating, validating, and exchanging test public health case reports originating from commercial EHRs or health information exchanges (HIEs). According to CDC officials, many healthcare providers currently send clinical information to public health agencies via phone calls, fax, or mailed paper forms, as well as electronic fill-in-the-blank forms. The irregular and delayed public health reporting process often creates inconsistencies and duplication of efforts. The research program aims to develop a new approach to defining and delivering public health reporting by drawing insights from structured and unstructured data that currently exists in disparate systems. Scientists are creating templates for public health case reports that work with EHRs.This allows stakeholders to collect critical information, such as the demographics of a patient, clinical symptoms, and immunization records, in a format that all parties can easily understand. New template tools and automated reporting technology were pilot tested for a year with public health information systems in Delaware, New York State, and San Diego County. Healthcare providers sent information electronically to local, county, state, and federal public health agencies to help them speed up their response times and enhance their efforts to control the spread of communicable diseases. [ Most of the largest healthcare data security and privacy breaches have involved lost or stolen mobile computing devices. For possible solutions, see <a href="http://www.informationweek.com/news/galleries/healthcare/security-privacy/232500404?itc=edit_in_body_cross"> 7 Tools To Tighten Healthcare Data Security</a>. ] The researchers hope to publish the full results of the pilot project at the end of the month, but preliminary results show that duplication of information was reduced, and the evidence suggests that improvements in the organization and management of clinical data from EHRs hold great promise. According to Lipskiy, by computerizing clinical information, data doesn't have to be entered twice. For example, providers could avoid filling out a hard-copy form and faxing it to the public health department. Instead, a physician could fill out an electronic chart with patient demographics and clinical information and send it to a hospital's electronic system in the format of electronic templates. These templates can be easily repurposed and sent to a public health agency without additional data entry tasks. Furthermore, program scientists aim to describe clinical symptoms using standard nomenclature, and <a href="http://www.informationweek.com/healthcare/policy/dont-hit-snooze-button-on-icd-10/232900195">ICD-10</a> codes, which help health providers know what information to include in their reporting document. The results of the three-year program will inform the <a href="http://www.cdc.gov/ehrmeaningfuluse/siframework.html">Standards and Interoperability Public Health Reporting Initiative</a>, which is a project run by the Office of the National Coordinator for Health Information Technology in collaboration with the CDC that addresses the challenge of electronic data exchange between clinical care providers and public health agencies. The initiative creates a roadmap to harmonize health IT standards between clinical care and population health systems beyond the Meaningful Use Stage 1 objectives. However, developing a standardized approach to electronic public health reporting from EHR systems is not always a straightforward proposition, observed Dr. Seth Foldy, senior advisor for health informatics and practice at CDC's Public Health Surveillance and Informatics Program Office. "We need to stay abreast of the standards that the clinical healthcare world is using, such as the clinical document architecture approach of sending an electronic document," Foldy said in an interview with InformationWeek Healthcare. "We have to slowly migrate at a pace that can be tolerated. It is a gradual and complex process." Sondra Renly, lead scientist of collaborative public health transformation for IBM Research, said in a statement that a huge investment has been made to implement standards for the exchange of electronic health records, which contain critical clinical data that public health agencies need in a time of crisis. "This community effort will bring near real-time automated reporting to public health and give public health the information required to protect society," Renly said. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.) 2012-08-22T11:52:00ZHospitals Seek Analytics Tools In Rush To Meet MandatesHealth analytics adoption will hit 50% by 2016, reports Frost & Sullivan.http://www.informationweek.com/news/240005948?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/admin-systems/240001004"><img src="http://twimgs.com/informationweek/galleries/automated/798/01_Intro_tn.jpg" alt="11 Healthcare-Focused Business Intelligence Tools" title="11 Healthcare-Focused Business Intelligence Tools" class="img175" /></a> <div class="storyImageTitle">11 Healthcare-Focused Business Intelligence Tools</div> (click image for larger view and for slideshow)</div>  Hospitals will soon see a significant increase in the use of analytics tools, according to new research from Frost & Sullivan. In fact, new figures show that only 10% of U.S. hospitals implemented health data analytics tools in 2011. That number will grow to approximately 50% adoption in 2016, representing a 37.9% compound annual growth rate (CAGR). The report, "<a href="http://www.frost.com/c/10046/sublib/display-report.do?id=NA03-01-00-00-00">U.S. Hospital Health Data Analytics Market</a>," makes the assertion that investments in analytics software will closely follow the implementation of electronic health records (EHRs). As of 2011, approximately 35% of U.S. hospitals had implemented either a basic or comprehensive EHR. By 2016, Frost & Sullivan forecasts that 95% of U.S. hospitals will have EHR systems in place, representing a 22.1% CAGR. Legislative mandates, specifically, the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 and the Patient Protection and Affordable Care Act (PPACA) of 2010, are driving the shift toward <a href="http://www.informationweek.com/big-data/news/healthcare/clinical-systems/240004286/poor-data-management-costs-healthcare-providers">investments in analytics tools</a> soon after the implementation of EHRs. These laws call for U.S. hospitals to implement and use technology, including data analytics, to improve quality measures and patient outcomes. Health data analytics, which the report describes as "advanced analytics techniques applied to clinical, financial, and administrative data that is used to improve the quality and efficiency of patient care," will become more ubiquitous over the next three to five years. [ Is it time to re-engineer your clinical decision support system? See <a href="http://www.informationweek.com/news/galleries/healthcare/clinical-systems/232300511?itc=edit_in_body_cross">10 Innovative Clinical Decision Support Programs</a>. ] As the nation modernizes its health information infrastructure, the report notes that historically, healthcare delivery organizations have implemented business analytics that focused on financial and administrative systems. During the last five years, however, implementing clinical IT systems such as EHRs has raced to the top of the priority charts. Still, the report asserted that the majority of providers have not yet applied advanced data analytics tools that can access information from EHRs to gain actionable insights from this information. The report also noted that providers have yet to <a href="http://www.informationweek.com/healthcare/leadership/healthcare-cost-cutting-hinges-on-it/240005305">integrate clinical information with financial and administrative data</a>--a process that must occur if hospitals want to implement a comprehensive data analytics strategy. "To transform healthcare, all data have to come together in order to get a clear picture of what is happening with individual patients and patient populations in terms of clinical treatment and outcomes, costs and reimbursement, and resource utilization," said Nancy Fabozzi, principal analyst covering Healthcare at Frost & Sullivan, the author of the report. "Hospital executives will increasingly view these data [elements] as a core asset that must be leveraged to support every organizational goal, including financing, reimbursement, recruiting, and--most importantly--patient care." The good news is that hospital CEOs, CFOs, and CIOs are fully aware that they need to elevate their analytics capabilities, which means channeling additional investments toward a new technology infrastructure to support that function, as well as establishing new processes and workflows around data governance and oversight of this critical asset, Fabozzi said in an interview with InformationWeek Healthcare. So what will it take to build and leverage a hospital's data assets? "Integration is the first hurdle," Fabozzi declared. "Some hospitals, mostly larger integrated delivery network (IDNs), and/or academic medical centers, are building data warehouses to integrate data from numerous disparate systems within the enterprise so that the data is amenable to robust analytics." The second big task is getting hospitals to agree on basic key performance indicators (KPIs). As the health industry enters an era of more government regulations, government will determine many KPIs."The need to report on a growing number of metrics around healthcare quality and safety as well as to report to growing numbers of constituents (e.g., local, federal, and state regulators, government and commercial payers, patients, employers, etc.) will drive the need to present the most complete data on KPIs," Fabozzi observed. "Providers may want to develop special programs and metrics around quality that go beyond government regulation in order to gain competitive advantage." Other challenges that will confront healthcare IT executives as they implement health data analytics tools, according to the report, include: -- High implementation and licensing fees. Implementation and subscription/licensing fees for advanced analytics are just one more financial burden and can add to the budgetary woes faced by many hospitals today. Advanced health data analytics systems can cost over $100,000 for implementation and about the same for annual subscription/licensing fees, making it difficult for hospitals to justify spending, at least in the short term when they are so focused on implementing EHRs and upgrading revenue cycle management (RCM) systems. -- Communication barriers in hospitals that slow information sharing. Many hospitals have siloed departments and service lines that operate as independent units. They have not previously had to share data across multiple departments within the same hospital, much less across an entire IDN. -- Lack of standardized health data that affects analytics use. Inconsistency in capturing and defining data limits the use of clinical data for patient care metrics. Hospitals are increasingly working to integrate and standardize data across various operational units. However the lack of robust and consistent <a href="http://www.informationweek.com/healthcare/leadership/us-healthcare-needs-data-standards-regis/240002483">data standards</a> will likely limit the uptake of advanced health data analytics to some extent. -- Continued use of existing basic analytics tools that restrict the implementation of newer solutions. Many hospitals, particularly small and rural hospitals, continue to rely on their existing, rather basic, legacy business intelligence systems--think Excel and Access. These tools are often only used at the department level and likely use only retrospective data to develop reports. According to Fabozzi, many hospitals intend to continue using business intelligence tools that focus mainly on financial and administrative data, but change is inevitable. "Realistically, a lot of hospitals will continue to use these processes for some time because of all the other aforementioned barriers to changing over to newer systems," Fabozzi said. "Legacy business intelligence tools will be seen as "good enough for now" until it just becomes too inefficient to continue."2012-08-17T10:04:00ZConsultants Play Bigger Role In Public Health Information ExchangesCSC and Impact Advisors are early leaders in KLAS's report on HIE IT systems integrators, staffers, and technical advisers.http://www.informationweek.com/news/240005727?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"> <a href="http://www.informationweek.com/news/galleries/healthcare/interoperabil ity/240001675"><img src="http://twimgs.com/informationweek/galleries/automated/805/Maine_Healath _infonet_tn.jpg" alt="8 Health Information Exchanges Lead The Way" title="8 Health Information Exchanges Lead The Way" class="img175" /></a> <div class="storyImageTitle">8 Health Information Exchanges Lead The Way</div> (click image for larger for slideshow) </div> As health information exchanges begin to develop an IT infrastructure to support the electronic sharing of patient records among health delivery organizations, KLAS has found that 60% of public HIEs are engaging third-party consultants, compared with 40% of private HIEs. KLAS's "<a href="http://www.klasresearch.com/klasreports/?productid=775&PR_HCS">HIE Consulting: Leveraging Third-Party Expertise for HIE Success</a>" report evaluates health IT consultancy firms providing assistance with systems integration, advisory work, staff augmentation, and technical support to the burgeoning HIE market. The report noted that more public HIEs are courting third-party consultants because they need help navigating the complexity of government regulations that require data standards for the electronic exchange of clinical data among providers. KLAS researchers also found that public HIEs need assistance in a variety of areas--everything from preparing the paperwork to apply for <a href="http://www.informationweek.com/healthcare/interoperability/hhs-announces-grants-for-innovative-heal/228701983">public funds</a>, to coordinating participating <a href="http://www.informationweek.com/healthcare/interoperability/ny-accelerates-state-health-information/240001935">public HIE stakeholders</a>. Private HIEs, however, did not require as much assistance because they are privately sponsored entities with less government involvement. According to KLAS's definition, private HIEs typically are based around one or more integrated delivery networks (IDNs) or large hospital organizations banding together to pull in community practices. The majority of their funding and governance comes from private entities. By comparison, public HIEs encompass specific regions and involve multiple hospital-based organizations. The majority of their funding and governance comes through government entities, such as state HIEs. "There's a lot of complexity that comes with creating a public HIE," Erik Westerlind, the report's author, said in an interview with InformationWeek Healthcare. "Providers need to sort out who will have access to patient data, they want to know where the data will reside, and what security policies should be put in place." [ Are you paid what you're worth? See <a href="http://www.informationweek.com/news/galleries/healthcare/leadership/240004124?itc=edit_in_body_cross">Health IT Pros Face Salary Gap</a>. ] KLAS based its findings on interviews with executives at 27 healthcare delivery organizations participating in HIE development. These health organizations are engaging firms such as Accenture, CSC, CTG, Deloitte, Harris, Impact Advisors, J2, maxIT, Peer Consulting, PwC, Orchestrate, Vitalize, and Xerox--all companies that are included in the research. Providers also describe the work their consultants perform for them, including strategic, operational, regulatory, hosting, and IT outsourcing work, as well as how the vendors perform. The report describes the scope of services provided, specializations offered, and the depth and breadth of HIE experience, which distinguish some vendors from others. Several key findings of the report include: -- Impact Advisors and CSC are the two early leaders in the HIE consulting market. KLAS found Impact Advisors to be the only fully rated vendor providing HIE advisory and technical work, while CSC is the only option for HIE hosting and managed services. -- Ninety-six percent of providers reported benefits from engaging their third-party firms. -- Fifty-five percent of executives interviewed said they chose their HIE consulting service based on trust and because they had worked with the vendor before. -- To gain an advantage, some firms have begun to join forces to bring their diverse skills and expertise to HIE projects. For example, KLAS verified a partnership between Orchestrate and Medicity, and a number of other relationships appear to be emerging. In related news, earlier this month the Obama administration approved $17 million to help establish <a href="http://www.mass.gov/eohhs/gov/newsroom/press-releases/eohhs/first-medicaid-funded-statewide-health-info-exchange.html">Massachusetts' statewide HIE</a>, which will allow providers, hospitals, and other health delivery organizations to exchange clinical data via a secure statewide network.2012-08-15T13:39:00ZHospitals Look To EHRs To Reduce ReadmissionsProspect of decreased Medicare reimbursements drives hospitals to find ways to keep patients from quickly returning. Technology will play an essential role, new report says.http://www.informationweek.com/news/240005621?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/leadership/240004124"><img src="http://twimgs.com/informationweek/galleries/automated/839/01_BEst-openingslide-dreamstime_tn.jpg" alt=" Health IT Pros Face Salary Gap" title=" Health IT Pros Face Salary Gap" class="img175" /></a> <div class="storyImageTitle"> Health IT Pros Face Salary Gap</div> (click image for larger view and for slideshow)</div>  As hospitals tackle the issue of how to reduce their readmission rates, new research shows that health IT can play a key role in tracking patients after they've been discharged from hospitals, but more needs to be done to capture patient information and share it among caregivers, concludes a report from CSC Global Institute for Emerging Healthcare Practices. <a href="http://assets1.csc.com/health_services/downloads/CSC_Preventing_Hospital_Readmission.pdf">Preventing Hospital Readmissions: The First Test Case for Continuity of Care</a>, is a report that evaluates research on hospital readmissions, and examines the approaches successful hospitals have taken to reduce readmissions. The research suggests that while there is no one model that all hospitals can adopt that will magically decrease readmission rates, there is an opportunity to use electronic health records (EHRs) and other technology to support hospital discharge practices and procedures designed to follow patients more intensely after they've left the hospital. The quest for hospitals to reduce readmission rates reflects both the desire to raise the quality of care, as well as the need to preserve reimbursement. Under the Patient Protection and Affordable Care Act, the federal government can withhold a portion of Medicare payments to hospitals that have excessive 30-day readmissions rates. Starting October 1, 2012, the maximum penalty will be worth 1% of a hospital's base Medicare reimbursement. In 2013, the penalty jumps to 2% of base Medicare reimbursements, then 3% the next year. According to a <a href="http://www.kaiserhealthnews.org/Stories/2012/August/13/medicare-hospitals-readmissions-penalties.aspx?utm_source=khn&utm_medium=internal&utm_campaign=viewed">report</a> published Monday in Kaiser Health News, more than 2,000 hospitals will be penalized by the government starting in October. In total these hospitals will lose about $280 million in Medicare funds because many of their patients were readmitted to the same hospital that recently discharged them. To avoid these penalties, hospitals are advised to include patient monitoring in post-discharge care plans to address any gaps in care--such as a patient forgetting to take medications or follow up with a physician--that may result in a patient's return to the hospital. Adopting an approach that continues to follow patients, the report said, "will only be possible with the assistance of health IT to accomplish communication and close loops." [ Get practical advice on formulating a healthcare social media plan. See <a href="http://www.informationweek.com/news/galleries/healthcare/patient/240003634?itc=edit_in_body_cross">Healthcare Social Media: Time To Get On Board</a>. ] While technology will be a significant driver in post-discharge care coordination, however, hospital CIOs and other IT managers face many challenges as they seek to integrate different technologies and manage information both within a hospital network and with organizations outside of a hospital system. The report also suggests that an increasing volume of information related to the patient's condition and circumstance must be captured, which ranges from data on medication reconciliation, scheduling appointments for clinicians to visit patients, tracking the completion of transition milestones, and providing online access to up-to-date contact information for clinical partners. According to Jane Metzger, the report's author, post-discharge procedures and protocols must address the transition risks, as well as the medical condition of each patient, and EHRs can help make this possible. For example, the EHR can help build the transition care plan that might include a follow-up phone call on the first day after hospital discharge to a pneumonia patient who is at high risk of readmission, or on the second day for a surgery patient to make sure there is no fever and the wound is healing. While significant opportunities exist to reduce hospital readmissions, applying technology to support transitions in care is still in the early stages of development. "We have not yet done a lot of work on enough extensions of the EHR, new enhancements to the technology, or possibly bridge applications that fit in between," Metzger said in an interview with InformationWeek Healthcare. She added that many organizations are hampered because they have deployed different EHR systems across various departments within a hospital, which makes the task of integrating these systems more difficult. Metzger also said today many institutions depend on faxes, email, and phone calls to coordinate transitions in care, and noted that "unfortunately we are not at a point today where the EHR is going to do all this." In the meantime, with the rapid adoption of EHRs and the advent of health information exchanges, healthcare providers can look forward to an advanced health IT infrastructure that will drive patient information to caregivers and help them improve their plans to coordinate transitions in care. According to the report, "Meaningful use for HITECH will provide the critical foundation of much more complete patient information available in the EHR and the basic infrastructure for communicating with clinical partners through health information exchange."2012-08-13T14:35:00ZAT&T, Alere Partner On Diabetes ToolsDiabetes patients will be able to monitor their vital signs via mobile devices and the Web, using WellDoc's DiabetesManager system.http://www.informationweek.com/news/240005372?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/mobile-wireless/240003081"><img src="http://twimgs.com/informationweek/galleries/automated/828/01_Doctor_Ipad3_tn.jpg" alt="11 Super Mobile Medical Apps " title="11 Super Mobile Medical Apps " class="img175" /></a> <div class="storyImageTitle">11 Super Mobile Medical Apps </div> (click image for larger view and for slideshow)</div>  AT&T has joined forces with Alere Health to offer WellDoc's DiabetesManager system to adults with type 2 diabetes. The program will allow diabetes patients to monitor their vital signs anytime and anywhere. Alere Health offers care management programs in conjunction with health plans, physicians, and employers, and it currently serves over 290,000 individuals with diabetes. Participants in the program, outlined in a joint <a href="http://www.att.com/gen/press-room?pid=23187&cdvn=news&newsarticleid=35057&mapcode=enterprise%7Catt-business-news">statement</a>, will be able to enter blood glucose readings and medication data into DiabetesManager's health application on their compatible mobile device or the Web. Once the information is uploaded via AT&T's network, the data is sent to Alere Health's advanced clinical care management system, Apollo, which contains information about the patient's medical history. Alere Health will provide nurses 24 hours a day to assess patients' information and identify whether glucose readings are normal or not. If the patient's glucose readings are abnormal, a nurse will call the patient to provide real-time feedback regarding their blood glucose control and suggest immediate actions to address the problem. <a href="http://www.informationweek.com/healthcare/electronic-medical-records/do-ehrs-improve-diabetes-care/240001747">Diabetes</a> is a major cause of heart disease and stroke, and the leading cause of kidney failure. Nearly 26 million Americans have diabetes and an estimated 79 million adults have pre-diabetes. If current trends continue, as many as one in three U.S. adults could have diabetes by 2050, according to statistics from the Centers for Disease Control and Prevention. [ Learn more about why mobile health is so important. Read <a href="http://www.informationweek.com/healthcare/patient/healthcare-must-leverage-tech-to-boost-c/240004692?itc=edit_in_body_cross">Healthcare Must Leverage Tech To Boost Consumer Satisfaction</a>. ] With this personalized approach to diabetes care management, Alere Health hopes to prevent a patient's health condition from deteriorating, which often leads to hospital emergency room visits and a higher cost of care. The FDA-cleared DiabetesManager will target higher risk and more acute patients, in contrast to Alere's Mya solution that is designed for lower risk patients. Alere is AT&T's business customer, and the announcement not only expands the relationship between the two companies, but will help AT&T enhance its own mobile health strategy, Randall Porter, assistant VP of AT&T ForHealth, said in an interview with InformationWeek Healthcare. "mHealth is an area increasingly being recognized as offering promising solutions for enhancing patient engagement and improving outcomes. mHealth solutions can enable caregivers to really have insight into what is happening with a patient at home or on the move and bridge that gap as it exists today," Porter said. AT&T and Alere Health will jointly market and sell the solution to health plans and corporate payers. Further clarifying the arrangement, Porter said <a href="http://www.informationweek.com/healthcare/interoperability/att-welldoc-ink-telehealth-partnership/227900040">AT&T</a> will sublicense WellDoc's DiabetesManager to Alere. Alere will integrate its Apollo care management platform with DiabetesManager, and then sell the combined system as part of its core portfolio. Mobile health firms are developing new sales channels by strategically partnering with more established companies that can introduce their products to a wider variety of customers. The relationship between WellDoc and AT&T is an example of how a small mHealth firm can expand its market share, explains Anand Iyer, president of WellDoc. "In the disease management channel, the AT&T mHealth Solutions group acts as our U.S. enterprise sales force, and landing Alere is a fantastic win--not only because they are the largest health management company, but also because Alere shares WellDoc's passion for decentralizing healthcare and empowering patients," Iyer said in an interview with InformationWeek Healthcare. Company officials said the system is expected to be available in the third quarter of this year.2012-08-10T14:22:00ZHealthcare Cost Cutting Hinges On ITHealth IT will curb rising healthcare costs--even those related to malpractice suits--and increase efficiency, top healthcare experts say.http://www.informationweek.com/news/240005305?cid=RSSfeed_IWK_Authors <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/policy/240005118"><img src="http://twimgs.com/informationweek/galleries/automated/848/SS_ACO_dreamstime_01_tn.jpg" alt="8 Accountable Care Organizations Worth Closer Examination" title="8 Accountable Care Organizations Worth Closer Examination" class="img175" /></a> <div class="storyImageTitle">8 Accountable Care Organizations Worth Closer Examination</div> (click image for larger view and for slideshow)</div>  Several of the nation's top healthcare experts, led by bioethicist Ezekiel Emanuel, believe that building an IT infrastructure that supports the electronic exchange of patient data and integrating administrative data with clinical information from electronic health records (EHRs) will cut the nation's healthcare costs and increase efficiency. In a recent paper in the <a href="http://www.nejm.org/doi/full/10.1056/NEJMsb1205901">New England Journal of Medicine</a>, Emanuel and his colleagues, supported by the Center for American Progress, an independent nonpartisan think tank, confront the issue of out-of-control healthcare spending which, in this election year, will reach $2.8 trillion or about 18% of U.S. gross domestic product (GDP). The authors cite estimates suggesting that by 2037, national health spending will grow faster than the economy, increasing from 18% to about 25% of GDP. Federal health spending will also increase from 25% this year to approximately 40% of total federal spending by 2037. [ Is it time to re-engineer your clinical decision support system? See <a href="http://www.informationweek.com/news/galleries/healthcare/clinical-systems/232300511?itc=edit_in_body_cross"> 10 Innovative Clinical Decision Support Programs</a>. ] "These trends could squeeze out critical investments in education and infrastructure, contribute to unsustainable debt levels, and constrain wage increases for the middle class," the authors wrote. The authors point out that the nation spends nearly $360 billion on <a href="http://www.informationweek.com/healthcare/clinical-systems/poor-data-management-costs-healthcare-pr/240004286">healthcare-related administrative costs</a> each year. Although the Patient Protection and Affordable Care Act requires health plans and providers to adhere to uniform standards and operating rules for electronic transactions between these organizations, the authors lament that while "plans must comply with these standards and rules, the law does not require providers to exchange information electronically." To create greater efficiency in the system, Emanuel and his colleagues recommend that payers and providers quickly adopt the practice of electronically exchanging eligibility, claims, and other administrative information among their respective organizations. Additionally, the authors suggest that during the next five years providers use EHRs to integrate clinical and administrative functions such as billing, prior authorization, and payments. By implementing <a href="http://www.informationweek.com/healthcare/clinical-systems/bi-tools-prep-clinicians-for-accountable/231600457">business intelligence</a> tools to collect actionable information from administrative systems, providers and health plans can discover inefficiencies within the system as they seek to improve their workflow while reducing administrative tasks and costs. For example, in one step a clinical service could be ordered electronically for a patient and automatically be billed to the payer. Emanuel and associates also recommend establishing a task force comprised of payers, providers, and vendors to "set binding compliance targets, monitor use rates, and have broad authority to implement additional measures to achieve system-wide savings of $30 billion a year." In an interview with InformationWeek Healthcare, Emanuel indicated that he sees the integration of physicians' EHRs with administrative data, as "a very good step in the right direction" and "one very important element" that can reduce healthcare costs. The article also says technology can reduce the cost of defensive medicine, explaining that the risk of a malpractice suit causes physicians to order moretests and procedures. But implementing a strategy that imposes arbitrary caps on damages for patients who are injured as a result of malpractice would result in only a 0.5% reduction in national health spending. "A more promising strategy would provide a so-called safe harbor, in which physicians would be presumed to have no liability if they used qualified health information technology systems and adhered to evidence-based clinical practice guidelines that did not reflect defensive medicine. Physicians could use clinical decision support systems that incorporate these guidelines," the authors said. They added: "Under such a system, the physician could use the safe harbor as an affirmative defense at an early stage in the litigation and could introduce guidelines into evidence to avoid a courtroom battle of the experts." According to Emanuel, using technology to provide evidence that a doctor followed the correct practices and procedures while attending to patients is a useful tool to defend against lawsuits. "Part of what we are suggesting is that we use malpractice reform to incentivize better behavior in terms of installing electronic health records, installing decision supports, and following guidelines. That is a much more meaningful way of getting malpractice reform," Emanuel asserted. InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/073012hc?k=axxe&cid=article_axxt_os">CIO Roundtable</a> issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)