Physicians, Hospitals Need Access to EHR Systems

Source: iHealthBeat (California Healthcare Foundation Magazine)
7 Jul 2008

According to a Boston Globe editorial, recent personal health record initiatives are an important part of providing consumers with access to their personal health data, but what is "more important is getting doctors and hospitals connected into a single system."

Blue Cross Blue Shield of Massachusetts' recent agreement to allow its members to access their personal health records through Google Health is "part of a movement to put consumers in charge," but it is "unclear, however, whether patients want this control," according to an editorial in the Boston Globe .
"What's more important is getting doctors and hospitals connected into a single system," the editorial states. But "private companies are taking the lead on electronic health records because of the failure of many U.S. health care providers to embrace the Internet," according to the editorial.
The editorial warns patients about using PHRs, noting that patients should be concerned that they are not covered by federal privacy laws.

eHealth Collaborative

According to the editorial, "The most impressive [health IT] program" in Massachusetts is the " eHealth Collaborative ", which has established EHR pilot programs to connect physicians and hospitals in North Adams, Brockton and Newburyport, Mass.
The collaborative is funded through a four-year, $50 million grant BCBS. However, the grant will run out Dec. 31, and "there will still be much work to be done in the three communities," the editorial states.
The Massachusetts state budget's recent agreement to include $25 million to advance the creation of EHR systems "doesn't specify who should get the money," but the editorial states that the eHealth Collaborative should gain state support and identify other communities willing to participate in the EHR initiative.
The editorial adds that "$25 million won't buy much software or many computers," but the funds "will lay the foundation for a more expensive program requiring a combination of public and private funds"

Editorial:
U.S. Doctors Need To Catch Up With Others in EHR Adoption

Source:  iHealthBeat  (California Healthcare Foundation )
24 Jun 2008

If the U.S. "does not accelerate the conversion from paper" to electronic health records, "many of the gauzy promises of health care reform made by politicians and health planners will become irrelevant," according to a New York Times editorial.

The editorial cites last week's New England Journal of Medicine study, which found "a paltry 4% of the doctors [surveyed] had a 'fully functional' [EHR] system that would allow them to view laboratory data, order prescriptions and help them make clinical decisions, while another 13% had more basic systems."
The Survey represents a "startling contrast with other industrialized nations," including Australia, Great Britain, the Netherlands and New Zealand, where the majority of physicians use EHRs, according to a 2006 Commonwealth Fund survey -  the editorial states.

The editorial also highlights Denmark's comprehensive health information exchange, which allows physicians to view patient health and prescription histories "that most American doctors lack."

"Other industrialized nations have moved faster because of strong national leadership in setting standards and helping to finance adoption," according to the editorial.

In addition, both presidential candidates are urging greater use of health IT, and Sen. Barack Obama (D-Ill.) has even called for investing $50 billion over five years to help physicians adopt IT.

The editorial concludes, "It is time to drag private physicians out of the paper age" ( New York Times , 6/24).

USA-Health and Human Services Department (HHS) considers genetic information to EHRs

Source:  HealthImaging.com ( http://www.healthimaging.com )
12 Jun 2008

The American Health Information Community ( AHIC ) is recommending that the federal government start preparing for the capability to electronically store a patient's genetic makeup so that doctors can match medical treatments to their genes.
According to "Government Health IT" , the connections between patients'genetic characteristics and responses to particular medications are beginning to be understood by scientists. For example, certain breast cancers are linked to the patient's genes, and those cancers can be treated more effectively now that the connection is understood.

If Health and Human Services Department ( HHS ) Secretary Michael Leavitt accepts AHIC's recommendations, genetic information will be included in EHRs and research databases.
One of the recommendations calls for HHS agencies and the National Institute of Standards and Technology to clarify and determine the role that each would play in standardizing pharmacogenetic data . AHIC also recommends that HHS agencies identify the genetic data that EHRs should contain.

AHIC has recommended that The National Library of Medicine, which already has taken a lead role in some HHS work on genetic information, head the effort to integrate genetic information into EHRs or personal health records, reported Government Health IT . 
Another recommendation calls for the National Institutes of Health and other federal agencies involved in research to develop best practices for patients to consent to uses of their genetic data.

“HHS should work with stakeholders, including professional associations representing clinicians, clinical laboratories, pharmacists and others, to develop a white paper on the opportunities and challenges associated with dispensing pharmaceutical drugs based on pharmacogenomic test-derived interpretations in inpatient, ambulatory and mail-order services,” according to a letter from AHIC to Leavitt.

AHIC's Personalized Health Care Workgroup, an HHS advisory committee, developed the recommendations.

AMA to HHS: Finish E-Script Standards

Source: HospitalData Management
9 May 2008

The American Medical Association is calling on Congress to require the Department of Health and Human Services to complete all national technical standards to support electronic prescribing by the end of 2009.  Further, if e-prescribing is mandated under Medicare or more broadly, the Chicago-based organization supports a two-year transition period after the standards are complete, during which physicians and pharmacies can use facsimiles to transmit prescriptions.

But there's lots of leeway in the AMA's proposals, outlined May 9 during a forum on e-prescribing at the Brookings Institution in Washington.

In April, the Centers for Medicare and Medicaid Services issued a final rule adopting three standards to support formulary and benefits, medication history and fill status notification components of e-prescribing. Now, the AMA wants quick action on three additional standards. “Prescribers should be able to efficiently transmit accurate and complete instructions for medications being prescribed, use standard medication terminology, and use real-time prior authorization,” Stack said. “So, it really is essential that these three incomplete standards be finalized and fully functional in order to realize the truly robust e-prescribing benefits sought by so many.”

Further, the AMA called for elimination of federal Drug Enforcement Administration prohibitions on e-prescribing of controlled substances. The association estimates these substances account for 20% of all prescriptions

Who Should Own Data Captured in Personal Health Records?

In: iHealthBeat ( http://www.ihealthbeat.org/ )
May 2008
Source: HIMSS ( www.himss.org/ )

Ninety-two percent of health care IT professionals said patients should own the data captured in personal health records, according to a survey by the Healthcare Information and Management Systems Society. Four percent of respondents said providers should own PHR data, while 1% said the company supplying the PHR should own the data.

The survey also found that nearly half of respondents said that privacy and security issues are the biggest barrier to the use of a PHR. Twenty-four percent of respondents said that the biggest barrier to PHR use is that their clinician does not use electronic records.

Thirty percent of respondents said they access a PHR, while 76% of respondents said they believe PHRs need to be integrated with an electronic health record to have value in patient treatment.

Results are based on an April online survey of 675 health care IT professionals.

Home Telemonitoring for Chronic Disease
A Case Study of Resurrection Home Health Services, and Conclusions

Source: TIE - Telemedicine Information Exchange    ( http://tie.telemed.org/ )
Apr 2008
By Kevin Cassin

Introduction

Congestive heart failure (CHF) and the home use of telemonitoring equipment is an area that has recently been explored in an effort to control the cost of chronic disease ( Kinsella, 1998 ; Knox and Mischke, 1999 ). The advent of modern communication and adaptation of computer equipment has now made it possible to equip almost any home with devices that will record and report a patient's daily temperature, heart rate and blood pressure ( Schneider, 2004 ). Collectively known as vital signs (VS), this information can then be transmitted automatically to a central reporting station that is attended by clinical personnel such as a registered nurse (RN). Add to this the customization possible with these devices; they can be fitted with oxygen sensors (O2 SAT), prothrombin time and international normalized ratio (PT/INR) coagulation meters or glucose monitors. The ability of a clinician to triage a patient from a distance has come into fruition ( HomMed Company Brookfield, 2005 ).

Recent studies by healthcare providers have demonstrated the effectiveness of home monitoring in controlling length of stay (LOS) and rehospitalization costs with CHF populations ( Knox and Mischke, 1999 ; Schneider, 2004 ). Yet universal acceptance or expectation of telemonitoring use has lagged behind in many home health agencies due to cost and the high tech nature of these devices ( Kinsella, 1998 ). In the case of Resurrection Home Health Services (RHHS) , deployment of a telemonitoring system was a planned initiative first researched in 2005 (R. Prosser, personal communication, March 9, 2007). Using a grant received from the Retirement Research Foundation the implementation of this program was seeded in April, 2006 ( Prosser and Watson, 2005 ).

The HomMed telemonitor , used at RHHS, is a standardized unit that records VS, O2 SATS and weight. It also allows patients to key in answers to yes and no questions specific to their diagnosis. While commonly used with CHF populations, equipment changes allow for deployment within many different diagnostic groups. Diagnostic pathways exist not only for chronic disease such as CHF but also other types of ailments like asthma, diabetes or irregular heart beat ( HomMed Company Brookfield, 2005 ). At RHHS the telemonitor has been employed when CHF is the first or second diagnostic criteria. (read more....)

6th Annual ICOST 2008: International Conference On Smart homes and health Telematics
Theme: "Gerontechnology: Enhancing the Quality of Life for Rural Elders"
28 Jun - 2 Jul 2008
Iowa State University
Iowa
USA
Visit the Conference Site

UC Berkeley Researching on Integrating Medical diagnostic devices with Network technologies

Source: Federal Telemedicine News
Date: 13 Feb 2008

The Center for Information Technology in the Interests of Society (CITRIS) at the University of California campuses (Berkeley, Davis, Merced, and Santa Cruz) is involved in health IT research. Studies on exchanging medical records and developing and using IT for telemedicine are ongoing.

John Canny at UC Berkeley and his researchers are working on integrating diagnostic medical devices with network technologies in an "all-in-one device".

A device developed in the current research program monitors EKGs, EMG (back muscle activation), GSR (galvanic skin response—a stress reducer), chest sounds, temperature, and movement.

The researchers want to see the all-in-one device provide longitudinal monitoring for the early warning of more serious conditions. As a Bluetooth device, the goal will be to gather data without network connectivity for daily upload to another Bluetooth device. But at the same time be able to communicate with specific cell phones from Bluetooth for real-time monitoring.

The next step for UC Berkeley is to find partners to explore home and clinical applications for the device by developing data analysis and visualization tools for these applications. The research program is specifically interested in home wellness monitoring, using telemedicine in developing regions, and crisis reporting and analysis.

CHCF Expands Project to Prevent Diabetes-Related Blindness through Telemedicine

An innovative project to prevent diabetes-related blindness has proven so successful in California's Central Valley that it is being expanded across the state, with a goal of serving 100 clinics and 100.000 patients, according to the California HealthCare Foundation (CHCF), the project's sponsor.

Diabetic retinopathy is the leading cause of blindness among working-age adults and 24.000 diabetics become legally blind each year in the United States. With regular screening, blindness can often be prevented, but half of all patients with diabetes don't get recommended yearly eye exams. The problem is even greater in the Central Valley, with a high incidence of diabetes, shortage of health providers, rural setting, and high numbers of poor and uninsured patients.

CHCF's Better Chronic Disease Care program funded a pilot project that uses telemedicine software developed by the University of California Berkeley School of Optometry, expert consultation, digital retinal cameras, and screenings during regular office visits at 13 Central Valley safety-net and rural clinics. The successful pilot led to a $1.8 million expansion of the project to selected clinics across California.

See the press release with the list of selected clinics and a short video about the program.

House considers new agency to lead healthcare IT standards development

By Diana Manos, Senior Editor
Date 27 Sep 2007    

WASHINGTON – In a bill that went relatively unnoticed, a House committee Sept. 26 considered changing the agency that oversees healthcare IT standards development. The oversight work first began in 2005 by President Bush's executive order.

A hearing held Wednesday by the House Committee on Science and Technology considered making the National Institute of Standards and Technology (NIST) the oversight agency on healthcare IT standards development, replacing the Department of Health and Human Services.
The hearing follows a bill proposed in May by Bart Gordon (D-Tenn. ), chair of the Science and Technology committee, to put NIST at the helm of coordinating healthcare IT standards development.

Meanwhile, the Administration has already announced it will spend $13 million in grant money to design a permanent private version of its healthcare IT advisory panel. 
In testimony before the committee, Michael Raymer, general manager of global product strategy for GE Healthcare Integrated IT Solutions, was concerned that the change to NIST could interfere with “valuable work that has been done to date.”

“GE supports NIST's increased involvement – but not at the expense of processes that are already working well, such as the Health Information Technology Standards Panel [HITSP],” Raymer said. “HITSP represents a best practice in public/private collaboration. We should be wary of any action that would result in diminishing the effectiveness of this group.”

Linda Kloss, CEO of the American Health Information Management Association said standards development has been slow because it has been mainly supported through volunteer efforts. She recommended that any changes made to the current standards process include financial support and staffing.

“Achieving consensus on complex standards and an understanding of their uniform application is a monumental task even with a shared vision,” Kloss said. She said Gordon's bill could be used positively to sustain and accelerate the role that HITSP already plays.

As of June, the Certification Commission for Healthcare Information Technology under the Bush Administration had certified 90 electronic health record products with standards approved by HITSP, representing 40 percent of the ambulatory electronic health record vendors on today's market.

To access Archives :  http://www.hl7.org/listservice

HHS Report: Health IT, Genetic Medicine To Personalize Care

Source: iHealthBeat  Today's News (CHCF)
Date: 20 Sept, 2007

The Department of Health and Human Services report offers a long-term plan for creating more customized treatment for patients, including the use of genetic information and health IT. The report predicts that individualized care will create a new doctor-patient relationship. HHS also said personalized care cannot be realized without interoperable, electronic systems. (Healthcare IT News et al) (read the full announcement....)

World Healthcare Innovation and Technology Congress
9-11 Dec 2007
Washington Mandarin Hotel  
Washington D.C.   
USA  
For more information visit http://www.whitcongress.com

Open Source - the Ignorance of Crowds

Source: (CANARIE.ca)  
Date:  June 2007
By: Bill St. Arnaud  

General Introduction (BSA)
[There have been several good articles and discussion on some lists about the value of open source programming especially related to some of its inherent limitations. I agree with most critics about the challenges of open source with respect to large software projects. But to my mind the debate is becoming increasingly irrelevant.  The problem is not about the pros and cons of open source - but about large monolith programming projects.  Web services, Web 2.0, etc is slowly eliminating the need for such architectural approaches to solving large complex problems. Instead programmers and computer scientists are recognizing that a lot of this work can be incorporated into stand alone web services linked across the network.  The modules can be developed independently by small teams of open source developers, where the same module can be re-used by many different applications.  The value no longer remains resident in the software but how you mash up these services together to create new innovative solutions. Thanks to Frank Coluccio and Andrew Odlyzko for these pointers -- BSA] bill.st.arnaud@canarie.ca

The Ignorance of Crowds
by Nicholas G. Carr
  strategy+business
  Issue 47 | Summer 2007

The open source model can play an important role in innovation, but know its limitations. Ten years ago, on May 22, 1997, a little-known software programmer from Pennsylvania named Eric Raymond presented a paper at a technology conference in Wurzburg, Germany. Titled The Cathedral and the Bazaar the paper caused an immediate stir, and its renown has only grown in the years since. It is now widely considered one of the seminal documents in the history of the software industry.

Continued at: http://www.strategy-business.com/press/freearticle/07204

Open Source Software Development as a Special Type of Academic Research
http://www.firstmonday.org/issues/issue4_10/bezroukov

A Second Look at the Cathedral and Bazaar:  http://www.firstmonday.org/issues/issue4_12/bezroukov

(Report) Health Information Technology: Are Long Term Care Providers Ready?

Source: iHealthtBeat (CHCF)
Date: April 2007

This Report explores the readiness for Health Information Technology (HIT) from the perspective of California's long term care providers: nursing facilities, residential care facilities, and community-based service providers. Four questions are examined to better understand provider readiness or level of preparedness for HIT:

1. Where do providers think HIT has the most promise to improve care delivery?
2. What is the state of HIT in long term care?
3. How ready are providers to invest, implement, and effectively use HIT?
4. What should providers, policymakers, and community leaders consider as they develop plans to support HIT adoption and use in long term care?

The findings show that the realities of the long term care environment must be taken into account in planning and that they must be addressed during implementation if HIT adoption and use are to be a success. Several next steps are put forth to address identified barriers, make HIT a priority, and increase provider perception of HIT benefits over costs.

The complete Report is available under Document Downloads below.
Health Information Technology: Are Long Term Care Providers Ready? (418K)

Report: Fragmentation /Unlinked Hospitals ePrescribing Systems Exacerbates Drug Error Risks

Source: California Healthcare Foundation (www.ihealthbeat.org)
(By: Robeznieks, Health IT Strategist, 8th March) .
Date: 09 March, 2007

Fragmented systems and a lack of oversight raises the risk of medication errors, according to a report released this week by the U.S. Pharmacopeia Center for the Advancement of Patient Safety, Health IT Strategist reports.

The report did not include specific technological solutions to the problem. However, the report found that computerized physician order entry systems may not be helpful in reducing medication errors in the outpatient setting because they might not be linked or affiliated with a hospital's electronic prescription system, radiology department or lab that dealt with the patient, so all relevant patient data may not be provided. The researchers used Medmarx software -- an anonymous, Internet-based program -- to analyze more than 11,000 medication errors that occurred between 1998 and 2005 at 590 facilities across a variety of surgery settings.

"Even if the best technology is available in the physicians' offices, laboratories' radiology centers and (outpatient settings), there is still a lack of integration among those settings," the report stated. The settings included outpatient surgery, preoperative holding areas, operating rooms and post-anesthesia-care units.

The researchers found that 5% of errors resulted in patient harm and four errors were fatal. Nearly 12% of pediatric medication errors also caused patient harm in these settings. The report gave its strongest technology recommendation for automated dispensing systems and bar-coding systems for the post-anesthesia-care units, where medication errors were found in 11% of sample cases, including two errors that required life-saving interventions.

The report also recommends that more research is needed to discover how CPOE and electronic health records can lower medication errors in surgery.

HRSA Provides Funding for EHR Implementation Initiative

Source:  FEDERAL TELEMEDICINE NEWsLetter (www.federaltelemedicinenews.com/)

Date:  25th March 2007  
By: Carolyn Bloch, Editor

Health Record funding opportunity (HRSA-07-125) will be used to support an electronic health record to meet the President's Health Center Initiative and the goal for universal adoption of electronic health records by 2014. The goal is to use electronic health records and other forms of health IT as tools to improve quality of healthcare and health outcomes. The implementation of the EHR will take place in the context of the HRSA Quality Initiative.  

The estimated amount for the competition is $6,000,000 with eight awards. The average size of the award is $550,000. The application was available March 15, 2007, the letter of intent is due April 5, 2007, and the projected award date is September 1, 2007.

Eligible applicants include public and non-profit organizations, but applicants must be from health centers or be from operational networks acting on behalf of the health center.

For more information, contact Susan Lumsden at sl umsden@hrsa.gov

Kentucky Unveils Hospital Comparison Web Site

 In : "iHealtBeat" Today's News.
(California Healthcare Foundation www.ihealthbeat.org )
Date: 20 th March, 2007

Kentucky has launched a Web site lets residents compare care quality at hospitals throughout the state, the Louisville Courier-Journal reports.

The online Health Care Information Center includes hospital data, such as: patient death rates during treatment for heart attacks, strokes and other conditions, and it identifies how they compare with the national average (Louisville Courier-Journal , 3/19).

The Web site also provides how often each hospital performs caesarean section deliveries, cardiac catheterizations and other procedures ( Business First Louisville , 3/19).

The site offers links to other comparison Web sites, including the Kentucky Hospital Association's Web site that lists median prices for various medical procedures ( Louisville Courier-Journal , 3/19).

The Kentucky Office of Health Policy and the Kentucky Hospital Association collaborated to develop the Web site ( Business First Louisville , 3/19).

A TELEHEALTH@Listserv “TeleDerm” Interview (from US to Austria)

An interview with Dr Cesare Massone, MD, of “telederm.org” , Austria.
(mail: cme.dermoscopy@meduni-graz.at )

Interviewer: Bob Pyke Jr. ( repyke@infionline.net )

Summary: Discussion about “telederm.org”, a DermOnline community and teleconsultation service

Source: Federal Telemedicine News ( www.federaltelemedicine.com )

Date: December 4, 2006

(read the article)

Source: iHealthBeat News (www.ihealthbeat.org)
Date: November, 2006

Nursing & Home Care in Wilton, Connecticut, has placed 17 telehealth video units in the homes of patients with conditions such as high blood pressure, respiratory illness and chronic pulmonary disease, the Stamford Advocate reports.
The program was launched in 2003 with a $45,000 grant from the New Canaan Community Foundation and Pitney Bowes, a provider of messaging management equipment. Nursing & Home Care has four nurses who specialize in the system, one of whom is a full-time employee, and provides telehealth consultations. The nurses visit patient homes once per week, the Advocate reports.
Sharon Bradley, executive director of Nursing & Home Care, said the technology is useful because serious health problems are detected early by nurses, which often eliminates trips to the emergency department. Bradley said patients "are less anxious about their medical conditions because they know they can get a nurse very quickly" (Damast, Stamford Advocate, 11/13).

New Jersey Health System Uses Teleneurology in Stroke Treatment

Source: iHealthBeat (California HCare Foundation)
Date: 18 July 2006

Virtua Health has launched a telemedicine program to aid the diagnosis and treatment of stroke patients at emergency departments at its four hospitals, the Burlington County Times reports.

Virtua Health has partnered with Brain Saving Technologies to implement teleneurology technology in its hospitals. The technology lets neurologists remotely view in real-time CAT scan results of stroke patients admitted to a Virtua ED. Neurologists also can use the technology to communicate with physicians, patients and their families.

The teleneurology technology currently is available eight hours a day, but, in the coming months, it will be available 24 hours a day, said Dr. Mitchell Rubin, medical director of the Neurosciences Program of Excellence at Virtua Health .

2005: A Developmental Model for Rural Telepsychiatry

Telepsychiatry represents a promising means to increase access to care for rural American Indian communities. This article describes rural telepsychiatry clinics operated by the American Indian and Alaska Native Programs at the University of Colorado Health Sciences Center through a partnership with the Department of Veterans Affairs, the Indian Health Service, and local tribal health services that target American Indian veterans with posttraumatic stress disorder. A six-stage model for developing such services is presented. The model consists of needs identification, infrastructure survey, partnership organization, structure configuration, pilot implementation, and solidification. This article traces program development, presents challenges in implementing these services, and offers potential solutions. The model can guide the development of telepsychiatry services for American Indians specifically and rural populations in general.

(full Article under subscription here)

EU said to spurn Microsoft settlement proposal
Date: 17.02. 2004
Source: Reuters (http://zdnet.com.com/2100-1104-5159809.html)

The European Commission has rejected Microsoft's offer to settle its antitrust case by putting competitors' software on CD-ROMs sold with computers, a source familiar with the situation said on Tuesday.

The proposal and its rejection, first reported by the Financial Times, came as part of continuing negotiations between the commission and the Redmond, Washington, software company. (more)

Recent FCC Rulings Spur Fears for Future of Open Internet
Date: 25.11.2002
Source: USATODAY.com (www.usatoday.com)

Microsoft, Yahoo and other media and technology companies are joining consumer groups that say FCC rulings — such as the recent Comcast-AT&T Broadband merger approval — could threaten the open nature of the Internet.

In fact, Microsoft and Walt Disney Co. representatives joined Andrew Schwartzman, of the Washington-based Media Access Project advocacy group, in a recent meeting with one FCC commissioner. (more)

New Institute Examines Internet's Impact
Date: 01.10.2002
Source: BBC Technology News-UK

The latest care in cruise ship medical care allows the ship's doctors to send real-time images and consult with onshore doctors at major medical centers all over the world.

Today all the newer ships are equipped with satellite hook-ups. The satellites provide live two-way video links, where virtual emergency room visits allow x-rays, electrocardiograms, and other signals to be transmitted to specialists all over the world. (more)

As backers of privacy protection bills fight an uphill battle in the California Legislature, Europe's strict approach to data protection is forcing many U.S.-based tech companies to raise the bar.

A case in point is the Federal Trade Commission's recent privacy investigation of Microsoft's Passport, an online ID service that lets people enter one name and password for almost anything they do over the Internet. (more)

Linux software vendors Caldera, Turbolinx, SuSE and Conective - but not Linux industry leader Red Hat - have formed an alliance called United Linux for joint distribution and R&D, and will sell jointly developed products under their own names. Although Linux is given out free as part of the "open source" programming movement, individual companies charge for technical support and other services. Why wasn't Red Hat included in the alliance? It was invited to join, but a Red Hat executive said: "We are not sure what to make of it, because they called us yesterday and have been working on it for months. We cannot join anything we don't understand." (AP/San Jose Mercury-News 30 May 2002)

http://www.siliconvalley.com/mld/siliconvalley/3368020.htm

The physicians at Vanderbilt University Medical Center are using a decision support computer system that inputs data from staff specialists, physician committees and peer-reviewed medical journals. Physicians at the medical center make thousands of decisions everyday. Some of these decisions are simple but can also be very complex. (more)

While most healthcare organizations are struggling to implement systems for HIPAA transactions, a new approach is emerging.  A new real-time concept that enables a provider to check eligibility, capture charges, submit claims, and receive payer approval electronically before the patient leaves the provider organization. (more)

Web Inches Along from FOR-FREE to FOR-FEE
Date: 18.03.2002
Source: NewsScan Daily

Although the vast majority of content on the Web is still free, an increasing number of sites are requiring visitors to pay subscriber fees for at least some of the content they're providing. NASCAR races are no longer offered free on the Web, and recently ABC News has ended its free video; now CNN has decided to phase out free video clips on its news, sports and financial sites. The general manager of CNN rival Foxsports.com is sympathetic with CNN's decision: "I don't think the future is too far off where most sites will turn off a lot of the freeness. The big companies that support Web sites are going to take a very hard look - can we afford to continue losing $100 million to $150 million a year on this thing?" (USA Today 18 Mar 2002).

http://www.usatoday.com/life/cyber/tech/2002/03/18/paycontent.htm

Wireless Technology Criticized For Vulnerabilities
Date: 29.01.2002
Source: NewsScan Daily

Lawrence Livermore National Laboratory in California has banned all wireless networks, including Microsoft's Wi-Fi, because of security concerns. Wi-Fi supporters say the technology is secure when it's been properly installed, but experts say that only about 10% of all users install them correctly.

For more information visit :
http://www.usatoday.com/life/cyber/tech/2002/01/29/wifi.htm

Measuring online advertising campaigns
Date: 15.01.2002
Source: New York Times

The Interactive Advertising Bureau (IAB) has joined forced with a group of Web publishers and technology advertising companies to establish guidelines for measuring the effectiveness of online advertising campaigns. Why not just use "click-throughs" as a measure? Michigan State University advertising professor says: "People won't click unless they have a real need at that moment. But even if you do not click, you still see the message. So we've found that branding is really the essence of advertising." The new standards will use five critical measures to assess the "branding" effectiveness of online advertising: ad impressions, clicks, page impressions, total visits, and unique visits.

ISPs form a new association
Date: 14.01.2002
Source: Wall Street Journal

Several Internet companies have banded together to form a new group that will focus on compliance and liability issues. The U.S. Internet Service Provider Association (US ISPA) will replace the Commercial Internet eXchange, which is folding. Founding members of the new group including AOL, Cable & Wireless, Earthlink, eBay, Teleglobe, Verizon Online and WorldCom.

US ISPA vice president Tom Dailey says the group will examine such issues as online security, liability and compliance with the new antiterrorism law, the USA-Patriot Act, and the Council of Europe Convention on Cybercrime. In addition, the US ISPA will raise "a variety of other policy and legal issues of concern to ISPs, such as Internet privacy, content regulations and intellectual property."

First Pilot Project Automated Prescription Drug Dispenser Unveiled
Date: 11.12.2001
Source: Federal Telemecine News

According to the Associated Press, InstyMeds is the first automated prescription drug dispenser to be used in a doctor's office. So far InstyMeds is a pilot project, but Minnesota pharmacy regulators just approved its use anywhere in the state. Now the inventor, Dr. Ken Rosenblum, plans to place the dispensers in doctor's offices and emergency rooms around the country.

Many hospitals now use bar coded drug stocks for inpatients to ensure that they get the right drug. About 4% of doctors use Palm Pilots for electronic prescription pads, eliminating the handwriting problem and allowing a quick records check to ensure that a new prescription won't interact dangerously with a patient's current drugs. InstyMeds combines these computerized safety systems to let patients buy their prescriptions at the touch of a few buttons.

More details on the InstyMeds system at: http://www.federaltelemedicine.com/n121001.htm

New Mexico Department of Health Supporting the New RSVP System
Date: 11.12.2001
Source: Federal Telemecine News

The New Mexico Department of Health is applying resources to the Rapid Syndrome Validation Project (RSVP) system and pilot project currently under development. The system implements a touch screen based system enabling health care providers in an Urgent Care and Emergency Room setting to rapidly enter clinical and demographic data on patients with a variety of infectious disease syndromes.

Currently, RSVP is a collaboration of Sandia and Los Alamos National Laboratories, University of New Mexico Emergency Medical Department and the New Mexico Department of Health, Office of Epidemiology.

More on the RSVP system (and contact information) is at http://www.federaltelemedicine.com/n121001.htm

National Cancer Institute's Informatics Progress and Future Plans
Date: 11.12.2001
Source: Federal Telemecine News

NCI has implemented several informatics initiatives such as:

• Establishing the NCI's Center for Bioinformatics in 2001 to provide standardized bioinformatics support and integration of research initiatives
• Establishing the new clinical trials infrastructure to increase information sharing among many clinical trials and other research efforts
• Establishing the Cancer Genome Anatomy Project that integrates cancer genetics information not available elsewhere
• Establishing the Mouse Models of Human Cancer Consortium informatics efforts to provide critical information and tools to researchers.
• Establishing a web based clinical trials information system that is called Net-Trials

More information (including 2003 Funding Objectives) is at: http://www.federaltelemedicine.com/n121001.htm

The Role of Informatics in Drug Development is the topic for the AMIA Meeting
Date: 07.11.2001
Source: Federal Telemecine News

The AMIA 2002 Spring Congress has major tracks that will deal with the Role of Informatics in Drug Development through the Point-of-Care. The meeting will be held at the Doubletree Paradise Valley Resort in Scottsdale Arizona on May 20-22, 2002. (more)

Telemedicine low cost used in follow-up care of Hepatitis C
Date: 17.10.2001
Source: Federal Telemecine News

Hepatitis C is a significant cause of chronic liver disease in the U.S Army. Nearly 2% of all
military personnel and their dependents test positive for hepatitis C (HCV).

The antiviral medications used to treat hepatitis C often causes side effects, one of many reasons why the patients taking these medications require close monitoring.

The telemedicine directorate at the Walter Reed Army Medical Center is working on using low cost, desktop video teleconferencing (VTC) equipment efficiently and without compromising
patient care to make the follow-up evaluations on hepatitis patients.

The initial phase of this study will attempt to validate the use of an inexpensive desktop VTC system to conduct visual exams on patients with hepatitis C, and to manage patient compliance with anti-viral medication schedules.

Patients with hepatitis C will be evaluated using both in-person exams, and VTC based exams.
One hundred and twelve adult patients currently receiving treatment will be evaluated.
Comparisons will be made on in-person patient evaluations versus those performed using the VTC system.

For more information,
email Sean.Kennedy@amedd.army.mil

Indian Health Service Increases Access to Mammograms in Northern Arizona
Date: 17.10.2001
Source: Federal Telemecine News

The Indian Health Service dedicated a new digital mammography unit, the Mobile Breast Care Center (MBCC) to improve access to mammography services for American Indian women. The Indian Health Service is planning to use the MBCC at Tuba Cite a remote site on the Navajo reservation Arizona. The MBCC is a component of the Mobile digital Telemammography Project initiated by DOD and HHS to address the barriers to sustaining critical health care services in underserved populations.

The MBCC provides onsite patient screening, diagnosis, and education all during one visit. Based on technology developed by GE Corporation Research and Development Center, the MBCC is equipped with a digital mammography unit that captures images by a unique detector plate instead of the traditional film used in mammograms. After full field mammograms are obtained, the digital images are immediately transmitted to a medical center for diagnosis and evaluation. Before leaving the Center, the patient has a private consultation with a member of the health care staff to discuss her results and appropriate follow-up care. Patient education can also be provided during the visit using the Internet or video and audiotapes.

For more information, contact Dianne Hammack, Indian Health Service Public Affairs at (301) 443-3593

ArticHealth Web Site for POLAR REGIONS
Date: 12.10.2001
Source: Federal Telemecine News

The National Library of Medicine created the ArticHealth site http://artichealth.nlm.nih.gov to provide access to evaluated health information from hundreds of local, state, national, and international agencies, as well as from professional societies and universities. The site is devoted to chronic diseases, behavioral issues, traditional medicine, environmental/ pollution data, and environmental justice information. Hospitals, clinics, libraries, and remote villages now have a web site devoted to health issues of concern to them.

ArticHealth was created for a much narrower audience than MEDLINEplus and ClincalTrials.gov. This new site is the first health information site for special populations and the health professionals who serve them. NLM plans to work with the Regional Medical Library at the University of Washington in Seattle since the university is already working with health issues in the Arctic region.

New Technology Allows Hospital to Communicate with the Deaf
Date: 13.09.2001
Source: Federal Telemecine News

The emergency room at Frederick Memorial Hospital in Frederick MD is able to communicate better with deaf patients using a special television monitor and a small camera. With the Maryland School for the Deaf located less than a mile from the hospital, officials believe there is a great need for the machine. Currently there is a shortage of sign language interpreters in the U.S.(more)

CyberCare System Reaches to Rural Home Healthcare Agencies
Date: 13.09.2001
Source: Federal Telemecine News

The Health Access and Alert Network of Texas (HAANet) a statewide secure network sponsored by the Texas Rural Hospital Telecommunications Alliance (TRHTA) and the Texas Association of Local Health Officials (TALHO) is working with the CyberCare System to broaden the network’s outreach to rural home healthcare agencies.(more)

NASA and the University of Mississippi Medical Center Working Together
Date: 13.09.2001
Source: Federal Telemecine News

NASA and the University of Mississippi Medical Center (UMC) have joined together to work on performing surgical procedures in space for future long-term space ventures. In a test project to prepare for future medical attention in space, NASA is providing telecommunications and medical imaging linkups.

A UMC physician Dr. Sewell, Chief of UMC’s Division of Interventional Oncology and Assistant Professor of Radiology in Jackson Mississippi is directing interventional (image guided) surgeries to patients in 2 hospitals in Japan. The physicians, who will perform the interventional surgeries in Japan, as directed by Dr. Sewell are Dr. Tadashi Shimizu of Hokkaido University Hospital in Sapporo and Dr Jyunta Harada of Jikeo University Hospital in Kashiwa

The medical telecommunications networking logistics such as sending high quality I-MRI images in nearly real time from either of the Japanese hospitals to Dr. Sewell in Jackson, and performing simultaneous video conferencing, will be perfected in the near future.

As the system is developed, it may one day allow on-board astronaut/physicians to perform a variety of surgeries on long term missions. Surgical specialists will be able to perform surgeries on space stations or on trips to Mars. The project is beneficial to UMC, as the project may allow internationally accomplished surgeons to practice globally or in space via state-of-the-art telecommunications networking.

"Wireless Healthcare Applications & Technologies Conference
& Exhibition"
Date: 05.09.2001

This promises to be an exciting event and interest is extremely high among all the industry stakeholders. The room block at the beautiful Alexis Park Spa & Resort is expected to be a sell-out, so call today to make your reservation at 800-582-2228, to ensure the Medical Records Institute group discount.

Find out what works and what doesn't during 3 days of networking, market intelligence, case studies, and ROI presentations with more than 400 your industry peers. Join us for a full day of pre-conference tutorials, 50+ educational sessions and exhibition that promises further resources, as well as opportunities for networking, and professional contacts for the vendor and health systems professional.

Register today by calling 617-964-3923 or register online, at www.medrecinst.com/wireless. In addition, view the conference program, event co-sponsors, and exhibition information.

Federal Telemedicine News
Date: 20.08.2001

HRSA’s Bureau of Primary Health Care (BPHC) in conjunction with the Health Center Information Systems Workgroup is providing Community Health Centers with information on Electronic Medical Records and Disease Management to assist with implementing systems to support clinical data management. (more)

The Red Eye: Streaming News
Date: 31.05.2001

SAN FRANCISCO, CALIFORNIA -- San Francisco streaming-media summit. This time around, we were interested in getting an update on whether bandwidth costs are falling.

As our Red Eye readers know, we are believers in the streaming-media opportunity and anticipate growing consumer interest in viewing video over the Internet as more and more consumer devices, such as Palm Pilots and TVs, become Internet-equipped over the next two Christmas seasons.

Driving this boom will be Gilder's law, which states that bandwidth grows at least three times faster than computer power. To compare, Moore's law, the computing paradigm that Mr. Gilder builds on, says that computing power roughly doubles every 18 to 24 months. If Mr. Gilder is right in his assertion, then growth of bandwidth will be quite rapid. To date, we've already seen great progress. In fact, Mr. Gilder likes to say that the amount of Internet traffic that went across a network in an entire month in 1997 can now be transmitted in a single second. Still, this is just the beginning.

Launch Media's Mr. Goldberg had some evidence to support Mr. Gilder. He says the cost of bandwidth is beginning to fall very quickly, as supply is exceeding demand. "The cost of bandwidth is going down 40 to 50 percent per year. It becomes an infinitesimally small cost," Mr. Goldberg says. "It's more like water than electricity. Once you've built the infrastructure for water, it just flows."

Streaming costs come in two categories: bandwidth, which is variable, and the fixed cost of storage. As bandwidth costs fall, the idea is that broadband will be more affordable. This should help adoption of streaming media on both the consumer end and for enterprises.

------------------------------------------------------------

FORD EVERY STREAM
Interestingly, another company recently introduced a technology that could revolutionize streaming. Digital Fountain's Mr. Meltzer is hoping that his company's technology, which eases point-to-multipoint streaming, will make bandwidth practical and affordable.

Next month, the company is scheduled to begin sales of its servers, coupled with a new way of sending information over the Internet. Instead of data traveling in packets that must arrive in order, Digital Fountain's packets, called "meta- content," can arrive in any order. This decreases the burden on the servers and thus lowers the overall cost. We just might see the streaming-media landscape undergo a shift, thanks to cost savings from technologies like Mr. Meltzer's.

Still, falling bandwidth costs just might generate the critical mass needed for the streaming space to come of age.

Privacy rules delayed
May 16, 2001
(Source: TIE)

An article in the February 27th New York Times, Health Secretary Delays Medical Records Protections says that the new Health and Human Services Secretary, Tommy G. Thompson, has said that he will delay and reconsider HIPAA rules issued in December by the Clinton Administration.

On 28 February he re-opened the final rule for the protection of identifiable health information for a 30-day public comment period before the regulation goes into effect on April 14, 2001. Under the Clinton Administration, the proposed rule evoked more than 52,000 comment letters. However, in his February 23 announcement the Secretary stated, "The department will review the comments it receives to determine whether changes in the final rule are needed."

The privacy regulation issued by the Clinton Administration in December 2000 was originally scheduled to go into effect on February 26, 2001, but was delayed since it was not transmitted first to Congress for review. The public has until March 30, 2001, to submit comments to HHS on the regulation. Comments will be received either electronically or via mail at:

U.S. Department of Health and Human Services, Attention: Privacy I, Room 801 Hubert H. Humphrey Building, 200 Independence Avenue, S.W. Washington, D.C. 20201

Military Telemedicine News

(article from TIE, published March 2001)

"A U.S. Air Force imaging expert transmitted live ultrasound images from an aircraft in flight to a medical team on the ground, in a test performed in September on a crew member. They used a new microminiaturized ultrasound system in a probe, introduced by Terason Division of Teratech Corporation."...(more)

Center for Telemedicine Law

A non-profit organization which keeps telemedicine practitioners and interested parties aware and informed of legal developments affecting telemedicine. (link)

Med-Tel Technology Links Rural Patients With Specialists

• Read the full article here

Directory of Health Technology Assessment Organizations Worldwide

The Medical Technology and Practice Patterns Institute (MTPPI), Bethesda, Maryland, USA, is a WHO Collaborating Center on Technology Assessment.
We are pleased to announce the publication of the Directory of Health Technology Assessment Organizations Worldwide, a compilation of information about 131 government agencies, university groups, and private health research organizations from 27 countries that specialize in assessing health-care technologies (medical devices, pharmaceuticals, and medical and surgical procedures).
This new directory will be of interest to health policy-makers, regulatory agencies, health care providers, medical device and pharmaceutical manufacturers, insurance companies, medical librarians, ministers of health and regional health planners, other health professionals, and individuals interested in health services research.

It catalogs health technology assessment activities in the U.S. and around the world, providing decision-makers, researchers, and other health professionals with a status report on this growing field as well as a valuable resource in the search for both information and potential partners.
If you wish to learn more about the Directory or MTPPI, please visit the website at www.mtppi.org.

There you will find an executive summary and table of contents for the Directory, as well as ordering information.
You will also find more detailed information about MTPPI and its various health research activities.

Contact:
Dennis J. Cotter President MTPPI
4733 Bethesda Ave.,
Suite 510
Bethesda,
MD 20814
phone 301-652-4005
fax 301-652-8335
e-mail: dcott@mtppi.org