Friday, June 27, 2008

DEA Issues Proposed Regulations to Allow Electronic Prescriptions for Controlled Substances

ePrescribing of controlled substances will further improve operations in doctors' offices. SV

JUN 27 -- DEA today published proposed regulations that would provide physicians and other authorized prescribers with the option of issuing electronic prescriptions for controlled substances. These regulations would also permit pharmacies to receive, dispense, and archive these electronic prescriptions. The agency is seeking public comment on the proposed regulations. Any member of the public wishing to submit comments may do so by mail or electronically on or before September 25, 2008.

These regulations provide pharmacies, hospitals, and practitioners with the ability to use modern technology for controlled substance prescriptions while maintaining the closed system of controls on controlled substances dispensing; additionally, the proposed regulations would reduce paperwork for DEA registrants who prescribe or dispense controlled substances and have the potential to reduce prescription forgery.


Thursday, June 26, 2008

Personal Health Records (PHR) privacy protections codified: Common Framework for Networked Personal Health Information

The Markle Foundation has published the suggested rules of operation that should give greater protection to users of PHR type products. Google, Microsoft, among others, are on-board. SV

Tuesday, June 24, 2008

Our Pen and Paper Doctors New York Times Editorial June 24 2008

I just read the editorial which refers to the June 18, 2008 New England Journal of Medicine article which surveyed 2,700 physicians. It notes that in countries with single payor systems, electronic health record use is almost universal. In those countries, the government foots the bill. All the financial benefits are then funneled back for re-investment etc. The major barriers noted here in the United States relate to the cost of acquisition, the cost of maintenance, the lack of standards and fear of early obsolescence among others.

Unfortunately, the editorial ends with the sentence, "It is time to drag private physicians out of the paper age".

There is no need to disbarage the concerns of physicians. The financial barriers are real and the financial benefits unfortunately mostly accrue to others. Physicians need not be "dragged", they just need the financial assistance to get started and a fair share of the benefits that will be generated. Once this is done, I believe that most physicians will do their fair share of pulling health care away from the Pen and Paper of the previous century.

Salvatore Volpe MD
Co-Chair of the Medical Society State of New York, Health Information Technology Committee

NY Times
The Ultimate Guide to Taking Control of Your Health Records

Here's a pretty good compilation of services and tools for laypersons and medical professionals related to electronic health records and personal health records. SV

Nursing Online Education Database NOEDb

Monday, June 23, 2008

AT&T, Covisint and Microsoft Partnership: Nationwide Health Information Exchange

This promises to bring information from disparate sources together.
Not mentioned, is possible collaboration with other organizations attempting to create a National Health Information Exchange. More details are welcome. SV

The new eHealth information exchange is a revolutionary approach designed to reduce costs and improve the quality of care while putting patients in control of their medical records. It allows consumers using Microsoft® HealthVault™, a software and service-based platform for storing and accessing personal health information, to share information with authorized physicians and health care providers connected to AT&T Healthcare Community Online.

The new eHealth information exchange, enabled by Covisint’s On-Demand Healthcare Platform and layered on AT&T’s patented eHealth solutions and Multiprotocol Label Switching (MPLS) network, shares information electronically and in a security-enhanced way across the continuum of care — from patient to provider communities such as HealthVault, health-information exchanges and insurers.

Press Release

Saturday, June 14, 2008

Blue Cross Blue Shield of Massachusetts To Integrate With Google Health

Congratulations to BCBSMA and GOOGLE!

Remember this is just claims data, but it does help supplement the information that can be collected by practices participating in the Massachusetts eHealth Collaborative by providing data from hospitals and physicians not part of the Collaborative. SV

Blue Cross Blue Shield of Massachusetts (BCBSMA) announced today a partnership with Google Health that will expand options for members who want to create their own Personal Health Record (PHR). BCBSMA is the first health insurance company to sign an agreement to integrate on the Google Health platform. After the integration is complete, BCBSMA members can import their claims data into their Google Health profile safely and securely. Google Health, a new product that launched in mid-May of this year, allows patients to store and organize their medical records online.

Once this sharing relationship is established, Google Health will give BCBSMA members the ability to:

Organize, store and manage their medical records and personal health information online in one secure location, including BCBSMA claims data;
Download medical records and prescription history from other connected providers, such as retail pharmacies, Pharmacy Benefit Managers (PBMs), labs and doctors offices;
Share their medical information with providers and or third party services they may offer customized services;
Learn about important health issues and potential drug-to-drug interactions;
Search for a doctor or hospital online.


Wednesday, June 11, 2008

Kaiser Permanente My Health Manager partners with Microsoft Healthvault

This will be a major test of interoperability capability. SV

OAKLAND, Calif., and REDMOND, Wash. — Kaiser Permanente and Microsoft Corp. announced today that the two companies will pilot health data transfers between Kaiser Permanente's My Health Manager and the Microsoft HealthVault consumer health platform. Pairing two leaders in online health innovation, this pilot program is expected to unveil new strategies for expanding consumer access to online health information and management tools.

The pilot program will extend the functionality of the successful Kaiser Permanente personal health record, My Health Manager. Already, My Health Manager's more than 2 million users have convenient and easy online access to clinical information and health management tools, including e-mailing your doctor, online prescription refills and appointment scheduling. Connecting My Health Manager to the HealthVault platform will allow users to combine personal health information from Kaiser Permanente and a wide range of health and wellness management applications and devices such as blood pressure monitors.

Kaiser Permanente
CCHIT names PHR Advisory Task Force

Special congratulation to Dr Agrawal, an advocate of Medication Reconciliation. SV

Members of the task force are:

Mark Leavitt, CCHIT, and Paul Tang, M.D., Palo Alto Medical Foundation

Abha Agrawal, M.D., Kings County Hospital Center, Brooklyn, New York
Richard Benoit, Intel Digital Health Group
Lorraine Doo, Office of e-Health Standards and Services, CMS
Steve Findlay, Consumers Union
Meighan Girgus, American Heart Association
Theresa Hancock, Veterans and Consumers Health Informatics Office, U.S. Department of Veterans Affairs
Leslie Harris, Center for Democracy and Technology
Missy Krasner, Google Health
Steve Lampkin, Wal-Mart
Holly Miller, M.D., University Hospitals, Cleveland, Ohio
Don Mon, American Health Information Management Association
Anna Lisa Silvestre, Kaiser Foundation Health Plan
Michael Stokes, Microsoft Corporation
Michael Ubl, Blue Cross Blue Shield of Minnesota
Patient representative (to be named)
CCHIT establishes Personal Health Records (PHR) Work Group

The Personal Health Records (PHR) Work Group was established in 2008 as part of the Certification Commission expansion. It is preparing to engage in CCHIT Certified 09 efforts.

Special congratulations to Dr Eytan:physician, philosopher, traveler. SV

Personal Health Records Work Group Members


Ted Eytan, MD MS MPH
Medical Director, Health Informatics & Web Services
Group Health Cooperative

Lory Wood
VP, Chief Security and Compliance Officer
Good Health Network


Nicole Antonson, RN, MBA
Program Manager, Patient Safety

Suzie Burke-Bebee, MSIS, MS, RN
Senior Health Informatician
Dept Health and Human Services

Albert Chan, MD, MS
Physician Champion of Electronic Health Record and PAMFOnline
Sutter Health, Palo Alto Medical Foundation/Palo Alto Foundation Medical Group

Haris Domazet
Division Lead of Web Technical Services
Epic Systems Corporation

Donna DuLong, RN, BSN
Program Director
TIGER Initiative

Paul Edge
VP, Clinical Solutions
Misys Healthcare Systems

Michael Galang, DO, MS
Chief Medical Information Officer
Catholic Health System of Western New York

Lenel James, BS, MBA
Senior Project Manager
Blue Cross and Blue Shield Association

Jerry Lin
Product Manager

Cortney Nicolato
Senior Manager, Strategic Alliances & Health IT
American Heart Association National Center

Jan Oldenburg
Practice Leader
Kaiser Permanente

Juhan Sonin

Stelle Smith
Clinical Product Marketing Manager
Sage Software

James Tosone
Director, Healthcare Informatics
Pfizer Inc

Lawrence Williams
President / CEO
Roadside Telematics Corporation

Julie Wolter, MA, RHIA
Assistant Professor
Saint Louis University

eHealth Initiative: Roadmap and Practical Guides for Rapid Expansion of Electronic Prescribing

eHealth Initiative and The Center for Improving Medication Management Release National Roadmap and Practical Guides for Rapid Expansion of Electronic Prescribing

Multi-stakeholder Group Touts Benefits from E-Prescribing and Makes Recommendations on How to Accelerate its Adoption and Effective Use

The report provides concrete recommendations to move e-prescribing into mainstream practice. Recommendations in the report include:

Adoption and effective use of e-prescribing. All prescribers should adopt e-prescribing as it becomes a mainstream model of care, including small practices, small hospitals, and long term care facilities.

Replicate and expand successful incentive programs. Align incentives developed by federal and state governments, payers, employers, health plans, and health systems.

Address the DEA ban on e-prescribing controlled substances. The federal government should act soon to end the DEA ban on e-prescribing of controlled substances to eliminate the need for physicians to manage duplicative work processes.

Create a public-private multi-stakeholder e-prescribing advisory body. The e-prescribing advisory body must be created to monitor, assess and make recommendations to accelerate the effective use of e-prescribing, and should be made up of diverse stakeholders across every sector of health care.

All stakeholders should advance the e-prescribing infrastructure. The industry should encourage all pharmacies to accept electronic prescriptions and provide medication history information, all payers/PBMs to deliver formulary, eligibility, and medication history information through e-prescribing, and all vendors to deploy and support high-quality e-prescribing applications.

Continue development of additional standards for e-prescribing. While fully connected e-prescribing is delivering real benefits based on the national standards in place today,additional standards development and adoption processes should be supported and accelerated and all stakeholders, including the federal government and the private sector, must be involved.

HHS Secretary Mike Leavitt:named 12 communities: CMS EHR Demonstration project

Congratulations and good luck!
We New Yorkers anxiously await expansion of the project. SV

HHS Secretary Mike Leavitt today named 12 communities that will participate in a national Medicare demonstration project that provides incentive payments to physicians for using certified electronic health records (EHR) to improve the quality of patient care. The five-year, first-of-its-kind project is expected to improve the quality of care provided to an estimated 3.6 million Americans.

“The use of electronic health records, and of health information technology as a whole, has the ability to transform the way health care is delivered in our nation,” Secretary Leavitt said. “We believe that EHRs can help physicians deliver better, more efficient care for their patients, in part by reducing medical errors. This project is designed to demonstrate these benefits and help increase the use of this technology in practices where adoption has been the slowest – at the individual physician and small practice level.”

The communities selected to work with the Centers for Medicare & Medicaid Services (CMS) on the EHR demonstration project range from county- and state- level to multi-state collaborations. They include:

Jacksonville, FL (multi-county)
Maryland/Washington, DC
Pittsburgh, PA (multi-county)
South Dakota (multi-state)
Madison, WI (multi-county)


Tuesday, June 03, 2008

ONCHIT releases strategic HIT plan for 2008 to 2012

EHRs and PHRs are felt to be the key tools help the plan succeed.
While many states have raised significant sums to help this succeed, the Federal government has not done so to the same degree. The Patient Centered Medical Home and other similar initiatives will be need by the Public and Private sector to help accelerate the process. SV


The Plan has two goals, Patient-focused Health Care and Population Health, which are defined as follows:

Patient-focused Health Care
: Enable the transformation to higher quality, more cost-efficient, patient-focused health care through electronic health information access and use by care providers, and by patients and their designees.

Population Health
: Enable the appropriate, authorized, and timely access and use of electronic health information to benefit public health, biomedical research, quality improvement, and emergency preparedness.

Each goal has four objectives and the themes of privacy and security, interoperability, adoption, and collaborative governance recur across the goals, but they apply in very different ways to health care and population health.