December 15, 2009
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Since the Canadian and U.S. stimuli directed fuding towards electronic medical records (EMR), we’ve been following developments in the area as part of our Biotech Trends series here on the blog and have noted successes and failures. A few recent stories highlight risks and benefits:
A recent Scientific American story (H/T @mikesgene) turned an analytical eye on the University of Pittsburgh Medical Center‘s implementation, the current iteration of which started in 2004. Case studies have been an important part of the EMR narrative, and many so far have focused on Kaiser Permanente’s implementation, which is the world’s largest civilian system, so it’s nice to see an in-depth analysis of a different experience. The article closes with a quote from National Institute of Standards and Technology (NIST) Director Patrick Gallagher, who says the stimulus effort
“is about using technology to bring health care information together to reduce medical error, reduce the need for testing, put information in front of patients, and put information in front of researchers.”
A FierceHealthIT story reported on an initiative by the American Telemedicine Association, which is running a demonstration program with DocTalker Family Medicine. DocTalker, founded by Dr. Alan Dappen (partnered with @drval) is providing remote health services to Association members and employees. It’s being pitched as an employee benefit that can promote worker health and productivity by reducing the need for office visits and providing round-the-clock responsiveness.
Telemedicine’s role in EMR also features in this story about a pacemaker developed by St. Jude Medical that allows patients and doctors at the Montreal Heart Institute to get data and alerts from the device, which also transmits cumulative data to the doctors in advance of patients’ follow-up visits.
With all of these electronic data floating around, security is key, but it remains an elusive target. Dan Vorhaus tweeted about a ModernHealthCare.com article that highlights numerous security breaches this Fall. Microsoft’s purchase this week of Sentillion, which focuses on EMR security, was for an undisclosed sum but you can bet it’s key to Microsoft’s EMR strategy.
November 12, 2009
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Ontario is providing up to $29,800 per physician over 3 years for new adopters of electronic medical records. In the few weeks since the program has been implemented, the OMA has gotten over 650 inquiries and over 150 applicants. There’s a local option and a cloud option, which runs off the eHealth Ontario servers. Interestingly, up to $14,400 is available for early EMR adopters who complete upgrades to the latest spec.
Some interesting features at OntarioMD try to increase the effectiveness of the implementation:
- EMR Advisor, an Ontario-based blog that includes information, tips and case studies;
- A transition support program;
- A support guide; and
- Practice management consultants (on the government’s dime).
Meanwhile, Canada Health Infoway got its own clean bill of health from the Auditor General.
October 26, 2009
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David Pogue waded into the EMR narrative this week, with a piece on CBS News that took a look at the U.S. efforts with an interesting focus on Kaiser’s EMR efforts. Pogue follows up with a blog post containing a transcript of his full interview with David Blumenthal. Interestingly, the main negative angle in his CBS piece is cost; but as we’ve noted, many providers are offering loans or guarantees or both to cover the cost until the federal payments kick in.
Meanwhile, Australia is only three years away from a full national EHR system, complete with a lifetime ID and scary music for the privacy-related segments:
August 6, 2009
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The President’s Council of Advisors on Science and Technology is meeting now. The meeting is broadcast live online at http://tr.im/vK3G.
They just finished introductions. Eric Schimidt, Eric Lander and Harold Varmus are there, among other luminaries. 100% in-person attendance.
“21 members include 4 winners of MacArthur ‘genius’ awards, 3 Nobel laureates, 2 university presidents, as well as 16 members of one or more of the U.S. national academies of science, engineering, and medicine.”
August 5, 2009
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The WSJ Health Blog notes today that Salesforce.com’s investment in Practice Fusion, though not a large financial investment, follows an appealing trend in the EMR space. Both Salesforce.com and Practice Fusion are cloud computing plays (aka hosted services / ASP) where software and data live on company servers rather than on local PCs in doctors’ offices. This will be particularly attractive for smaller practices without their own IT capabilities.
We’ve been following the world of electronic medical records, which has attracted billions of dollars in U.S. stimulus money and over $400 million in Canada, and have been keeping track of notable implementation successes and privacy challenges.
July 10, 2009
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New data yesterday from a home telehealth monitoring program developed by the University of Ottawa Heart Institute claims a whopping 54% cut in hospital readmission for heart failure patients. Readmission rates dropped to under 15% for patients on the program, which includes daily vitals monitoring and immediate contact if anything seems amiss. UOHI says they realize up to $20,000 in savings for each patient safely diverted.
Of course, any time you create electronic medical records, you create privacy risks, as this week’s fiasco in Alberta shows. Over 11,000 patients were notified of a privacy breach after a virus infected over 100 Alberta Health Service computers. A follow-up CBC story quotes a computer security expert who is appalled (the virus is 7 years old).
If you still want to hop on the electronic medical record bandwagon, McGill University Health Centre is collaborating with Medical.MD to promote a 300-subscriber beta test (first-come, first served) for Medical.MD’s web-based personal health records management tool — MedforYou. Medical.MD says the service will be very user-friendly and will include information on allergies, procedures, providers and medications as well as a journaling function.
June 15, 2009
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GE has put $100 million — the first installment of a promised $6 billion commitment to its “healthymagination” goals — into funding zero-interest loans to physicians’ offices, hospitals, clinics, etc. to support the purchase of (GE’s own) electronic medical records (EMR) systems.
The program is called “Stimulus Simplicity” and it has a couple of very smart features:
- 1. The interest-free period extends through 2012, a year after the U.S. stimulus funding will give credits to EMR purchasers; and
- GE will include a “certification warranty” that will ensure the systems qualify for the stimulus funding.
Highly Ymaginitive, GE!
[A side note for the lawyers in the audience: GE says Stimulus Simplicity contracts feature "extremely simple language." Truly plain language contracts ... that could be a $6 billion benefit right off the bat.]
May 19, 2009
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CNET News has been taking a look at electronic medical records over the last few days in a feature called “Your eHealth Future” (hat tip to the WSJ Health Blog). They are covering health care reform from the IT side, presented in six articles, all accessible through this link:
- 1. Dragging health records into the Digital Age;
- Microsoft, Google in healthy competition;
- What you need to know about e-health records faq;
- Politicos prep for another health care showdown;
- Why are doctors such Luddites? and
- Taking your health record with you.
Two Canadian developments on the electronic medical records front:
Telus and Microsoft are developing a patient-centred system that would allow individuals to access and manage their medical records and would interface directly with health care providers’ systems to gather and share the data. Canada Health Infoway wants to make sure it’s secure. The CBC story mentions that the IBM/Google Health team is looking at a Canadian implementation as well.
GE held an event today at MaRS launching a global healthcare initiative — called “healthymagination” — with announcements in 4 other cities around the world including Washington.
GE is devoting $6 billion over the next 6 years to meet three goals by 2015: reduce the cost of healthcare by 15% (focusing on procedures and processes); increase access by 15% (to services, technologies and health education); and improve quality by 15% (partner with physicians and stakeholders to simplify procedures and accelerate adoption of standards of care).
The initiative was introduced in Toronto by Elyse Allan, President & CEO of GE Canada, and by Peter Robertson, General Manager of GE Healthcare Canada, who did a good job of speaking to Canadian-specific issues. One program that was heavily discussed was the Pan Northern Ontario PACS Project (PNOP) agreement with GE Healthcare for the creation of a Diagnostic Imaging Repository (DI-r) and longitudinal patient records across northern Ontario. The program is being funded in part by Canada Health Infoway and the Ministry of Health and Long Term Care’s eHealth Program.
Dr. Suzanne Strasberg took over as the incoming president of the Ontario Medical Association (OMA) Saturday night at their annual gala. The OMA press release headlines Dr. Strasberg’s call for access to family physicians, but health IT also figures prominently. Dr. Strasberg indicated that she would focus on a number of initiatives, including “expansion of the use of IT and eHealth” and cited support for “Electronic Medical Records, which have enhanced patient safety and improved the quality and continuity of care, as examples of where further expansions should be made immediately.”
Click here for our other posts on electronic medical records.
April 21, 2009
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One of the concerns about the privacy of electronic medical records is that many of the major providers — notably Google and Microsoft — are not “covered entities” under HIPAA and are therefore not subject to its privacy provisions.
The funding for Electronic Health Records in the American Recovery & Reinvestment Act of 2009 comes with a requirement that HHS study, in consultation with the FTC, “potential privacy, security, and breach notification requirements” with respect to entities not covered by HIPAA, and make recommendations within one year.
In the interim, Section 13407(g)(1) of the Recovery Act requires the FTC to promulgate regulations on breach of security notification provisions.
The FTC has proposed a breach notification rule, and is coordinating with HHS. The proposed rule:
- requires vendors of personal health records and related entities to provide notice to consumers following a breach, and reaches through to require the vendors’ service providers to notify the vendors;
- sets the standard for what triggers the notice requirement, as well as the timing, method, and content of notice; and
- requires FTC notification of any breaches.
- the nature of entities to which its proposed rule would apply;
- the particular products and services they offer;
- the extent to which vendors of personal health records, PHR related entities, and third party service providers may be HIPAA-covered entities or business associates of HIPAA-covered entities;
- whether some vendors of personal health records may have dual roles as a business associate of a HIPAA-covered entity and a direct provider of personal health records to the public; and
- circumstances in which such a dual role might lead to consumers’ receiving multiple breach notices or receiving breach notices from an unexpected entity, and whether and how the rule should address such circumstances.
April 15, 2009
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Two Camels! Dolly the cloned sheep, meet Injaz the cloned camel.
Two R&D Heads! The combined Pfizer-Wyeth will have Mikael Dolsten heading up the newly created BioTherapeutics Research Group and Martin Mackay heading up the small molecule PharmaTherapeutics Research Group. (Two CapitalLetters!) The In Vivo Blog has a podcast interviewing both.
Two VA Initiatives! In addition to the electronic medical records initiative we mentioned earlier this week, the Department of Veterans Affairs is also setting up a large cohort genetic study that will establish a database of genetic information from patients that will be linked to the participants’ electronic health records. This is great news for personalized medicine because it will ensure that the EHR standard that comes out of the VA project will accomodate and utilize individualized genotypic data.
Two R’s, Two L’s, Two B’s! G. Steven Burrill (two r’s, two l’s, one b) says he’s confident he can raise $1 billion (there it is!) to develop the Pine Island biotechnology project and a private equity/venture capital fund, which will support development of new technologies out of the Mayo Clinic and the University of Minnesota, among others.
Two Guidance…s! Health Canada issued a finalized version of a Guidance Document on data protection (only applicable to qualifying innovative drugs that received an NOC on or after June 17, 2006) AND a revised version of the draft Guidance Document on Subsequent Entry Biologics, (which includes a 6-year data protection period). More to come on this.
Two Border Crossings! Simponi, a biologic developed by Johnson & Johnson and Schering-Plough, crossed the border Northbound — gaining approval from Health Canada before the FDA; and Molecular Templates Inc. crossed the border Southbound — leaving Ontario for the Texas Life-Sciences Collaboration Center.