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Biotechnology, Health and Business in Canada, the United States and Worldwide

Tag Archives: EMR

Trends Update — Electronic Medical Records: Importance of Telemedicine, Implementation and Data Security

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.

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Trends Update — Electronic Medical Records: Ontario’s New EMR Adoption Program

floppy-disk1Ontario 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.

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Trends Update — Electronic Medical Records: Pogue Mugs On CBS and Interviews Blumenthal While Australia Shows How It’s Done

floppy-disk1David 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:

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Cumberland Ends Bio IPO Drought But Prices Under Range. Next Up, Emdeon.

Cumberland Pharmaceuticals (NASDAQ: CPIX) raised $85 million in its IPO today, pricing at $17 per share.  This was less than the $19-21 per share range, but since it’s the first bio IPO since November 2007 we won’t complain.

The company is planning to use the proceeds to buy late-stage or approved therapies for acute care and gastroenterology to go along with their existing approved products – Caldolor, an IV form of ibuprofen, and Acetadote, which treats acetaminophen overdose.

The WSJ Health Blog notes that Cumberland is the first of two planned healthcare IPOs this week.  Stay tuned for Emdeon, an electronic medical-billing systems company that is looking for over $330 million tomorrow.

Trends Update — Electronic Medical Records: President’s Council of Advisors on Science and Technology (PCAST) Meeting on Health IT

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.”

Trends Update — Electronic Medical Records: Salesforce.com Clouds the EMR Field

floppy-disk1The 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.

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Trends Update — Electronic Medical Records: Ottawa Telehealth Success, Privacy Fiasco in Alberta, Beta Test in Montreal

floppy-disk1New 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.

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Trends Update — Electronic Medical Records: GE’s First Healthymagination Project Aims to Speed EMR Adoption, May Also Help GE Sell Stuff

floppy-disk1GE 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. 1.    The interest-free period extends through 2012, a year after the U.S. stimulus funding will give credits to EMR purchasers; and
  2. 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.]

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Health IT in Ontario: Electronic Medical Records, eHealth Procurement Need Help; Online Resources Make Progress

floppy-disk1The Ontario Health Quality Council’s (OHQC) 2009 Annual Report On Ontario’s Health System was released earlier this week, and it notes that Ontario lags when it comes to EMR adoption:

25 percent of family-practice doctors in Ontario had electronic medical records, compared to 50 percent in Alberta, 98 percent in the Netherlands and 89 percent in the United Kingdom.

Of course, eHealth Ontario is focused on other priorities: wait times, diabetes management, medication management…  and crisis management.  Ontario’s EMR target for full adoption is 2015, but the Ontario Medical Association and the Ontario Hospital Association both issued releases supporting the OHQC Report’s call for more EMR adoption.

Meanwhile, the Pew Research Centre has a new report out today about how consumers use the internet to find and interact with sources of health information that shows a pretty high level of engagement — according to the WSJ Health Blog’s interview with a co-author of the report:

Nearly 60% [of internet users] said they have consulted blog comments, hospital reviews and doctor reviews, listened to podcasts about health care and signed up to receive updates about health or medical issues. And 20% have posted comments, reviews, photos, audio or video online related to health care, such as participating in an online group forum.

On this front, Ontario is doing pretty well.   The Canadian Medical Association launched an online diabetes tool for family physicians with chronic disease patients at mydoctor.ca which:

allows patients to share important diabetes-related information – such as blood sugar, weight and exercise results – with their doctor in a secure, online environment.

Also, the Ontario Hospital Association’s myhospitalcare.ca website, which started off pretty thin, has gotten an information upgrade this week.

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Trends Update — Electronic Medical Records: Health IT and EMR Have an Advocate in New OMA President Suzanne Strasberg

floppy-disk1Dr. 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.

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FTC Proposed Rule for Medical Record Privacy for Non-HIPAA Entities

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.
Public comments are being accepted through June 1, 2009, and can be submitted online at https://secure.commentworks.com/ftc-healthbreachnotification.  In particular, the FTC is seeking comments on:
  1. the nature of entities to which its proposed rule would apply;
  2. the particular products and services they offer;
  3. 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;
  4. 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
  5. 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.

 

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Wednesday Brain Dump: Two of Everything! Edition

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.

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