The American Medical Association and the Medical Group Management Association have released a new online directory of practice management information systems that are capable of meeting HIPAA 5010 transaction standards, Health Data Management reports (Goedert, Health Data Management, 4/28).

HHS has set a deadline of Jan. 1, 2012, for using HIPAA 5010 transaction sets, which regulate the transmission of certain health care transactions (iHealthBeat, 3/14).

AMA President Cecil Wilson said, “As the date for compliance with the government’s updated standard for electronic claims transaction rapidly approaches, physicians need to have practice-management software in place that meets those standards.”

The directory includes information on:

• Product pricing;
• How many users have installed a product;
• The number of years a product has been on the market (Conn, Modern Healthcare, 4/29); and
• Affiliated electronic health record products (Health Data Management, 4/28).

Source: iHealthBeat

Social networking tools, when paired with the use of personal health records, can be valuable in monitoring chronic diseases, according to a study published in PLoS ONE by researchers at Children’s Hospital Boston, Healthcare IT News reports.

The project used a social website, TuDiabetes.org, to invite users to share their personal data regarding one common diabetes control measure known as hemoglobin A1c status. Data were submitted through an application called TuAnalyze, which is based on the hospital’s personal health record program. Data then were shown on county- or state-level maps in real time (Merrill, Healthcare IT News, 4/26).

Overall, one in five website users signed up for the application, and 81% of those users shared their data, the researchers said (Evans, Modern Physician, 4/29).

According to the study, users who signed on to the system within the first two weeks of its launch and those who shared their A1c data openly reported lower average A1c values than those who began using the program later or shared only their aggregate data (Healthcare IT News, 4/26).

Reaction

Kenneth Mandl — associate professor of medicine at Harvard Medical School and director of the Children’s Hospital Informatics Program’s Intelligent Health Laboratory — said, “There is growing recognition that online communities not only provide a place for members to support each other but also contain knowledge that can be mined for public health research, surveillance and other health-related activities” (Modern Physician, 4/29).

Elissa Weitzman — an assistant professor of pediatrics and adolescent medicine at Harvard — said that using population-based reporting systems can help inform individuals about health research (Healthcare IT News, 4/26).

Source: iHealthBeat

More states are seeking federal approval to use Medicaid funds for telehealth services as they work to address persistent budget deficits and a growing shortage of in-home care providers, the Louisville Courier-Journal reports.

Indiana already provides Medicaid reimbursements for telehealth. Meanwhile, Kentucky’s Cabinet for Health and Family Services recently asked for federal permission to use Medicaid funds for such services.

About the Technology

Some telemedicine products use cameras to help remote caregivers monitor elderly individuals and people with disabilities. The caregivers can alert residents or family members of health or safety issues that arise.

In addition, electronic sensors can detect temperature changes, carbon monoxide levels and other risk indicators. Some telehealth products also provide services such as medication reminders and food preparation guidance.

Cost Benefits for States

One provider of telemedicine services, called Rest Assured, typically charges $10 an hour, which is about half as much as in-home care. Telehealth services also are significantly less expensive than nursing home care, which can cost upward of $5,000 monthly.

A 2010 study in the Journal of Telemedicine and Telecare found that Indiana could reduce spending by $13.4 million annually if about 450 residents used telemedicine services. However, officials say they have yet to realize that amount of savings because residents have been slow to adopt the technology (Howington, Louisville Courier-Journal, 4/24).

Source: iHealthBeat

Twenty-eight percent of surveyed health care CIOs who reported barriers to meeting meaningful use criteria cited capturing and submitting quality data as their top concern, according to a March College of Healthcare Information Management Executives survey.

That figure is up from a November 2010 CHIME survey in which 22% of respondents said capturing and submitting quality data was their foremost concern.

Of surveyed health care CIOs who in March reported concerns with meeting meaningful use criteria, 28% cited capturing and submitting quality data as their top concern, compared with 22% who cited the quality data issue as their foremost concern in November 2010, according to a College of Healthcare Information Management Executives survey.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.

In the most recent survey, 16% of respondents cited certification as their top concern, up from 11% in November 2010.

Nearly 41% of respondents indicated that they are accelerating plans to implement EHRs and other applications necessary to achieve meaningful use, compared with 36% of respondents in November 2010, according to the survey.

In addition, the survey found that 39.5% of respondents feel well-positioned to meet meaningful use rules with their current IT strategies and technology, down from 42% in November 2010.

Results are based on an online survey of 200 CHIME members conducted between March 4 and March 20.

Source: CHIME

Electronic clinical decision support reminders can help physicians avoid ordering unnecessary treatments, according to a study published in the journal Pediatrics, Modern Healthcare reports.

Researchers at Stanford University School of Medicine and Lucile Packard Children’s Hospital studied whether automated alerts built into the hospital’s electronic health record system could aid physicians in complying with new red blood cell transfusion guidelines.

According to the study, the system alerted physicians ordering transfusions about the new guidelines whenever a patient did not meet appropriate criteria for the procedure. The reminders prevented 460 unnecessary transfusions and saved a total of $165,000 in one year, the researchers said.

David Cornfield — medical director of critical care at Lucile Packard Children’s Hospital and a senior author of the study — said the study “demonstrated that having clinical decision support baked into the fiber of ordering practices can have a significant, durable impact on the delivery of clinical care” (McKinney, Modern Healthcare, 4/18).

Source: iHealthBeat

“The spread of pay-for-performance payment” and adoption of health IT tools raise “concern that physicians might” engage in “cherry-picking” and “lemon-dropping behaviors,” Carson Strong and Jim Bailey — professors in the Department of Medicine at the University of Tennessee Health Science Center — write in an American Medical News opinion piece.

Cherry-picking refers to the practice of selecting healthier individuals to accept as patients in an effort to meet performance criteria and keep medical practice costs down. Lemon-dropping or “patient dumping” refers to terminating care for patients who could be more costly or difficult to treat.

Strong and Bailey write, “The widespread adoption of [electronic health records] will provide physicians with powerful new tools for data mining that could assist in selection of profitable patients.” They write, “Lemon-dropping can be conducted easily with a highly functioning [EHR] system that includes registries for patients with chronic diseases,” adding that federal privacy rules “do not specifically prohibit these activities.”

However, Strong and Bailey write that “[p]atient selection of this sort is unethical on many levels.”

Reasons Behind Argument

According to Strong and Bailey:

• Medical organizations “that employ these practices can be expected to increase both taxpayer and employer-funded health care costs”;
• These practices “disrup[t] continuity of care and can result in adverse health outcomes”;
• Health care providers who do not engage in these practices “will care for a disproportionate number of sicker, more costly patients, which makes cherry-picking an unfair competitive practice”; and
• Such practices could “undermin[e] public trust in the profession.”

Recommendations

Strong and Bailey provide three recommendations for dissuading cherry-picking and lemon-dropping behaviors:

• “[P]ayment approaches … need to be designed carefully to avoid creating incentives for patient selection”;
• Health care providers should call for accountable care organization rules “that encourage population-based care for everyone”; and
• “American medical organizations should develop position statements on cherry-picking” (Strong/Bailey, American Medical News, 4/18).

Source: iHealthBeat

About 27% of primary care and specialty physicians own an Apple iPad or a similar tablet computer, according to a survey released by market research firm Knowledge Networks and the Physicians Consulting Network, American Medical News reports.

The survey polled 5,490 physicians about their use of mobile devices.

Key Findings

The survey found that physicians have adopted tablet computers at a rate five times higher than the general population. It also found that 64% of physicians own a smart phone.

Researchers found that drug reference tools were some of the most popular mobile applications among physicians. Knowledge Networks also noted that more doctors are using mobile devices for:

• E-mail;
• Research; and
• Taking surveys.

‘E-Detailing’ Not Catching On

However, the survey found that few physicians are participating in “e-detailing,” or electronic communication between pharmaceutical sales representatives and doctors.

When asked about their preferred communication method with drug company representatives, 23% of primary care physicians and 28% of specialists said they preferred e-detailing.

In addition, few physicians reported using mobile apps from drugmakers (Dolan, American Medical News, 4/18).

Source: iHealthBeat