A Weekly Compilation of Clinical Laboratory and Related Information
from The Division of Laboratory Science and Standards
May 30, 2013
- CLIA and the Exchange of Lab Results Across States
- FDA Approves First A1c Test to Diagnose Diabetes
- FDA Considers More Stringent Oversight of Blood Lancet Devices
- ICD-10: No One Is Listening . . . Yet the Clock Is Ticking
- Physicians Sound an Urgent Call to Retool Stage 2 EHR Program
- HL7 Developing New Health Care Messaging Standard
- Health IT Adoption Doubles From 2012
- Health Care Quality Slowly Improving, While Some Americans Still Lack Access
- Augusta Tuberculosis Patient Who Refused Treatment to Be Arrested
- New Bird Flu Found to Be Resistant to Roche’s Tamiflu Drug
- WHO Chief Sounds Alarm Over Novel Coronavirus, 'A Threat To The Entire World'
View Previous Issues - Healthcare News Archive
CLIA and the Exchange of Lab Results Across States
Legislation in the New York State Senate, Senator Toby Ann Stavisky’s Senate Bill 634A (S634A), revolves around the aged Clinical Laboratory Improvement Amendments (CLIA) and transitioning into health information exchanges with relation to lab results. The objective of the 1988 CLIA federal regulatory standards are to ensure quality laboratory testing; however, the hitch is that labs cannot be sent directly to New York’s health information exchanges (HIEs), when that would actually provide a more fluid patient portal or HIE. Many states have the ordering provider act as the translator which requires them to intercept the results in order to provide them to the patient and thus assure that the patient can correctly understand them.
Presently, in New York State, the patient must request a copy of a lab report from a physician. This can take a great deal of time and is sometimes difficult. This bill would provide for the release of test results to the patient subsequent to the results being reported to the physician who ordered it. This would allow the patient to be an informed participant in his or her own medical care and if the patient were to change doctors or seek additional opinions regarding care, test results would be readily accessible. This practice is in effect in New Jersey. Others states such as Texas an Oregon are also addressing this same hurdle somewhat created by CLIA.
Advanced Molecular Detection (AMD) and Response to Infectious Disease Outbreaks
The AMD initiative proposed in the President’s 2014 Budget represents a major enhancement of CDC’s current microbiology and bioinformatics capabilities to find and stop deadly infectious disease outbreaks that threaten every American every day. Investing in AMD would bring the U.S. public health system a more precise and accurate means to
- find smoldering disease outbreaks we are missing now,
- find disease outbreaks faster to protect communities, and
- stop threats in our food supply.
With support through the AMD initiative, CDC will be able to build critical molecular sequencing and bioinformatics capacities at national and state levels to take back the advantage in controlling infectious diseases.
- Enhancing AMD capacity means reducing diagnostic costs in the future. For example, states would no longer need to submit lab cultures to CDC to identify outbreak pathogens—a slow and less precise method.
- With AMD, CDC could rapidly look for a microbe’s match among the thousands of reference samples in its world-class microbe library.
- CDC will refine the use of new technologies to make them work smarter for public health and train others to use these tools to prevent and stop disease outbreaks.
Hagel Directs Pentagon to Seek new Software for Health Records
Secretary of Defense Chuck Hagel directed the Pentagon to seek new healthcare management software that would better integrate military health care records with the Department of Veterans Affairs. The inability of the Department of Defense and the VA to develop a single, integrated electronic health record has been the source of much frustration on Capitol Hill. In February, the departments announced they were abandoning efforts to create a single system. A bipartisan group of House representatives sent a letter to President Obama urging him to intervene and “end the back and forth” between the two departments.
OIG Pushes for Monthly Blacklist Cross-Check
Amid looming shortages in healthcare workers, one branch of the federal government is ramping up aggressive efforts to keep some of them far away from patients. HHS' Office of the Inspector General adds about 300 new names every month to its List of Excluded Individuals and Entities (LEIE) that are banned from working for Medicare and Medicaid. The growth of the healthcare blacklist is expected to accelerate in tandem with the widening crackdown on healthcare crooks, fraudsters and clinicians who don't repay government-backed student loans. All told, 51,729 people were banned from caring for government-insurance patients, as of the release of the latest exclusion list May 14. That same day, a national fraud crackdown in eight cities rounded up another 89 people accused of crimes that could end with their exclusions.
CMS Issues Pricing for MDx Codes; Labs, Test Developers Still Critical of Rates and Methodology
The Centers for Medicare & Medicaid Services earlier this month issued for public comment pricing on new CPT codes describing various molecular diagnostics, but lab groups and test developers are still dissatisfied with the agency's reimbursement determinations. CMS has decided to use the controversial gapfill process to establish new pricing for more than 100 CPT codes for molecular diagnostics issued by the American Medical Association.
ICD-10: No One Is Listening . . . Yet the Clock Is Ticking
On Jan. 16, 2009, the federal government published its final rule adopting ICD-10 as the replacement for ICD-9, requiring physician practices and clinical laboratories to use this new code set for all HIPAA standard transactions. Originally set to take effect on Oct. 1, 2013, the date was officially pushed back to Oct. 1, 2014 during fall 2012. Nothing seems to have progressed much over the past year, yet the clock keeps ticking.
Augusta Tuberculosis Patient Who Refused Treatment to Be Arrested
An Augusta tuberculosis patient who has refused medical treatment and could be contagious will be taken into custody, a judge ruled Tuesday. The Richmond County Health Department filed a petition in Richmond County Superior Court earlier this month seeking the court’s help in getting Richard Pearre Jr. to comply with medical treatment. Judge Sheryl B. Jolly heard from the health department staff, who testified that they have tried working with Pearre since January, when his infectious disease was reported, but he stopped cooperating.
Jolly found cause to have Pearre arrested. He will be held pending another court hearing where Jolly could order a commitment of up to two years.
Another Infection Outbreak Tied to a Compounding Pharmacy
Seven patients injected with corticosteroids from a Tennessee compounding pharmacy have fallen ill, including at least one case of apparent fungal infection, the FDA said. The agency said it was working with the CDC and authorities in Tennessee to investigate the adverse events, linked to methylprednisolone acetate compounded by Main Street Family Pharmacy in Newbern, Tenn. "Clinical information about these patients is pending; at least one of these infections appears to be fungal in nature," an FDA statement said.
Physicians Sound an Urgent Call to Retool Stage 2 EHR Program
Physicians may not be able to meet rigid electronic health record requirements unless the Centers for Medicare & Medicaid Services revisits stage 2 criteria for demonstrating meaningful use, the American Medical Association stated in a letter to six senators. Specialty and state medical societies also expressed similar concerns as thousands of physicians prepare to meet much tougher EHR standards in 2014. New requirements mean that physicians must meet 100% of the measures to earn EHR payments and stop future penalties. Achieving high thresholds is unnecessarily burdensome when using an EHR in a meaningful way, the AMA stated in the May 17 letter. Interoperability and information-sharing gaps also present challenges to practices that will need to manually enter data, such as lab test results, so they can fulfill mandates. “The AMA firmly believes that the most prudent course of action is to comprehensively evaluate what worked well in stage 1 and assess where implementation challenges remain,” wrote AMA Executive Vice President and CEO James L. Madara, MD.
Pathology for the Public—a Small Cascade of Realities
If, like me, you don’t have your own TV vehicle to “off road” into the lives of others, how might you bring a dose of sensible reality to your patients, their families, and the community at large? I was approached about setting up a pathology booth in the atrium of the cancer center.
I greeted patients, families, and friends with de-identified slides and “live” digital images of cancers of their choice. I explained the basics of cytodiagnosis and histodiagnosis of many different types of tumors and showed groups of interested onlookers how melanoma, renal cell carcinoma, breast cancer, and others appear under the microscope. One group of teenagers spent more than an hour at the booth asking questions about pathology and its practice as well as about health professions in general.
Some might ask, is all of this worth it? Is anybody really benefiting? As in reality TV, some parts of life are scripted while others are spontaneous. In learning what they can about their diseases, many patients feel empowered. Being visible in the community benefits pathology as a field and unquestionably benefits pathologists as professionals. Our being visible can definitely be of help to patients as they face their health challenges.
For the past four years, a group of pathologists has been diligently considering one question—Exactly how should whole slide imaging be validated?—all the while knowing that some laboratories consider WSI validation an unnecessary undertaking. “The biggest argument I’ve heard is: ‘Why should we validate these instruments? We don’t validate our microscopes. It seems to be overkill,’” says Alexis B. Carter, MD, a member of the expert panel that created the CAP’s guideline titled “Validating Whole Slide Imaging for Diagnostic Purposes in Pathology,” published online May 1 in the Archives of Pathology & Laboratory Medicine. Dr. Carter, assistant professor of pathology and laboratory medicine at Emory University School of Medicine in Atlanta, obviously disagrees. So does Liron Pantanowitz, MD, the leader of the panel that wrote the 50-page, 55-footnote document, which represents the first standard guideline regarding validation of WSI for diagnostic use.
Transfusions: Hopkins Issues New Guidelines
Using blood utilization data extracted from new electronic anesthesia information management systems (AIMS), Johns Hopkins researchers have developed new guidelines to optimize the process of preoperative blood ordering.
The recommendations -- the first in more than 35 years -- can potentially improve operating room efficiency, increase patient safety and decrease costs, Steven M. Frank, MD, of Johns Hopkins Medical Institutions, and colleagues reported online in Anesthesiology. Frank said that while the blood-ordering guidelines are specific to Johns Hopkins, they can be adapted by other medical centers with computerized anesthesia records -- a figure he put at roughly 50% of hospitals in the United States. At Johns Hopkins, the guidelines would potentially save the medical center more than $200,000 a year, he said.
MRI Scans Could Make Baby Autopsies More Acceptable
In a report in The Lancet, scientists say this minimally invasive autopsy (MIA) was as effective in determining the cause of death as a conventional autopsy. Since the vast majority of parents whose babies die during or soon after birth currently refuse any autopsy, the researchers suggested the MIA could both improve rates of uptake and reduce parents' distress while offering clear answers. Taylor and colleague Sudhin Thayyil, a consultant neonatologist, compared the accuracy of a standard autopsy with that of whole-body, post-mortem MRI with or without other minimally invasive tests. These included blood samples taken by needle, visual examination of the body and genetic and metabolic tests.
FDA Considers More Stringent Oversight of Blood Lancet Devices
The FDA is taking a closer look at blood sampling devices to determine whether the technology merits a higher level of regulatory oversight. Currently classified as class I, blood lancets are only subject to general regulatory control. However, the FDA will host an advisory committee meeting on June 26 to determine whether blood lancets merit class II or class III regulatory status. The committee will offer its recommendation to the FDA based on the scientific data presented.
FDA Approves First A1c Test to Diagnose Diabetes
The FDA has cleared Roche to market its Cobas Integra 800 Tina-quant HbA1cDx assay for use in diabetes detection. It is the first HbA1c test that the agency has allowed to be marketed for diabetes diagnosis. The HbA1c tests currently on the market are FDA-cleared for monitoring blood glucose control but not for diagnosing diabetes. "Based on the research and recommendations of international diabetes experts, many health care providers have already been using some A1c tests to diagnose diabetes, in addition to the established diagnostic procedures of a fasting blood glucose test and an oral glucose tolerance test to diagnose diabetes," the FDA said in a news release. "However, before this, A1c tests were not specifically designed or granted permission by FDA to be marketed for diabetes diagnosis.
One More Tool
"Providing healthcare professionals with another tool to identify undiagnosed cases of diabetes should help them provide patients appropriate guidance on treatment before problems develop," said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Devices at FDA's Center for Devices and Radiological Health. "As the Tina-quant HbA1cDx assay was designed for diabetes diagnosis and has been reviewed by the FDA, physicians can have confidence that this test is reasonably safe and effective when used for its intended purposes of monitoring and diagnosing diabetes," Dr. Gutierrez added.
A new study funded by the Agency for Healthcare Research and Quality (AHRQ) found that providing interactive voice recognition follow-up calls to diabetes patients is effective in identifying safety triggers. “Safety Events during an Automated Telephone Self-Management Support Intervention” appeared in the May issue of the Journal of Diabetes Science and Technology. The “safety triggers” the study examined were problems such as extremely high or low blood sugar, not having medications or supplies, or experiencing significant side effects. Using an automated voice system, patients with type II diabetes received self-management support through interactive messaging.
Source: http://journalofdst.org [PDF 158.93KB]
'Nano' Medicine Might Someday Free Diabetics From Daily Needles
Researchers have developed a network of so-called "nanoparticles" that theoretically could be injected into the body and release insulin to counteract rising blood sugar levels in people with diabetes. Tested so far in mice, the nano-network was able to maintain normal glucose levels for more than a week with a single injection. Currently, patients have to inject themselves with insulin several times a day to control their blood sugar levels.
Genomic Analysis Lends Insight to Prostate Cancer
Mayo Clinic researchers have used next generation genomic analysis to determine that some of the more aggressive prostate cancer tumors have similar genetic origins, which may help in predicting cancer progression. The findings appear online in the journal Cancer Research.
"This is the first study to examine DNA alterations using next generation sequencing in adjacent Gleason patterns in the same tumor allowing us to correlate genomics with changes in pathology," says John Cheville, M.D., Mayo Clinic pathologist and one of the authors on the paper.
Low HDL, High CRP May Predict Risk of Some Complications After Bariatric Surgery.
Low levels of high-density lipoprotein (HDL) cholesterol and high levels of C-reactive protein predicted the likelihood of postop cardiopulmonary complications in patients undergoing bariatric surgery. The odds of a cardiopulmonary complication occurring within 3 months of the procedure were more than doubled among those whose cardioprotective HDL was at or below 40 mg/dL at baseline (odds ratio 2.4, 95% CI 1.11-5.19), Trit Garg, a medical student at Stanford University in Stanford, Calif., and colleagues found in a cohort of 1,634 patients who had bariatric surgery during a 10-year period.
Having high-sensitivity C-reactive protein of 11 or higher also was predictive (OR 2.22, 95% CI 1.05-4.67), suggesting that systemic inflammation may contribute to disease burden and risk of complications.
Canada Clears Abbott HPV Molecular Diagnostic Test
The Medical Device Bureau of Health Canada has granted a license to Abbott to market its RealTime High Risk HPV molecular diagnostic test for detecting human papillomavirus, Abbott announced. The test, which was CE marked in 2008, detects 14 high-risk HPV genotypes with simultaneous detection of HPV genotypes 16 and 18, which are known to pose the highest risk of progression to cervical cancer. About 70 percent of cervical cancer cases are found to have HPV 16 and/or 18, Abbott said.
Researchers collaborating among a number of French institutions have developed and validated a novel gene-expression signature that classifies colon cancers into six distinct molecular subtypes with different pathological characteristics and varying prognoses. If the group can further validate the finding — published in PLOS Medicine — the classifier could be useful in predicting which patients are more likely to suffer recurrence after curative surgery for localized cancer and as a tool to inform more personalized treatment. The researchers wrote that the new classifier is the first "robust transcriptome-based classification of [colon cancer] that improves current disease stratification based on clinicopathological variables and common DNA markers," like BRAF and KRAS mutations.
Mayo Clinic Teams with Cancer Genetics to Launch OncoSpire Genomics
Mayo Clinic (Rochester, Minn.) and Cancer Genetics Inc. (Rutherford, N.J.) have teamed up to launch OncoSpire Genomics, a 50/50 joint venture that aims to improving cancer care by discovering and commercializing diagnostic tests that leverage next-generation sequencing. Launched this week, the company will focus on mutually identified projects in the Biomarker Discovery Program within Mayo’s Center for Individualized Medicine, beginning with hematological and urogenital cancers.
Spanish-First Clinical Lab Opens Patient Testing Centers in Miami and Union City, NJ
Laboratorio Buena Salud (www.LaboratorioBuenaSalud.com) has opened two patient testing labs dedicated to the medical concerns and clinical testing needs of the Hispanic community.
Laboratorio Buena Salud (LBS) ushers in a new level of service to a traditionally underserved segment of New Jersey and Florida's population, where inequities in healthcare persist for those who do not speak proficient English. All services of the laboratory– including patient care, educational literature, customer service and billing—are provided in Spanish. The laboratory does not operate as a traditional English-speaking business with bilingual capabilities, but as a Spanish-speaking service that can handle English-speakers as needed.
The Classroom Within
Students at a handful of institutions across the US turn to their own DNA to learn about their genetic risk and ancestry. This year, students in Stanford University School of Medicine's Genetics 210 class — which the Mercury News says is open to medical students, graduate students, and undergraduates — learned about their risk for Achilles tendon injuries and dementia, but also about how closely related they are to Neandertals or whether they had a different father than they'd thought. Similar courses are offered by Mount Sinai School of Medicine in New York, the University of Miami, Harvard Medical School, and others.
Surveillance and Screening
What is your facility doing to prevent MRSA?
Despite advances in detection methods and testing, methicillin-resistant Staphylococcus aureus (MRSA) remains a major threat in health facilities across the country. In the fight to eradicate the infection from hospitals, the laboratory continues to play a major role -- providing the screening and early detection necessary to stop an outbreak before it starts. In a recent interview, Susan M. Novak, MD, D (ABMM), director of microbiology, Southern California Permanente Medical Group (SCPMG) Regional Reference Laboratories, discussed emerging resistant strains and prevention solutions.
Researchers evaluated the effect of a bundle of infection control measures on MRSA transmission rates at two similar Veterans Health Administration hospitals. One hospital implemented Centers for Disease Control and Prevention-recommended contact precautions, which include wearing a cover gown. The other hospital modified the precautions to include only the use of gloves. During the four-year study period, hospital A had 1.58 MRSA transmissions per 1,000 patient days and hospital B had 1.56. Both hospitals significantly reduced MRSA healthcare-associated infections, and there was no significant difference in the incidence of MRSA HAIs or MRSA surgical site infections between the hospitals. Annual acquisition costs for cover gowns were $183,609 at hospital A and $25,812 at hospital B.
Unnecessary Breast Biopsy Surgery Performed on More Than One Third of Texas Women Diagnosed With a Breast Mass
Minimally invasive biopsies are most commonly done under ultrasonographic or X-ray guidance, with either a fine needle or preferably a "core tissue extraction" needle. They do not require surgery or anesthesia and leave little to no scarring. Most importantly, a diagnosis of benign (non-cancerous) or malignant (cancerous) breast mass can be determined before any decisions about treatment are made. In spite of these benefits, new research from the University of Texas Medical Branch published in the Journal of the American College of Surgeons shows that expensive, invasive surgical breast biopsies remained the first diagnostic step for 35 percent of women diagnosed with a breast mass between 2000 and 2008 in Texas. The investigators performed an exhaustive analysis of Texas Medicare data from 2000 to 2008, including more than 87,000 breast biopsies.
Taming Suspect Gene Reverses Schizophrenia-like Abnormalities in Mice
NIH-funded study raises hope for recovery of some adult patients, despite early damage
Scientists have reversed behavioral and brain abnormalities in adult mice that resemble some features of schizophrenia by restoring normal expression to a suspect gene that is over-expressed in humans with the illness. Targeting expression of the gene Neuregulin1, which makes a protein important for brain development, may hold promise for treating at least some patients with the brain disorder, say researchers funded by the National Institutes of Health. “The deficits reversed when we normalized Neuregulin 1 expression in animals that had been symptomatic, suggesting that damage which occurred during development is recoverable in adulthood,” explained Lin Mei, M.D., Ph.D. of the Medical College of Georgia at Georgia Regents University, a grantee of NIH’s National Institute of Mental Health (NIMH). Mei, Dong-Min Yin, Ph.D., Yong-Jun Chen, Ph.D., and colleagues report on their findings May 22, 2013 in the journal Neuron.
New Bird Flu Found to Be Resistant to Roche’s Tamiflu Drug
A gene mutation known to make flu viruses resistant to Roche Holding AG (ROG)’s Tamiflu was identified in two patients infected with the H7N9 bird flu virus in China, a study found.
The gene was discovered in two of three patients who became the most severely ill in a study of 14 patients treated with Tamiflu after being admitted to a Shanghai hospital in April with H7N9 infection, according to an article published in The Lancet medical journal. In one patient, the resistance developed after the initial infection, suggesting treatment with Tamiflu may have spurred the mutation. The finding is the first official confirmation of resistance to Tamiflu. In the other patients, treatment with the drug was associated with clearing the virus, and early treatment of suspected or confirmed cases is “strongly encouraged,” wrote a group of researchers led by Zhenghong Yuan of Fudan University.
H7N9 Bird Flu can Pass Between Mammals, Researchers Find
Scientists are gaining a better understanding of the H7N9 bird flu that has sickened more than 130 people -- and killed more than 30 -- in China and Taiwan since February. The latest research into the virus, which before this year had never been detected in humans, was published in the online edition of the journal Science. Working with ferrets, an animal that is often studied to gain insight into flu transmissibility in people, scientists in China, Canada, and the U.S. found that H7N9 could spread from one ferret to another -- suggesting that it could also pass between humans. "Under appropriate conditions human-to-human transmission of the H7N9 virus may be possible," the co-authors wrote.
A new flu, H7N9, has killed 36 people since it was first found in China two months ago. A new virus from the SARS family has killed 22 people since it was found on the Arabian Peninsula last summer. In past years, this might have been occasion for panic. Yet chicken and pork sales have not plummeted, as they did during flus linked to swine and birds. Travel to Shanghai or Mecca has not been curtailed, nor have there been alarmist calls to close national borders. Is this relatively calm response in order? Or does the simultaneous emergence of two new diseases suggest something more dire? Actually, experts say, the answer to both questions may well be yes.
“We’ve done a great job globally in the last 10 years,” said Dr. William B. Karesh, a wildlife veterinarian and chief of health policy for the EcoHealth Alliance, which tracks animal-human outbreaks. “Compared to H5N1 and SARS, we’re getting on top of these diseases much, much faster.” But he added that “people have become desensitized over time — it’s ‘Oh, O.K., another one.’ ” And scientists say the world cannot afford to relax. The threat is real. New diseases are emerging faster than ever.
'Universal' Flu Vaccine Effective in Animals
Current flu vaccines use inactivated whole viruses and must be regularly remade to target the strains most likely to cause illness in the coming year. But the new nanoparticles would require fewer updates because they induce the production of antibodies that neutralize a wider range of flu strains. They could even protect against varieties of flu that have not yet emerged.
New Flu Vaccine Beats Current Products in Animal Testing
A new type of flu vaccine developed at the U.S. National Institutes of Health outperformed existing products in animal tests, possibly paving the way for a new generation of vaccines.
Researchers led by Gary Nabel, the former director of the Vaccine Research Center at the NIH’s National Institute of Allergy and Infectious Diseases, fused a protein called hemagglutinin, on the surface of the virus, to ferritin, another protein that carries iron in the blood, creating a new type of nanoparticle that elicited broader and more potent immunity than products sold by Sanofi and Novartis AG (NOVN), according to the study, published online in the journal Nature.
Hand, Foot and Mouth Disease: First Vaccine
The first vaccine which protects children against hand, foot and mouth disease has been reported by scientists in China. The infection causes a rash and painful blisters, but in some cases results in brain infections which can be fatal. A trial involving 10,000 children, published in the Lancet, showed the vaccine was 90% effective against one virus which causes the disease. It does not protect against other viruses that result in the disease.
Modified Polio Virus May Help Fight Brain Tumors, Study Suggests
Treatment is harmless to normal cells but attacks cancer cells; finding is preliminary, researchers say A modified version of the polio virus might one day help fight brain tumors, preliminary research suggests. Scientists at Duke Cancer Institute said the investigational therapy, known as PVSRIPO, uses an engineered form of the virus that is harmless to normal cells, but attacks cancer cells. The therapy shows promise in the treatment of glioblastoma, the most common and aggressive brain tumor, they said. "These early results are intriguing," principal investigator Dr. Annick Desjardins, an associate professor of medicine at Duke University School of Medicine, said in a news release. "
Univ. of Louisville researchers have uncovered how to create nanoparticles using natural lipids derived from grapefruit, and have discovered how to use them to deliver medicines.
Huang-Ge Zhang, endowed professor of microbiology and immunology, Qilong Wang, James Graham Brown Cancer Center, and their team published their findings in Nature Communications. “It made sense for us to consider edible plants as a mechanism to create medical nanoparticles as a potential non-toxic therapeutic delivery vehicle.” Zhang and his team also analyzed the nanoparticles from tomatoes and grapes. Grapefruits were chosen for further exploration because a larger quantity of lipids can be derived from this fruit.
HL7 Developing New Health Care Messaging Standard
Health Level Seven International, a standards body for health care data, is developing a new framework that will ease sharing of patients' electronic health records. The standard, Fast Health Interoperable Resources (FHIR), consists of modular components called "resources" that allow health IT systems to read extensions using a common framework. They're used by "back-office" software, social media apps on mobile phones, cloud software, EHR data sharing and server communications, according to an HL7 document.
"These resources can easily be assembled into working systems that solve real world clinical and administrative problems at a fraction of the price of existing alternatives," HL7 stated.
A challenge in health care IT is to get multiple health care systems to be compatible. As standards bodies add fields and options to their specifications, they become more complex and costly to implement, according to HL7.
EHRs Fail Tests, Certifications Revoked
Two electronic health record systems, previously certified under the EHR Incentive Program, failed recently to meet industry requirements and have had their certifications revoked, ONC officials announced. As a result, National Coordinator for Health IT Farzad Mostashari, MD, said providers can no longer meet meaningful use requirements using these products. EHRMagic-Ambulatory and EHRMagic-Inpatient, both developed by Santa Fe Springs, Calif.-based EHRMagic, are the first-ever EHRs to have their certifications revoked
EHRs Used to Identify Wrong Diagnosis, How Care Could Be Improved
Most cases of wrong diagnosis (diagnostic errors) occur with common ailments and are related to process break-downs that happen during visits with health care providers, according to a study supported by the Agency for Healthcare Research and Quality. Researchers used electronic health records to identify cases of diagnostic error in primary care settings. Some of the most commonly missed conditions were pneumonia, heart failure, kidney failure, or new cancers. Failures in taking patient histories, physical examination and follow-up testing were the most common contributors to wrong diagnosis, which can put patients at risk for moderate to severe harm. The study suggests that better methods are needed to help clinicians gather and synthesize information, especially for illnesses that have similar symptoms.
EHR Interoperability Training Module Suite Online Now at HealthIT.gov
The State HIE Program Policy Office and the Regional Extension Center Program are excited to report that the full suite of five Interoperability Training Modules to support the attainment of Stage 2 Meaningful Use measures is now available at HealthIT.gov.
The suite of five training modules is self-paced and can be taken as frequently as needed. To effectively inform and guide the process they are broken up into five distinct training lessons associated with aspects of Stage 2 Meaningful Use:
- Interoperability basics
- Transitions of care between care providers and care venues
- Lab interoperability between hospitals and ambulatory providers
- View, download, and transmit of information between patients and providers
- Transmission of information to public health agencies
Health IT Adoption Doubles From 2012
According to a 2012 Centers for Disease Control and Prevention survey, the percent of physicians using an advanced EHR system was pegged at 17 percent in 2008. Today, more than 50 percent of eligible professionals, mostly physicians, have demonstrated meaningful use and received incentive payments. For hospitals, just 9 percent had adopted EHRs in 2008, compared with 80 percent today.
Further, just in January 2012, these numbers were pegged at 1,600 eligible hospitals and 38,000 eligible providers who had attested. “We have reached a tipping point in adoption of electronic health records,” said Sebelius, in a statement. “More than half of eligible professionals and 80 percent of eligible hospitals have adopted these systems, which are critical to modernizing our healthcare system.
If You Want a Job in Tech, Learn to Code
Kirk McDonald, president of PubMatic, an ad tech company in Manhattan, [wrote] an op-ed in The Wall Street Journal. “I run a cool, rapidly growing company in the digital field, where the work is interesting and rewarding,” McDonald writes to recent graduates. “But I’ve got to be honest about some unfortunate news: I’m probably not going to hire you.” It’s largely because our nation’s education system has fallen short in grooming graduates with the skills necessary to effectively work in science, technology, engineering and mathematics fields, McDonald writes, citing a potential shortage of roughly 80,000 IT workers over the next decade. While states and companies should be working together to address this crisis, McDonald encourages current and recent graduates to take matters into their own hands and learn how to speak computer code.
IBM Watson Masters Customer Service as Engagement Advisor
IBM is calling on its Watson cognitive system supercomputer to help enterprises rapidly sift through big data to provide better service to customers and users. At the IBM Smarter Commerce Global Summit 2013, the company on May 21 unveiled its new Watson Engagement Advisor. According to the company, it's a technology breakthrough that allows brands to crunch big data in record time to transform the way they engage clients in key functions such as customer service, marketing and sales.
Health Care Quality Slowly Improving, While Some Americans Still Lack Access
The quality of U.S. health care is slowly improving, while access to health care remains a great challenge for some Americans, especially racial and ethnic minorities and low-income people, according to AHRQ’s 2012 National Healthcare Quality Report and National Healthcare Disparities Report. The new reports call for “urgent attention” on continuing improvements in the quality of diabetes care, maternal and child health care, and treatment for conditions such as pressure ulcers and blood clots. Included in this year’s reports are new measures on early and adequate prenatal care, colorectal cancer screening, national rate of hospital-acquired conditions, standardized infection ratios at the state level for central line-associated bloodstream infections, and patient safety culture hospital survey findings.
CDC: Teen Births at Record Lows
The teen birth rate in the U.S. has fallen to a record low level, and recent declines have been steepest among Hispanic teenagers, according to the CDC. The birth rate among 15 to 19-year-olds fell sharply between 2007 and 2011 -- the latest five-year reporting period -- resuming a decline that began in 1991 but was interrupted in 2006 and 2007, according to a newly released report from the National Center for Health Statistics (NCHS).
In California, the most populous state in the country, one might think that insurers would be tripping over themselves to get plans on Covered California, the state's health insurance exchange. But that would be wrong. Despite the fact that 20% of the state's population is uninsured, according to 2011 data from the Kaiser Family Foundation, several large insurers, including Aetna, Cigna Corp. and UnitedHealth Group, are all taking a pass on the Golden State's exchange—at least initially.
Anthem Blue Cross of California, Blue Shield of California and Kaiser Permanente, three of California's largest insurers, are among the 13 that will participate in Covered California, the state's exchange, exchange officials said.
ISU Hands Over $400K for HIPAA Violation
Idaho State University will pay $400,000 to the U.S. Department of Health Human Services to settle alleged violations of the HIPAA Security Rule. The settlement comes after ISU’s Pocatello Family Medicine Clinic disabled server firewall protections for a period of at least 10 months, resulting in the breach of electronic protected health information for 17,500 patients. ISU operates 29 outpatient clinics and is required to provide health information technology systems security at those clinics.
With Money at Risk, Hospitals Push Staff to Wash Hands
At North Shore University Hospital on Long Island, motion sensors, like those used for burglar alarms, go off every time someone enters an intensive care room. The sensor triggers a video camera, which transmits its images halfway around the world to India, where workers are checking to see if doctors and nurses are performing a critical procedure: washing their hands.
This Big Brother-ish approach is one of a panoply of efforts to promote a basic tenet of infection prevention, hand-washing, or as it is more clinically known in the hospital industry, hand-hygiene. With drug-resistant superbugs on the rise, according to a recent report by the federal Centers for Disease Control and Prevention, and with hospital-acquired infections costing $30 billion and leading to nearly 100,000 patient deaths a year, hospitals are willing to try almost anything to reduce the risk of transmission.
WHO Chief Sounds Alarm Over Novel Coronavirus, 'A Threat to the Entire World'
The head of the World Health Organization (WHO) says that novel coronavirus is a threat to the entire world, and called on the global community to respond to the alarm bells. "Through WHO and the International Health Regulations, we need to bring together the assets of the entire world in order to adequately address this threat. We need more information, and we need it quickly, urgently," WHO Director-General Dr. Margaret Chan told the valedictory session of the 66th World Health Assembly in the Swiss city of Geneva. She announced that joint WHO missions with Saudi Arabia and Tunisia would take place as soon as possible to gather all the facts needed to conduct a proper risk assessment. Dr. Chan said looking at the overall world health situation, her greatest concern right now was the novel coronavirus.
New Investments Needed to Advance Progress on AIDS, TB and Malaria in Africa
New report shows that strong partnership between African and G8 governments has delivered impressive results but gaps remain in efforts to improve health across the continent.
The recommendations were published in the first-ever accountability report focused on health issues by the African Union (AU), the New Partnership for Africa’s Development (NEPAD) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). The report, Delivering Results toward Ending AIDS, Tuberculosis and Malaria in Africa, was endorsed by African Heads of State and Government at the 21st African Union Summit. The report outlines that African countries have embraced transformative reforms that are producing results in the responses to AIDS, TB and malaria whilst at the same time strengthening health systems. It notes that although African governments have made important progress in increasing health financing, only six countries have fulfilled their commitment to devote 15% of government expenditures to health. For African governments overall, this percentage increased from 9% in 2001 to 11% in 2011.
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