U.S. Hospital Association (AHA) Fights Digital Data Access for Patients | Center for Democracy & Technology

Hospital Association Fights Digital Data Access for Patients | Center for Democracy & Technology

Forbes: (U.S.) Hospital Association "Declares War" on Patient Empowerment

 Blogger's Note: click on the pdf link for letter from AHA (as below):

"A firestorm has been triggered by the American Hospital Association’s (AHA) 68 page letter (PDF) commenting on the Stage 2 Meaningful Use proposed requirements."
 "Our members are particularly concerned with the proposed objective to provide patients with the ability to view, download and transmit large volumes of protected health information via the Internet (a “patient portal”). The AHA believes that this objective is not feasible as proposed, raises significant security issues, and goes well beyond current technical capacity. We also believe that CMS should not include this objective because the Office of Civil Rights, and not CMS, regulates how health care providers and other covered entities fulfill their obligations under the Health Insurance Portability and Accountability Act (HIPAA), including the obligation to give patients access to their health records. Please see our detailed comments for more
recommendations on changes to specific objectives and measures."

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Hospital Association "Declares War" on Patient Empowerment:

A firestorm has been triggered by the American Hospital Association’s (AHA) 68 page letter (PDF) commenting on the Stage 2 Meaningful Use proposed requirements. The reaction has been swift from various individuals and organizations focused on patient rights and empowerment.

Consumer Rights and Patient Empowerment Organizations also weighed in.

• The Center for Democracy & Technology picked apart the legal “hail mary” that the AHA was using in their response. See Hospital Association Fights Digital Data Access for Patients for more.
• The Society for Participatory Medicine stated the following. “Patient engagement is the cornerstone of a successful, cost effective, and high-quality health care system,” said Daniel Z. Sands, MD, the Society’s president and a practicing internist. “Those goals cannot be achieved unless we give patients access to their own health information and encourage them to use it.”

open access: Impact of electronic medical record on physician practice in office settings: a systematic review

Impact of electronic medical record on physician practice in office settings: a systematic review:

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Background:
Increased investments are being made for electronic medical records (EMRs) in Canada. There is a need to learn from earlier EMR studies on their impact on physician practice in office settings. To address this need, we conducted a systematic review to examine the impact of EMRs in the physician office, factors that influenced their success, and the lessons learned.

Results:
For this review we included publications cited in Medline and CINAHL between 2000 and 2009 on physician office EMRs. Studies were included if they evaluated the impact of EMR on physician practice in office settings. The Clinical Adoption Framework provided a conceptual scheme to make sense of the findings and allow for future comparison/alignment to other Canadian eHealth initiatives.In the final selection, we included 27 controlled and 16 descriptive studies. We examined six areas: prescribing support, disease management, clinical documentation, work practice, preventive care, and patient-physician interaction. Overall, 22/43 studies (51.2%) and 50/109 individual measures (45.9%) showed positive impacts, 18.6% studies and 18.3% measures had negative impacts, while the remaining had no effect. Forty-eight distinct factors were identified that influenced EMR success.
Several lessons learned were repeated across studies:

(a) having robust EMR features that support clinical use;
(b) redesigning EMR-supported work practices for optimal fit;
(c) demonstrating value for money;
(d) having realistic expectations on implementation; and
(e) engaging patients in the process.

Conclusions:
Currently there is limited positive EMR impact in the physician office. To improve EMR success one needs to draw on the lessons from previous studies such as those in this review.

abstract: Electronic Healthcare: The Development and Change Management Strategy of Sunnybrook Health Sciences Centre's MyChart

ElectronicHealthcare, 10(3) 2012: e10-e14

Feature

The Development and Change Management Strategy of Sunnybrook Health Sciences Centre's MyChart™*

Abstract

The e-Health environment has focused primarily, to date, on enabling clinicians; patients and families, on the other hand, have not been the target of focus.

Across the globe, there has been mixed success in the patient-focused e-Health marketplace – including a few high-profile failures.

Sunnybrook Health Sciences Centre's personal health record (PHR) MyChart™ is a true Canadian success story in patient-focused e-Health.

This paper describes the development, history and change management strategy utilized in establishing a successful patient-focused e-Health solution in a Canadian setting. Our ultimate goal is to not only share the lessons learned in developing and implementing MyChart™ but also to measure and investigate the connection between patient-focused e-Health solutions and health outcomes.

'Too Much Information': Are EHRs Drowning Primary Care?

'Too Much Information': Are EHRs Drowning Primary Care?: A new survey has found that half of "additional signature requests" are "unimportant" or contain extraneous information.
Medscape Medical News

press release: 10 rights and responsibilities of users of electronic health records - The "rights" for clinicians

10 rights and responsibilities of users of electronic health records

Providing clinicians ten rights and responsibilities regarding their electronic health record use could serve as the foundation on which to build a new approach to health care in the electronic age, states an article in CMAJ (Canadian Medical Association Journal).
Despite commitments to electronic health initiatives by governments in Australia, Belgium, Canada, Denmark, the United Kingdom and the United States over the past decade, clinicians experience challenges in adoption and use. Clinicians may still be unsure that the benefits of these systems outweigh the time and resources required to maintain and update electronic records. To overcome these challenges, two US researchers identified 10 topics that they propose as professional "rights," along with corresponding responsibilities that if addressed, may help overcome the electronic health record use challenges facing clinicians.
"The 10 key issues discussed here form a set of features, functions and user privileges that clinician users require to deliver high-quality, safe and effective care," write Dr. Dean Sittig, University of Texas Health Sciences Center at Houston and Dr. Hardeep Singh, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine.
The "rights" for clinicians include the following:

• Uninterrupted access to electronic health records
• Ability to view all clinical information relating to their patients
• Succinct summaries of patient health histories, including medical problems, medications, lab results and other information
• Ability to override computer-generated clinical interventions
• Clear, evidence-based rational for computer-generated clinical alerts or recommendations
• Reliable performance measurement
• Safe electronic health records
• Training and assistance in all features of electronic health records
• Safe, effective usable electronic health records that are compatible with actual clinical practice
• Electronic systems that support communication and teamwork in the real world

While these topics are proposed as "rights" for clinicians who are expected to adopt and use an electronic health system, the clinician also has a set of responsibilities to ensure safe, efficient and effective use of the electronic health record.
"Addressing these rights and responsibilities comprehensively will be challenging but can make the care delivered through the electronic health records–based work system safer and more efficient," conclude the authors.

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Vote: Should Patients Have Electronic Identification Numbers? - Health Blog - WSJ

Survey Asks Doctors And Patients If Doctor’s Notes Should Be In The EHR (electronic health records)

Observations: Electronic health records face human hurdles more than technological ones

free full access: The anxious wait: assessing the impact of patient accessible EHRs for breast cancer patients

Conclusions

Participants generally found the portal easy to use; however, the perceived value of improved participation was not detected in the self-efficacy scores. Having access to personal health information did not increase anxiety levels. While these results suggest that the use of this PHR (personal health records) may be of benefit for informing patients, further research is required to investigate the impact on the experiences of patients, their participation in their care, their relationships with the health care team, and their health outcomes.

Harris Interactive: Harris Polls > Few Americans Using 'E-' Medical Records

Future Oncology - Summary - Different volatile signals emitted by human ovarian carcinoma and healthy tissue

Note: in plain english this refers to a small study using 'electronic' smelling (eg. past articles regarding dogs with the ability to 'smell' ovarian cancer)

CBC News - Health - Give control of electronic health records back to patients

"Lots of people don't know [an EPHR] is not available. They don't know they don't already have an electronic health record," says Alex Jadad, head of the Toronto Centre for Global eHealth Innovation at the University of Toronto....."For a patient's voice to be heard, who should they go to, to complain about things?" Jadad says to me. A family doctor? A hospital. All hospitals in their city? A province? Ottawa? Everyone seems to have taken some responsibility for ensuring health records become digitalized, and yet nobody seems specifically in charge of making sure it happens for patients."

Note:  Comments are open and welcome until Tuesday, March 23, 2010 at 11:59 p.m.