Along with reducing paperwork, easing administrative burdens, and generating some cost savings, the rise of electronic health records (EHRs) in health care settings has significantly increased the risk of data breaches. Mobile devices alone, according to one recent industry news report, were responsible for 116 breaches between Sept. 22, 2009 and May 8, 2011—exposing the personal health information (PHI) of more than 1.9 million patients in the process.

 

It’s a modern fact of life that PHI is now more mobile that ever—traveling not just on smart phones, tablets, and laptops, but on a host of mobile media, including easy-to-lose flash drives.

 

As healthcare CIOs struggle to balance their responsibility to safeguard patient data against the need for health care professionals to access that information, they’re adopting a variety of approaches, including a return to mobile media encryption and implementation of in-house mobility management programs.

 

A good example can be found at Morristown, N.J.-based Atlantic Health System, which ranks among the best and most wired hospitals in the U.S. In addition to some 8,000 desktops and 1,500 laptops, the health system includes an ambulance company and a home care company. Employees across the system’s footprint, of course, carry a broad range of mobile devices and mobile media.

 

Linda Reed, RN, MBA, vice president and CIO at Atlantic, recalls arming all of her organization’s laptops with pre-boot encryption a few years back. “It was lucky we did,” she says, “because just after that our home care division had a couple laptops stolen and we would have been in a bind.”

 

Next, Reed and her team waded into doing mobile media encryption, but the technology was still a little clugey and the workforce wasn’t quite ready, so they backed away from it, focusing instead on encrypting all of Atlantic’s back-up drives. Reed also made it a matter of policy to eliminate tape storage, opting for disk-to-disk back-up right on site.

 

“We might need to revisit tapes at some point again for temporary back-up,” Reed says, “but right now we don’t do that; everything stays on site and it’s encrypted.”

 

Roughly six months ago, Atlantic revisited mobile media encryption, thanks to improved technology and a growing awareness in the healthcare industry that data breeches attributable to mobile are serious business.

 

Today, if you put any kind of flash drive or portable media card into any Atlantic device, you will receive a message informing you that you must encrypt it before proceeding.

 

As part of the health system’s budding mobility management program, Reed says Atlantic will soon be able to enforce PINs on all mobile devices, track them wherever they go, and wipe them remotely as needed.

 

The program itself will be rolled out in waves. The first step includes a marketing campaign, which Reed says will provide ample warning to all staff regarding the coming changes.

 

For health IT professionals at organizations lacking the funds to put such guardrails in place, Reed says the only thing you have in your favor is education and awareness. Her suggestions: educate senior management on the threats and consequences by referring them to breach reports published regularly via HHS.gov. Specific to mobile, she also urges health IT professionals to implement an awareness campaign around mobile media, such as The Dangers of Flash Drives.

 

“Because it’s a two-pronged issue,” adds Reed. “It’s not just what you’re taking out of the organization, it’s also what you’re bringing back in.”

 

What do you think?

 

As a B2B journalist, John Farrell has covered healthcare IT since 1997 and is Intel’s sponsored correspondent.

Mobility is one of the topics during the Intel Healthcare Innovation Summit webcast series on Tuesday, Oct. 23. There's still time to register before the sessions if you'd like to join us. Sign up here.

 

In this podcast, Ashley Perry, Healthcare Ambassador at Lenovo, talks about mobile point of care and mobile devices in healthcare, innovation coming down the road to help clinicians in their workflows, and what CIOs need to know to get ready for implementing more mobile devices into their health IT systems. Listen and let us know what questions you have. And remember to register for the webcasts.

 

On Tuesday, Oct. 23, Intel is hosting three one-hour Health IT webcasts on mobility, big data and caring for an aging global population. These brief sessions will feature online discussions with experts on the next wave of healthcare technology, plus live Q&A so you can ask questions to those who are on the forefront of health IT transformation. Register for the webcast series here.

 

Leading up to the online webcasts, we have asked industry leaders to share some of their thoughts on the future of healthcare technology. Today’s guest blog is from Andrew Litt, M.D., chief medical officer at Dell Healthcare and Life Sciences, on how the cloud is key to managing big data in healthcare.  Let us know what you think and remember to sign up for the webcasts.

 

With the growing digitization of clinical data, more healthcare providers are recognizing the value of data analytics as a tool for driving better outcomes with greater efficiency. Yet healthcare is still lags behind other industries in creating integrated, longitudinal, client-focused databases that can serve as the foundation for in-depth analytics.
   
Access to such data creates an opportunity for fostering more predictive care delivery by dramatically altering care patterns, delivery approaches, and use of resources and modalities. Healthcare providers are challenged not only by the quantity of the data, but the need to ensure real-time access and mobility throughout the enterprise and beyond. The other legitimate concern is how to manage this flood of data and make sure it is secure as it becomes more easily accessible.

 

An essential element in managing “big data” in healthcare is cloud computing technology. A secure healthcare cloud is a future-ready IT platform that makes it possible to create a system for applied healthcare analytics. Since most of the protected health information breaches that occur are a result of loss or theft of a physical device, moving data to the cloud actually improves its security. This system – in which information is secure but accessible to those who need it for analyzing, selecting, and administering treatments – streamlines administration, enhances the quality of care and ultimately supports personalized medicine.

 

Just as important is the ability to connect healthcare information currently locked in silos to enable coordinated care where all the physicians’ efforts are synchronized around the whole patient. Longitudinal electronic medical records data combined with social history data and ongoing real-time measurement can reduce the time and expense of bringing new drugs to market and support the development of targeted treatments for patients who do not respond to today’s drugs due to individual genetic differences.


Once we tap the digital data generated by electronic medical records, imaging and genomics research for intelligence, the possibilities for innovation and health advancement are unlimited.


The cloud can be leveraged not only for documentation and exchange, but also for expert diagnosis and analytics. Because of the amount of data that will be generated, stored and analyzed, the cloud can speed computational processes, manage and store the resulting data, and provide a forum for analytics and global collaboration. For visionaries who make the decision to strategically change the way they look at information now, the benefits of their data assets will be reaped for years to come.

 

What do you think?

Healthcare costs around the world are rising, and one solution is collaborative care workflows that utilize mobile technology. Because this issue is so important to the future of healthcare technology, it’s the focus of one of our online webcast discussions during the 2012 Intel Healthcare Innovation Summit coming up on Oct. 23. You can register for this free online series here.


Here’s a short preview of what you can expect to hear during the panel on collaborative care and mobile tools. Carol Raphael, Advanced Leadership Fellow at Harvard University and former President/CEO of the Visiting Nurse Service of NY, talks about mobile technology tools and how the need to consolidate devices would improve workflow.

 

 

What do you think about mobile health IT devices? Remember to register for the webcasts prior to Oct. 23.

For patients with complex needs, it’s a big task to coordinate care within the walls of one clinic and hospital. But to truly meet the individual’s needs – as well as the societal demands to improve healthcare quality and access at a sustainable cost – care coordination requires a community approach.


The role of primary care is critical. Yet it’s been often overlooked or under-invested in fee-for-service healthcare. Many communities are working hard to change that now, some with a “hotspot” model of incorporating community-based services and care plans for people who need the highest levels of care coordination. Intel has ethnographers, project managers, and IT architects working with a small set of these communities.


Based on our observations so far, Intel has produced a new white paper, A Global Imperative to Design the Nucleus of Care, which explores four pillars of community-based primary care models such as the primary care medical home.

 

Read the paper and let us know what questions you have.


Coordinated care will also be a main topic of discussion during the Intel webcast series on Oct. 23. I encourage you to register for the webcasts today and join us for the health IT panel discussions. Register here.

Coordinated care and global aging are some of the topics that will be addressed during the first Intel Healthcare Innovation Summit webcast on Oct. 23. You can register for this free online event here. During the webcast, you will hear from Sen. Ron Wyden (Ore.) about how to treat a growing aging population, and how Oregon is taking an innovative approaching to healthcare.

 

To give you a deeper insight into Oregon's initiatives, listen to the below podcast discussion with Dr. Bruce Goldberg, Director of the Oregon Health Authority, who talks about how the state is leading the charge when it comes to establishing a new infrastructure of care, healthcare reimbursement for Medicare, and coordinated care reform. Listen and let us know what questions you have.

 

 

Remember to register for the Healthcare Innovation Summit webcasts by Oct. 23.

On Oct. 23, Intel is hosting three healthcare IT webcasts. These online sessions will feature panel discussions with experts on the next wave of healthcare technology, plus live Q&A so you can ask questions to those who are on the forefront of health IT transformation. Register for the webcast series here.


Leading up to the online webcasts, we have asked industry leaders to share some of their thoughts on the future of healthcare technology. Below is a guest blog from Ashley Perry, Healthcare Ambassador at Lenovo, on the role of tablet technology at the point-of-care and some questions you should be asking when considering these tools for a healthcare environment  Let us know what you think and remember to sign up for the webcasts.

 

As healthcare organizations move to electronic health records and away from paper based systems, tablet PCs and slate tablets are becoming increasingly popular. These devices are playing an expanding role, especially at the point-of-care. With the limited resources that many healthcare organizations face, tablets can be a critical component of cost effective productivity. Real time information throughout all stages of the healthcare delivery process can result in saved time, reduced error, and better care.


Lenovo is always asking our healthcare customers for feedback on all of our technology including discussions on the attributes of each product and how these products can be utilized to assist them in doing their jobs better. Recently in our healthcare customer roundtables and in our business partner network, the popular question of late has become: How can tablets help meet the important goals of providing better quality and more efficient patient care?

 

When we talk to HIT professionals about point-of-care tablet needs, the conversation usually revolves around  speeds and feeds, battery life, weight, connectivity, security, durability, support for software applications, price and service level agreement. It is relatively straightforward to create a competitive matrix based on the information outlined above with top tablet options being considered along with a cost-benefit analysis.


However, what has become clear during collaborative conversations with HIT and clinical professionals is that this evaluation process needs to be more about how the tablet impacts the patient experience and not just its technical resume. These features are clearly related, but beyond identifying the technical requirements, the question then becomes how does the tablet actually function at the point-of-care?

 

Here are a few more critical questions to ask when considering tablet options:


Q: Does the device support an instant and always on, always connected experience?
A: As smartphones and other mobile devices are more widely adopted, users are expecting the same type of instant gratification experience with their tablet PCs and slate tablet devices. When point-of-care tablets are optimized this way, clinical professionals are able to be efficient and productive, which means they have more time to spend with patients.


Q: What are the input options? Keyboard, voice, touch?  If the device is touch enabled, is it capacitive finger-based touch, a true digitizer pen-based experience, or both?
A: The tablet user experience should not prevent the clinical professional from focusing on the patient while simultaneously viewing/entering information. Multiple options for input are critical. If the tablet is not optimized for input, it can result in a bad patient care experience or the workflow can resort to paper or memory and consequently batch processing rather than real-time entry.


Q: How long is the battery life and how heavy is the tablet?
A:  In many healthcare environments, tablets are used on long, 8-12 hour shifts. Lightweight, long battery life options are essential. It is important to choose a tablet and/or additional batteries and charging solutions that can support long shifts; however, there is a delicate balance between battery life and weight. Typically, in order to achieve long battery life, bigger and heavier batteries are required. Selecting the right solution that balances the two is imperative.


Q: What connectivity options are available?
A:  Tablets need to integrate into existing infrastructure to provide continuous mobility throughout the facility or at least the workflow.


Q: Is the tablet platform secure?
A:  Healthcare devices must be secured with multiple layers of protection in order to adhere to patient health information regulations. Secure tablet platforms that are optimized for various layers of protection are paramount.


Q: Can the device be imaged for zero touch deployment and/or can it be centrally managed?
A:   If the organization plans to deploy and manage clinical tablets, the tablets must have the necessary attributes to make this process efficient and effective. Custom imaging options can help create customized and standardized devices for deployment while centralized management makes on-going management/updates a streamlined process. This type of support gets and keeps users up and running and reduces time spent customizing and maintaining the tablets.


Q: How durable is it?
A: Tablets used at the point-of-care need to hold up amongst a swirl of activity and unpredictability. Some tablets meet military spec testing requirements and there are also industry reports available for warranty claim rates by manufacturer. This is a good indication of how well the tablet will hold up in healthcare environments at the point-of-care.


Q: Can it, and does it need to, pass infection control requirements?
A:  If the tablet will be used in areas where it needs to pass infection control, it is important to choose a specialized tablet that has been qualified for this. Typically, these types of tablets are priced at a premium. There are also many different use cases at the point-of-care that do not need to pass infection control and therefore do not require the additional investment.


Q: What is the user experience like with each software application that needs to be used?
A: As healthcare organizations transition to EHR platforms, collaboration between hardware and software providers is an important piece of making sure the experience is optimized.


Q: What kind warranty support is available?
A: The speed at which parts, replacements, and new units can be acquired is a very important consideration. Also, the terms of the warranty need to match expectations for the tablet’s lifecycle.


One very important message, that seems to resonate above all else on this topic, is that one size does not fit all. Flexible technology ecosystems are essential. While a tablet may be the perfect fit in some scenarios, it can struggle in others. Varying levels of screen size and performance are offered in product portfolios which include tablets, notebooks, desktops, workstations and servers. Since a vast variety of infrastructures, workflows, and use cases exist within healthcare environments, unique combinations of these technology choices can help support the increasing role tablets are playing in the care delivery process.


Any time there is technology at the point-of-care, the focus should be on the patient. This means a tablet should be optimized both at a hardware and software level so that the user experience is smooth. Often a disconnect exists between the people tasked with purchasing/supporting the technology and the people actually using it at the point-of-care. However, there is a shift happening in the industry where these departments are working more collaboratively to ensure that point-of-care technology investments are made based on a balanced evaluation.


An Informatics Professional can help bridge the gap if this role exists at the organization. Otherwise, it is very important to involve both sides during the evaluation to ensure that the right tablet is chosen. Our role, as leader in the industry, is to listen and to innovate. With all of the demands of the healthcare delivery process, it is clear that the right tablets at the point-of-care can be great productivity tools to enable more efficient and more effective patient care.

 

What questions do you have about tablets in health IT?

 

From a physician’s point of view, the more information available on a patient the better. That’s why Big Data is one of the topics during the Intel Healthcare Innovation Summit webcast series coming up on Oct. 23. You can register for this free series here.

 

In this podcast, Dr. Andrew Litt, chief medical officer at Dell Healthcare & Life Sciences, talks about Big Data in healthcare, what it means to healthcare IT professionals, and what CIOs need to know to get ready for the onslaught of Big Data. As a physician, he speaks from experience on how data can be used to improve patient outcomes.

 

Give a listen and let us know what questions you have. And be sure to register for the webcasts on Oct. 23.

 

Big Data is one of the topics that will be covered in the upcoming Intel Healthcare Innovation Summit webcast series on Oct. 23. If you haven't signed up yet, you can register for this free series here.


In this preview clip from the Big Data webcast, John D. Halamka, CIO of Beth Israel Deaconess Medical Center and Dean of Technology at Harvard Medical School, outlines that the main challenge of Big Data is turning data into knowledge, information and ultimately wisdom. His equation for Big Data is capture data in a structured form, normalize it so it can be analyzed, exchange it so it’s in the right place at the right time, and keep it private and secure.

 

 

What do you think? What's your take on Big Data?


Remember to register for the webcasts before Oct. 23.

On Oct. 23, Intel is hosting its Healthcare Innovation Summit webcasts. These online sessions will feature roundtable discussions with experts on the next wave of healthcare technology, plus live Q&A so you can ask questions to those who are on the forefront of health IT transformation. Register for the webcast series here.


Leading up to the online webcasts, we have asked industry leaders to share some of their thoughts on the future of healthcare technology. Today’s guest blog is from Bob Rogers, PhD, chief scientist at Apixio, Inc., on Big Data. Let us know what questions you have.

 

As a healthcare technology leader, you ask, “Isn’t my data warehouse already Big Data?”

 

I hear this question frequently as Chief Scientist at a startup specializing in Big Data Analytics for Healthcare.

 

My response: “Probably not. ‘Lots of data’ is not the same thing as Big Data.”

 

“What is Big Data Analytics?”

 

Don’t get me wrong: Healthcare is generating Big Data. A typical healthcare system with 200,000 patients has 500,000 encounters each year, submits 5 million claims and creates 3 million documents. In five years this adds up to over 1.5 billion distinct references to medical concepts equaling 10 Terabytes of data. That is bigger than the entire print collection of the U.S. Library of Congress.

 

However, Big Data Analytics is really about new methods to infer knowledge directly from data, which requires three components:

 

1.    Scalable data storage with parallel computing capability
2.    Analytical tools, such as machine learning and statistical natural language processing, that can make sense of both structured data and clinical narrative
3.    Instantaneous access to enough data to infer something useful in real time

 

“So what will I learn from Big Data Analytics?”

 

Here’s an example. To best care for diabetics, you enroll them into a disease management program, which means you must identify patients with diabetes accurately. You then need to compute quality measures, such as whether their latest Hemoglobin A1c lab value was above 9.

 

Sadly, your information system only contains structured data and you quickly find that this data is a mess. First, many patients with “diabetes” entered in their problem lists are actually not diabetic.  This is called “chart lore,” and is a phenomenon endemic to electronic healthcare data. Strike one.

 

Next, you discover that a significant fraction of your real diabetics do not have any coded term for diabetes in their problem lists so they are not being tracked for disease management. Strike two.

 

Finally, you discover that 25 percent of your patients are part of a provider group that your organization recently acquired. Although you loaded all of their coded data into your data warehouse, their lab codes are not recognized by your reporting system. Strike three.

 

There is no way you can actually compute the measures you need to run your business!

 

Here’s where Big Data Analytics comes in. With the ability to analyze unstructured data, you infer from encounter notes and consult letters which patients are truly diabetic.

 

What about the unrecognizable lab codes? You utilize machine learning to leverage a Big Data-sized set of patient histories to infer which of these mystery codes correspond to Hemoglobin A1c measurements. You are back in business.

 

Healthcare is at the intersection of two revolutionary events: The first is fueled by new Big Data technologies that extract valuable knowledge from huge amounts of data. The second was sparked by Meaningful Use and the electronic liberation of previously unavailable clinical data. The resulting explosion in Big Data for Healthcare will light the way for years to come.

 

What do you think?

Coming up on Oct. 23, Intel is hosting its Healthcare Innovation Summit webcasts. These brief sessions will feature online  roundtable discussions with experts on the next wave of healthcare technology, plus live Q&A so you can ask questions to those who are on the forefront of health IT transformation.  Register for the webcast series here.

 

Leading up to the online webcasts, we have asked industry leaders to share some of their thoughts on the future of healthcare technology. Here is a guest blog from Justin Barnes co-chair of the national Accountable Care Community of Practice (ACCoP) and a vice president at Greenway Medical Technologies on patients as consumers. Let us know what you think and remember to sign up for the webcasts.

 


The healthcare industry is understanding that patients should no longer be perceived as passive recipients of healthcare services.

 

Instead, the new patient-consumer is seeking quality, affordability and access to their data. It is health IT’s role to provide caregivers with innovative solutions as patient engagement becomes central to improved delivery.

 

Today’s patient-consumers are also embracing technology, a message that needs to be instilled into the provider community. A Qualtrics/Vista Consumer Research survey this summer found that 81 percent asked felt that care provider use of health IT at the point of care helps physicians do a better job. That’s a foundational baseline to work from.


That same survey found that 58 percent have shopped or plan to shop by price when considering a physician.

 

And a Rand Corp. study published this summer found that patient segments are increasingly seeking basic healthcare needs at less expensive and accessible retail clinics, a growth from 1.5 to nearly six million visits from just 2007 to 2009.

 

Much of this is being driven by the equal rise in high-deductible employer health plans, and the fact that patients are simply utilizing many forms of technology in their daily lives.

 

So far HHS and ONC recognize this trending through meaningful use, CMS Shared Savings and related means to push patient engagement forward: no less than four engagement measures in Stage 2: providing the viewing, download and transmitting of patient records; providing clinical summaries per office visit; using technology to identify and provide patient-specific educational materials; and the use of secure online messaging.

 

Related in Shared Savings is quality measure scoring tied to patient engagement and even surveys (seven measures and 25 percent domain scoring weight), the placement of a beneficiary on governing boards and the documentation of how patient engagement is being promoted.


But ultimate success relies on the healthcare information technology and EHR community to move beyond external requirements.

 

We’ve already experienced the establishment and growth in online portals, and are now seeing the integration of personal health records into these bi-directional and patient empowering solutions. Developers are also enhancing mobile applications linking patients and providers to each other and to pertinent databases.

 

Progressive EHR solutions are also advancing open architecture to developer partners to speed innovations in engagement solutions offered to the provider community, and are working with retail and workplace clinics to deploy EHRs to advance services in those ambulatory settings.

 

At the same time, standards-based interoperability and data exchange is advancing within the marketplace to connect physician practices and hospitals as the flow of data is itself paramount to all of these advancements.

 

It was no surprise – and indeed a measure of foresight – that ONC sponsored the inaugural Consumer Heath IT Summit in conjunction with National Health IT Week in mid September.

 

As our 21st century healthcare system progresses, we should be able to look back at a wealth of gains in patient engagement keeping pace with patient consumerism, and begin to tie those efforts to improved outcomes and sustainability.

 

What do you think?

 

Justin Barnes is co-chair of the national Accountable Care Community of Practice (ACCoP), chairman emeritus of the EHR Association and a vice president at Greenway Medical Technologies.

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