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· The big-data revolution in US health care: Accelerating value and innovation. Link Over the last decade, pharmaceutical companies have been aggregating years of research and development data into medical databases, while payors and providers have digitized their patient records. Meanwhile, the US federal government and other public stakeholders have been opening their vast stores of health-care knowledge, including data from clinical trials and information on patients covered under public insurance programs. Fiscal concerns, perhaps more than any other factor, are driving the demand for big-data applications. After more than 20 years of steady increases, health-care expenses now represent 17.6 percent of GDP. While health-care costs may be paramount in big data’s rise, clinical trends also play a role. Physicians have traditionally used their judgment when making treatment decisions, but in the last few years there has been a move toward evidence-based medicine, which involves systematically reviewing clinical data and making treatment decisions based on the best available information. Aggregating individual data sets into big-data algorithms often provides the most robust evidence, since nuances in subpopulations (such as the presence of patients with gluten allergies) may be so rare that they are not readily apparent in small samples. Some health-care leaders have already captured value from big data:

· Kaiser Permanente has fully implemented a new computer system, HealthConnect, to ensure data exchange across all medical facilities and promote the use of electronic health records. The integrated system has improved outcomes in cardiovascular disease and achieved an estimated $1 billion in savings from reduced office visits and lab tests.

· AstraZeneca established a four-year partnership with WellPoint’s data and analytics subsidiary, HealthCore, to conduct real-world studies to determine the most effective and economical treatments for some chronic illnesses and common diseases.

Traditional medical-management techniques must change, since they pit payors and providers against each other, framing benefit plans with respect to what is and is not covered rather than what is and is not most effective. All stakeholders must recognize the value of big data and be willing to act on its insights, a fundamental mind-set shift for many and one that may prove difficult to achieve.

· ONC partnership eyes interoperability through governance - Link Rather than trying to create new information exchange governance standards, the Office of the National Coordinator is pursuing the goal of nationwide HIE interoperability and security via a cooperative agreement with Direct Trust and the EHR/HIE Interoperability Workgroup to build on current successes, while sorting out ongoing barriers.

· Policy Committee Hears Report on New EHR Vendor Alliance - Link The alliance -- which was announced in March at the Healthcare Information and Management Systems Society conference -- aims to facilitate greater access to health data through improved interoperability. The five participants in the partnership are:

· Allscripts;

· athenahealth;

· Cerner;

· Greenway Medical Technologies; and

· McKesson.

· RelayHealth, a subsidiary of McKesson, also is participating in the project.

· According to a McKesson spokesperson, the participating vendors together represent:

· 41% of the hospital electronic health record market; and

· 23% of the ambulatory care EHR market (iHealthBeat, 3/6).

· The Alliance “CommonWell” aims to accomplish this by:

· Enabling health care providers to identify patients using a unique identifier -- such as a telephone number or email address -- instead of a national patient identifier;

· Offering a way to match patients with their health records as they move through different facilities;

· Allowing patients to manage consent and authorization for sharing their data;

· Providing HIPAA-compliant, patient-centered data management; and

· Enabling authorized health care providers to submit targeted queries for peer-to-peer data exchange (Healthcare IT News, 4/4).

According to Egerman, EHR vendors will need to pay an annual subscription fee to use the record locator service. During the Policy Committee meeting, Judith Faulkner -- committee member and CEO of Epic, an EHR vendor that was not invited to be a founding member of CommonWell -- raised several questions about the initiative. "What is it? Is it a competitive business? Is it a service?"

· Framework Outlines Key Principles for Protecting Privacy of Patient Data Link The framework aims to help health care organizations measure how well their IT systems and research projects meet certain best practices for protecting patient privacy. The framework was developed in partnership with: Microsoft; PricewaterhouseCoopers; and The Coalition for Patient Privacy. The framework's 15 core privacy principles call for health care organizations to ensure that:

1. Patients can easily locate, review and understand the organization's privacy policy;

2. The privacy policy fully discloses how the organization will and will not use personal health data;

3. Patients can decide whether to participate in sharing data;

4. Patients receive notification before their data are accessed by any outside entity that does not fully comply with the organization's privacy policy;

5. Patients can decide and actively indicate whether they want to be profiled, tracked or targeted;

6. Patients can decide whether and how their sensitive information is shared;

7. Patients have the ability to change any data that they input personally;

8. Patients can decide who can access their data;

9. Patients with disabilities can manage their health data while maintaining their privacy;

10. Patients easily can determine who has accessed or used their information;

11. Patients receive prompt notification if their data are lost, stolen or improperly accessed;

12. Patients easily can report privacy concerns and receive help;

13. Patients can expect the organization to penalize any employee or contractor who misuses patient data;

14. Patients can expect their data to be secure; and

15. Patients can expect to receive a copy of all disclosures of their information

· Patient Experiences With Full Electronic Access to Health Records and Clinical Notes Through the My HealtheVet Personal Health Record Pilot: Qualitative Study Link In the study, researchers wrote that patients "overwhelmingly felt that having more, rather than less, of their health record information provided benefits"

· According to the study, patients said that having online access to their EHR data helped them:

· Improve communication with their health care providers;

· Share their health information with non-VA physicians;

· Better understand their health conditions; and

· Increase their participation in their care.

· However, some patients reported experiencing negative effects of online EHR access as a result of:

· Derogatory language in physician notes; and

· Inconsistencies between physicians' verbal and written comments

· Ninety percent of Americans have never emailed or texted with their doctor. Should they? Link The average American writes a novel's worth of email every year. They also read a novel's worth of trend stories about how all we do is text -- how 15 million texts sent every minute are destroying the art of conversation, rotting our souls. Still, only about one in ten Americans has ever emailed or texted with their doctor. The formal in-office face-to-face patient-doctor dynamic is largely sacrosanct. In a survey conducted for The Atlantic in conjunction with GlaxoSmithKline, 1000 Americans talked about their health tech habits:

· A Healthy Dose of Social Media Link In Ohio, 90 percent of hospitals are using social media, about half say they will devote more staff time to these channels in 2013 and 39 percent increased their social media budgets this year, according to a survey by the Ohio Hospital Association and the Columbus firm Mindset Digital.

· New HIPAA rules take effect Link A 563-page “omnibus” privacy and security rule was released by HHS on Jan. 17, with an effective date of March 26.

· The new rule expands HIPAA privacy and security rule coverage and direct liability for violations to business associates of HIPAA “covered entities.” Those contractors might include vendors of remote-hosted EHRs to office-based physicians or firms providing hospitals with clinical and financial data analytics. In addition to healthcare providers, HIPAA covered entities include claims clearinghouses and insurance plans.

· Another major change under the rule involves the policies and technologies needed to comply with a patient consent management provision. Under the ARRA, a patient who pays out-of-pocket for treatment can ask a provider not to share a record of that treatment with the patient's health insurance plan and providers must comply with that request.

· KLAS’ Target for a Single-Vendor Performance Report: Agfa Link

· In the new report, Agfa HealthCare 2013, the vendor provides “second-rate performance as an imaging partner,” according to KLAS. The company is not focused on client success, its PACS performance is mediocre, its cardiovascular systems are disappointing, the radiology information systems functionality has significantly deteriorated in the past year, and its service and support is holding back the technically strong area of image archiving, the report contends.

· Agfa’s best performance comes in speech radiology and digital X-ray, particularly its computed radiography systems, which KLAS calls “reliable, rock-solid equipment.”

· Overall, however, too many customers don’t see Agfa as a real partner, according to KLAS. “Clients do not report an intense focus from Agfa on customer success, making it an area ripe for improvement. Agfa speaks to a successful partnering model and appears to be incorporating elements of the model, yet historically, Agfa has not delivered anywhere close to an ideal level.”

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