HealthTech

Articles that catalogue health and beauty industry.

Tuesday, March 22, 2005

Memorial opens digital-age hospital

People driving behind the young communities along Southwest 172nd Avenue in western Miramar might think the street's intersection with tree-lined Pembroke Road is a strange location for a Mediterranean-style hotel.

But that blue "M" on the sides of the recently constructed buildings doesn't stand for Marriott. It's the Memorial Healthcare System's new 128-bed hospital.

South Broward County's publicly funded health care system shelled out $143 million to build Memorial Hospital Miramar, which will open to patients on March 17. Designed with features like wallpaper, crown molding and wood-imitating sheet vinyl floors in the patient rooms, it resembles a hotel. And with an array of the latest health care technology that makes it nearly paperless, the hospital promises to be among the most advanced in South Florida.

Forbes.com:Breath Test Could Spot Bioterror Bugs

Forbes.com:: "Health
Breath Test Could Spot Bioterror Bugs
-- Robert Preidt


MONDAY, March 21 (HealthDay News) -- A simple breath test currently under development could let doctors quickly identify who's been infected to any one of a number of bioterror agents.
'We want to have a tool that can help in the emergency room or first responders to triage on site so that people who are infected can get treatment first,' Joany Jackson, a researcher at Johns Hopkins University, said in a prepared statement.
Reporting March 21 at the American Society for Microbiology Biodefense Research Meeting, her team explained that when cells in the body are exposed to organisms that cause disease, they release proteins called cytokines that help immune cells identify and fight the infection. The researchers believe cytokines may work their way up through tissue to be exhaled through water vapor in the breath.
A breath test that captured and identified specific cytokines might help bioterror first responders detect newly infected individuals, they said.

$9 million infusion for medical bar-coding company-- Medical Errors

$9 million infusion for medical bar-coding companyPatients at hospitals and nursing homes don't always receive the correct medication -- a costly mistake that results in as many as 45,000 deaths per year.

But a 3-year-old Kent company by the name of Integrated Healthcare Systems believes it can eliminate those errors by bar-coding medicines, thus saving lives and billions of dollars for the health care industry.

HealthLeaders - Do MDs or MBAs Make Better Leaders?

HealthLeaders - HealthLeaders NewsThe concept of the physician executive, meanwhile, has migrated from the fringe of healthcare to its core. Today's physician leaders are seen as key players in the ongoing effort to reinvent the struggling healthcare system.

This transformation of the physician executive from outcast to savior reflects a widespread belief that doctors bring vital skills to the executive suite. For one, physician leaders are more connected to the daily grind of healthcare.

Monday, March 21, 2005

washingtonpost.com: A Personal Record

washingtonpost.com: A Personal RecordWhile most consumers can retrieve cash from a bank account anywhere in the world, research virtually any topic instantly and buy books, sell unwanted stuff and take university courses online, the medical system is a laggard in information technology. Only 10 to 15 percent of U.S. hospitals and doctors can access patient records electronically -- and often they contain data from only a single provider or hospital.

CDC - New Study Shows Limited Use of Electronic Medical Records - March 15, 2005

CDC - New Study Shows Limited Use of Electronic Medical Records - March 15, 2005March 15, 2005 — Less than a third of the nation’s hospital emergency and outpatient departments
use electronic medical records, and even fewer doctors’ offices do, according to
released today by the Centers for Disease Control and Prevention (CDC).

Friday, March 18, 2005

Cheap At-Home Genetic Testing Opens Deep Pandora's Box

Cheap At-Home Genetic Testing Opens Deep Pandora's BoxAn increasing number of online startups are marketing tests that can show predisposition to any number of maladies, from breast cancer to blood clotting. They are exploiting the blizzard of genetic discoveries reported almost daily since scientists published the complete map of all human genes five years ago.

Friday, March 11, 2005

Fw: Career Planning:The Job and Work Roles of Nurse Informatics Specialists


Career Planning

The Job and Work Roles of Nurse Informatics Specialists

The current and future jobs that nursing informatics specialists may hold are evolving, and as such there is a considerable range of titles, roles, work settings and pay scales. Historically, nurse informatics specialists have not always been formally trained. As noted in A New Definition for Nursing Informatics, "A typical career pathway for an informatics nurse (has been): The nurse in a hospital is hired to help implement a nurse documentation system in that organization. After gaining some implementation experience, the informatics nurse may be hired by the vendor of that product to install systems at other hospitals in the region or nation. These positions require travel away from home up to 100 percent of the time. With experience at multiple sites, the installation specialist may then work for a consulting firm advising clients how to implement the system." More and more, this pathway will change, as formal education becomes more widely available, and more important.

Job Outlook
Healthcare organizations are increasingly installing clinical information systems in response to both competitive market pressures and recent evidence on errors in medicine. These organizations recognize that nurses, in fact all clinicians, are important team members in the process of IT conception, design, installation and maintenance. This field will be one in which continued demand for trained specialists will be the norm.

Job Roles
Some of the areas in which specialists can work include patient education, nurse education, project management, system design and development, information technology consulting, system selection and implementation, and research. Some representative examples include:
  • Clinical nurse informaticist Likely hospital-based, and known as a clinical nurse analyst or clinical informatics specialist. Typical responsibilities include data collection, outcome reporting, designing and managing clinical databases, creating quality surveys, creating communications using desktop publishing, and designing forms.
  • Nurse analyst An analyst may have little or no patient contact - instead they concentrate on the work processes, understanding how to improve them using technology and data management concepts. A component of the role involves education of clinicians in information system concepts and, conversely, educating the technical people about health care.
  • Nursing administrators Manage department finances by using software that provides for budgeting and cost accounting. Staffing, scheduling and resource use can be managed with computer programs. Office automation incorporating word processing, electronic mail, spreadsheets, presentation graphics and databases make the work easier for the nurse administrator.
  • Nurse researchers Access decision support systems, such as knowledge about diabetic care, or maintain information using database management tools. Quality monitoring can be enhanced by documenting risks and incidents. A major emphasis now is on the use of technology to prevent medication errors by having the ordering provider directly enter an order into the computer system.
  • Nursing Informatics Educators Utilize technology-driven instruction for both nurses and clients. More and more online classes are being conducted using the Internet. Nurses can obtain bachelor's, master's and even doctoral degrees using technology. Computers can help to manage the data surrounding courses such as registration, maintenance of student grades and course certificates.
  • Executive Health information Manager coordinates all information management functions across the enterprise that encompass the quality, appropriateness, retrieval and analysis, and security of patient-related and other enterprise data.
  • Data quality improvement expert implements methodologies known to improve data quality that are required in today's healthcare environment.
  • Information security expert designs, implements and/or maintains an information security program that balances requirements of privacy, integrity and availability of data.
  • Information resource planner employs systems and strategic planning, integrates and maintains information resources, understands acquisition and implementation of systems.
  • Data analyst/research specialist employs skills in data retrieval, data mining, modeling and statistical tools for analysis of healthcare data.
  • Information systems user liaison understands vocabulary of the healthcare professional, serves as the human interface between the healthcare professional and systems professional with technical expertise, and the systems environment, constructs data models
  • Project manager manages the implementation of systems necessary to support computer-based patient record and other systems implementation projects.
adapted from A New Definition for Nursing Informatics

Employers
Work environments for nurse informaticists are also far-ranging. These include hospitals and clinics, home care and long term care, nursing schools, IT vendors and consultants, medical software companies, the pharmaceutical industry, and regulatory/governmental organizations.

Job Titles
Job titles vary quite widely for nurses in informatics, and differing often titles reflect similar work. A recent survey of nursing informatics positions in the US revealed these job titles:
  • Nursing Informatics Specialist
  • Clinical Applications Coordinator
  • Chief of Nursing Informatics
  • Director of Nursing Informatics
  • Manager of Clinical Services
  • Clinical Information System Coordinator
  • Director, Information Services
  • Clinical Systems Coordinator
  • Director, Clinical Information Systems
  • Nursing VP for Informatics
  • Nurse Consultant
  • Nurse Systems Specialist
  • Clinical Systems User Project Manager
The American Medical Informatics Association website keeps a list of sample job descriptions: http://www.amia.org/jobexch/jobs/fpost.asp

Salary
While clear data are not available, some authors have estimated an average salary range of $35,000 to $60,000 per year, climbing as high as $100,000 - $200,000 per year for senior consultants with experience. As with most specialty nursing positions, salary is dependent on the hiring organization, the geographic location, job responsibilities and accountability, and the candidate's education and experience.

Nursing Informatics Interest Groups

There are a growing number of professional groups focused on nursing informatics. A partial list is noted here - for more complete information please check the University of Maryland web page at http://nursing.umaryland.edu/~snewbold/skngroup.htm

National Organizations
  • American Medical Informatics Association (AMIA) Nursing Informatics Working Group
  • American Academy of Ambulatory Care Nursing - Informatics Special Interest Group
  • American Nurses Association (ANA)
  • American Nursing Informatics Association (ANIA)
  • Health Information and Management Systems Society (HIMSS)
International Organizations
  • International Medical Informatics Association (IMIA) Special Interest Group on Nursing Informatics (SIGNI)
  • Australian Nursing Informatics Council (ANIC)
  • Brasilian Nursing Association Nursing Informatics Group at Brazilian Nursing Association
  • Canadian Organisation for Advancement of Computers in Health (COACH)
  • Health Informatics New Zealand (HINZ) (www.hinz.org.nz)
  • Spanish Society of Nursing Informatics and Internet (SEEI)
  • Swiss Special Interest Group Nursing Informatics (SIG-NI)

Health Industry Under Pressure to Computerize

February 19, 2005
Health Industry Under Pressure to Computerize
By STEVE LOHR

DALLAS, Feb. 17 - Dr. David J. Brailer, the federal official who is trying to prod the nation's health care system into the computer age, has delivered a warning to the health care industry: take steps soon to make it happen or the government will probably impose a solution.

Across the ideological spectrum, health care experts and politicians agree that the nation's hodgepodge of paper medical files needs to move into the digital era, so that eventually each person has an electronic health record that can travel across networks and be read by doctors, hospitals, insurers and the patients themselves. Doing so, the thinking goes, would reduce medical errors, improve health care and save money.

Congress has been doing its own prodding on the matter, with another bill introduced this week. Trying to pick up the pace, Dr. Brailer, in meetings with health care and technology executives here at their industry's big annual convention, has told them to come up with a single set of technical standards for electronic health records.

The approach, he said, must include a method to certify that the records can be opened and read by doctors and specialists, as authorized by the patient, even when different clinics and hospitals have different computer systems.

If the industry cannot agree upon such standards by this summer, "then government will probably do what government does best - put out a mandate," Dr. Brailer said in a talk to information technology companies here Wednesday. "Some people think that would be a train wreck, and some people think that would be a great idea."

Dr. Brailer's comments amount to goading with intent. A 45-year-old physician and economist, he explained over a late-night dinner here with a reporter that he regarded his job primarily as taking steps to repair a market failure in health care information technology. He is part policy maker, technologist, cheerleader and arm-twister, traveling much of his first 10 months on the job to meet with doctors, hospital administrators, technology executives and others.

At the Dallas convention, sponsored by the Healthcare Information and Management Systems Society and attended by more than 23,000 people, Dr. Brailer spent a typically adrenalin-charged day and a half. He arrived Tuesday night for a business dinner that ended at 11 p.m. His first appointment the next morning was shortly after 6 a.m., beginning a stream of meetings and talks that ended after 10 p.m., with groups that ranged in size from a few hundred people to a handful.

Thursday morning began with an early meeting, then off to an 8:30 a.m. speech to an audience of more than a thousand in the convention center's main arena. Next came a quick tour of the convention floor, before heading to the airport.

In the smaller gatherings, Dr. Brailer took notes and asked questions as much as he spoke. He is still wrestling with just how large and how direct a role the government should take in trying to accelerate the adoption of computerized health records. But it is clear that a common technical standard for those digital documents is a vital step.

In most markets, technical standards - from uniform railroad track sizes in the 19th century to software protocols for the Web in the 1990's - have enabled the growth of markets and industries that are built on those public standards.

Once a basic standard for electronic health records is in place, Dr. Brailer says, it will be less risky to invest in digital records for doctors or hospitals that may now worry that the software they purchase today, and struggle to learn to use, may become obsolete sometime later. "We've got to take the risk out of purchasing electronic health records," he told the group working on the standard.

The industry is poised for growth, judging from the turnout at the convention. It set an attendance record for the show, and more than 700 exhibitors displayed their wares on the trade floor. The booths were a corporate who's who of household names like I.B.M., Microsoft, Cisco Systems and General Electric, as well as health technology specialists like Cerner, McKesson, Epic and Allscripts.

Dr. Brailer, appointed last year by President Bush as the national health information technology coordinator, said that he would greatly prefer to see an industry consortium agree upon a technical standard, because it might be more flexible and open to future technical improvements than one determined by government edict, however well intentioned.

The industry group that is supposed to develop the electronic health record standard, the Certification Commission for Healthcare Information Technology, was formed last year, with members drawn from large medical centers, technology companies, insurers, physicians, nonprofit groups and consultants.

Speaking to a meeting organized by the commission, Dr. Brailer said their early efforts showed "great promise." Then, he added, "We're banking on this, until it is clear that you can't do it."

In small group meetings, Dr. Brailer urged the technology executives to set aside their narrow corporate interests, giving up some of their proprietary lock on customers, to open up a larger market opportunity for everyone. Each company cannot get all it wants, he said. Yet technical standards groups often bog down amid conflicting interests.

At one point, Dr. Brailer asked a group of technologists what they wanted from government. Wes Rishel, a veteran of health technology standards groups and a member of the certification commission for electronic health records, replied, "We need a tie-breaker - someone who is somewhere between a czar and a diplomat."

By now, the need to computerize a health care system that is choking on paper is beyond dispute. Health experts say that moving to electronic records, which would reduce paper handling and eliminate unnecessary or duplicative tests, could cut 10 percent or more from the nation's $1.7 trillion a year in health care spending. And a digital system should sharply reduce medical errors, which are estimated to be responsible for 45,000 to 98,000 deaths a year - more than breast cancer, AIDS or motor vehicle accidents, according to the Institute of Medicine of the National Academy of Sciences.

The electronic patient records could also open the door to a national health information network in which patient information, stripped of personal identification, could be used for national health research projects, impartial assessments of drugs' effectiveness and other data-mining possibilities.

Health care is already rich in high technology when it comes to diagnosis, surgery and treatment - from advanced body scanners to all manner of medical devices and drugs - in large part because those investments clearly generate revenue. But in information technology, health care lags well behind most other industries. In health care, the average investment in information technology computer hardware, software and services is only about $3,000 annually for each worker, compared with $7,000 a worker on average for private industry and nearly $15,000 a worker in banking.

Falling prices for personal computers and software, and the blossoming of the Internet in recent years, have brought down the cost of adopting electronic health records and made it easier to connect to specialists, hospitals and insurers.

But health care remains a fragmented industry, with much of the care still provided by physicians in small practices. An estimated 60 percent practice in offices with 10 physicians or fewer and 35 percent in offices with three physicians or fewer.

And for these physicians, who essentially are small- business people, information technology still represents a daunting cost: $30,000 a physician to adopt electronic health record technology, according to a recent study, which factored in the cost of hardware, software and time lost in terms of patients not seen while learning the system.

"The elephant in the living room in what we're trying to do is the small physician practices," Dr. Brailer said. "That's the hardest problem, and it will bring this effort to its knees if we fail."

Dr. Brailer is still studying what might be the right mix of incentives to encourage physicians to embrace digital health records. The incentives, he noted, could include federally backed loans, grants and extra reimbursement by Medicare and other insurers for using electronic health records.

Many large hospitals and medical centers already have electronic health records, accounting for most of the 10 to 15 percent of all physicians who have adopted computerized patient records. It will be essential for them, Dr. Brailer said, to make sure they conform to the new open standard, when it is developed by industry or mandated by government, so they can share information with other groups.

Once adoption reaches 45 percent or 50 percent, Dr. Brailer predicted, the benefits from digital records will be so apparent in terms of savings and quality of care that a tipping point will be reached. "That's when the network economics will take over," he said. "It will become a condition of being in business, like e-mail is in most businesses."

Dr. Brailer's challenge is to fashion the right policies to get there. "This is not about technology," he said. "It's really about transforming health care, fixing this market."

AMNews: March 7, 2005. Optimistic outlook for consumer-driven health care ... American Medical News

AMNews: March 7, 2005. Optimistic outlook for consumer-driven health care ... American Medical News

Monday, March 07, 2005

Fw: 8 city hospitals are candidates for shutdown

 

8 city hospitals are candidates for shutdown


Consensus builds for consolidation

By Gale Scott
Published on February 21, 2005

Eight New York City hospitals are emerging as likely targets for closing, as the consensus grows that the state has too many hospitals.

Area hospital executives and consultants agree that the facilities ripe for shuttering include Interfaith Medical Center, Peninsula Hospital Center and Victory Memorial Hospital in Brooklyn; Our Lady of Mercy Medical Center in the Bronx; Cabrini Medical Center and St. Vincent's Midtown Hospital (the former St. Clare's) in Manhattan; and Mary Immaculate Hospital and Parkway Hospital in Queens.

"Everyone's got a list of which hospitals could go," says Francis Serbaroli, a partner and health care specialist at law firm Cadwalader Wickersham & Taft.

The likelihood that some of these hospitals will close in the near future is growing, now that the Greater New York Hospital Association, the 1199 SEIU health care workers union and the Hospital Association of New York State have all publicly agreed that closings are necessary.

With Gov. George Pataki determined to rein in skyrocketing state Medicaid costs, and scores of hospitals already losing money or barely staying alive, the hospital groups and union say they are eager to find a way to close some facilities to make limited resources go further.

Simply losing money, as 53% of the state's hospitals did in 2003, is not criterion enough to make the hit list, because some money-losing hospitals are in areas that desperately need their services. In all eight cases, it's believed that the surplus hospitals have little to offer patients that couldn't be provided at another nearby hospital. By continuing to operate, these hospitals siphon off patients from their competitors.

Niche services

For example, under new ownership, Parkway Hospital expects to make money by offering gastric bypass surgery and lucrative wound care treatments using a hyperbaric chamber. At the same time, the hospital is abandoning less profitable services such as obstetrics and pediatrics--leaving those essential services to nearby hospitals, including North Shore-LIJ's Forest Hills Hospital.

The Saint Vincent Catholic Medical Centers system is trying a similar approach in turning its Hell's Kitchen affiliate, formerly known as St. Clare's, into a high-tech heart disease center. Critics say it won't work.

"There's St. Luke's-Roosevelt doing that a few blocks north, St. Vincent's Hospital to the south, and Beth Israel Medical Center, and other centers all over Manhattan. It's hard to see why there's a need," grumbled a competitor's chief executive, asking not to be named.

However, most of the hospitals on the hit list insist they don't belong there, citing reasons like neighborhood growth, new niche strategies, or a history of serving the poor.

Yet most in the industry agree that some hospitals need to go, although they differ on how to reach that goal. One argument favors forcing some closings. Another backs a more free-market approach by giving hospital systems financial resources to help them restructure, downsize or close down on their own.

A recent report from the governor's task force on hospitals and health care, headed by Stephen Berger, calls for creating a 19-member commission to set criteria for deciding which hospitals should close, then coming up with a strategy that would permit the state to revoke their licenses to operate.

Base-closing advocates

The GNYHA and the union say they believe such a "base-closing commission" could work, but differ from Mr. Berger's plan by calling for unions, the hospitals, the public and legislators to have far more say in deliberations.

But HANYS disagrees with this approach. Its president, Daniel Sisto, says that board members, including 20 from New York City, voted overwhelmingly at a recent meeting to reject the idea of having a commission decide their fates.

"We don't want 19 political appointees with their own agendas making these decisions," Mr. Sisto says, adding that hospital systems would close marginal facilities on their own if the state would cover their outstanding debt.

Mr. Serbaroli predicts that with a commission deciding which facilities to close, unionists on the panel would favor closing nonunion hospitals, and big hospitals' representatives would favor closing any small competitors.

"No one should tell a hospital that it should close if it's making money," says Mr. Serbaroli.


Wednesday, March 02, 2005

TCE - Fast Forward

TCE - Fast ForwardWhat do the CEOs, CFOs, and financial stakeholders of the top global media and entertainment companies think will keep their businesses successful in the fast-changing future of the media and entertainment industry? Ernst & Young asked 23 of them for their insights at this critical time of transformation and, combined with research and analysis by our top thought leaders, produced "Fast Forward: Technology Propels Media and Entertainment CEOS into the Future."

Tuesday, March 01, 2005

A model patient records system-The VA's VISTA software is tapped for expanded service

A model patient records systemWhen people think of cutting-edge computerized health systems, the Department of Veterans Affairs is probably not the first organization that comes to mind. But VA officials have developed a system that many believe could be the low-cost foundation of the nationwide electronic health record (EHR) system that President Bush wants to deploy.