End-of-life planning isn't exactly fun—especially when you are very sick and your days are probably numbered. But researchers at Pennsylvania State College of Medicine and Pennsylvania State University are trying to make it easier with a computer program that helps patients think through difficult questions, such as whether they want aggressive treatment to prolong their lives or whether they'd rather maximize their quality of life, even if it means they'd probably die sooner. The researchers tested their program with 20 patients who had moderate-to-severe chronic obstructive pulmonary disease. The patients sat down with a computer and worked their way through the program. At the end, the program produced an advanced healthcare directive—also known as a living will—to convey to doctors what they would want in their final days. Overall, the patients were quite satisfied with those computer-generated advanced directives. On a scale of 1 to 10 (with 10 being the highest), the patients gave their living wills an average score of 8.5. They also liked the computer program itself, giving it an average rating of 8.6.
Of the three tenets of meaningful use -- adopt certified electronic health record technology, demonstrate core and menu set requirements, and report on clinical quality measures -- the piece about adopting certified EHRs is more complicated than most healthcare providers anticipated. For starters, the Office of the National Coordinator of Health IT clarified in December 2010 that healthcare providers must possess all of the meaningful use capabilities, not just those that they intend to report on. This means that even though CMS has afforded healthcare providers the flexibility in reporting on any five of the 10 menu requirements in addition to all the core requirements, ONC requires those providers to possess all the core set and the 10 menu set capabilities. In essence, healthcare providers are being forced to possess capabilities that they do not intend to use and report on in Stage 1.
Electronic prescriptions among U.S. office-based prescribers increased 71% to 326 million in 2010, compared with 190 million the previous year, according to an annual progress report from e-prescribing network vendor Surescripts. Major drivers of the increase, according to report authors, include the electronic health records meaningful use incentives program and Medicare's e-prescribing incentive program, particularly among physicians without EHRs.
Farzad Mostashari, MD, the national coordinator for health IT, summarized the dynamic tension of "keeping our eye on the prize and feet on the ground, being clear about where we want to go but also being cognizant of where we are today. No hospital CIO should feel that they have to make a choice between do I prepare for accountable care or do I go for meaningful use. We should make meaningful use the roadmap of what we need to do to succeed where increasingly care is going to be reimbursed based on quality, efficiency, coordination and safety rather than pure quantity." Among the initial proposals, some measures from stage 1 were moved from the optional menu category to core or required for stage 2, such as incorporating laboratory results as structured data for 40% of test results ordered. In other measures from stage 1, the thresholds were increased to encompass more patients or make the electronic process more pervasive, such as the use of computerized physician order entry for 60% of patients with at least one medication order from 30%.
Hospital CIOs in the U.S. say they're planning to increase IT spending in 2011-- and they're not alone. Healthcare CIOs in the United Kingdom and Canada are also upping their IT investments this year, according to a new survey. Of the 152 hospital CIOs surveyed across North America, Europe, and Australia about their IT budgets and priorities over the next 24 month, 42% said they are increasing IT spending in 2011, according to a new report from U.K-based research firm Ovum. Almost a quarter, 22%, of the CIOs said they plan significant increases to IT spending in 2011, compared to only 14% who planned big increases last year. Last year, 22% of healthcare CIOs said they'd slash their IT budgets, but that figure dropped to 17% for 2011.
Doctors can make a stroke diagnosis using an iPhone application with the same accuracy as a one made using a medical computer workstation, a study from the University of Calgary's Faculty of Medicine revealed. The research, which was published in the Journal of Medical Internet Research, has significant implications for iPhone use among physicians treating stroke patients, and is another example of how mobile health applications are enabling doctors to make medical diagnoses based on images viewed on their mobile devices. Neuro-radiologists in the study looked at 120 recent consecutive non-contrast computed tomography (NCCT) brain scans and 70 computed tomography angiogram head scans that were obtained from the Calgary Stroke Program database. The scans were read by two neuro-radiologists, on a medical diagnostic workstation and on an iPhone, and the results showed that there was a 94% to 100% rate of accuracy for diagnosing acute stroke compared with a medical workstation that has a much larger screen.