Annapolis, MD-based Anne Arundel Medical Center has been fined $20,000 by the Maryland Department of the Environment after reporting two incidents in which cancer patients received the wrong doses of radiation. MDE officials said they received reports of two similar incidents in 2007 of "misadministration" of radiation by cancer care providers.
Though UCLA Medical Center has portrayed its recent privacy breaches as rare actions, the hospital has known since at least 1995 that staffers were peeking into the medical records of prominent patients, according to records and interviews. The California Department of Public Health has been investigating UCLA since the hospital fired 13 workers and disciplined 12 others for snooping on pop star Britney Spears. Since then, reports showed a different worker inappropriately accessed the electronic records of 61 patients.
In the United States, 32 percent of mammography clinics now have at least one digital machine, up from only 10 percent in 2006. Eventually, film will be phased out, but progress is causing some centers to repeat mammogram tests for some patients. During this transition period, doctors are learning to interpret digital mammograms and compare them to patients’ previous X-ray films. The digital and film versions can sometimes be hard to reconcile, and radiologists may be more likely to play it safe by requesting additional X-rays and/or biopsies.
A device called an "Evacusled" is one of the newest devices used at Des Moines, IA's Mercy Medical Center and Mercy Capitol hospital to help move patients during emergency evacuations. Health officials say Hurricane Katrina and 9/11 brought the issue of hospital emergency preparedness to the forefront, with one key piece being patient evacuation. New, specialized equipment such as the Evacusled are a great improvement over other techniques of transporting patients, such as wrapping patients in bedsheets or blankets and carrying or dragging them, hospital officials say.
Congress' passing of a federal medical privacy law in the 1990s was hailed as a new level of protection for patients nationwide. But even though the government has received about 34,000 complaints of privacy violations since in the last five years, only a handful of defendants have been criminally prosecuted. Critics say the government's approach may be too lenient, especially when medical records are increasingly being shifted from file folders to computers. The goverment's current approach focuses on getting providers to correct violations.
A recent essay in Health Affairs (Dec. 11, 2007), "The State of Regional Health Information Organizations: Current Activities and Financing," likely won't make it to CNN. Nevertheless, for IT proponents, this is essential reading. The report suggests that many--perhaps even most--data exchanges, or RHIOs, are not going to survive. Among 145 surveyed RHIOs, nearly one in four was defunct. Only 20 were exchanging clinical data.
Despite federal support for the idea, data exchanges face plenty of hurdles. The industry is pouring plenty of effort into them. Perhaps that's why, when the well-known Santa Barbara data exchange folded up shop last year, you could practically hear the collective sigh. After all, isn't data sharing the whole point of IT? And ultimately, if you can't make it work beyond the boundaries of one hospital, what's the point?
Well, for my money, many data exchanges are the cart before the horse. Local hospitals and medical groups need to get their own acts together first before they can even begin thinking about trading data with others. I've interviewed numerous industry leaders involved with data exchanges. They invariably point to politics, not technology, as the challenge. To be sure, they are intertwined. Take the cross-community master patient index. Before that hurdle can be approached, there needs to be a community consensus--at least on the need, if not the solution.
One IT industry group, the National Alliance for Health Information Technology, is attempting to spark that consensus. The group ended 2007 with a renewed call for a national patient identifier. "One of the biggest obstacles to progress in developing an interoperable national health information network remains reaching agreement on how to correctly match medical information to patients while guarding their privacy," says Scott Wallace, Alliance president and chief executive officer.
A national identifier may be a lofty goal, especially when you reflect back on the Health Insurance Portability and Accountability Act of 1996. The original law called for a national patient identifier, but the provision generated so much controversy it was scrapped. The need, however, has not disappeared. The patient identifier is just one of many political roadblocks that can block data sharing, regionally or nationally. It is one of many horses needed to pull the cart. Kudos to NAHIT for recognizing that.
P.S. This issue marks the completion of the first year of HealthLeaders IT. Thanks to the many people who have commented on my essays, contributed their own articles, and directed me to newsworthy stories. I look forward to serving you in the year ahead.