Better Living Through Technology
Articles in this Winter 2011 TMIS eNewsletter:

As we enter the new year, the transition to electronic health records (EHRs) from paper records is well underway by the healthcare industry. Not necessarily easy or seamless, the transition has not been without its tensions between health information technology (HIT) vendors and their customers. Recognizing a need for oversight of this process by an unbiased third party who can analyze gray areas, a task force was appointed by AMIA, the leading professional association for informatics professionals. Their recommendations have just been released in a report, “HIT Vendors, their customers and patients: New challenges in ethics, safety, best practices and oversight.”

Driven by the belief that reliance on paper records is a hindrance to quality patient care, HIT systems have become ubiquitous. These recommendations demonstrate a high-value commitment to patient safety, quality care, and innovation — healthcare goals sometimes difficult to reconcile. Among the recommendations is contract language specified to protect patient safety and to spell out the shared responsibility that vendors and their customers have for successful implementation. “Hold harmless” clauses in contracts between vendors and purchasers or clinical users that absolve vendors for errors or defects in their software have been declared unethical by JAMIA. HIT vendors and their customers are urged to adopt enterprise-wide ethics education to parallel what accrediting healthcare organizations require. The report can be found in the January/February 2011 print edition of JAMIA, and also as a full text open-access document on-line at www.jamia.org.

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- Mary M. McLaughlin

From the Front Page of TMIS News
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Fortify HIT Contracts With Education and Ethics to Protect Patient Safety, Say Informatics Experts
Washington, DC

An original and progressive report on health information technology (HIT) vendors, their customers and patients, published online, makes ground-breaking recommendations for new practices that target the reduction or elimination of tensions that currently mar relationships between many HIT vendors and their customers, specifically with regard to indemnity and error management of HIT systems. In light of the Obama Administration's $19 billion investment in HIT, paid out in ARRA stimulus funds, these recommendations are particularly significant in helping to foster greater use of electronic health records and other tools in the transition from paper records, largely understood to be a hindrance to quality patient care.

The recommendations, adopted by AMIA -- the association of informatics professionals and a trusted authority in the HIT community -- strive to imbue the HIT vendor-customer relationship with transparency, veracity, and accountability through collaborative education focused on the installation, configuration and use of HIT systems, in combination with enterprise-wide ethics education to support patient safety. The recommendations are the result of deliberations by an AMIA Board-appointed Task Force. The position statement will appear in the January/February 2011 print edition of JAMIA, the scholarly peer-reviewed journal of informatics in health and biomedicine, co-published by AMIA and the BMJ Group.

"There was a need to consider, study and analyze questions of appropriate oversight," said AMIA Board Chairwoman Nancy M. Lorenzi, PhD, Assistant Vice Chancellor for Health Affairs and Professor of Biomedical Informatics, Vanderbilt University. "With as much interest and investment in HIT as there is today, AMIA -- an unbiased third party -- wanted to take a fresh look at gray areas that currently exist between vendors and their customers to see where new practices could be implemented to better support patient outcomes and protect patients, who these systems ultimately serve. We think these recommendations do an excellent job of addressing fairness and balancing accountability in the HIT marketplace and in the health sector."

The report, titled "HIT Vendors, their customers and patients: New challenges in ethics, safety, best practices and oversight," makes specific recommendations on Contract Language, Education and Ethics, Ethical Standards, User Groups, Best Practices, and Marketing. An additional section addresses Regulation and Oversight of the HIT Industry and next steps.
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Healthcare IT Is Tuned In to the Need for Uptime Assurance as Industry Adopts Electronic Records, Survey Finds
Maynard, Massachusetts

Healthcare organizations are moving steadily toward electronic health record (EHR) adoption to improve patient care but, at the same time, are aware of downtime's potential to erode EHR's benefits, according to a Stratus Technologies-ITIC survey. More than 70 percent of healthcare organizations surveyed have either implemented on-premise EHR systems or plan to. The number rises to 81 percent when outsource EHR providers are factored in. While only 6 percent of respondents are in the process of deploying an EHR system now, 35 percent plan to launch an on-premise system within the next year and 37 percent within the next 20 months.

"The survey results show that the majority of healthcare organizations clearly recognize how electronic health records can reduce overhead expenses and improve patient care," said Laura DiDio, principal at ITIC. "They also understand that those benefits are contingent on maximum uptime, and where downtime would have the most serious effect."

Uptime's importance is clear in responses to questions about disruptions to patient care and important administrative processes. Only 11 percent said that inability to access EHR files would cause minor disruptions; 64 percent said there would be notable disruptions, mainly administrative; processing insurance claims and scheduling patient appointments were the most frequently cited at 67 and 53 percent. However, nearly half the respondents -- 49 percent -- said EHR system disruptions can increase the potential for patient data recording errors and 32 percent said it could cause errors in prescribing medications.

Despite the broad awareness of uptime's importance, almost 20 percent of respondents were still unsure how inaccessible health records would affect administration and patient care. "It's heartening to see that most healthcare IT professionals understand their uptime needs, though we still need to be concerned about the 20 percent that doesn't seem to grasp the issue, or have yet to begin an EHR evaluation or implementation," said Nelson Hsu, senior director, Avance product line. "Uptime isn't a 'nice to have' in medical applications. If a healthcare organization can't see where interrupted access to patient medical records affects care, then they don't understand why they need reliable hardware and software infrastructures that provide continuous uptime. Without that, their EHR projects -- on premise or outsourced -- lead to business disruption and the potential for compromised patient care."
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On The Eve of a Technology Breakthrough-OLED Production Set to Increase Tenfold in 2011
Hofstetten, Australia

"In 2011 we will all experience the decisive breakthrough of OLED technology in displays and lighting," says Erich Strasser, Publisher and Editor-in-Chief of the online portal OLED-display.net. The OLED expert has thoroughly analysed market and insider information: by mid-2011 Strasser expects global OLED production to have multiplied tenfold and promises numerous new, exciting products in the future.

According to Strasser, windows with transparent OLEDs (Organic Light Emitting Diodes) will be commonplace in a few years time: during daylight hours they are transparent – in the evenings the OLEDs become a source of light. Windscreens in cars will function similarly, allowing navigation information to be transmitted through transparent OLEDs. Over the coming months, the publisher of OLED-display.net expects huge advances in OLED technology: "The lifespan of the OLEDs will double, and contrast and colours will improve significantly."

OLED have already reached the mass markets in smartphones: companies like Nokia and Samsung have a few models with OLED displays on the market. "In the future, almost all smartphones will include OLED," Erich Strasser says. Strasser has been focusing on OLED technology since 2004 and opened the first online portal on the topic in the same year.

The advance in technology will continue at a record pace in 2011. Strasser: "The manufacturers have recognised the future of OLEDs. LG Display and Samsung Mobile Display alone will be investing EUR13b in new OLED production sites over the coming five years. A similar sum was invested in LCD technology at the time. It's clear: in the coming years, OLED will also conquer the Flat-TV market and will gradually replace LCD and plasma technology."

Erich Strasser: "As soon as 2011, LG plans to offer a 31" OLED 3D TV. And Samsung is even planning rollable OLED TVs within the next 24 months."
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Health, Budget Concerns Will Drive Food Flavor and Ingredient Market in 2011
New York, New York

Consumer thriftiness and health-consciousness will continue to exert a notable influence over the food and beverage ingredient and flavor trends to emerge in 2011, according to Food Flavors and Ingredients Outlook 2011, the eighth edition of the annual series by market research publisher Packaged Facts.

"Heading into 2011, consumers are growing evermore weary of economic and nutritional health gloom and doom. Many have spent the last few years reinventing their financial and employment lives, and are now starting to focus more emphasis on their overall wellbeing and happiness in a way that is reflective of their values, being more pragmatic and deliberate in making decisions about how to spend both their time and their resources," says Don Montuori, publisher of Packaged Facts.

Packaged Facts believes food marketers, from the retail and foodservice sectors, will take that consumer mindset to heart in 2011. Some of the key trends Packaged Facts forecasts to hit it big in 2011 are:

Flavors From Around the Globe -- Ethnic food will remain a bright spot for foodservice and retailers, providing variety and interest without taxing smaller food budgets. The growing presence of food trucks, with their varied ethnic fare at reasonable prices, will bring this national trend home to the local level.

Sustainability Trumps Local, Organic and Natural -- Local, organic and natural foods will more often be connected with eco-friendliness and a more holistic lifestyle approach to eating that promotes sustainability. As a result, Packaged Facts predicts that there will be greater use of natural, organic, local and antibiotic and hormone-free ingredients at quick serve restaurants and fast casual restaurants in 2011. At retail, the popularity of private label organic products is anticipated to continue while growth in directly marketed local and organic produce, meats and locally processed foods sold via farmers' markets and community-supported agriculture is anticipated.
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The Top 5 Mobile Resolutions Marketers Need to Make for 2011
San Mateo, California

The mobile marketplace is a moving target and for Fortune 500 organizations, getting a mobile offering right couldn't be more essential to building a successful brand. These companies have been in a frenzy to launch mobile offerings that capture the attention of consumers and keep them one step ahead of competitors. From identifying consumer's mobile needs to dealing with the onslaught of new mobile device introductions, CMOs and CIOs are pulled in too many directions and are often overwhelmed by the task of developing a successful mobile offering that reaches all consumers across all devices.

"The additional revenue potential in mobile applications for consumer brands is astronomical. With the variety of devices, operating systems, features and capabilities that brands face today, it's near impossible for a company to parse out what's going to make them successful in the space and give them the greatest bang for their mobile dollar," said Raj Koneru, CEO of Kony Solutions, Inc., the mobile application platform provider with Write Once, Run Everywhere technology, enabling applications to be designed and developed just once, in a device independent manner, and deployed across multiple channels, including on-device applications, mobile web, SMS, web gadgets, desktop applications, and tablets.

Koneru continued, "2011 provides brands with an opportunity to slow down and really strategize about their mobile portfolio, make the right investments and find the right partner that will help them to protect their investment and see solid return. With so many new innovations hitting the mobile market every day, it's essential for companies to understand which new features and trends will be most important to leverage in the New Year."

Drawing on extensive experience designing, developing, and maintaining mobile portfolios for Fortune 500 brands across a variety of industries and the entire breadth of mobile devices, operating systems and channels on the market today, Kony Solutions predicts the five key trends these companies need to leverage as part of their mobile offering in 2011.

1. Augmented Reality Meets Shopping

To-date augmented reality applications have been focused on navigation programs, being used primarily to direct users to a location. In 2011, the mobile space will see more experimentation with augmented reality. Applications will begin to harness its power to engage consumers, offering incentivizing information on products in-store. Consumers will be able to hold their phone's camera up to a product and see discounts or coupons on the product layered over the real-life image.

2. Voice Is Key In Security

A significant roadblock to consumer adoption of mobile wallet technologies has been consumers' concerns over the security of storing sensitive information on their mobile handsets. Developers have attempted to quiet these concerns by implementing protection features such as multi-factor authentication to their apps. In 2011, voice biometrics will emerge as the new standard for security. According to Citibank Australia CEO Roy Gori, using an individual's voiceprint for security purposes can be more accurate than any other means of identification, while also making obsolete the typical series of log-in passwords and questions for users resulting in increased ease-of-use and consequently, adoption.
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Top Five Trends Shaping the Mobile Enterprise Market in 2011
Jersey City, New Jersey

Antenna, enabling business transformation through intelligently designed mobile applications, unveiled its Top Five Trends for the mobile enterprise in 2011. These predictions are driven by Antenna's twelve years of mobility expertise and experience leading mobility deployments for global companies, including Coca-Cola Enterprises, Hallmark, ING DIRECT and Xerox.

In the coming year, Antenna expects the mobile enterprise market to significantly expand, driven mostly by continued consumerization of the enterprise and the proliferation of smarter mobile devices. Businesses will leverage mobile and social technologies to help them provide immediate gratification to users, offer relevant information and dynamic content at the point of need, and deliver services and goods with deeper end user insight and a more personal touch -- in other words, "deploy happiness" to a world with increasingly connected, passionate and engaged employees and customers.

The foundation that underpins and enables these advancements will be the mobile cloud, as IT organizations push to simplify the integration of mobile into existing technology infrastructure by choosing to consume mobile apps and services in a hosted, on-demand model, rather than building the mobile infrastructure and platform themselves and supporting it with costly resources.

Top Five Mobile Enterprise Market Trends for 2011

Mobile is the Mortar

Many industry analysts predict smartphone sales will eclipse PC sales by 2012. Tablets such as the iPad, those powered by Android, and soon RIM's PlayBook are being adopted at unprecedented rates. Antenna has already seen a sharp uptake in enterprise tablet interest, and 2011 will prove to be the first year of significant tablet deployment, which will likely come at the expense of laptops. The mobile channel will become seamless, as enterprises integrate mobility with their 'bricks and clicks' operations. Mobility is not a separate channel but one that has the unique ability to drive new growth to Web and physical storefronts, augmenting growth, driving new revenues, and deepening customer relationships with the brand.

The Mobile Cloud Reigns

Cloud-based mobility (a set of hosted services, typically powered by a mobile enterprise application platform or MEAP) will allow businesses and service providers to offer a 'switch in the cloud,' enabling them to build, publish, manage and secure mobile apps and content and scale mobility projects much more rapidly and cost effectively. As mobile apps proliferate for employees, customers and partners, enterprises will look to deploy their own branded app stores for greater application management, control and protection of the brand.
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JDSU Announces Top Tech Trends for 2011
Milpitas, California

JDSU has announced 2011 technology trends for the markets it serves, from the emergence of 4G to advancements in gesture recognition and clean energy solutions. JDSU top technology trends for 2011 include:

Mobility Gets Fitter and Faster to Support New Applications

The smart phone boom and resulting migration to faster and higher-performing wireless networks will continue to be a big focus as mobile traffic grows dramatically in 2011. "As new wireless network architectures emerge, expect them to better support demanding applications such as mobile video blogging, advanced games and professional services," said Jay Stewart, director of Ethernet Service Assurance at JDSU. "JDSU provides a range of solutions critical to the smooth testing, deployment and management of new LTE and 4G networks to bring new applications seamlessly to the user."

Online Video Pushes the Internet to Become More Self Aware

The Internet will continue to grow as a key utility in people's lives in 2011 with millions of people expected to watch full-length TV episodes and movies online, consuming a large portion of bandwidth during peak viewing hours. "As fast as engineers can create on-demand applications, people are adopting them," said Sinclair Vass, senior marketing director of Communications and Commercial Optical Products at JDSU. "A big priority for JDSU is to support the need for faster data rates, more powerful network switching, and smarter, 'self-aware' network architectures that can handle unpredictable and fast-changing traffic patterns."
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Wavelink Enhances Voice Capabilities in New Version of Terminal Emulation
New York, New York

Wavelink Corporation has announced the availability of Wavelink Terminal Emulation 7.3 with enhancements to the Speakeasy voice solution. The Wavelink Speakeasy client already removes the implementation cost and bandwidth usage barriers often associated with voice-enabled data entry, and the new features make it even easier to use for both end users and administrators and improves the accuracy of the voice recognition.

A new speech-to-text engine provides end users with flexibility on their mobile devices. Speakeasy remains a user-independent solution in which any user can pick up any mobile device with the Speakeasy client and utilize the voice features. Now users can also choose to train the speech engine to their particular voice and speech patterns. The voice training is saved and managed via Wavelink Avalanche as a voice profile, so the user can still login to any device and have it equipped with their voice training profile. This improves the accuracy of the voice recognition and still maintains the user flexibility to operate any mobile device.

"Wavelink Speakeasy empowers IT departments to quickly and easily add voice support to their terminal emulation applications," said Mikkel Storm, Wavelink senior product manager. "In addition to having removed technology and cost barriers, we now offer the ability for a user's profile to follow them from device to device for greater flexibility and accuracy."

Another new feature is the addition of Speakeasy monitoring and diagnostics tools in the Wavelink Terminal Emulation client. This allows users to calibrate the speech recognition engine for their particular hardware and environment and to view a real-time speech confidence level to better diagnose the cause of inaccuracies in recognition.

Administrators can now use the Terminal Emulation Screen Reformatter to improve the efficiency for users providing voice input. Specific fields can be designated for speech-to-text and text-to-speech entry, and the user interface can be tailored to specific users or applications. The ability to easily import and export multiple scripts allows administrators to add advanced functions to meet their company's specific needs and processes.
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