Glosario eSalud | eHealth Glossary
Glosario sobre eSalud | eHealth Glossary
Special | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | ALL
Dr. Sarfaraz Niazi: Flexibility Is Key To Innovation
The Most Interesting Man Revolutionizing The Health World
Nicole Fisher | Contributor
He wrote his first world-renowned book at the age of 26. On weekends he recites love poems (ghazals) on Voice of America. He casually – and humbly – references his more than 70 patents that range from aging wine to chewing gum to bioreactors to air scrubbing systems at his infamous Chicago wine parties. And his mustache rules his twitter feed. In 2013 he was awarded the Star of Distinction, the highest civil award by the Government of Pakistan, for his inventions that are making significant impact in developing countries. He has written over 50 books, well over 100 research papers, and hundreds more articles in the field of science, philosophy, rhetoric, poetry and religion, drawing thousands of hits per day on his blog. Dr. Sarfaraz Niazi might just be the most interesting man in the world, but he is certainly the most interesting man pursuing biosimilars in the United States.
Dr. Sarfaraz Niazi
Throughout his career his driving principle has been to make things simpler. He did this while at Abbott Labs, as a former tenured professor at the University of Illinois at Chicago (UIC), in developing countries, and presently in his independent career at Therapeutic Proteins International, LLC (TPI) where he is working on biosimilars – or “copies” of current biologic pharmaceuticals that are about to lose their patents. Although only 17 biosimilars have been approved to date worldwide, though none in US, Dr. Niazi and TPI have nine in the pipeline to transform the entire market. According to photographer Steve Huff, Dr. Niazi is, “An amazing man, in fact the most interesting man in the world!”
Flexibility Is Key To Innovation
When asked his advice to other inventors in a recent interview, Dr. Niazi explained his philosophy that, “You should never get enamored by your thoughts. If the idea does not solve a problem or move the quality of life farther, there are many more things to be invented.” With that mentality, he is filing two products this year alone, similar toAmgen Inc.’s $6 billion molecule white blood count product, due to its expiring patent in the cancer market. Next year, the two molecules he plans to take to market are similar to AbbVie’s expiring $12 billion product Humira.
With movement like that, it’s no wonder Dr. Niazi claims that the U.S. Food and Drug Administration (FDA) is his “friend.” Nevertheless, he notes extreme complications with the rolling submission model, which can cost up to $4 million per submission in fees alone. Additionally, the four levels of the FDA’s “analytical similarity” benchmarking can be troublesome if one has a new biologic entity. This benchmarking, however, allows scientists and the FDA to work together in a predictable, step-wise fashion to move products to market quickly that have fingerprint-like similarity to existing US-licensed biologic products.
Dr. Niazi’s strategy is to create an analytical and clinical equivalent to biologics with expiring patents, which is preferred even over a Phase 3 clinical trial. By doing this, the cost of production is reduced drastically and the speed of development increases by 2-3 times. Dr. Niazi estimates an overall reduction in production costs for his biosimilars of up to 50% or higher compared to market competitors.
By being flexible, his products are proving to be bio-revolutionary.
Can The United States Catch Up?
Additionally, thanks to the Affordable Care Act (ACA), a shorter licensing path for lower-cost versions of cell-derived drugs is now possible, giving inventors like Dr. Niazi another pathway for approval and distribution.
While he claims that the ACA will not reduce health costs, he does believe that independent shocks to the health market will. By this, he believes that making biosimilars easier, faster, cheaper and better translates directly into his mission of making all things simpler. Further, cost-effectiveness in the US and European Union (EU) can directly convert into worldwide distribution and scalability that is safe.
Although a friend of the FDA, Dr. Niazi is not hesitant to note the tough decisions US-based companies face to stay in the states. Having FDA approval carries weight around the world, but the financial and regulatory burden can be great for inventors and business owners. In contrast, he asserts that the EU has moved ahead of the rest of the world, with the most established and advanced regulatory framework for the authorization and marketing of biosimilars, which has since been adopted by the World Health Organization (WHO).
Additionally, Dr. Niazi says that it is difficult to raise money in the US. Venture capitalists and corporate investors are less likely to take risk and have notoriously poor track records with the health sector.
Investing In The Windy City
Through a focus on creating “generic equivalents,” Dr. Niazi is proving that TPI can be wildly successful in the Midwest, and further, that in the same way generics revolutionized how people access pharmaceuticals, biosimilars can revolutionize the way those around the world access lifesaving treatments.
As his biosimilars enter the market with FDA approval, the ability of Dr. Niazi to impact the entire health sector grows because his biosimilars can be substituted for its reference product without provider or patient intervention. However, the FDA has not yet finalized these guidelines, and only 17 biosimilars have been approved internationally to date, of which none are by the FDA.
Ultimately, with numerous billion-dollar biologics coming off patent over the next six years, and the exorbitant cost for specialty drugs, the nine biosimilars TPI has in the pipeline stand to make a huge impact in the health sector. While Dr. Niazi could be doing many interesting things these days as an international man of mystery, he has devoted his research, time and energy to bringing high quality, cost-effective treatments to the US, and beyond. So long as he maintains his wine parties and poetry readings, its certain no one will complain.
E-Prescribing Giant Surescripts Emerges As A Player In Push For Interoperability
Zina Moukheiber | Contributor
With health care providers scrambling to meet a government deadline this year to electronically send and receive patient information, an unlikely actor has emerged to facilitate that transaction.
As the country’s largest electronic prescribing network, processing 1 billion prescriptions last year, Surescripts has amassed information on more than 200 million patients—from phone numbers to birthdate. Capitalizing on its network, it started four years ago offering health care providers the ability to exchange clinical messages using government-sanctioned standards. The service, slow to take off, has quadrupled since March, with health care providers exchanging nearly 1 million clinical messages in August. Jeff Miller who heads clinical network services, says that number is rapidly rising. Surescripts has signed up 130 health systems, including Geisinger Health System, Mount Sinai Health System, and St. Joseph’s Hospital Health Center.
Donny Patel who’s director of interoperability at Mount Sinai, a 7-hospital system in New York, implemented Surescripts’ messaging service earlier this year, ahead of his July deadline. The second phase of meaningful use calls for health care providers to transmit a patient summary electronically in order to qualify for financial incentives. Instead of fax or phone, a doctor at Mount Sinai can now forward to another physician on a different electronic health record a patient’s discharge instructions, medications list, and diagnoses, among other things. Mount Sinai uses electronic health records from multiple vendors. “They [Surescripts] have a network, and they know my vendors,” says Patel.
Giving Surescripts a major boost is Epic. The dominant electronic health record connects to Surescripts’ clinical messaging service, and many of Surescripts’ clients are on Epic. Other major vendors that use Surescripts include Siemens (now part of Cerner) and Meditech.
Surescripts says it added 1,000 hospitals to its network this year. The more it adds, the more likely it makes its clinical messaging service indispensable.
Effective and Efficient Use of EHR System
Three Tips to More Effective and Efficient Use of Your EHR
By Avery Hurt
Choosing, buying, and installing EHR software is hard enough. Then there's training staff and making sure patient data is secure. And for practices that choose to take part in CMS' meaningful use program, learning to use the EHR as efficiently and effectively as possible is crucial.
"This is not an easy task," Steven Waldren, director of the American Academy of Family Physicians' Alliance for eHealth Innovation told Physicians Practice. "We've struggled to help our members with this." Nonetheless, he has some practical advice. "Keep in mind that the goal is not just to automate your practice, but to make it work better. In order to do this, you have to think outside the box."
Here are some ideas to get you started to get the most of your EHR to meet those meaningful use requirements:
• Examine work flow.
• Have a practice powwow.
• Reach out to peers.
Don't be overwhelmed by the challenges of integrating this technology into your practice. "Little steps make a big difference," said Waldren, "and you'll have more success in the long run if you consider this another quality improvement practice."
eHealth at WHO
eHealth at WHO
Programmes and projects
EHR Adoption Hits Record Levels for Hospitals and Physicians
HHS: EHR Adoption Hits Record Levels for Hospitals and Physicians
EHR adoption for hospitals and physicians are higher than before, according to two new studies published today by the HHS Office of the National Coordinator for Health Information Technology (ONC).
The studies, published in the journal Health Affairs, found that in 2013, almost eight in ten (78 percent) office-based physicians reported they adopted some type of EHR system. About half of all physicians (48 percent) had an EHR system with advanced functionalities in 2013, a doubling of the adoption rate in 2009. The information in the studies was collected by the Centers for Disease Control and Prevention’s National Center for Health Statistics and the American Hospital Association in 2013.
About 6 in 10 (59 percent) hospitals had adopted an EHR system with certain advanced functionalities in 2013, quadruple the percentage for 2010. Unlike the physician study, the hospital study does not have an equivalent, established measure of adoption of some type of EHR system; it only reports on adoption of EHRs with advanced functionalities.
The data from the report provides an early baseline understanding of provider readiness to achieve Stage 2 Meaningful Use of the Medicare and Medicaid EHR Incentive programs. Stage 2 will begin later this year for providers who first attested to Stage 1 Meaningful Use in 2011 or 2012. According to the data, 75 percent of eligible professionals and more than 91 percent of hospitals have adopted or demonstrated Stage 1 Meaningful Use of certified EHRs.
Stage 2 Meaningful Use Struggles
According to CMS data from 2013, the meaningful use dropout rate was 20% when providers only had to attest for MU stage 1 and is expected to increase even higher as more providers prepare for MU stage 2. The CDC data also show that more work is needed to support widespread health information exchange and providers’ ability to achieve Stage 2 Meaningful Use requirements under the Medicare and Medicaid EHR Incentive Programs. Among the details include the following:
According to the 2014 Medscape EHR Report, 22% of physicians are opting out of meaningful use. Thesurvey found that 16% said they will never attest to meaningful use requirements, and another 6% of participants said they are abandoning meaningful use after meeting the requirements in previous years, up 2% from 2012. Overall, 78% of participating physicians said they were attesting to meaningful use Stage 1(30%) or Stage 2 (48%) in 2014.
HHS: EHR Adoption Hits Record Levels for Hospitals and Physicians by Jasmine Pennic
EHR Optimization Strategies
Physician Perspectives on EHR Optimization Strategies
I recently shared my thoughts on the physician perspective of EHR optimization strategies and physician EHR use. Now I have decided to expand the conversation by getting the take of two individuals, both within large health systems: Philip Baney, MD, from Reading Health System and Trista Eidmann, Clinic Administrator with UnityPoint Clinic.
We discussed how the EHR adoption has affected their physicians’ productivity, the types of optimization activities they have conducted, how the EHR has changed physicians seeing patients, and what they have done beyond an application optimization to improve the quality of the patient visit.
They brought varying perspectives, as Reading Health System has been on their EHR for one and a half years while UnityPoint Clinic has been on their current system for over 10 years. UnityPoint is in the process of switching over to a new application and is in the process of implementing their new system across their multi-state organization.
Trading eye contact for clicks
When asked about the top complaints in their organization regarding physician productivity in the EHR, the concerns were not surprisingly similar. Dr. Baney indicated that there are “more clicks, more busy work” and Ms. Eidmann responded that with more being handed down to them, they are “documenting more and more” and reimbursement isn’t any higher. Patients do not understand why the physicians’ heads are in the chart.
Years after organizations have implemented their EHR, I was not surprised that this continues to be a concern. Dr. Baney had a creative way to deal with this concern when he first started on the EHR. He would have a ruler in the room that he would give to patients and told them that when they were tired of looking at his ear they were allowed to use the yardstick to move his head so that he was looking at them. Most physicians have found that balancing the interaction with the patient and the time spent on their workstation in the exam room takes some effort. Dr. Baney added that he tries “to do as little on the computer when I am in the room with the patient and incorporate them in the process.”
Additional complaints within the organizations are that the providers are not getting their charts done, managing their inbox, or getting the bang for their buck. With all the data going into the system, they are not able to easily extract that information without additional steps being added.
But you’ve optimized, right?
When I asked what types of optimization activities their organizations have conducted to date, Ms. Eidmann responded that their efforts these days are to identify gaps in their current system and prepare to move over to the new system. Dr. Baney indicated that “there have been some attempts to identify things, but unfortunately many of those optimizations seems to be more clicks for the providers” and that he felt there was much more that could be done. This confirms what many organizations have already realized, that optimization and utilization of their EHR will be an ongoing process. This is especially true as a pay for value service is on the horizon.
Healthcare providers do not want to worry about where or how they put the data in the system — their focus is getting it in there as efficiently as possible. As developers and builders of the application, the focus should be on making the data entry easier for the end-user with the ability to easily extract that data out of the system.
Going beyond optimization
I next posed the question I discussed in my first article: What can be done beyond application optimization? Dr. Baney shared an anecdote about how his group realized that around the time school was out, their system would begin to run slowly. They discovered that their service provider didn’t have them on any higher provider priority, and all the school age kids would come home from school and suck up the bandwidth. What appeared to be an application issue was really a task for the internet provider. Another crucial problem identified was to have a triple redundant system. A final recommendation Dr. Baney made was training and evaluation — using their pulse reports to identify another provider who is strong who could mentor providers who are struggling. All of these are great recommendations for organizations that have not looked outside their application in their optimization efforts.
We must take the perspective of optimizing our systems so that end-users can work more efficiently while ensuring we can extract the data needed and also maintain a standard of quality patient visits. It will take time and creativity, but we have the tools needed to add value and increase enthusiasm to use an EHR. I thank Dr. Baney and Ms. Eidmann for their valuable time and input.
Jerri Cowper serves as Ambulatory National Practice Director at Innovative Consulting Group.
EHR Replacement Guide
EHR Replacement Guide
Making the decision to replace a subpar EHR is not easy, and the process of installing and optimizing a new system is certainly not a simple one. Earlier this year, Black Book findings indicated that EHR end-users were assessing the value of EHR vendors and their products based on their ability to deliver innovative tools capable of supporting clinical quality improvements in a few key areas.
"Top scoring EHR vendors that are attracting the available market share are looking for patient engagement tools, clinical decision support, quality measurement solutions, mobile capabilities, intelligent interoperability, and financial analytics as part of their EHR compendium," the research firm's Managing Partner Doug Brown said in March. "There are growth opportunities for vendors actually delivering those robust product strategies to the market."
With tight budgets, cramped time frames, frustrated staff, and a pressing need to keep business moving as usual, undergoing an EHR replacement is a serious undertaking with far-reaching effects. Many healthcare organizations and providers find themselves in the same predicament, searching for an EHR replacement that will enable them to reach their goals. Their aims may differ — ranging from achieving quality improvements and enabling clinical integration to qualifying for meaningful use incentives and avoiding penalties as a result of federal or state mandates — but their belief that EHR technology will help them achieve their goals do not.
The purpose of this guide is to help healthcare organizations and providers understand the potential problems they are likely to face as they work to replace their current health IT infrastructure. This guide comprises important insights from industry insiders and subject-matters with ample experience navigating the process of replacing EHR systems efficiently and effectively.
Please read the attached whitepaper.
EHRs and improved life expectancies
Could there be a correlation between EHRs and improved life expectancies?
Beckers Hospital Review -
According to the National Center for Health Statistics, the current life expectancy in the United States is roughly 78 years. For the rural population served by the Peter Christensen Health Center in Lac du Flambeau, Wis., which is primarily composed of Chippewa Indians, the life expectancy was only 56 years in 2005. But in the past five years, the life expectancy of the community has gone up to 59 years. So what changed?
EHRs: Moving Past the Mandate
EHRs: Moving Past the Mandate
by Pulse Systems, Inc.
While the industry is transitioning to a value-based care model, physicians will need an EHR system to collect and track patient metrics. Exploring the stage beyond the government mandate, practices can utilize several tools within an EHR to aid them on their reimbursement path ahead. Pulse Systems provides guidance on the opportunities to attain operational efficiencies, deeper patient engagement, and increased revenues all through utilizing their EHR system.
Please read the attached whitepaper.