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Archive for 2011

PubMed Advanced Search Page Updated

The PubMed Advanced search page will soon be modified to provide users with a less cluttered, more intuitive way to build searches.

PubMed Advanced Search Builder page

Highlights include:

  • Terms entered in the builder will automatically populate the search box.
  • Users may change the search field from the All Fields pull-down menu, and then enter terms in the search box.
  • Terms entered in the builder will be added with the default Boolean operator AND, unless OR or NOT are chosen from the pull-down menu.
  • Search field menu selections will be rearranged to display by category, e.g., date search fields will be listed together.
  • The MeSH Terms field will also be enhanced to include an autocomplete feature.

For more information and screenshots of the new PubMed Advanced search page, please go to the NLM Technical Bulletin.

HHS Announces Changes to Timeline for Meaningful Use

On November 30, 2011, US Department of Health and Human Services Secretary Kathleen Sebelius announced policy changes designed to make it easier for health care providers and hospitals to qualify for meaningful use incentive payments, Modern Healthcare reports. Secretary Sebelius announced the changes during an event at Cuyahoga Community College in Cleveland, Ohio. Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments. Under current regulations, eligible health care providers that attest to Stage 1 of the Medicare EHR incentive program this year would need to meet Stage 2 requirements in 2013. However, health care providers who attest to Stage 1 in 2012 would not need to meet Stage 2 requirements until 2014, but they still would be eligible for the same total incentive payment amount.

To encourage greater participation in the meaningful use program, Secretary Sebelius said that health care providers who meet Stage 1 requirements this year would not need to meet the Stage 2 standards until 2014. According to an HHS statement, “Doctors who act quickly can also qualify for incentive payments in 2011 as well as 2012.” HHS will launch outreach efforts to inform health care providers and health IT vendors about the policy changes. The agency said it will target outreach, education and training to eligible health care providers that have registered for the Medicare EHR incentive program but have not yet met the meaningful use requirements.

Secretary Sebelius also announced the release of a new Centers for Disease Control survey showing that the percentage of U.S. physicians who have adopted basic EHRs has doubled from 17% in 2008 to 34% in 2011. During the same time period, the percentage of primary care doctors using basic EHRs nearly doubled from 20% to 39%. The survey also found that 52% of office-based U.S. physicians now plan to participate in the meaningful use incentive program.

National Library of Medicine Launches YouTube Channel

NLM YouTube HomepageThe National Library of Medicine, the world’s largest medical library and a component of the National Institutes of Health (NIH), is pleased to announce the launch of its new YouTube channel! YouTube is a free video-sharing Web site, created in February 2005, on which users can upload, view and share videos. Unregistered users may watch videos, and registered users may upload an unlimited number of videos.

The NLM YouTube channel will post a variety of videos on topics from database training, NLM exhibitions (like an overview of the new Native Voices: Native Peoples’ Concepts of Health and Illness), Public Service Announcements, lectures and more. Interested parties can subscribe to be notified whenever new content is posted on the NLM channel. The NLM site also features links to NIH YouTube channels and other federal health resources.

NLM Announces Enhancement of Drug Naming Standard for Electronic Health Records

The RxNorm standard clinical drug vocabulary produced by the National Library of Medicine (NLM) now contains more accurate and complete connections between National Drug Codes (NDCs) and standard nonproprietary names of medications recommended for use in electronic health records (EHRs). NLM is the world’s largest medical library and a component of the National Institutes of Health. It also includes, for the first time, the complete set of NDCs from Thomson Reuters’ Red Book, a drug database widely used in the health care industry.

NDCs are product identifiers assigned by manufacturers and packagers of drugs in the United States. They are published on medication labels and packages and are often used in pharmacy inventory control and in dispensing and billing for drugs. If a single manufacturer issues the same medication in packages of different sizes (25 tablets, 50 tablets, etc.), each size has a different NDC. If more than one manufacturer produces the same medication, each assigns different NDCs. In contrast, the RxNorm vocabulary creates standard names and identifiers for the combinations of ingredients, strengths, and dose forms (such as Aspirin 325 MG Oral Tablet) that exist in drugs marketed in the United States. This is the information doctors typically include when they write a prescription because they often can’t know the specific product that will be used to fill it. All medication products that contain the same active ingredients, the same strengths, and the same dose forms have the same RxNorm standard name. This standard name is connected to other information in RxNorm that can be used within EHR systems to improve patient safety.

Accurate and complete connections between NDC product codes and RxNorm standard names and identifiers have many potential uses within an individual patient’s EHR. These include the use of an NDC on a medicine bottle to speed standard data entry or to trigger an alert written in the RxNorm standard that could prevent a medication error. At present, there is no single source that contains the NDCs for all medications currently marketed in the United States. RxNorm has included NDCs provided by the Food and Drug Administration, the Department of Veterans Affairs, and the Multum and Gold Standard drug information sources for a number of years. Starting with the Feb. 7, 2011 release, RxNorm included a revised, filtered version of the NDC data that segregates obsolete NDCs from those currently in the marketplace. It also included First DataBank’s set of NDCs. Since August of 2011, it has included the NDCs from Red Book. Other useful data that Red Book is providing to RxNorm includes better linkages between branded drugs and their NDCs, information about whether or not drugs are still on the market, and Drug Enforcement Agency Class for controlled drugs. This additional information is instrumental in the production of the Current Prescribable Subset of RxNorm.

In a recently published study sponsored by the Centers for Medicare & Medicaid Services and performed by the RAND Corporation and others, RxNorm was found to have entries for essentially all of the drugs in a sample of 19,743 ambulatory e-prescriptions (electronic prescriptions for patients seen in clinics or physician offices). Some e-prescriptions in the study sample failed to match automatically to an NDC in RxNorm, however. A more complete set of NDCs is likely to eliminate this gap.

For more information about RxNorm, visit the NLM News Release and the NLM UMLS website.

U.S. Surgeon General declares Thanksgiving as “Family Health History Day”

United States Surgeon General Dr. Regina Benjamin today declared Thanksgiving 2011 as the nation’s eighth annual “Family Health History Day,” when families can share information by using the My Family Health Portrait website to gather their family’s health history in one place. My Family Health Portrait is secure, free and takes about 20 minutes to create your unique family health portrait. It is available in English, Spanish, Portuguese, and Italian. Information can be shared with other family members who may not be home for Thanksgiving. They can build on your Family Health Portrait by adding their health information and can choose to share with you.

When you complete the questions, the website creates a personalized “family health tree” that can be saved to your home computer. From there, families may update the information at any time. Your information remains private. The federal website does not retain the information once the tool has been used to assemble it. Prepare for a Thanksgiving Day conversation by making a list of your relatives including your parents, grandparents, brothers, sisters, and cousins. Because some health conditions skip generations, be sure to talk to your older relatives who may know additional family history. Offering your doctor, physician assistant, or nurse practitioner your family health history can enable them to recommend specific tests or treatment plans to prevent or delay disease.

AIDSinfo and infoSIDA Redesigned

AIDSinfo Redesign ScreenshotTo mark World AIDS Day 2011 (December 1), a redesigned AIDSinfo Web site has been released, along with the Spanish-language infoSIDA. These sister sites offer federally approved information on HIV treatment and research, including medical practice guidelines and treatment and prevention research studies, to health care providers, researchers, people affected by HIV/AIDS, and the interested public. Information is available in both English and Spanish. AIDSinfo and infoSIDA are services of the US Department of Health and Human Services (HHS), managed by the National Library of Medicine (NLM). NLM is the world’s largest medical library and a component of the National Institutes of Health (NIH).

Redesign of the sites was based on research on user needs and behaviors and focused on reorganization of content and improved navigation to make information easier to find. Changes to the sites include:

  • Reorganizing content logically into six main categories, including new categories for Education Materials and Mobile Resources and Tools.
  • Creating a home page design that gives users a snapshot of the entire Web site, direct access to all site content, and the ability to search for information without having to click away from the home page.
  • Improving navigation to reduce the number of clicks necessary to access information anywhere on the sites.
  • Providing links to resources such as mobile applications and social media tools (including Facebook and Twitter) throughout the sites to make them accessible from any page.
  • Creating a distinct Web address for infoSIDA- to make it easier for users to bookmark and for search engines to index infoSIDA.

Personnel Changes in NLM’s MEDLARS Management Section

The National Library of Medicine is pleased to announce that Steve Emrick has been selected as the Terminology Quality Assurance (QA) & User Services Unit Head, and Sara Tybaert as the Bibliographic Data Management Unit Head, both in the MEDLARS Management Section (MMS). Steve Emrick joined the National Library of Medicine in 2007 as part of the MMS UMLS team, where he performed UMLS data QA, developed web documentation, and launched the UMLS Webcast series. Before that, he worked in Juneau, Alaska, at the Juneau Empire newspaper, where he managed content on the Juneau Empire’s web site. Steve also served as a Noncommissioned Officer in the United States Army as a Signals Intelligence Analyst in the Republic of Korea, in both the 2nd Infantry Division and 501st Military Intelligence Brigade. Steve will transition to his new position effective November 20, 2011. As the Unit Head, he will be responsible for the management and supervision of his Unit and will assume the role of MMS UMLS Coordinator, which oversees the production and quality assurance cycle of bi-annual UMLS releases.

Sara Tybaert has an established history of excellence in NLM’s Library Operations. She came to the NLM with a diverse skill set that formed the foundation for her success working with multifaceted data and systems. As a contractor with Library Systems and Services, she participated in the reclassification from the Dewey Decimal System to the NLM Classification of two libraries. At OCLC she coordinated the activities of LS/2000, an integrated library system. While employed with Centel Federal Services Corporation, she provided technical support for DATALIB, an integrated library system, and JOURNALINK, a comprehensive union list service. Sara’s start date is December 4, 2011. She will continue her responsibilities related to maintaining NLM’s MEDLINE data, including the coordination of Year End Processing; data quality control and testing; Serials Extract File collaboration; systems design, maintenance and testing; and, complex customer support duties while assuming her new supervisory role.

NLM Announces New Online Exhibition “Building a National Medical Library on a Shoestring: 1872, the First Year”

John Shaw Billings, c.1870sThe National Library of Medicine, a component of the National Institutes of Health, celebrates a crucial turning point in its history with a new Web exhibition, “Building a National Medical Library on a Shoestring: 1872, the First Year.”

The exhibition focuses on the dramatic 1872 change in the library’s mission. Founded in 1836 as the office library for the Army Surgeon General, the Library came under the stewardship of Army Major John Shaw Billings in 1865. Seven years later, the Library embarked on a venture to acquire the most complete set possible of medical books and journals. Billings and his work set the course for the Library’s identity today as the world’s largest medical library.

The core of the exhibition is found in the stories, difficulties, and situations that Billings encountered as he began building a comprehensive collection as quickly and frugally as possible. The exhibition also shows the Library’s early years, exploring the practical uses that the limited collection then supported. Included is a full bibliography of published materials by and about John Shaw Billings, including articles and pamphlets, reports, books and monographs, and speeches.

Modest Improvements in Awareness of Racial and Ethnic Health Disparities over a Decade

Despite persistent racial and ethnic gaps in health care and health status, awareness of such disparities remains low among the general public. Much work remains to be done to better inform the U.S. population of health conditions that disproportionately impact specific racial and ethnic minority groups, according to an OMH survey conducted by NORC at the University of Chicago. The survey found:

  • Fewer than two-thirds of Americans are aware of racial and ethnic health disparities;
  • Awareness of racial and ethnic health disparities generally increases with education;
  • Awareness of racial and ethnic health care access disparities is increasing, but remains low;
  • Awareness of racial and ethnic disparities for key health status indicators and diseases remains low;
  • Awareness of racial and ethnic health disparities remains low even among disproportionately affected minority groups;
  • African Americans are more aware of racial and ethnic disparities;
  • Awareness of racial and ethnic health disparities impacting Asian Americans/Pacific Islanders remains very low; and
  • Public familiarity with important national health disparities reports and awareness campaigns is generally low.

The article about the OMH/NORC survey and its web supplements (General Population Questionnaire; Creating an Awareness Index) are available on the Health Affairs website. In addition, copies of the Study Brief and 2010 General Population Toplines are available on the Office of Minority Health website.

HHS Announces New, Refined Survey Standards to Examine, Help Eliminate Differences in Care Based on Race, Ethnicity, Sex, Primary Language, or Disability

On October 31, 2011, the Department of Health and Human Services (HHS) released final standards to more consistently measure race, ethnicity, sex, primary language, and disability status, thereby improving our ability to highlight disparities in health status and target interventions to reduce these disparities.

The Affordable Care Act requires new standards for the collection and reporting of health care information based on race, ethnicity, sex, and primary language. Making data standards consistent will help identify the significant health differences that often exist between and within ethnic groups, particularly among Asian, Hispanic/Latino, and Pacific Islander populations. The new data collection requirements also will improve researchers’ ability to consistently monitor more dimensions of health disparities among people with disabilities. Collection of all data will take place under HHS’ longstanding, strict commitment to protecting privacy.

The standards, effective upon publication after accepting comments on proposed standards, apply to health surveys sponsored by HHS, where respondents either self-report information or a knowledgeable person responds for all members of a household. The standards will be used in all new surveys and at the time of major revisions to current surveys.

For more information on the final data standards, visit the Office of Minority Health website.