Tuesday, September 23, 2014

This Really Says It All! The Department Of Health Has No Idea If Health Investments Are Paying Off Or Making A Difference. About Time They Did!

Was browsing around the other day and found this page:

eHealth Program Evaluations

Evaluations of the Health Connect, Managed Health Networks Grants, and Broadband for Health programs
Page last updated: 20 January 2011
The link is here:
The HealthConnect Evaluation Report - which is by no means the only one done - is dated from mid 2009 - and the program is defunct.
The Managed Health Networks Grants program similarly is defunct and died in 2009.
Astonishingly the Broadband for Health Program began over a decade ago and died in 2007.
Here is a summary of what this was about.
“The BFH program was a $69 million program to encourage the uptake of secure, business-grade broadband by general practitioners, Aboriginal Community Controlled Health Services, GP Afterhour locations, Royal Flying Doctors Service and community pharmacies nation­wide. The program commenced in August 2004 and concluded on 31 December 2007.”
Socrates made the point that “The unexamined life is not worth living” can I suggest, equally, the unexamined Government Health IT project is not worth doing.
Come on Department Of Health - show us the difference you have made since 2009.
If they can’t maybe the Auditor General or the Productivity Commission might like to take a close look!
David.

Monday, September 22, 2014

Weekly Australian Health IT Links – 22nd September, 2014.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Another quiet week with a lot of activity in specialist Health IT sectors and little happening with the National E-Health Program. It’s now 3 weeks since consultation on the fate of the PCEHR and no idea revealed as to what was learnt and what future plans are. We wait and watch….
The SAI-Global / Standards Australia imbroglio seems to have resolved itself without resolution and so we await Plan B!
Interesting to see lots of reporting on the Apple HealthKit.I wonder where this will all go over time and what difference this will make in the longer term?
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Blown-out Australian Defence Force e-health records rolled out

Summary: The Australian Defence Force has rolled out a new e-health program for initially 25,000 members at over double the initial budget of AU$55 million.
By Josh Taylor | September 19, 2014 -- 06:30 GMT (16:30 AEST)
The rollout of an AU$133 million national e-health system for the Australian Defence Force (ADF) is the first full national e-health record system, according to Assistant Minister for Defence Stuart Robert.
"This government places great demands on our soldiers, sailors, air men and women. Our expectations are high of our personnel, because we truly believe service is unique," he said.
"In return, we will ensure our personnel have the best possible healthcare and support."
The system, which began development in 2011 with CSC Australia, is based on a system that has been provided by Edgton Medical Information Systems in the UK since 2007. Robert said that for this reason, it is a mature technology that has been proven. However, despite the maturity of the technology, the budget for the project blew out from AU$55 million in 2011 to AU$133 million.
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ADF eHealth system rollout underway

The Defence eHealth Information System is being implemented for the Australian Defence Force's Joint Health Command by CSC.
The Defence eHealth Information System will hold the health records of each member from enlistment to retirement, and the information will be available to ADF health professionals at the point of care and at all levels of management.
The project began in 2011, but the rollout didn't start until April this year, and the parties have only just announced it.
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Defence deploying $56M e-health system

25,000 ADF members currently have an individual health record
Byron Connolly (CIO) on 19 September, 2014 16:26
The Australian Defence Force (ADF) in December plans to complete the rollout of a $56 million e-health information system, which will be used by 2,300 health practitioners and support staff across the country.
The rollout began in April in Queensland and has already started contributing to improved clinical outcomes for ADF members and overall efficiency of primary care delivery.
The Defence eHealth Information System, supplied by UK firm EMIS, provides ADF personnel with an individual medical record from enlistment through to retirement.
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Tech-savvy health fanatics could be sharing their most intimate information

Date September 15, 2014 - 11:41PM

Natasha Boddy

People using smartphone apps and wearable technology to track their health and fitness, weight loss or bodily functions could be unwittingly handing over some of their most private information to third parties. 
University of Canberra Centenary Research Professor Deborah Lupton has warned that when people use digital devices that connect to computing cloud storage facilities or developers' data archives, they could be losing ownership or control of their personal – and sometimes very private – data.
She said such information was a commodity that was potentially being used for commercial, managerial and government purposes and sometimes sold to third parties. 
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Mobiles, wearable media devices expose target

Lara Sinclair

MOBILE and wearable media devices such as watches and glasses will soon track the wearer’s pulse rate, as well as physiological changes and eye movements, which could help reveal not only the media and advertising messages people see, but how they react.
Combined with location data and spending information such as online purchases and mobile payments, that could help build a comprehensive picture of the consumer, according to Tom ­Eslinger, worldwide digital ­director at global advertising network Saatchi & Saatchi.
Eslinger says the mobile landscape is changing so quickly, companies must appoint a ­“mobile god” or goddess whose job is to keep up with new apps and other mobile developments.
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Bug infects Apple's iOS 8 HealthKit, delaying app launches

The iOS 8 feature plays a key role in Apple's health tracking ambitions
Zach Miners (IDG News Service) on 18 September, 2014 10:57
The Fitness app monitors all of your activity and movement through the day. Workout app lets you set specific goals for specific types of workouts, like cycling or running.
A bug in Apple's HealthKit -- a back-end feature in iOS 8 -- is delaying the launch of outside developers' fitness and health apps, the company said Wednesday.
HealthKit is a new tool for developers in iOS 8 designed to let their apps talk to Apple's native health apps. HealthKit is meant to pull in information from other apps and devices, like calories burned or heart rate, and make it more useful. For instance, it could allow a nutrition app, with the user's permission, to tell other fitness apps how many calories the person consumes in a day, Apple says.
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Apple yanks HealthKit apps due to unspecified bug

Summary: Third-party apps won't be allowed on the App Store until later this month thanks to a newly-discovered bug.
By Jo Best | September 18, 2014 -- 08:51 GMT (18:51 AEST)
Apps that work with Apple's HealthKit platform have been disappeared from the App Store due to an unspecified bug.
The health and fitness focused HealthKit, one of the headline features of iOS 8, was supposed to be supported by a range of apps when the operating system was released to users on Wednesday. However, Apple has temporarily removed them from its store.
Apple said: "We discovered a bug that prevents us from making HealthKit apps available on iOS 8 today. We're working quickly to have the bug fixed in a software update and have HealthKit apps available by the end of the month."
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Hooked on cloud - as Apple Watch debuts, new models step up

Socialisation technologies are inexorably drawing health and government into new models of industry engagement and industry-led protocols to protect health data. 
This week Apple CEO Tim Cook rolled out Apple's health-enabled smartwatch today amidst increasing scrutiny of healthcare apps and the storage of healthcare information in Apples iCloud service.
The new watch, known simply as Apple Watch, embodies a range of sensors, including pulse rate, workout intensity and the type of exercise. Using the HealthKit App, the watch is able to share the health information with healthcare providers and other associated apps, a move that has drawn interest in the US from players including Mayo Clinic and Memorial Sloan-Kettering.
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Wearable Sensor Launches in U.S. after FDA Approval

SEP 15, 2014 8:40am ET
Australia-based dorsaVi, a developer of wearable medical devices, has launched sales of its ViMove platform in the U.S., following 510(k) clearance by the Food and Drug Administration for measuring, recording, and reporting on movement and muscle activity of the lower back and lumbar spine.
ViMove consists of wearable sensors that are placed on the body to measure movement and muscle activity.
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Community Meds suppliers collaborate for safety, accuracy, efficiency.

The Australian community pharmaceutical industry is on the cusp of a significant change that will enable greater safety, efficiency and convenience in the supply and delivery of medicines.
Set to come into force in February 2015, Australia’s CSO pharmaceutical wholesalers (Symbion, Sigma, API and National Pharmacies) have agreed to set aside their differences to standardise their supply chain data by adopting the international GS1 standard and using GS1net, a national central product database managed independently by GS1 Australia.
Australia has an established history of industry-led collaborative/competitive projects such as the banking industry's BPAY that is unique to the country. In this case the wholesalers have been supported and encouraged by the National Pharmaceutical Service Association (NPSA), that represents them, along with the National E-Health Transition Authority (NEHTA) and GS1 Australia.
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Orion Health system underpins medical records in NSW

The Justice Health & Forensic Mental Health Network (JH&FMHN) has gone live with an electronic medical record suite from e-Health technology company Orion Health to support the delivery of complete electronic medical records across the New South Wales public health system.
Justice Health’s goal is specifically to provide a critical platform for the Justice Health electronic health system’s (JHeHS) migration to a computerised record of a patient’s medical history related to the clinical care received while in JH&FMHN. This will contain a subset of information previously held in paper medical records including patient details, medical conditions, appointments, pathology results, electronic forms and medicines prescribed. 
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Datacom makes e-health play

Company acquires 20 per cent stake in SmartWard, appoints chief medical information officer
Hamish Barwick (CIO) on 18 September, 2014 10:01
Datacom is set to acquire a 20 per cent share in Canberra-based health informatics software company SmartWard as it moves into the e-health space.
The Australasian IT services firm will install SmartWard’s health informatics software in hospitals around Australia. The software automates nursing records and removes the need for paper documents.
According to clinical trials conducted in 2013 by Deakin University’s Centre for Clinical Nursing Research at two Eastern Health hospitals in Melbourne, the SmartWard software reduced the amount of time nurses had to spend filling out patient records and increased patient care times.
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Government agency leaks customer details without telling

Date September 18, 2014

Beau Donelly

A government authority has leaked the billing and contact details of Victorians online, but decided against telling affected customers even though the privacy breach posed a "medium to high" level threat.
The undisclosed state authority responsible for the breach notified Privacy Victoria about problems affecting its online payment system after discovering the personal information of some customers could be seen by other users.
According to the Victorian Privacy Commissioner's annual report, tabled in state parliament on Thursday, the exposed details included customers' full names, home addresses and amounts owing on bills.
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Clinical Governance

The purpose of Clinical Governance is to:
  • Confirm that all NEHTA products, services and solutions are clinically appropriate and are clinically safe for release to the Australian community;
  • Making sure that clinical perspectives are clearly articulated, implemented and documented through the product development lifecycle.
Practicing clinicians with diverse clinical backgrounds are assigned to various areas of the NEHTA work programme. They are known as Clinical Governance Advisors.
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The 'Clinical Terminology Guidance' documents and 'AMT Development Approach' are now available for download

Created on Monday, 15 September 2014
These documents can be downloaded from the following areas of the NEHTA website.
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NEHTA Chair Dr Steve Hambleton Talks About eHealth

Created on Wednesday, 17 September 2014
NEHTA Chair Dr Steve Hambleton in Pulse+IT magazine talking about his role with NEHTA and his future plans for eHealth.
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#CochraneTech: technology and the future of systematic reviews

  • By: Julian Elliott, Ida Sim, Jessica Thomas, Nancy Owens, Gordon Dooley, Jacob Riis, Byron Wallace, James Thomas, Anna Noel-Storr, Gabriel Rada, Caroline Struthers, Tracey Howe, Harriet MacLehose, Linn Brandt, Ilkka Kunnamo & Chris Mavergames
  • On: September 19, 2014, 12:30
Since the birth of systematic reviews, technology has been an integral part of efforts to understand health evidence. Nevertheless, review authors commonly conduct the majority of their work on a patchwork of general software products poorly adapted to their needs, much of the data they handle is not captured for future use, and the core review output of a static PDF document limits the ability to search and process the contents of the review.
In recent years a combination of increasing frustration with the limitations of current systematic review technologies, an awareness of the impact technological developments have had in other fields, and promising results of recent innovations have led to an increasing focus on the opportunities afforded by emerging technologies. To help move the field forward Cochrane convened the #CochraneTech Symposium immediately prior to the 21st Cochrane Colloquium in Quebec City, Canada, in 2013. Following the success of this event, the second #CochraneTech Symposium will be held in Hyderabad, India, on Saturday 20th September (tech.cochrane.org/cochranetech).
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Google Analytics for your baby's movements is closer than you think

Date September 19, 2014

Sholto Macpherson

When Nico Miceli decided to help his aunt record her baby's first years, pulling out a video camera seemed a little old-fashioned. Instead the open-source software enthusiast added a motion sensor to the baby's crib, attached it to a miniature computer and tracked the child's movements using a Google software that monitors websites.
"I like measuring things like that. Especially around a time when mums want to scrapbook everything," Miceli, who works in California for Web Analytics Demystified, says.
Miceli's experiment was one of the earliest non-commercial uses of Google Analytics in sampling offline data. Two years ago Google released an updated version of its tool, called Universal Analytics, that could track information offline as well as online.
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SAI Global bidders get their Standards Australia meeting

In a truly 11th-hour move, bidders for standards, assurances and compliance firm SAI Global’s suitors were given full access to the top brass of Standards Australia in a meeting on Monday.
Just a day before final bids were due to be filed, and three days after the initial deadline, SAI took its suitors to meet with the company’s key counterparty Standards Australia.
But there was a catch, in the best traditions of a chaperone, to make sure everyone behaved properly.
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Standards Australia members angry over failed sale process

Simon Evans
Another of the member organisations of Standards Australia has come out swinging against what they consider to be a ‘’raw deal’’ from SAI Global as they back a push to try to wrestle back control of their own destiny.
Lighting Council Australia chief executive Bryan Douglas said he didn’t agree with the move to split off a lucrative publishing and licensing agreement in 2003 into the separate company SAI, which listed on the stock exchange with a motive to increase profits.
He was speaking after a sale process undertaken by SAI over the past four months ultimately didn’t deliver any whole-of-company bids for the company despite an initial $1.1 billion buyout proposal in May by Pacific Equity Partners, which later joined up with Kohlberg Kravis Roberts.
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Revised eHealth publications

The OAIC has published updated versions of eHealth records and healthcare identifiers resources. Minor amendments have been made to the existing resources to reflect the Australian Privacy Principles and update the language to reflect the current functionality of the personally controlled electronic health record system.
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MEDIA RELEASE

15 September 2014

New Chronic Pain Resource to Help GPs and Patients

Painaustralia and Healthshare have partnered to provide GPs with easy access to a useful resource to help patients with chronic pain better understand and manage their condition.

Painaustralia’s fact sheets are now available inside Healthshare’s Fact Sheets application. The application is integrated into the GP’s clinical software to provide patient education at the time of consultation. When the GP adds any chronic pain-related term as the patient’s “reason for visit” Healthshare’s application will present Painaustralia’s materials for the GP to print out or email to the patient.
Unlike acute pain which is relatively easy to treat, chronic pain is a very complex condition which can often challenge GPs. There is no simple answer and medication has limited – if any long term effect.
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Turnbull reflects on 'killing the dream' of NBN 'fibre fanatics'

Summary: A year into the job, Communications Minister Malcolm Turnbull says he is worried that some believe every Australian town can be a Silicon Valley with fibre to the premises, as he insists there is no money being saved in the fibre rollout.
By Josh Taylor | September 18, 2014 -- 05:36 GMT (15:36 AEST)
Communications Minister Malcolm Turnbull has warned of ongoing risk in the National Broadband Network (NBN) a year after coming to office, and claimed that there is no evidence that the cost of rolling out fibre to the premises (FttP) is declining, despite NBN Co's claims to the contrary.
Speaking today at the National Conference on Corporate Turnarounds and Transformations, Turnbull reflected on the NBN in the first year since the election of the Abbott government in September 2013. He said that while the fibre rollout has picked up pace in the last year, during which the government and NBN Co went through a number of reviews, a change of board and management, and a move to a "multi-technology mix" model that requires testing of fibre to the node and hybrid fibre-coaxial (HFC), the pace of the changeover has not been as fast as the government expected.
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Possible Telstra competition against NBN Co could upset economic model

Telstra may be constrained by structural separation undertaking, says Henry Ergas
Adam Bender (Computerworld) on 12 September, 2014 15:39
If Telstra were to compete against NBN Co, it would change the economic model for the National Broadband Network, NBN Co CEO Bill Morrow has said.
Telstra could be mulling whether it should copy TPG’s plan to compete against the NBN, according to reports.
Speaking at a Communications Alliance panel Friday morning, Morrow agreed this could be an issue for the NBN business model.
“If Telstra were allowed to go into this, and Telstra then had Optus follow and others, then it becomes material in nature, staying within that $29.5 billion and having the requirements of the speed, universal access, same price [and] all of those other factors, yes, it becomes a problem.”
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Hackers lock up thousands of Australian computers, demand ransom

Date September 17, 2014 - 3:36PM

Ben Grubb

Deputy technology editor

Thousands of Australian computers are being locked up by hackers using malicious software that encrypts files and asks for a ransom to make them available again.
Fairfax Media understands Australian government agencies and a number of large enterprises and individuals have been successfully targeted by the scam.
Called "Cryptolocker" and "CryptoWall", the "ransomware" comes in various forms with the CryptoWall version estimated by the government e-safety alert service Stay Smart Online to have infected approximately 20,000 Australian computers.
Computers are typically infected after victims click on a malicious link in an email purporting to be from Australia Post or Telstra. Files on their computer and network drives are then encrypted and a ransom demanded within a certain timeframe before a decryption key is supplied to unlock files. If no ransom is paid, the hackers threaten to never allow access to the files. 
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Enjoy!
David.

This Wiki On Health IT in Australia Is Now Costing Me - So Help To Make It More Useful Would Be Really Appreciated!

I have just been told the above wiki is going to cost me $US 5 per month to keep alive.

You can visit the wiki from this link:

https://ozhealthithistory.wikispaces.com/OzHealthITHistory+Home

I think this is a useful resource for those wanting to understand what has happened in National and GP Health IT. An obvious gap is input from each of the States and Territories.

The money is not an issue but I would be keen for a few others to become editors and improve the contents. That would make the cost even less important if this were possible.

Please have a look and apply to be an editor if you have something you feel you can add. It would be great if this can become a useful resource for all who are interested.

Many thanks.

David.



Sunday, September 21, 2014

I Think DoH and NEHTA Is Being A Fraud In Suggesting The PCEHR Is All Of E-Health. They Are Just Confusing People.

We have had news of two/three new Health IT systems this week. First we had this for NSW Prisons:

Orion Health system underpins medical records in NSW

The Justice Health & Forensic Mental Health Network (JH&FMHN) has gone live with an electronic medical record suite from e-Health technology company Orion Health to support the delivery of complete electronic medical records across the New South Wales public health system.
Justice Health’s goal is specifically to provide a critical platform for the Justice Health electronic health system’s (JHeHS) migration to a computerised record of a patient’s medical history related to the clinical care received while in JH&FMHN. This will contain a subset of information previously held in paper medical records including patient details, medical conditions, appointments, pathology results, electronic forms and medicines prescribed.  The data is now held in one consolidated place and available state-wide as opposed to being held in multiple paper files and stand-alone electronic registers.
The Orion Health solution will enable the replacement of manual sharing of information between JH&FMHN and other health care providers by implementing applications that will support the patient journey and, in turn, aid clinicians in their decision making processes, while improving communication between clinicians by providing information at the point of care.
More here:
Additionally we have had lots of coverage on this new initiative:

Datacom makes e-health play

Company acquires 20 per cent stake in SmartWard, appoints chief medical information officer
Hamish Barwick (CIO) on 18 September, 2014 10:01
Datacom is set to acquire a 20 per cent share in Canberra-based health informatics software company SmartWard as it moves into the e-health space.
The Australasian IT services firm will install SmartWard’s health informatics software in hospitals around Australia. The software automates nursing records and removes the need for paper documents.
According to clinical trials conducted in 2013 by Deakin University’s Centre for Clinical Nursing Research at two Eastern Health hospitals in Melbourne, the SmartWard software reduced the amount of time nurses had to spend filling out patient records and increased patient care times.
For example, the amount of time nurses spent at patient bedsides rose from 32.8 per cent to 48.1 per cent. Time spent filling out forms fell from 15.7 per cent to 6.4 per cent..
The Deakin University clinical trials were reviewed by Deloitte Access Economics on behalf of SmartWard.
According to Deloitte, the redeployment of nurse time to patient care increased nurse’s job satisfaction and shifted their time away from “low-value administrative work” to clinical care.
Lots more here:
Lastly there is lots about this newly implementing system:

Defence deploying $56M e-health system

25,000 ADF members currently have an individual health record
Byron Connolly (CIO) on 19 September, 2014 16:26
The Australian Defence Force (ADF) in December plans to complete the rollout of a $56 million e-health information system, which will be used by 2,300 health practitioners and support staff across the country.
The rollout began in April in Queensland and has already started contributing to improved clinical outcomes for ADF members and overall efficiency of primary care delivery.
The Defence eHealth Information System, supplied by UK firm EMIS, provides ADF personnel with an individual medical record from enlistment through to retirement.
It will be used by doctors, dentists, psychologists, physiotherapists, as well as a practice managers and administrators through the Joint Health Command, CSC's account general manager Defence Health, Drew Wilson, told CIO Australia.
More here:
There is also a lot of other coverage of which this is typical.

Blown-out Australian Defence Force e-health records rolled out

Summary: The Australian Defence Force has rolled out a new e-health program for initially 25,000 members at over double the initial budget of AU$55 million.
By Josh Taylor | September 19, 2014 -- 06:30 GMT (16:30 AEST)
The rollout of an AU$133 million national e-health system for the Australian Defence Force (ADF) is the first full national e-health record system, according to Assistant Minister for Defence Stuart Robert.
"This government places great demands on our soldiers, sailors, air men and women. Our expectations are high of our personnel, because we truly believe service is unique," he said.
"In return, we will ensure our personnel have the best possible healthcare and support."
The system, which began development in 2011 with CSC Australia, is based on a system that has been provided by Edgton Medical Information Systems in the UK since 2007. Robert said that for this reason, it is a mature technology that has been proven. However, despite the maturity of the technology, the budget for the project blew out from AU$55 million in 2011 to AU$133 million.
More here:
The PCEHR, which NEHTA and DoH are running around marketing as e-Health, is a small subset of Health IT and is by far the least important in terms of what is being delivered and how much is being spent.
Private developers are showing that support of care providers is what Health IT is all about and where improvements can be delivered which is hardly what is being seen from the all-consuming PCEHR monster.
Sadly, however, the DoH e-Health page essentially talks of little else but the PCEHR and all its various trials and tribulations.
It is time DoH and NEHTA looked outside their obsession with this obvious failure and stopped suggesting the PCEHR is the be all and end all of eHealth. It’s not!  Systems that support clinicians doing their work are, so maybe that should be their focus!
David.

AusHealthIT Poll Number 236 – Results – 21st September, 2014.

Here are the results of the poll.

Given That After A Year The Government Was Elected, It Has Yet To Figure Out What To Do With The PCEHR Should The Program Simply Be Abandoned And A New Plan For National E-Health Developed?

Yes 83% (190)

No 9% (21)

I Have No Idea 7% (17)

Total votes: 228

This is a pretty clear and enthusiastic outcome. The Federal Government is getting a clear fail on not making its mind up about what to do.

Again, many, many thanks to all those that voted!

David.

Saturday, September 20, 2014

Weekly Overseas Health IT Links - 20th September, 2014.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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HIMSS to Congress: 3 actions to improve health IT

September 12, 2014 | By Susan D. Hall
HIMSS has presented three "Congressional Asks"--formal requests to Congress to accomplish specific goals to advance health IT.
These proposals will be presented to Congress during the annual HIMSS Public Policy Summit Day, Sept. 18, as part of National Health Information Technology Week, according to an announcement.
The three requests include:
1. Minimizing disruption in our nation's health system emanating from federally-mandated health IT program changes. This request notes that various federal agencies are involved in regulating aspects of health IT development and adoption, often leading to confusing and conflicting regulatory guidance.
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Ebola Outbreak Drives Home Need for ICD-10

SEP 12, 2014 7:14am ET
The ongoing outbreak of the Ebola virus is an example of the way transitioning to ICD-10 can benefit the ability of public health officials to respond to global pandemics, according to an executive at 3M Health Information Systems.
In a recent blog post, Ann Chenoweth, the company's director of industry relations, said the lack of specificity in classifying Ebola in ICD-9 can hamper quick coordination of action.
"When looking at ICD-9 today, Ebola is often classified to 078.89, Other specified diseases due to viruses," Chenoweth wrote, "but I have also seen Ebola classified to 065.8, Other specified arthropod-borne hemorrhagic fever. This lack of specificity in the ICD-9 code description makes it extremely difficult, if not impossible, to clearly identify Ebola patients in the data. In turn, the ability for our public health organizations to quickly and proactively identify emerging epidemics can be severely compromised."
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Sticking to the Plan: Apps Improve Medication Adherence

SEP 11, 2014 1:49pm ET
It is simple in theory: Patients take their drugs on time and in the dosages prescribed by their physicians. However, in practice, medication non-adherence continues to be a serious problem in the United States, with a patient dying every 90 minutes due to an accidental overdose or missed dose of a prescription drug, according the Express Scripts 2013 Drug Trend Report. It's also costly for the U.S. health system: the United States wastes $317.4 billion annually on unnecessary medical costs that could be avoided by eliminating medication non-adherence, according the same report.
A 2013 poll of U.S. adults showed that nearly two-thirds of Americans who take prescription medications do not take their medication as prescribed. The poll was conducted by Greenberg Quinlan Rosner Research and Public Opinion Strategies for the Council for Affordable Health Coverage.
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Engaging patients: 5 things providers can learn from payers

Posted on Sep 08, 2014
By Andrew Underhill, Systems Made Simple
Payers have long embraced the idea that patients who are engaged in their care are ultimately healthier than those who are not. In recent years, insurers have worked to boost patient engagement by creating incentive programs, social media campaigns and targeted education that encourages healthier lifestyles, regular wellness visits and chronic disease management. The underlying goal is to educate beneficiaries on the critical role they play in preserving their health.
While these efforts are laudable, it is ironic that payers are taking the lead in patient engagement when healthcare providers have more direct contact with patients. Providers are in the middle of a cultural evolution from delivering care to patients to partnering with patients. Moreover, current payment models do not reward engagement strategies because reimbursement is tied to care episodes rather than long-term health management.
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ONC not going at interoperabilty alone

By DAVID PITTMAN | 9/12/14 6:40 AM EDT
You could go blind reading all the reports and recommendations on the vexing issue of interoperability of health information systems.
But despite all the advisory committees, task forces and expert panels dealing with the subject, the country’s health IT czar isn’t seeing stars. The federal government needs help from companies and expert groups of all kinds to move interoperability forward, she says.
 “Interoperability is the perfect example of where we’re not going to only do this federally, and we have got to partner with the private sector,” National Coordinator Karen DeSalvo said at the eHealth Initiative’s 2020 Roadmap Executive Summit.
Her comments came after a day-long meeting Thursday where eHealth Initiative [eHI] members, dozens of providers, payers, employers, EHR vendors and other health IT thought leaders gathered to stamp out details of the initiative’s forthcoming 2020 Roadmap, a vision to advance health IT use in a post-meaningful use era.
The initial report is set to be released in November, with a more fleshed-out version in the spring.
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PwC-led team to offer 'open source' EHR to DoD

September 8, 2014 | By Marla Durben Hirsch
PwC has joined forces with Medsphere, DSS, Inc. and General Dynamics Information Technology to vie for the coveted U.S. Department of Defense Healthcare Management Systems Modernization (DHMSM) electronic health record contract, and plans to merge "open source" software with commercial applications in its proposal, PwC has announced.
Perhaps in acknowledgement of the increased pressure on DoD to ensure that its new system has the capability to share data with the U.S. Department of Veteran Affairs (VA), the PwC partnership intends to propose "open architecture,"  which "promotes greater ease of integration with existing DoD legacy systems, as well as unlimited access to ongoing EHR innovations," according to PwC's Sept. 5 announcement.
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ONC: EHRs are improving patient safety

September 9, 2014 | By Marla Durben Hirsch
Electronic health records are making major strides in improving patient safety, according to the Office of the National Coordinator's latest data brief. The brief, based on the 2013 National Ambulatory Medical Care Physician Workflow Survey of 11,000 physicians, found that three times as many physicians reported that their EHR prevented a potential medication error than caused one; 47 percent were reminded to provide preventive care by their EHRs.
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Why final rule comes as last straw

Posted on Sep 11, 2014
By Bernie Monegain, Editor
CMS and ONC disappointed many CIOs and IT teams around the country on Aug. 29 when it issued a final rule for Stage 2 meaningful use that lacked the flexibility on reporting that so many had counted on – and perhaps expected, because what they had proposed seemed like a reasonable compromise to them.
CHIME, which represents 1,400 CIOs, fired off a statement the same day.
Russell Branzell“CHIME is deeply disappointed in the decision made by CMS and ONC to require 365-days of EHR reporting in 2015,” Russell Branzell wrote in his response to the rule. “This single provision has severely muted the positive impacts of this final rule. Further, it has all but ensured that industry struggles will continue well beyond 2014.”
CHIME and other industry organizations had proposed reporting on Stage 2 requirements for any three-month quarter. In their view, it was a practical approach, one that made it more likely they would succeed and one that showed their continued support for the Meaningful Use Program.
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NIB strategy due ‘later this year’

8 September 2014   Sam Sachdeva
The National Information Board is set to release its long awaited informatics strategy later this year, outlining a ten-year plan for how to make the most of data and technology in healthcare.
An update on the NIB’s informatics strategy in the board’s latest working group papers says the document is due to be released soon.
The National Information Board is comprised of representatives from a number of health organisations including the Department of Health, NHS England and the Health and Social Care Information Centre.
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Telemedicine beneficial in management of chronic diseases, lowering costs

September 11, 2014 | By Katie Dvorak
There are many uses for telemedicine to manage chronic diseases, and no matter the process, the technology offers beneficial results and costs reductions, according to a recent study.
The study, published online in the journal Telemedicine and e-Health, looks at the impact telemedicine has on cost, quality and access to care, focusing three chronic diseases: congestive heart failure, stroke and obstructive pulmonary disease.
The authors, which include former American Telemedicine Association President Rashid Bashshur (pictured)--executive director of eHealth at the University of Michigan Health System--found that for each chronic disease, a different telehealth approach was needed.
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Providers: Apple Watch, HealthKit intriguing for patient care, but challenges persist

September 11, 2014 | By Dan Bowman
As Apple looks to team with provider organizations and other health technology vendors on efforts relating to its forthcoming HealthKit platform and its new wearable device, Apple Watch, it will be interesting to see how much traction it gains among clinicians.
To that end, we queried our FierceHealthIT Editorial Advisory Board for their thoughts on Apple's new offerings. Here's what six of our advisers had to say:
Roger Neal, vice president and CIO, Duncan (Oklahoma) Regional Hospital: Ultimately, as a geek, I really like stuff like that for myself. But, my professional techie persona is trying to figure out how to make it all work in our new healthcare world. Some of these systems are capturing more and more relevant information that would be wonderful to have in a patient's global chart, but trying to get at that data securely, import it somewhere and store all of it on patient after patient scares me. Where is it all going to go and how are we going to make it all work securely and privately together?
I think at some point, a lot of this information will be more relevant for healthcare than today. We'll get there and the sophisticated tracking and monitoring via watch, wristband, clothing or whatever will play a part in that. I think on the population wellness front, these types of tools can be of great use if you can co-manage all the data coming in on hundreds or thousands of patients.
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Global Kinetics's wearable KinetiGraph helps diagnose Parkinson's disease

September 10, 2014 by Arezu Sarvestani

Australia's Global Kinetics Corp. lands FDA clearance for its wrist-worn Personal KinetiGraph to help diagnose symptoms of Parkinson's disease.
FDA medtech regulators put the stamp of approval on Global Kinetic Corp.'s Personal KinetiGraph, a wearable device designed to help physicians diagnose symptoms of Parkinson's disease and other movement-based disorders.
The Personal KinetiGraph is the 1st device of its kind, capturing movement outside of the clinic and creating automated reports that neurologists and other caregivers can use to identify signs of neurological disorders. Most Parkinson's diagnoses today are done with in-clinic evaluations, patient's personal reports of symptoms and reactions to medication, Global Kinetic said.
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L.A. County's New EHR System Could Become Model for Rest of U.S.

by Michelle Stuckey, iHealthBeat Contributing Editor Thursday, September 11, 2014
Los Angeles County's Department of Health Services is installing a new countywide electronic health record system that officials say could end up being a model for other health care organizations across the country.
An L.A. County Civil Grand Jury report examined the initiative this summer, assessing how EHR implementation and integration of EHR systems and data among county departments could set the pace for development of a countywide health information exchange for both private and public providers.

L.A. DHS Faces Unique Challenges

Los Angeles DHS is the second largest public health system in the U.S. and serves nearly 10 million residents, according to the report. Robert Bart, CMIO of the department, said DHS includes four traditional hospital-based facilities -- Harbor-UCLA Medical Center, Los Angeles County-University of Southern California Medical Center, Olive View-UCLA Medical Center and Ranchos Los Amigos National Rehabilitation Center -- as well as several offsite clinics.
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ONC Releases Final EHR Guidelines

9/10/2014 05:13 PM
Office of the National Coordinator for Health IT abandons voluntary 2015 criteria and instead adds flexibility to 2014 EHR certification criteria.
The Office of the National Coordinator for Health IT (ONC) on Thursday released a new final rule for electronic health records (EHRs), which increases the flexibility of the 2014 edition of certification and adds some criteria initially proposed in the 2015 voluntary EHR certification criteria now abandoned by the ONC.
Although it believes that many of the reasons for creating a voluntary certification edition remain valid, the ONC opted to end its pursuit of this option after "consideration of public comment, further reflection of ONC goals and timelines, and a desire to adhere to the administration's principles," the office said, in a document slated to appear in the Federal Register on September 11.
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Report: eHealth Strategy South Africa (2012)

This 36-page policy document outlines the Department of Health's eHealth strategy, which is set to lead the department in improving patient information systems nationwide.
The document employs the World Health Organisation’s definition of eHealth as “the use of information and communication technologies (ICTs) for health to, for example, treat patients, pursue research, educate students, track diseases and monitor public health.”
It outlines ten strategic national priorities for eHealth leading up until 2017. These include capacitating health workers, standards and developing applications to support health care delivery.
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Drug Cost Comparison Tool Seen as Valuable Resource

SEP 9, 2014 8:34am ET
Doctors have great interest in a web-based resource that shows the current prices of comparable brand name and generic drugs at pharmacies in a chosen zip code, according to a study conducted by Community Catalyst.
In the study, physicians highly concerned about patients' abilities to pay for medications were presented with hypothetical resources showing the retail and out-of-pocket costs for drugs at local pharmacies. Following exposure to each resource, the doctors indicated that it would likely facilitate discussions of affordability, reduce non-adherence, and improve patient engagement. Physicians also reported which comparative features were the most useful, how often they would use such a resource, and how such a resource might save time addressing cost.
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States get telehealth report cards

Posted on Sep 10, 2014
By Erin McCann, Associate Editor
How do individual states stack up when it comes to telemedicine coverage and reimbursement? A new report from the American Telemedicine Association details just that -- assigning letter grades to each state and shedding light on the winners and those who still have a long way to go. 
After examining 13 key indictors relating to telemedicine coverage and reimbursement -- think Medicaid coverage, eligible providers, private insurance, etc. -- ATA researchers found both good news and some not-so-good news.
The good news? Some states did have comprehensive coverage and policies that promoted the adoption of telemedicine. Seven states, according to the research, reached the "A" level: those being Maine, Maryland, Mississippi, New Hampshire, New Mexico, Tennessee and Virginia. 
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Apple Watch Takes Tech Giant into New Territory

SEP 9, 2014 4:24pm ET
Apple on Tuesday unveiled a new product category for the Cupertino-Calif.-based company—a smartwatch designed to provide consumers with a variety of technology services including comprehensive health and fitness apps to help them lead healthier lives.
Called Apple Watch and available in early 2015 starting at $349, the device includes an activity app designed to help motivate users to be more active, and a workout app that provides metrics during workout sessions.  Billed as bringing together the capabilities of “an all-day fitness tracker and a highly advanced sports watch in one device,” Apple Watch uses an accelerometer, a built-in heart rate sensor, GPS and Wi-Fi from an iPhone to provide an overall picture of a person’s daily activity.
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The Apple platform for wellness arrives

Posted on Sep 10, 2014
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
On September 9 I was at the Flint Center in Cupertino where Steve Jobs introduced the first MacIntosh 30 years ago. Who can forget the iconic commercial “why 1984 won’t be like 1984”? It was the year I graduated from college and the year I married my wife Kathy.
Now, 30 years later, we’re on the cusp of a different kind of revolution: the consumerization of healthcare middleware that gathers data about your body/activity from multiple sensors and consolidates it into a secure container on your personal smartphone. No cloud storage is used. In fact, Apple has specifically changed its policies so that health data is never replicated to iCloud. Data remains on your device under your control. Apple does not specifically provide a function to transmit data off the device. The intent of Healthkit is that it serves as middleware, consolidating data and providing a container to share data with other apps that you specifically trust.
For example, Beth Israel Deaconess could create a Patientsite application that you trust to access healthcare data on your phone. Your care team could monitor this data for meaningful variations and intervene via a home care visit or telemedicine connection when appropriate.
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Success of Consumer-Based Apple Watch Tied to Healthcare Stakeholders

SEP 9, 2014 7:45am ET
Apple’s expected launch today of its long-awaited iWatch device could revolutionize the mobile healthcare market by capturing the hearts and minds of consumers.
However, two industry analysts say the success of this “smartwatch” with health/activity tracking capabilities hinges on more than just the ability of Apple to attract hordes of consumer users.
“No brand can do better than Apple in attracting consumers. And, no company has better resources and talent to design products that people want to use. The key is whether Apple will not only get the hardware/software piece right but also the right partnerships to help consumers with the motivational factors to positively change their health behaviors,” says Harry Wang, director of health and mobile product research at Parks Associates.
In addition to breakthrough wellness and fitness tracking functions, iWatch must garner partnerships with key healthcare industry stakeholders including providers and health insurers, argues Wang.
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Glasgow works with Emis on child health

8 September 2014  Sam Sachdeva
NHS Greater Glasgow and Clyde has implemented a bespoke version of Emis Web to build a single shared child health record, while it helps Emis to develop its child health functionality.
A total of 22 child and adolescent mental health services teams are using the system to securely share patient information within a single patient record, after the first team went live in March 2013.
Karen McFadden, the health board's programme lead, told EHI it chose Emis Web for its child health services because of the company’s flexibility and willingness to customise the software to meet its requirements.
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How to engage baby boomers in healthcare technology

September 9, 2014 | By Katie Dvorak
As baby boomers age, their increasing need for care will place a high demand on the healthcare industry. Advances in technology may help ease that burden, but only if developers use the right tools and platforms, according to a recent study.
The study, published in the Journal of Medical Internet Research, looks at the degree to which the baby boomer generation is prepared to embrace, or is currently embracing, consumer health tech.
Respondents of all ages, from 18-64 years, were surveyed for the study. The findings show that boomers are more likely than those age 64 and up to embrace five technologies: websites (84.5 percent), email (81 percent), call centers (52 percent), video conferencing (49.6 percent) and texting (49.6 percent).
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Nations should learn from each other on health IT strategies

September 9, 2014 | By Susan D. Hall
The use of health information and communications technologies (ICTs) to improve chronic care "is still in its early days," according to research at Health Affairs comparing approaches used in Australia, Canada, Denmark and the U.S.
The study looked at four types of solutions: electronic health records (EHRs), health information exchange (HIE), telehealth, and patient self-management tools.
The next five years will be critical in addressing common issues, the authors say, adding that common challenges present the opportunity for nations to learn from each other.
Australia has comparatively high EHR adoption (92 percent) and moderate health information exchange adoption (27 percent). The U.S. and Canada have comparatively moderate EHR adoption (around 50 percent) and low levels of HIE.
Denmark, meanwhile, has high EHR adoption (more than 80 percent among primary care providers) as well as high HIE adoption (90 percent).
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Study: Majority of patients ready for telehealth

Laura Pedulli
Sep 08, 2014
The majority of patients indicate a readiness for telehealth, according to a study published in Telemedicine and e-Health .
Researchers at the Mayo Clinic conducted a phone survey of a random sample of 263 patients who had been seen in the outpatient setting at a single institution. The sample was stratified by proximity to the local institution with oversampling for patients living outside a 120-mile radius.
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Mayo, Ralph, Stella and Sloane-Kettering: Will Fashion Meet Function in Wearables?

by Jane Sarasohn-Kahn Tuesday, September 9, 2014
Stella McCartney has been working with adidas for several years, integrating her fashion sense along with sensors in the miCoach sports bra. Women's fashion designer Tory Burch announced her collaboration with Fitbit at the 2014 Consumer Electronics Show. Barneys, the tony Manhattan fashion store, has been working with Intel (which acquired Basis Science, a maker of a wearable health-tracking device, for an estimated $100 million to $150 million this year) on chic smartwatch styling. And this month, Ralph Lauren announced that its iconic polo shirt will morph into a Tech Shirt, galloping into the fitness wearables space.
Will the Polo pony ride a growth curve for consumers and health wearables? And will fashion-meets-health-function move demand beyond early-adopting fitness folks?
Credit Suisse says wearables will be worth $30 billion to $50 billion in the next five years. Currently, Deloitte gauges the wearables market at $3 billion in 2014 (including smart glasses, fitness bands and watches), and VisionGain projects the market to be just over $5 billion by year's end.
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Doctors Say Electronic Records Waste Time

A new study shows that technology has slowed doctors' work.

By Kimberly Leonard Sept. 8, 2014 | 4:00 p.m. EDT + More
Doctors complain that they waste an average of 48 minutes a day, or four hours a week, when they record their patients’ health information into digital records, a new study shows.
The results were collected in a small survey, whose findings were put into a letter that was published Monday in the online edition of JAMA Internal Medicine. A draft of the letter was released Monday to a group of health care reporters at the National Library of Medicine. Dr. Clement McDonald, lead author of the study and director of the NLM Lister Hill National Center for Biomedical Communications, presented the letter, “The Use of Internist's Free Time by Ambulatory Care Electronic Medical Record Systems.”
The findings came from a 19-question survey that the American College of Physicians sent in December 2012 to 900 ACP members and 102 non-members. They received a 53.6 percent response rate; respondents had used 61 different EMR systems.
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Success of Consumer-Based Apple Watch Tied to Healthcare Stakeholders

SEP 9, 2014 7:45am ET
Apple’s expected launch today of its long-awaited iWatch device could revolutionize the mobile healthcare market by capturing the hearts and minds of consumers.
However, two industry analysts say the success of this “smartwatch” with health/activity tracking capabilities hinges on more than just the ability of Apple to attract hordes of consumer users.
“No brand can do better than Apple in attracting consumers. And, no company has better resources and talent to design products that people want to use. The key is whether Apple will not only get the hardware/software piece right but also the right partnerships to help consumers with the motivational factors to positively change their health behaviors,” says Harry Wang, director of health and mobile product research at Parks Associates.
In addition to breakthrough wellness and fitness tracking functions, iWatch must garner partnerships with key healthcare industry stakeholders including providers and health insurers, argues Wang.
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Almost 30% of Broadband Households Own, Use Connected Health Device

SEP 5, 2014 8:44am ET
New survey data from research firm Parks Associates shows that 27 percent of U.S. broadband households currently own and use at least one connected health device.
The survey of more than 5,000 U.S. broadband households also reveals that 13 percent of U.S. broadband households are very likely to purchase a connected health device within the next 12 months.
"The most popular connected health devices are treadmills, exercise bikes, and ellipticals," said Harry Wang, director of health and mobile product research at Parks Associates, in a written statement. "These devices come with built-in support for mobile health apps, which effectively merges the demands of mobile and healthcare consumers.”
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The promises and pitfalls of mHealth

Posted on Sep 08, 2014
By Eric Wicklund, Editor, mHealthNews
To say Harry Greenspun, MD, is well versed in mobile healthcare and technology is to put it mildly.
Greenspun, senior advisor at Deloitte's Center for Health Solutions, is also chairman of the HIMSS Government Relations Roundtable and a member of the new HIMSS mHealth Community, and has advised the Obama Administration on the importance of healthcare IT investment. 
Prior to joining Deloitte, he served as chief medical officer for Dell and Northrup Grumman. He's a co-author of “Reengineering Health Care: A Manifesto for Radically Rethinking Health Care Delivery,” and serves on the World Economic Forum’s Global Agenda Council on Digital Health, WellPoint External Advisory Council on Health Inequities and the advisory boards for Georgetown University, the Global Medical Microtechnology Association and Wireless-Life Sciences Alliance.
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Karen DeSalvo: Everyone can weigh in on path to interoperability

September 8, 2014 | By Susan D. Hall
The Office of the National Coordinator for Health IT is focused on gaining as much input as possible on how to make true interoperability happen, National Coordinator Karen DeSalvo said in a recent conversation with Sam Ho, M.D., executive director at United Healthcare and chairman of eHealth Initiative's Board of Directors.
The ONC plans to release a refreshed health IT strategic plan for comment later this year, DeSalvo said, and is "looking forward to some strong feedback on the priorities we should place to move forward."
"[T]here are going to be places where it makes more sense for there to be advancement from the private sector or perhaps the solutions can come from other sources. The solutions don't all have to come from the federal government," she said. "We look forward to another chapter of the strategic process that engages and incorporates what everybody can own and how to make sure we all have a piece of this."
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DeSalvo: America 'waiting for us to get interoperability right'

By Tom Sullivan, Editor
Calling it a “changing of the horizon,” national coordinator Karen DeSalvo, MD, said that her office is working to refresh the Federal Health IT Strategic Plan.
“It’s an opportunity to look at HIT beyond the EHR and policy levers beyond meaningful use,” DeSalvo said of the forthcoming plan. 
The Office of the National Coordinator for Health IT, in fact, has been reshaping itself for the future and is currently working on its strategic plan alongside a 10-year roadmap for interoperability — and that is against the backdrop of health IT reports put out by other federal entities, notably JASON and PCAST. 
Documents from JASON, conducted by independent scientists at The MITRE Group advising the Agency for Healthcare Research and Quality, and the President’s Council of Advisors on Science and Technology (PCAST) delve into health infrastructure and information exchange, essentially pointing to what needs to be done.
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ONC Data Brief: Physicians Report EHRs Prevent Medication Errors

September 5, 2014
Three times as many physicians report that electronic health records (EHRs) are preventing a potential medication error than causing one, according to a newly released data brief from the Office of the National Coordinator for Health IT (ONC).
The data brief used the 2013 National Ambulatory Medical Care Physician Workflow Survey to assess the physician-reported impacts of EHR use – both positive and negative – on quality and patient safety related outcomes. More than half of the approximately 11,000 physician respondents reported that the EHR alerted them to a critical laboratory value and 45 percent said it alerted them to a potential medical error. Only 15 percent said it led to a medical error.
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CMS pays out $24.8B in meaningful use incentives through July

Author Name Jennifer Bresnick   |   Date September 5, 2014   |  
The pace of Stage 2 meaningful use attestation among eligible providers and hospitals is picking up steam after a slow start earlier this year, contributing to more than $24.8 billion in incentive payments cashed by the healthcare industry during the lifetime of the EHR Incentive Programs.
The latest figures from CMS indicate that 95% of eligible hospitals (EHs) have registered for the programs, with 92% of facilities successfully receiving payments for either Stage 1 or Stage 2.  Similar success on the provider side shows that more than 90% of eligible professionals (EPs) have signed up, and more than three-quarters of EPs have already made some sort of financial commitment to EHR technology.
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Stage 2 MU Attestation Rate Remains Sluggish

SEP 5, 2014 10:23am ET
 As of Aug. 25, 143 eligible hospitals and 3,152 eligible professionals have attested to Stage 2 meaningful use, according to the Centers for Medicare and Medicaid Services.
CMS reported the latest Stage 2 attestation numbers during a Sept. 3 Health IT Policy Committee meeting. While the numbers are an improvement compared to the 78 hospitals and 1,898 EPs that had attested as of August 1, they are still sluggish.
“The numbers are very low, particularly for Stage 2 attestation. I mean they are like 4 percent of [providers] that should be currently going for Stage 2,” HITPC member and Intermountain Healthcare CIO Marc Probst commented during the meeting.
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Enjoy!
David.