Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
Privacy fear over NHS card loss
Thousands of NHS computer "smartcards" used to give access to confidential patient records have gone missing.
GP magazine Pulse, which reported the loss, said its survey of NHS bodies suggested the figure could be as high as 6,000.
Connecting for Health, in charge of NHS computer systems, said 4,147 were unaccounted for - but insisted that they were useless without PIN numbers.
As many as 1.2 million cards will eventually be issued to NHS staff.
| You can't expect stuff to remain confidential if a few hundred thousand people have access |
The government is trying to create an NHS-wide computer system allowing medical records to be available across the country at the touch of a button.
This has prompted fears that personal data could be vulnerable, despite security measures.
Any member of staff wanting to access the new system would need a "smartcard", similar to the "Chip and Pin" cards, which would have to be plugged into a slot on the PC to allow access.
Well over 400,000 cards have already been handed to NHS staff, and Connecting for Health revealed that just under 1% have been reported missing, with 1,240 of these reported in the past year.
Pulse's figure of 6,000 was based on Freedom of Information requests to NHS bodies across England.
Connecting for Health said that multiple reports of the same card loss might account for the difference.
One trust in ten said that it had no idea how many cards had been lost or stolen.
Continue reading here:
http://news.bbc.co.uk/2/hi/health/7230512.stm
This is a very interesting report and shows just how difficult it is in practice to secure information in a Shared Electronic Health Record while at the same time making the same information available to those who need it.
Second we have:
Doctors Use Wii Games for Rehab Therapy
February 9, 2008 - 5:05AM
Some call it "Wiihabilitation." Nintendo's Wii video game system, whose popularity already extends beyond the teen gaming set, is fast becoming a craze in rehab therapy for patients recovering from strokes, broken bones, surgery and even combat injuries.
The usual stretching and lifting exercises that help the sick or injured regain strength can be painful, repetitive and downright boring.
In fact, many patients say PT _ physical therapy's nickname _ really stands for "pain and torture," said James Osborn, who oversees rehabilitation services at Herrin Hospital in southern Illinois.
Using the game console's unique, motion-sensitive controller, Wii games require body movements similar to traditional therapy exercises. But patients become so engrossed mentally they're almost oblivious to the rigor, Osborn said.
"In the Wii system, because it's kind of a game format, it does create this kind of inner competitiveness. Even though you may be boxing or playing tennis against some figure on the screen, it's amazing how many of our patients want to beat their opponent," said Osborn of Southern Illinois Healthcare, which includes the hospital in Herrin. The hospital, about 100 miles southeast of St. Louis, bought a Wii system for rehab patients late last year.
"When people can refocus their attention from the tediousness of the physical task, oftentimes they do much better," Osborn said.
Nintendo Co. doesn't market Wii's potential use in physical therapy, but company representative Anka Dolecki said, "We are happy to see that people are finding added benefit in rehabilitation."
The most popular Wii games in rehab involve sports _ baseball, bowling, boxing, golf and tennis. Using the same arm swings required by those sports, players wave a wireless controller that directs the actions of animated athletes on the screen.
The Hines Veterans Affairs Hospital west of Chicago recently bought a Wii system for its spinal cord injury unit.
Pfc. Matthew Turpen, 22, paralyzed from the chest down in a car accident last year while stationed in Germany, plays Wii golf and bowling from his wheelchair at Hines. The Des Moines, Iowa, native says the games help beat the monotony of rehab and seem to be doing his body good, too.
Continue reading here:
http://news.smh.com.au/doctors-use-wii-games-for-rehab-therapy/20080209-1r67.html
This is a great example of an unexpected application of a game console to the health sector. It seems this could be a very cheap way of assisting people to regain their co-ordination after injuries. Good thinking on the part of a few rehabilitation doctors.
Third we have:
Remote control birth control
Louise Hall
February 10, 2008
VASECTOMIES could be a thing of the past thanks to Australian scientists who are developing a remote-controlled contraceptive implant for men.
The device stops and starts the flow of sperm with the push of a button, similar to locking a car with a key fob.
Researchers at the University of Adelaide say the valve would remain shut most of the time to act as a contraceptive barrier.
A man would use the remote control to open the valve and allow the sperm to pass through when he and his partner wanted to conceive.
The implant, still in laboratory testing, would provide a much-needed alternative to vasectomy, a surgical procedure not easily reversed if a man changes his mind.
Continue reading here:
http://www.smh.com.au/news/national/remote-control-birth-control/2008/02/09/1202234227423.html
This is an very surprising innovation. I must say the thing that concerns me is how one knows if the valve is in the open or closed position. I hope there is a mechanism to determine externally the current status – otherwise I don’t see this idea getting very far. This is an article I might have expected to appear on April 1.
Fourthly we have:
Medics sceptical about government data security
01 Feb 2008
Nine out of ten doctors have no confidence in the government’s ability to safeguard patient data online, a poll by BMA News magazine has revealed.
Over 90% of respondents said they were not confident patient data on the proposed NHS centralised database would be secure.
The magazine says the profession’s scepticism appears to flow from scandals such as security breaches in MTAS, the junior doctor’s online job application service, and the HM Revenue and Customs loss of computer discs containing the details of 25m child benefit claimants.
One respondent said: “With the MTAS debacle, the government has proven itself to be pretty incompetent in handling and protecting sensitive data. Forget ID cards; the national NHS database poses an even greater risk of our personal data being released into the public domain and being misused.”
Another said: “With the government’s recent underhand dealing with regard to general medical services contracts and the contracts of staff and associate specialist doctors, we might wonder whether it would have other uses for the information that might not be in patients’ best interests. Previous government guarantees of security have not been worth the paper they were written on.”
Only 4% of the 219 respondents said they felt they were in a position to assure patients that their data will be safe on the Care Records database.
One respondent said: “This will help with continuity of care and communication between primary and secondary care … There may be a risk, but paper records are also going astray. We need to join the 21st century and fast.”
Nine out of ten respondents to the Doctors Decide poll said they did not feel they were in a position to assure patients that their data would be safe, with one suggesting that the BMA should advertise its objections to the system.
Continue reading here:
http://www.e-health-insider.com/news/3438/medics_sceptical_about_government_data_security
It is interesting that so many doctors are so deeply suspicious of the proposed Care Records Database. I really wonder just how much these people actually understand about the steps being taken to protect the sensitive information. Either way it is clear a major educational effort is required to ensure the view expressed actually reflect a considered and informed view.
This level of medical distrust – if a considered view – is a major barrier to the overall success of this massive UK program.
Fifthly we have:
CBO says healthcare technology costs too much
By: Jean DerGurahian/ HITS staff writer
Story posted: February 4, 2008 - 5:59 am EDT
Technological advancements have spurred spending increases in healthcare and should be reined in to help lower costs, according to federal officials.
About half of the increased healthcare spending since 1965 came from technological advances that expanded the capabilities of medicine, the Congressional Budget Office said in its Jan. 31 report, Technological Change and the Growth of Health Care Spending. Peter Orszag, director of the CBO, testified last week in front of the Senate Budget Committee on the rising costs of healthcare.
The budget office estimated total healthcare spending will increase to 25% of the gross domestic product by 2025, up from the current 16% of GDP. By 2082, spending will be 49%, the office said.
Most of that spending was on advancements in treatments to manage chronic conditions, such as diabetes and coronary artery diseases, which allow older patients to live longer, according to the report. In addition, premature babies are surviving more frequently because of ventilation and nutrition delivery capabilities, the report stated.
Continue reading here:
http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20080204/REG/714635255/1029/FREE
The full report can be found here:
http://www.cbo.gov/ftpdocs/89xx/doc8947/01-31-TechHealth.pdf
This report raises really critical issues regarding the sustainability of technology driven growth in the cost of health services. The projection the health will cost 49% of the US GDP by 2082 is truly alarming as even the cost by 2025 – less than 17 years away – is clearly not affordable. Something has to alter this trajectory and clearly Health IT has a major potential role.
The data provided in the full report makes fascinating and important reading.
Lastly we have:
Life in Europe to become ambient assisted
05 Feb 2008
IT solutions that automatically close fridge doors, or switch off cookers when you leave the house. Bathroom cupboards that help chronically ill people remember to take their medication on time. Television-based home care gadgets operated by remote control. Welcome to the brave new world of Ambient Assisted Living (AAL).
Clearly possibilities are far reaching with AAL, a field of research and development combining the IT, medicine, social care and housing industries.
Like e-health, AAL has attracted the interest of the European Commission. Brussels has now set up an AAL programme to run from 2008 to 2013.
It is also being funded under article 169 of the EU treaty and complements the seventh Framework Programme, “Our goal is to foster the emergence of innovative ICT products and services for ageing well”, said Dr. Paul Timmers, Head of ICT for Inclusion at the EC’s Directorate-General Information Society and Media.
“In total, it will be a €600m programme”, said Dr Timmers, talking to around 400 guests at the first European AAL event in Berlin, on 1 February 2008.
Half of the money will be provided by 22 member states with the rest to be supplied by industry. Each partner state in the AAL programme has one seat in the coordinating body, the AAL Association.
The e-health connection
In Berlin it turned out that, although the initiative is called the ‘AAL programme’, it is very much concerned with e-health, at least in the initial stages.
“Our focus in 2008 will clearly be on e-health projects”, said the Vice President of the AAL Association, Peka Kahri from Finland. The first calls for proposals are expected to be issued in the spring. In 2009, the focus of the AAL programme will shift to ‘mobility’ and ‘information and learning’.
The AAL Association is looking for proposals for products or services related to homecare. “We expect solutions for elderly, with either risk factors or chronic diseases, that help people stay in their home environment longer, have less hospital admissions, and live a more comfortable life,” said Kahri.
Continue reading here:
http://ehealtheurope.net/comment_and_analysis/292/life_in_europe_to_become_ambient_assisted
This is an important ‘heads up’ on a technology trend that will clearly become important in the years ahead as the baby boomers age and need more help simply to undertake the basics of daily living.
Further useful reading can be found at the links below:
www.independent-living-for-elderly.eu
More next week.
David.
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