Monday, February 28, 2011

Weekly Australian Health IT Links – 28 February, 2011.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. 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:

The theme this week seems to be the lack of transparency in initiatives in E-Health in Australia. Both NEHTA and DoHA seem quite unable to use the ordinary processes of democracy to facilitate proper discussion and review of what is being planned - before it is just dropped on an unsuspecting public.

Any suggestions as to why this is welcome!


NEHTA exempt from FOI laws

  • Karen Dearne
  • From: Australian IT
  • February 22, 2011 4:32PM

THE National E-Health Transition Authority is impervious to freedom of information requests, according to Australia's new Information Commissioner, John McMillan -- at least for now.

Despite an earlier understanding that the heavily taxpayer-funded body was subject to Freedom of Information laws, Professor McMillan told a Senate estimates hearing that "the Act spells out the agencies which are subject to it, and NEHTA does not fall into that category".

Liberal Senator Sue Boyce asked why NEHTA had been listed as an agency subject to the Act in the latest annual report by FOI Minister Brendan O’Connor.

Professor McMillan said the statement in the annual report was "erroneous".


February 11, 2011 11:08 AM Eastern Time

Tunstall Chosen to Provide Telehealth Solutions for Chronic Disease Management Program in New South Wales, Australia

State-wide program will support over 40,000 people with long-term conditions using remote health management

DONCASTER, England--(BUSINESS WIRE)--Tunstall Healthcare, the leader in telehealthcare solutions, has been selected by the state Government of New South Wales in Australia as one of a panel of suppliers for its Connecting Care program, a new, large-scale initiative for chronic disease management.

The program, coordinated by New South Wales Health (NSW Health), will use telehealth systems to support state residents living with long-term health conditions including diabetes, CHF, coronary artery disease, COPD and hypertension.


Comparing an SLK-based and a name-based data linkage strategy: an investigation into the PIAC linkage

Data linkage series no. 11

In 2005, the Institute was funded to create a linked aged care database to enable analysis of pathways through aged care services. The linkage strategy for the project involved using a Statistical Linkage Key (SLK) because of the lack of either a name or a common person identifier on the data sets being linked. This paper validates the results obtained using the SLK linkage strategy by comparing it directly with a name-based linkage strategy.

Authored by AIHW.

Published 23 February 2011; ISSN 1833-1238; ISBN-13 978-1-74249-124-0; AIHW cat. no. CSI 11; 54pp.; INTERNET ONLY


NEHTA anticipates e-health record clarity

Looming release of draft concept of operations will begin wider discussion over e-health record

The Federal Government’s lead e-health agency is anxiously anticipating clarity around the $467 million personally-controlled electronic health record (PCEHR) program, with hopes the imminent public release of a draft concept of operations will catalyse greater cooperation from the wider industry.

Despite promises from health minister Nicola Roxon to publicly release the document, which has so far only been handed to potential bidders on key tenders, a spokesperson failed to respond to questions of exact dates at time of writing.


NSW's ambulance service diagnoses system virus

NSW's ambulance service has identified the computer virus that forced the shutdown of its system responsible for dispatching and tracking ambulances over a weekend but will not reveal which virus did the damage.

Technicians at the ambulance service discovered the virus while performing scanning tests in database boxes accessed by VisiCAD -- a globally adopted computer dispatch system used by the NSW service for 10 years.

Staff resorted to manual processes on the weekend of February 12-13 until the following Monday at all four ambulance control centres in Sydney, Charlestown, Dubbo and Warilla, after the virus struck.


Industry anger over Therapeutic Goods Administration bid to change processes

THE Therapeutic Goods Administration's proposed overhaul of the medical devices approvals and reporting process has been slammed by industry as costly and unlikely to benefit patient safety.

There has been an angry reaction to the TGA's statement that the Australian Register of Therapeutic Goods needed to change because some product sponsors were manipulating the listing process.

"If a sponsor has deliberately used this process to put a (non-approved) device on the market, the TGA has a wide range of powers to deal with offenders without passing on extra regulations and costs," said Geoff Purtill, managing director of home care and mobility provider Invacare Australia in a review submission.


Game plan for outsourcing is changing

GAVIN Larkings will require steady hands as he "retools the factory" -- CSC Australia's catchcry in the new year.

The IT outsourcing giant needs to change the way it operates internally to get a jump on the competition and retain customers such as AMP, Westpac, GE, Woodside, OneSteel, NEHTA, Defence, ATO and Immigration. The old outsourcing model may still resonate with some customers but that pool is fast drying up.

Mr Larkings, CSC Australia president and chief executive, realises the clock is ticking.

"The big change that we see is (IT) outsourcing but not as we know it. What's really driving that change is the consumerisation of IT," Mr Larkings says.

"Traditional outsourcing will still have to be retained for particular clients but emerging technologies and services such as cloud computing are going to move traditional services of IT consulting, systems integration and outsourcing into a different dimension.


Global Health 1H loss widens to $511k

Global Health, (ASX:GLH), a e-health solution provider, said its loss widened to $511k in the first half as a result of the strong Australian dollar

Australian e-health solution provider Global Health (ASX:GLH) has reported a net loss of $511,500 for FY11, as a result of foreign exchange losses.

Revenue grew 1.5 per cent to $2.6 million, with core healthcare license and services revenue increasing 15 per cent to $2.46 million. Ebitda losses meanwhile decreased to $229,000 from $288,000 in 1H09.


iSoft fights to get back in the black

By Suzanne Tindal, on February 25th, 2011

E-health company iSoft has logged a net loss after tax for the half year to 31 December 2010 of $84.1 million, staunching the outflow of cash while it attempts to turn itself around.

For the year to 30 June 2010, the company had reported a staggering $383 million loss, announcing plans to carry out a major restructure, cutting staff and implementing other operational savings.

However, the company has put a positive spin on the results for this half year, pointing to the earnings before interest, tax, depreciation and amortisation (not including restructuring costs or exceptional items) of $9.8 million. This compares to -$8.4 million in the half year to 30 June 2010 and $27.5 million in the half year to 30 December 2009. Restructuring and refinancing costs contributed to a high operating cash outflow for the first half year.


iSOFT swings to $84m loss

0 Links | 0 Comments | Submit link | Report | 19:40, 25th February 2011

By Dylan Bushell-Embling (CFO World)

Health IT company iSOFT (ASX:ISF) swung to an $84.1 million net loss in 1H11, due to restructuring costs and impairment charges.

ISF shares fell 10.29% to $0.061 in Friday's trading following the announcement.

The company, which had made a $4.8 million profit in 1H10, spent the most recent half attempting to restore the financial health of the business.

These efforts generated redundancy, property exit and restructuring and refinancing costs of $15.8 million for the quarter.

Revenue also declined 27% to $161.6 million, due mainly to an anticipated $20 million decline in revenue from the UK's National Programme for IT.


iSOFT takes to the sky with IBM

Tuesday 22nd February 2011

iSOFT Group Limited is to release a cloud edition of its Viaduct integration tool to meet the growing demand for simple, low-cost integration by non-specialists, as a first step to offering other market-leading healthcare solutions under its new cloud strategy.

The world's largest healthcare IT provider outside of the US, iSOFT has signed an agreement to run its Viaduct integration tool on the IBM Smart Business Development & Test on the IBM Cloud.

The move gives non-specialists access to a powerful, yet easy-to-use integration tool on a "try-before-you-buy" basis. The application can be downloaded at no cost for developers to design, build and test interfaces and assess its value fully.


Fibre optics to monitor health of IVF embryos. Scientists collaborate on world first research

TWO of the nation's great scientific minds are collaborating on world-first research that could revolutionise reproductive technology using fibre optics.

South Australian of the Year, physicist Tanya Monro, and gynaecologist Robert Norman, the state's 2009 scientist of the year, have established a reproductive health laboratory at Adelaide University.

Professor Norman said teaming physics and biology could provide a unique insight into in vitro fertilisation by using fibre optics to look at the development of an embryo on a nano scale.


Last rites for health IT system

Kate Hagan

February 21, 2011

HEALTH Department staff fear Victoria's $360 million health technology program is being shut down after being told that no contracts will be renewed for people working on it.

The news delivered to staff late last week follows an admission last month by Health Minister David Davis that he was considering abandoning the HealthSMART program, which is five years late and $35 million over budget.

He described HealthSMART - which is supposed to link computer systems in hospitals and give medical staff immediate access to patient records - as ''the myki of the health system''.


Note Date: And The Optimism Then.

Box Hill Hospital's state first in patient care

A GROUND-breaking new system will give Box Hill Hospital medical staff electronic bedside access to patients’ medical information.

Patient Egidio Mattiuzzo, Eastern Health chief executive Tracy Batten (left) and Veronica Whitter with the new system. N23WH311

Eastern Health is the first in Victoria to implement the HealthSMART Clinicals System, which it says will have a huge impact on the way doctors and nurses perform daily roles.

Program director Veronica Whitter said the system would help clinical decisions, making the process a lot quicker.

She said medical practitioners would have access to all the patients’ details, including pathology results, discharge information, allergies, alerts and appointments. “The key is all information at the right place and the right time,” she said.


MJA Supplement Contents

21 February 2011

Research enabling the e-health revolution

HTML The Australian e-Health Research Centre: enabling the health care information and communication technology revolution

David P Hansen, Phil Gurney, Gary Morgan and Bruce Barraclough — Med J Aust 2011; 194 (4): S5-S7.

HTML Developing a national emergency department data reference set based on SNOMED CT

David P Hansen, Madonna L Kemp, Sandra R Mills, Megan A Mercer, Paul A Frosdick and Michael J Lawley — Med J Aust 2011; 194 (4): S8-S10.

HTML The health lessons of a lifetime: what “wellbeing” means to me

Greg McCallum — Med J Aust 2011; 194 (4): S11.

And about 10 more articles


Federal govt collaborates on web traffic spikes

Updated: Talks surround potential internal government Cloud

The Department of Human Services has voiced support for an internal Cloud based on existing infrastructure shared and virtualised between Federal Government agencies, as a means of dealing with spikes in traffic on major government websites.

According to the department’s deputy secretary of IT infrastructure, John Wadeson, talks with other agency CIOs were ongoing about such an arrangement.

“We’re working away at the back-end... some people are calling it a government Cloud of sorts,” he said. “We are trying to get ahead of the game in massive provisioning of infrastructure.


The NBN must start delivering results to taxpayers

    Kevin Noonan, Ovum

KEVIN Noonan has a simple message for the federal government: if it wants the $36 billion National Broadband Network to succeed -- don't stuff up, and start delivering outcomes for citizens.

Similar advice is aimed at bureaucrats in charge of the $467 million personally controlled e-health records system.

The NBN has many backers, including Google chief internet evangelist Vint Cerf. Its critics, chiefly the opposition, have demanded a cost-benefit analysis on the project's viability.


Deal struck for FOI laws to cover National Broadband Network

  • From: AAP
  • February 24, 2011 10:15AM

THE Gillard government and the Australian Greens have struck a deal to make the national broadband network subject to freedom of information laws.

Labor previously had been opposed to such a move, arguing it would compromise the commercial confidence of the NBN Co, the company building the $36 billion network.

But Greens communications spokesman Scott Ludlam said the deal, struck over a fortnight of negotiations, would respect commercial sensitivity.


LibreOffice the last word in open source software

  • DOUBLECLICK: David Frith
  • From: The Australian
  • February 22, 2011 12:00AM

WHY do so many people and businesses keep buying Microsoft Office at about $200 for home users and $379 for businesses when there are good substitutes that cost zilch, or a only small fee?

It's a question DoubleClick, despite being a pretty dedicated Office user, has often pondered. The main reasons, we guess, are historical and environmental: most of us have used the suite for years, so we keep updating -- and so does pretty well everyone else around us with whom we may need to share files.

Then there's the bells-and-whistles thing. Footnotes, endnotes, indexing, collaboration tools, formulae, image editing, ribbons, macros -- Office has more bells, more whistles, more tricks and turns, than most of us are ever likely to learn or use.


Windows 7 Service Pack 1 is ready for download

Microsoft has released its first Service Pack for the Windows 7 operating system addressing minor OS nips and tucks.

Bug fixes and security patches don't make for the most exciting Windows update, but they're the high points of Windows 7 Service Pack 1, now widely available for download.

Windows 7 Service Pack 1 is now available from Microsoft's Website for download, or via Windows Update, and by ordering an installation DVD. Windows 7 SP1 takes roughly 30 minutes to install, and you'll have to restart the computer halfway through. System requirements and detailed installation instructions can also be found on Microsoft's Website.




AusHealthIT Poll Number 59 – Results – 28 February, 2011.

The question was:

Will The Health Identifier Service Actually Deliver Anything Useful in the Next Two Years?

The answers were as follows:


- 5 (11%)

Might Be Pretty Delayed

- 9 (20%)


- 2 (4%)

Probably Not

- 16 (36%)

It Will Never Actually Deliver As Planned

- 12 (27%)

Well that is seems pretty clear with only 33% suggesting that delivery was likely and would probably be slow!

Votes : 44

Again, many thanks to those that voted!


Sunday, February 27, 2011

The Time Has Come For Some Light To Be Shone into The Dark. Twelve Weeks Waiting Is Long Enough!

This really has become just too silly.

This appeared in early January.

Transparency call on privacy: patient records
8th January 2011
By: Karen Dearne - The Australian

Federal Health Minister Nicola Roxon has agreed to release confidential plans for widespread debate.

The Labor government's "personally controlled" approach to a nationwide system of sharing patients' medical records has caused much confusion since it was announced a year ago.

But Roxon says a draft concept of operations will soon be issued for public consultation.

Roxon is referring to a draft framework developed to give registered bidders for a $55 million funding pot for new e-health initiatives some idea of how the thing will work. It was produced by the National E-Health Transition Authority after "behind closed doors" consultations with selected consumer, medical and industry representatives. Other community groups are frustrated by the lack of openness.

Australian Privacy Foundation chairman Roger Clarke has written to NEHTA and the Health Department complaining about the exclusion of "civil society" from deep-level design consultations conducted secretly under non-disclosure arrangements.

The peak privacy body warns of serious deficiencies in PCEHR proposals to date.

"While we are told there is to be rigorous governance and oversight to maintain privacy, the specifics are yet to be decided," Clarke wrote after a consumer round-table in November.

"The slide-sets shown referred to a predecessor proposal and no documentation has been supplied.

More here:

Some 7-8 weeks later has the Minister done as she said she would?

Well not exactly.

Public kept in the dark on e-health record system

  • Karen Dearne
  • From: Australian IT
  • February 25, 2011 12:00AM

THE draft concept of operations for the $467 million personally controlled e-health record contains a "wealth of information" but is not yet ready to be shared with the general public, the federal Health department has told a Senate estimates hearing.

Queensland Liberal Senator Sue Boyce asked why the material had not been released for public discussion when it was being circulated for commercial purposes.

Health deputy secretary Rosemary Huxtable said the draft concept of operations for the PCEHR had not been finalised.

However, she confirmed it had been released to potential bidders for a range of PCEHR contractors.

"It is certainly at a very advanced stage, and it has been provided as part of the documentation at industry briefings," she said. "But there is still work occurring in consultations through the National E-Health Transition Authority's processes.

"The fact (the draft) is not quite finalised is not really an impediment to bidders using it to better understand the government's expectations."

Ms Huxtable said tenders for a national infrastructure partner and other PCEHR programs had been put to the market, but no contracts had been let.


E-Health strategy head Liz Forman said a Victorian Health department report that concluded the new $90m Healthcare Identifiers service patient numbers should not be relied on as a sole source of accurate information had been "welcomed".

"Certainly the team's level of enthusiasm is reflected in them doing such a thorough job," Ms Forman said. "The risk assessment report refers to using the individual healthcare identifier on its own -- it's never been the intention for the number to be used on its own as a form of identification.

"That report is quite a rigorous analysis of a whole lot of possible scenarios for using identifiers, where the risks are and how the system design will minimise that risk.

"Which is actually a very positive thing to do, and we welcomed the release of that material so it can be shared by other organisations looking at adopting identifiers."

Ms Forman said she was not aware of NEHTA doing any similar risk assessment


Full article here:

There is also comment in Computerworld.

NEHTA anticipates e-health record clarity

Looming release of draft concept of operations will begin wider discussion over e-health record

The Federal Government’s lead e-health agency is anxiously anticipating clarity around the $467 million personally-controlled electronic health record (PCEHR) program, with hopes the imminent public release of a draft concept of operations will catalyse greater cooperation from the wider industry.

Despite promises from health minister Nicola Roxon to publicly release the document, which has so far only been handed to potential bidders on key tenders, a spokesperson failed to respond to questions of exact dates at time of writing.

The National E-Health Transition Authority (NEHTA), unlike National Broadband Network wholesaler NBN Co, is currently exempt from Freedom of Information legislation, preventing parties from accessing the documentation without participating in the tender process.

The draft paper is yet to be finalised, according to members of the Department of Health and Ageing who appeared before a Senate estimates hearing earlier in the week, but will ultimately provide greater information on how the electronic health record will work and which elements will be included.

However, exactly which elements will be initially included in the record is still up for debate, according to NEHTA’s head of clinical leadership and engagement, Mukesh Haikerwal.

Haikerwal said the release of the document publicly would likely signal the beginning of a clarification process over initial elements to be included in the PCEHR, a matter that remains debatable among both health providers and the wider health industry.

“Everyone has a view of what should be in it; that view grows depending on who you talk to and so when you coalesce that you’ve got a massive elephant,” he told Computerworld Australia following his return from the United States.

More here:

There is no reason for DoHA and NEHTA to be just sitting on their hands and treating the public like mushrooms. If the entire vendor community and the Standards Australia community can have a copy of this document the why not others who are interested?

Here is the e-mail Standards Australia sent out:


From: Deleted

Sent: Wednesday, 23 February 2011 10:18 AM


26 Recipients


4 Others

Subject: PCEHR _Concept of Operations (Con-Ops)

Dear Members of IT-014,

Please find attached useful information on PCEHR and relevant teams to support it in NEHTA. This information is being distributed to you so that you have time to read and understand the contents and how it may affect the work program for 2011/2012 with regard to a national focus in this area. Please bring your valued recommendations to the parent committee meeting on 8th/9th March in Brisbane.

The contents of this email and attachment(s) are confidential to IT-014 Technical Committee Members only at this stage. Therefore do not forward this email, it is for your information only.

Please be advised that any breaches regarding confidentiality and non-distribution of this document will be acted on accordingly by Standards Australia.

Kind Regards


----- End E-Mail

What the e-mail says it that anyone who gets it will be doing the wrong thing if they indulge in “non-distribution”! Presumably that was meant was ‘on-distribution’ (grin). Don’t you just love the warning red and hollow threats etc!

Anyway I am happy to comply and distribute (I was not on the distribution list) as my feeling is that this nonsense has gone far enough.

Go here to download the apparently current draft as this is what SA is passing around.

(About 4.3 Megs) (Right-Click is the easiest way to download in Windows)

The SA file name is different (AS-NZS 31000-2009.pdf) but the version is identical as far as I can tell

Enjoy and comments welcome!

Before closing I have to highlight this:

“E-Health strategy head Liz Forman said a Victorian Health department report that concluded the new $90m Healthcare Identifiers service patient numbers should not be relied on as a sole source of accurate information had been "welcomed".

"Certainly the team's level of enthusiasm is reflected in them doing such a thorough job," Ms Forman said. "The risk assessment report refers to using the individual healthcare identifier on its own -- it's never been the intention for the number to be used on its own as a form of identification.”

Just amazing spin and in front of our Parliament! As a mate said ‘She deserves an Oscar!’


Saturday, February 26, 2011

Weekly Overseas Health IT Links - 26 February, 2011.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. 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.


Study: Clinical trial privacy safeguards lacking

February 17, 2011 | Molly Merrill, Associate Editor

OTTAWA – Security practices for transferring and sharing sensitive files for patients who are participating in clinical trials are inadequate, according to a recent study.

The two-part study, titled "How Strong Are Passwords Used to Protect Personal Health Information in Clinical Trials?," was led by Khaled El-Emam, Canada research chair in Electronic Health Information at the Children's Hospital of Eastern Ontario (CHEO) Research Institute.

The study, which was published in the Journal of Medical Internet Research, showed that the majority of passwords used to protect files are poorly constructed and easily cracked using commercial password recovery tools.

Study coordinator interviews indicated that electronic information shared in the context of clinical trials may put personal health information at risk.


CHIME: Delay MU Stage 2

HDM Breaking News, February 18, 2011

The College of Healthcare Information Management Executives, an influential group comprising 1,400 CIOs and other I.T. leaders, is recommending a delay in Stage 2 electronic health records meaningful use compliance.

"CHIME believes that it would not be prudent to move to Stage 2 until about 30 percent of eligible hospitals and eligible providers have been able to demonstrate EHR MU under Stage 1," according to a comment letter sent to federal officials. "We believe this approach would strike a reasonable balance between the desire to push EHR adoption and MU as quickly as possible, and the recognition that unreasonable expectations could end up discouraging EHR adoption if providers conclude that it will be essentially impossible for them to qualify for incentives."


Medical Home Assessment Tool Available

HDM Breaking News, February 16, 2011

The Primary Care Development Corporation, a not-for-profit organization providing financing and services to expand access to care in underserved communities, has released an update of its free online Patient-Centered Medical Home Assessment Tool.

The update enables the assessment and measurement of a primary care practice's current operations against the National Committee for Quality Assurance's new 2011 standards for its Patient-Centered Medical Home program (see story).


Doctors' digital divide could widen health care disparities

Government and private entities are looking to ensure that health IT adoption doesn't leave out physicians who treat poor and minority patients.

By Pamela Lewis Dolan, amednews staff. Posted Feb. 14, 2011.

As the federal government strengthens its push for health information technology adoption among physicians, there is growing concern that the effort may increase health care disparities in minority communities by adding a digital divide to the mix.

Efforts are under way by the government and private and nonprofit sectors to help advance health IT adoption and funding in minority communities, which advocates say have been slower to take advantage of federal programs to bolster adoption of electronic medical record systems. If done right, experts say, disparities will not only be kept from widening, they have the potential to disappear.


The limits of anonymisation in NHS data systems

NHS data provided to researchers in an 'anonymous' form is often easy to link to the patients concerned

  • Dr Lindsey Brown, research associate, University of Bristol
  • Guardian Professional, Thursday 17 February 2011 09.00 GMT

Current debates around the use of medical records for research become heated, with various arguments forwarded by different groups. Medical researchers believe research benefits patients by increasing knowledge around disease and treatment. This belief is sufficiently strong that they suggest laws governing research and the need for consent threatens research and as such puts lives at risk.


Whitepaper Highlights Policy Considerations Surrounding Data Segmentation Of Health Information

16 Feb 2011

A new whitepaper recently released by the Office of the National Coordinator for Health Information Technology of the U.S. Department of Health and Human Services, authored by faculty and researchers at The George Washington University's Department of Health Policy and researchers at AcademyHealth, explores key components of data segmentation, circumstances for its use, associated benefits and challenges, various applied approaches, and the current legal environment surrounding data segmentation in the area of health information exchange.

Data segmentation can be defined as the process of sequestering from capture, access or view certain data elements that are perceived by a legal entity, institution, organization, or individual as being undesirable to share. In the case of health information, some patients may prefer to withhold or sequester certain elements of their medical record, often when it is deemed by them (or on their behalf) to be "sensitive," whereas others may feel strongly that all of their health information should be shared under any circumstance.


Selective patient data protection difficult in health IT data exchange

February 17, 2011 — 11:47am ET | By David Perera

Patients need to know that despite all the potentially highly sensitive personal information being collected in an electronic health record, their data will be contextually protected from inappropriate disclosure, says a paper prepared for the Office of National Coordinator for Health Information Technology.

The paper, dated Sept. 29 but only recently posted on the ONCHIT website, acknowledges difficulties with what it terms data segmentation, but says that absent the ability to block the uniform distribution of patient data, some patients would react by hiding information from doctors.


Intermountain opens informatics research center

By Joseph Conn

Posted: February 17, 2011 - 11:30 am ET

Intermountain Healthcare announced the opening of the Intermountain Homer Warner Center for Informatics Research in Salt Lake City, named for a pioneer in medical informatics.

The center, which opened Wednesday, initially will be home to 60 full-time IT employees. Intermountain expects to add 100 more informatics specialists within the next 10 years, according to a news release from the system.

Dr. Homer Warner, 88, is chairman emeritus of the University of Utah's medical informatics department.


U.S. patients trust docs, but not e-health records, survey shows

Many respondents don't even trust themselves with their own records

Lucas Mearian

February 17, 2011 (Computerworld)

While Americans trust their physicians to keep their healthcare information private, they don't extend that same trust to computerized records systems, according to a new survey from CDW.

Thirty-five percent of 1,000 survey respondents indicated they are worried that their health information will end up widely available on the Internet. And, half of the respondents believe that electronic health records (EHRs) will have a negative impact on the privacy of their health data. Surprisingly, 24% of respondents said they don't even trust themselves with access to their own records.


Healthcare Social Media Sites Neglect Privacy Protections

Analysis of diabetes sites indicates that many lack scientific accuracy and put users' personal information at risk.

By Nicole Lewis, InformationWeek
Feb. 14, 2011

As the Internet in general and social networking in particular are used as a point of reference for gathering and sharing health information, a study that examined 10 diabetes-focused social networking sites has found that the quality of clinical information, as well as privacy policies, significantly varied across these sites.

The study, "Social but safe? Quality and safety of diabetes-related online social networks," was conducted by researchers in the Children's Hospital Boston informatics program who performed an in-depth evaluation of the sites and found that only 50% presented content consistent with diabetes science and clinical practice.

The research, published in late January in the Journal of the American Medical Informatics Association, also revealed that sites lacked scientific accuracy and other safeguards such as personal health information privacy protection, effective internal and external review processes, and appropriate advertising.


Drugmakers Create Mobile Phone Apps to Track Diabetes, Cancer

By Tom Randall - Feb 15, 2011 4:01 PM ET

Drugmakers led by Merck & Co. and Novartis AG boosted investments in mobile phone applications and educational websites by 78 percent to get patients to take their drugs, eat right and exercise, an Ernst & Young report found.

Pharmaceutical companies initiated 97 projects last year aimed at using information technologies to improve patient health, according to the report by the New York-based consulting firm, which relied on analyst reports and press releases to reach its tally. That compares with 124 projects started in the four prior years combined. About 41 percent of the projects were smartphone applications, an increase from 11 percent since 2006.


Drugmakers Create Mobile Phone Apps to Track Diabetes, Cancer

By Tom Randall - Feb 15, 2011 4:01 PM ET

Drugmakers led by Merck & Co. and Novartis AG boosted investments in mobile phone applications and educational websites by 78 percent to get patients to take their drugs, eat right and exercise, an Ernst & Young report found.

Pharmaceutical companies initiated 97 projects last year aimed at using information technologies to improve patient health, according to the report by the New York-based consulting firm, which relied on analyst reports and press releases to reach its tally. That compares with 124 projects started in the four prior years combined. About 41 percent of the projects were smartphone applications, an increase from 11 percent since 2006.


Speech recognition market poised for growth

February 15, 2011 | Bernie Monegain, Editor

OREM, UT – Providers report a demonstrable return on their speech recognition dollars, according to a new report from KLAS. Participants of the study indicated benefits of speech recognition such as staff reductions, improved report turnaround times and increased physician satisfaction.

"The speech recognition market is ripe for healthy growth," said Ben Brown, author of the report. "Currently, less than one in four hospitals use the technology, however, in light of meaningful use and the benefits providers point out in this study, we expect it will assume a more prominent place in the role of clinical documentation."


HHS 2012 budget seeks increase in health IT funds

By Mary Mosquera

Tuesday, February 15, 2011

The administration has requested $57 million for the Office of the National Coordinator for Health IT in the proposed budget for fiscal 2012, a 37 percent increase on the amount it received in 2010.

ONC would also receive additional funds from other sources, such as reimbursements from the Public Health Service Act, for a total of $78.4 million in 2012 compared with $60.5 million in 2010, according to the Health & Human Services Department.


Monday, February 14, 2011

Detailed Clinical Models

As the PCAST Workgroup ponders the meaning of a Universal Exchange Language and Data Element Access Services (DEAS), it is exploring what it means to exchange data at the "atomic", "molecular", and document level. See Wes Rishel's excellent blog defining these terms. For a sample of my medical record using one definition of an atomic form, see this Microsoft Healthvault screenshot. It's clear to me that if we want to exchange structured data at a level of granularity less than an inpatient/outpatient/ED encounter, we need to think about detailed clinical models to specify the atoms.

As I've discussed previously, it would be great if EHRs and PHRs with different internal data models could use middleware to exchange a reasonably consistent representation of a concept like "allergy" over the wire. I think of an allergy as a substance, a precise reaction description, an onset date, a level of certainty, and an observer (a clinician saw you have a severe reaction verses your mother thought you were itchy). PHRs often have two fields - substance and a severe/minor indicator. Any EHR/PHR data exchange without an agreed upon detailed clinical model will lose information.


80% of Recalled Medical Devices Got Little FDA Scrutiny

Cheryl Clark, for HealthLeaders Media , February 15, 2011

Of 113 medical devices recalled by the FDA between 2005 and 2009 because they were dangerous, 81% had been cleared under a lenient process reserved for devices deemed "substantially equivalent" to others already approved, revealing "critical flaws" in the federal review system.

That's the conclusion of a report in Tuesday's Archives of Internal Medicine that evaluated each medical device. The researchers discovered that these recalled cardiac and other devices were approved without clinical trials or higher levels of scrutiny under 510(k) protocols in which they were deemed similar enough to an already approved device and a few were exempt from the approval process entirely.

"These devices did not undergo clinical testing or premarket inspections, nor were postmarket studies required to determine safety and efficacy," as they would have under the U.S. Food and Drug Administration's higher level "premarket approval" or PMA process that requires clinical testing and inspections, wrote Diana Zuckerman of the National Center for Women & Families.


Parks Associates forecasts U.S. Digital Health Industry to triple in total revenues by 2015

Mobile technologies motivate growth in digital health

U.S. revenues from digital health technology-enabled solutions and services will exceed $5.7 billion in 2015, fueled by chronic-care monitoring solutions, senior aging-in-place services, and connected wellness and fitness apps and programs, a new industry report from Parks Associates forecasts.

According to Delivering Quality Care to the Digital Home: 2010 Update, industry revenues in 2010 hit $1.7 billion, and the projected compound annual growth rate (CAGR) for the next five years will be 27%. Mobile broadband will be a key growth driver as many emerging health devices and services rely on high-speed connectivity to track vital signs or enable interactive features.


NQF converting to electronic quality measures

By Paul Barr

Posted: February 15, 2011 - 12:00 pm ET

The National Quality Forum has released 113 NQF-endorsed measures of healthcare performance in an electronic "eMeasure" format.

HHS requested the conversion of the measures to an electronic format from a paper-based format to ensure that they comply with the information technology provisions of the American Recovery and Reinvestment Act of 2009. The goal is to make the performance measures "more easily readable by electronic health-record systems," according to a news release from the Washington-based NQF.


Taking up a challenge

Joseph Conn Blog

In early December, the President's Council of Advisors on Science and Technology uncorked a 108-page report recommending some new wrinkles for the federal government's healthcare information technology program.

Thus far, the council's report, subtitled "The Path Forward," (PDF) has shown remarkable legs.

Whether it will have the entire healthcare industry trudging off in the council's newly recommended direction remains to be seen. We should know more after a two-day hearing beginning Tuesday before a first-of-its-kind joint hearing of the federally chartered Health IT Policy and Health IT Standards committees and the work group established specifically to review and address the PCAST report.


Providers offer ideas for PCAST exchange goals but balk at burden

By Mary Mosquera

Thursday, February 17, 2011

Providers could begin to share immunization data with a state registry as a way of demonstrating how health information exchange could work in the next iteration of meaningful use criteria, health IT experts suggested this week.

That would an example of how to begin to realize the goals set out in a December report from the President’s Council of Advisors on Science and Technology (PCAST) , in line with ideas the Office of the National Coordinator for Health IT is seeking to foster more complex data exchange.

ONC held a two-day hearing Feb. 15 and 16 to gather information for how to put the PCAST goals into practice.


PCAST report criticism abounds at hearing

By Joseph Conn

Posted: February 16, 2011 - 12:00 pm ET

Witnesses testifying at a daylong hearing in Washington on Monday protested that a proposed shift to a Web-based architecture for information exchange was simply too much change, too soon.

Hosting the hearing were three key federal advisory panels—the Health IT Policy Committee, its sister panel, the Health IT Standards Committee, and a work group they both constituted to study the recommendations that the President's Council of Advisors on Science and Technology made in a 108-page report (PDF) on the federal health IT promotional program.

PCAST recommended that the federal government push harder toward achieving advanced interoperability of electronic health-record systems by including requirements for information exchange in the Stage 2 criteria for meaningful use of EHR systems. Stage 2 criteria are set to take effect in 2013. The council also recommended applying federal pressure toward creating and adopting a common computer language for information exchange based on a to-be determined dialect of Web-oriented, extensible markup language, or XML.


Telemedicine: The Case for Acting Sooner Rather Than Later

Gienna Shaw, for HealthLeaders Media , February 15, 2011

For this month's HealthLeaders magazine cover story I interviewed a number of healthcare organizations that are using remote health technologies to improve efficiency, respond quickly to emergencies, and open up new streams of revenue. Many of those I interviewed said telemedicine isn't just as good as being there—it's better. And although the technology is hardly widespread, it does show signs of growth, according to HealthLeaders Media's annual industry survey. Nearly half (46%) of respondents said they have one or more telemedicine programs in place. Another 41% say they'll have one in place in one to five years.

Advancing technology—the availability of faster and more reliable networks, wireless devices, high-definition digital images and video, and the ubiquity of mobile devices—is creating a foundation for a system of virtual healthcare where neither patient nor caregiver need be in the same place—or even in a clinical setting at all.


Security breaches of personal health information widespread

February 11, 2011 — 4:59pm ET | By Ken Terry

Hackers and other malefactors steal a surprising amount of personal health information by breaching computer security. Between August 2009 and December 2010, the electronic health records of more than 6 million individuals were compromised, and 61 percent of those security breaches were the result of malicious intent, according to Redspin, a leading provider of HIPAA risk analysis and IT security assessment services.

The Redspin report focuses only on breaches involving more than 500 people, which must be reported to the Department of Health and Human Services under the breach notification provision of the HITECH Act. So it's likely that far more than 6 million people actually had their personal health information compromised, and that's just during the study period.


Public health IT still getting the short end of the stick

February 11, 2011 — 3:20pm ET | By Ken Terry

From the inception of the government's health IT program in 2004, one of its major goals has been to increase the country's emergency preparedness and the ability of public health agencies to monitor incipient epidemics. But this is one area where the reality has fallen far short of the vision.

The good news is that the Department of Health and Human Services has finally allocated $137 million for public health infrastructure, including new technology and staff training, as part of an overall investment of $750 million for disease prevention efforts.

But this overdue move follows years of federal and state neglect of public health agencies' IT capabilities. In fact, according to the Government Accountability Office, HHS still hasn't developed a strategic plan to build a national electronic network for public health emergencies, four years after Congress ordered it to do so.


Five ways health IT will reduce the cost of care

February 10, 2011 | Jamie Thompson, Web Editor

Health IT presents many opportunities to dramatically improve healthcare delivery in America, from changing the way healthcare is financed to enhancing efficiency. Jerry Buchanan, account director, healthcare technology and services at eMids Technologies, shares five ways that health IT can cut healthcare costs in the long term.

1. Improved standards of care

Analyzing data collected by electronic health records provides the best treatment methods, leading to a healthier population. "Whether this data is combined with financial data to analyze cost effectiveness or not... is tangential to the overall goal of knowing the best way to handle treatment for each individual patient," Buchanan noted.


Virtual Care

Gienna Shaw, for HealthLeaders Media , February 13, 2011

From the consumer’s point of view, the online clinic Virtuwell has a number of things going for it. Open around the clock, for $40 a patient can go online, answer a series of questions, and receive a diagnosis and treatment plan, including prescriptions as needed, for simple medical conditions. As a business model, it’s helping the Minneapolis–based HealthPartners keep patients with minor complaints out of its busy clinics, and build loyalty and boost more profitable in-person business by driving patients who need advanced care to physician offices.

The virtual clinic was a natural outcome of the EHR technology the organization has been using for the past 10 years, says Kevin Palattao, vice president of patient care systems at HealthPartners, an integrated system that includes a health plan, several clinics, and three hospitals. The organization’s first foray into online care was in 2005, when it began releasing test results to providers and patients simultaneously.


EHRs can help researchers track newborns treated for disorders

By Kathryn Foxhall

Friday, February 11, 2011

The child health center of the National Institutes of Health said it is critical to make available in electronic medical records information on testing and treatment of certain disorders in newborns.

All states require babies to have some level of “newborn screening,” the testing of blood drops taken from the babies’ heals, for multiple disorders for which early treatment can prevent death, disability or mental retardation.

Although states vary somewhat in the disorders for which they require testing, nearly all of them direct screening for over two dozen conditions.


Black Book poll names best EMRs

Written by Editorial Staff

February 11, 2011

Black Book Rankings shared results of a four-month user poll to determine the highest ranked EHR/EMR inpatient organizations for 2011.

Black Book Rankings surveyed more than 30,000 healthcare records professionals, physician practice administrators and hospital leaders. The New York-based technology market researcher employed 18 key performance indicators targeted at ensuring high product and service performance through comparing vendors from the customer experience.


Best EMRs named by Black Book Rankings

February 17, 2011 — 1:35pm ET | By Janice Simmons - Contributing Editor

Following a four-month survey of 30,000 healthcare records professionals, physician practice administrators, and hospital leaders in the information technology arenas, Black Book Rankings has compiled its findings evaluating the highest ranked electronic health and electronic medical records (EHRs/EMRs) for inpatient organizations in 2011.

The New York-based technology market researcher narrowed down its results to the top 20 EHR vendors in each of 10 categories from a field of over 400 qualified healthcare software firms. The company used 18 key performance indicators.


Rational versus rushed

Joseph Conn Blog

First come, first served isn't a bad way to go about handing out some stuff, sometimes.

It works just fine with pie at church picnics, for example.

But give HHS rulemakers some credit for both listening to their critics before issuing a final rule last week and pulling back on a decision to use first-come, first-served as a way to select a small but important cog in the federal health information technology promotional machinery.

Here’s what happening. HHS is setting up a permanent program to select organizations to test and certify electronic health records systems as capable of meeting the meaningful-use requirements of the American Recovery and Reinvestment Act. It also soon will anoint one, independent body to accredit those organizations—there are six now—offering meaningful use testing and certification services.


DoD Seeks Details from EHR Vendors

HDM Breaking News, February 10, 2011

The Department of Defense has kicked into high gear its effort to develop a new electronic heath records system for the Military Health System and is doing so on a fast track.

TRICARE, the DoD heath care program serving active service members, retirees and their families, has issued a request for information for a Web-based electronic health records system, with a submission deadline of 4 p.m. EST on Feb. 18.


Big Breach at NYC Hospitals

HDM Breaking News, February 14, 2011

New York City Health & Hospitals Corp. is notifying 1.7 million patients, staff, employees of vendors and others who received services at two hospitals and two clinics during the past 20 years that some of their protected health information has been breached.


Online healthcare projects planned

by Tran Quynh Hoa

HA NOI — Viet Nam is going to launch its first national e-health plans this year, the Ministry of Health has said.

Director of the Department of Medical Services Administration Luong Ngoc Khue told Viet Nam News that a national telemedicine service and a synchronous electronic medical records system would be set up in four years' time under the plans.

The telemedicine service was awaiting approval from the Minister of Health and the Prime Minister and the blueprints for the records system would be completed soon, he said.

The telemedicine project would connect all central hospitals and many provincial hospitals across the country using video conferencing technology.


Former commissioner: Countries have to take 'ownership' of e-health

Published: 14 February 2011

Across Europe, national and local governments are experimenting with e-health initiatives to help relieve demand for healthcare services. But many challenges remain, says David Byrne, who served as the EU's health commissioner from 1999-2004.

David Byrne was the EU's health commissioner from 1999 to 2004. He is currently a patron for Health First Europe, a non-profit alliance of the medical technology industry, healthcare workers, patient groups and experts.

He was in Brussels last week to meet with members of the European Parliament about patient access to e-health.

He was speaking to EurActiv's Noelle Knox.


Monday, February 14, 2011

Small Calif. Company Center Stage in Data Exchange

Will Ross speaks geek, but doesn't consider himself one.

"I'm bilingual. I understand conceptually enough of health IT to be able to be a translator. I can figure out how to get things done."

Ross is project manager for Redwood MedNet, a small company in rural Mendocino County, Calif., about to launch the state's first contribution to the national Direct Project for electronic health information exchange. Involved since the project began March 1, 2010, Ross said the Direct Project -- an updated, distilled version of the Nationwide Health Information Network -- offered his company a rare chance to participate with the big guys.


Does E-Health Stand a Remote Chance?

Gienna Shaw, for HealthLeaders Media , February 13, 2011

Kathleen Webster, MD, had her keys in her hand and was on her way out the door—about to make the 30-minute commute to the Loyola University Medical Center in Maywood, IL, where she is the director for pediatric critical care and the medical director for the pediatric ICU—when a nurse called to say one of her patients had arrested. “Get the cart and bring it into the room,” Webster said. The nurse was bemused—of course the code cart was already in the patient’s room.

“Not the code cart,” Webster said. “The telemedicine cart!”

Instead of racing to the hospital while talking to the care team on her cell phone, Webster opened up her laptop and was at the bedside—virtually—in minutes. “I can do everything but touch the patient,” she says. “I see a lot of the studies that say telemedicine is equivalent to being there. But I actually think there is a case for saying at times telemedicine is better than being there.” It’s faster and easier (and safer than driving and talking on the phone). And a high-definition monitor and digital stethoscope allow her to see and hear better than she could if she were in the room.