Monday, May 28, 2012

Weekly Australian Health IT Links – 28th May, 2012.

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

We are rapidly heading to the time when the NEHRS (PCEHR) rubber actually hits the road. As the time approaches we are seeing more and more concerns in a range of areas from implementation support, value to practitioners, safety and functionality among other things.
It is my feeling that the launch will be utterly drowned out by the commencement of the Carbon Tax which I am sure will cause all sorts of noise and carrying on at a political level. We will need to wait a while to see what the real outcomes are and to see if the fear-mongering was justified or not.
Otherwise it seems to me with the comments on the PCEHR and Medicare Locals from the Opposition that we are rather entering some contested times for e-Health in general and that it is a pity we could not be undertaking sensible e-Health developments in a bipartisan fashion.
It might just be that the Government approach has been so flawed that this is simply not possible for the Opposition and I can certainly understand a position of that sort. Maybe if we had taken a more bipartisan approach years back we might have got a good deal further long before now?
To see how far all this has come un-stuck you only have to go and read the 19 page document on the PCEHR from the National Health and Hospital’s Reform Commission.
Go here to browse (if you missed yesterday's blog):
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The personally controlled electronic health record (PCEHR) – decision time approaching for general practitioners and practices

As general practitioners (GPs), every day we see patients falling through the cracks in our fragmented health system. As GPs working in primary care we understand better than any other healthcare sector that without improvements in e-health and medical information management systems we will continue to see our patients exposed to unnecessary risks, including adverse events and medication errors. That is why to date the College has been strongly supportive of the development of a shared electronic medical record.
A shared electronic medical record has the potential to improve our patients’ health outcomes and their experience of the healthcare system.
Savings to the health system will be achieved through a shared electronic medical record. These savings will be achieved from better medicines management and through reduced unnecessary duplication of tests and referrals. Our Health Minister has described it as, “a long-term return of $11 billion for a government investment which includes around $465 million over the last two years, and another $233 million in the next two”[1].
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RACGP wary of PCEHR roll out

22 May, 2012 Kate Cowling
Just weeks before the launch of the PCEHR, the RACGP has reaffirmed its support for a shared electronic medical record, but echoed the lingering concerns of some members.
In a memo to members, RACGP president Professor Claire Jackson says an online record would save the health system significantly, but only if a “national approach” is adopted and a few issues ironed out.
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50% won’t sign up for PCEHR

21 May, 2012 Michael Woodhead
Six weeks away from its launch, only one in ten people have heard of the PCEHR, and 50% of consumers say they won’t sign up for it, a survey has found.
In findings to be presented at the National Medicines Symposium this week, a survey of 203 consumers found that only 9% were aware of PCEHR.
And while almost 60% agreed with the implementation of the personally-controlled electronic health records system, only 50% said they would sign up to have a PCEHR themselves.
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Thousands sign up to 'wotif.com' for doctors

Rhianna King
May 24, 2012 - 8:49AM
A WA website which allows patients to view GP availability across the city and book appointments online has resulted in 3,000 booking in three months alone.
The Australian-first service is now being rolled out across the country after it proved a success with patients who weren't prepared to wait for an appointment.
Perth GP Marcus Tan, the medical director of the Healthengine.com.au site, said it acted like a "wotif.com for doctors".
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GPs to access patient’s prescription histories

22nd May 2012
BEGINNING in July, GPs around Australia will be able to access a patient’s entire prescription history during consultation, as part of a bid to curb doctor shopping and improve quality use of medicine.
Along with detailed information on doses and types of drugs a patient has been prescribed, they’ll receive alerts if there’s evidence of drug dependency, a conference has heard.
The real time reporting software, called DORA, is already being piloted successfully in Tasmania at five general practices, Dr Adrian Reynolds, clinical director of Tasmania’s Drug and Alcohol Services, told attendees at the Royal Australian and New Zealand College of Psychiatrists congress in Hobart yesterday.
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eHealth to save $11bn for budget

David Ramli
The federal government has claimed its troubled electronic health programs will save more than $11 billion over the next 15 years as it guns for a budget surplus.
Health Minister Tanya Plibersek made the comments during a speech to the Committee for Economic Development of Australia in Melbourne last week.
“The national eHealth records system will mean better, more efficient, more convenient healthcare,” she said. “We estimate eHealth will save the federal government around $11 billion over 15 years. However you look at it, that’s pretty good bang for your buck.”
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New rules for e-health PIP revealed

21 May, 2012 Sarah Colyer
New details have emerged showing what GPs must do to avoid losing e-health practice incentive payments worth up to $50,000.
Under changes to come into effect next February, practices seeking the incentive payments will be forced to sign up for the personally controlled electronic health record (PCEHR) system and meet several conditions.
These will include showing they have the capacity to upload event summaries and shared health summaries - which will include a list of patients' diagnoses, medications, adverse reactions and allergies, and are meant to be used by hospitals, after-hours services and other health professionals.
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Money woes cause GP PCEHR moans

General practitioners are increasingly worried about the looming July 1 deadline for the introduction of the personally controlled electronic healthcare record (PCEHR). Among the issues concerning them are data governance standards, along with remuneration issues associated with creating and maintaining a patient’s PCEHR.
“Members are worried about the extra workload,” Royal Australian College of General Practitioners president Professor Claire Jackson told eHealthspace.org in an interview.
“They are concerned about resourcing at a practice level, and the people power needed,” she said. “They need more than five weeks to prepare. GPs are the ones who are doing the heavy lifting in the ehealth system.”
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PCEHRs will be kept for 30 years after death

24 May, 2012 Paul Smith
Patient clinical information in e-health records will be held by federal bureaucrats for 30 years after the patient’s death — even if the patient has “deactivated” their records.
The government is expecting millions of patients to eventually sign up for personally controlled electronic health records (PCEHR) after the system is rolled out from July this year.
But it has emerged that even if the patient deactivates their records — which will include health summaries, diagnoses, treatments, event and discharge summaries — the e-health record and its contents will not be deleted from the system.
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GP security vital to e-health success: NEHTA

But security, funding concerns remain unanswered.

Former iSOFT Australia managing director Denis Tebbutt has urged general practitioners to better collaborate with the Government's lead e-health body to ensure success of the personally controlled electronic health record (PCEHR).
The $628.3 million initiative, scheduled to go live on July 1, allows Australians to opt into a shared electronic health record, providing information to authorised GPs and doctors on one's personal history and medication.
The records would be stored on a federated cloud of repositories operated nationally, in states and territories and at large hospitals.
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BUDGET Review 2012-13 Index

E Health
Dr Rhonda Jolly
In the 2010–11 Budget the Government committed funding in of $466.7 million over two years to establish key components of a person-controlled electronic health record system (PCEHR).[1] While there was some strident opposition to the idea of a PCEHR, based on concerns about issues such as the security and privacy of records in the system, most health stakeholders initially expressed cautious support for the idea of electronic health records. This was because it was generally agreed that these records could save lives and help limit escalating health expenditure.[2] From the beginning, however, many stakeholders doubted whether the amount of funding allocated by the Government would be sufficient to deliver promised outcomes.[3]
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Troubled HealthSMART System Finally Cancelled in Victoria Australia

POSTED BY: Robert N. Charette  /  Mon, May 21, 2012
 The Victorian state government finally decided last week to throw in the towel on the nearly decade-long implementation of its HealthSMART e-health record system project after recognizing that the "e" actually stood for an "extravagance" it could no longer afford.
In 2003, Australia’s Victorian government embarked on an ambitious modernization of the state’s health IT infrastructure. The idea was to combine its health-related financial systems with its patient record management systems through the creation of a comprehensive, Victoria-wide electronic health record (EHR) system. The original HealthSMART project budget was $A323 million and a completion date was set for June 2007. However, by the end of 2007, while some 57% of the money had been spent, only 24% of the project had been completed. Projected costs to complete had risen to $A427 million, and a roll out date was estimated to be sometime in late 2009. There was talk at the time of cancelling the project, but the government decided to keep the effort alive given what it believed to be its significant potential benefits.
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Fresh fears over e-health policing plan

23 May, 2012 Sarah Colyer
A redraft of a contract giving bureaucrats powers to enter GP practices and access records has failed to allay the concerns of doctors' groups.
The initial version of contract -- drawn up by the Federal Health Department as a requirement for any GP practice wanting to participate in the national electronic health record system -- was sent back to the drawing board last month after outcry from doctors.
At the time, the AMA, RACGP, medical indemnity groups and the nation's most senior clinical advisor on e-health, Dr Mukesh Haikerwal, all condemned the "search and seizure" powers in the contract, which had been leaked to the media.
But a new draft of the contract -- released to doctors' groups under strict gagging orders prohibiting them from talking about its contents -- has failed to settle the dispute.
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$50 million for Medicare Locals to help rollout eHealth records

18 May 2012
Health Minister Tanya Plibersek today announced $50 million over two years will be made available to Medicare Locals – networks that support frontline health providers – to assist GPs and other health care providers to adopt and use the Gillard Government’s new eHealth records system.
Ms Plibersek said the funding was part of a package to support doctors and other health professionals to help rollout the new system.
“Family doctors co-ordinate healthcare for most patients, so we know they have an important role to play in the eHealth records system,” Ms Plibersek said.
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Medicare Locals get $50m for e-health

By Josh Taylor, ZDNet.com.au on May 21st, 2012
The Federal Government will provide $50 million to Medicare Locals over the next two years, to support the adoption of e-health records from 1 July.
Minister for Health Tanya Plibersek announced the funding on Friday, stating that it will be provided in addition to the $233.7 million set aside in the 2012 Budget for the launch of the personally controlled e-health records (PCEHR). Medicare Locals are networks that help to support frontline health providers.
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Coalition pledge to abolish Medicare Locals

25 May, 2012 Michael Woodhead
Opposition health spokesman Peter Dutton says the coalition will abolish Medicare Locals as part of a drive to reverse Labor’s creation of “multiple health bureaucracies”.
Speaking at the AMA National Conference in Melbourne today, Mr Dutton said Labor had started with good intent in health but had failed to deliver, ignoring most of the health reforms recommended by its own advisory commission.
The only result was the creation of additional bureaucracies such as Medicare Locals, the Independent Hospital Pricing Authority and the Australian Commission on Safety and Quality on Health, he said.
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Web to aid health service delivery

THE internet could soon start to accelerate inter-governmental collaboration on delivery social and health services.
Victoria Health was in the early stages of talks with other states to syndicate content delivered from its highly successful online portal Better Health Channel.

Gerardine O’Sullivan head of BHC said it was recognised that the sites content was costly to reproduce and maintain, and that sharing it with other jurisdictions made sense.
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Health risks for kids online

HEALTH experts say doctors, parents and schools have a crucial role to play in minimising the negative effects of internet pornography on adolescents.
Their comments  follow the publication of an editorial in the MJA that draws on the latest evidence to show how an explosion in the use of sexually explicit online content by young people is affecting their health. (1)
The editorial authors — Dr Rebecca Guy and Professor John Kaldor, both from the Sexual Health Program at the University of NSW, and Professor George Patton, from the Centre for Adolescent Health at the University of Melbourne — said adolescents were now more easily able to engage with pornography than ever before, both by choice and inadvertently. They referred to a comprehensive Australian survey that showed that 28% of 9–16-year-olds had seen sexual material online.
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Queensland Health wins major IT excellence award

QUEENSLAND Health, which had been reeling from massive problems with its payroll system, has hit back by snaring a major industry-wide IT award presented last night at CeBIT.
The excellence in eGovernment awards in information technology were presented at a celebratory dinner last night at CeBIT, a major national information technology show this week at Sydney’s Darling Harbour.
Queensland Health won its eGovernment award for “The Viewer”, a project that has streamlined how clinicians access patient information about their patients.

SA Health's journey to e-health

By Michael Lee, ZDNet.com.au on May 23rd, 2012
Implementing e-health services for an entire state is a daunting task, but, as South Australian Health manager for e-health services, Bill Le Blanc, has revealed, even the preparation steps are complicated tasks.
Speaking at the e-health track of CeBIT's 2012 conference, Le Blanc outlined the process through which SA Health went to transform its state-wide IT systems.
SA Health was forced to reconsider its IT systems and reporting lines because of legislative changes put in place to prepare for e-health records. Reforming the health department was a legislative requirement, relegating return on investment and other commercial considerations to be of lesser importance, according to Le Blanc. He said that the department consequently had to jump into reform headfirst.
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http://www.newcastle.edu.au/news/2012/05/23/epidemic-reporters-needed-for-national-flu-tracking.html

Epidemic reporters needed for national flu tracking
Published: Wednesday, 23 May 2012
The world’s fastest growing online influenza surveillance program is seeking more participants to register their symptoms and help researchers better understand the potentially life-threatening disease.
Flutracking.net, an Australian initiative of researchers from the University of Newcastle and Hunter New England Health, is the second largest program of its kind in the world.
This flu season the program’s organisers are aiming to boost the total number of participants from approximately 12,000 to 15,000 to further increase the accuracy of the community influenza snapshot.

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Clinical Safety

The national eHealth system will improve clinical outcomes, and to do that it needs clinically safe and efficient foundations. That’s why the clinical safety and integrity of NEHTA’s products guides everything NEHTA does as an organisation.
There are three key clinical quality and safety processes in NEHTA, the Clinical Safety Unit; the Clinical Safety Working Group and the Clinical Governance Review Board, each ensuring safety.
.....
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NCTIS Newsletter

Welcome to Edition 4 of our NCTIS Newsletter of 2012. We have exciting news about recent and upcoming events as well as information about recent product releases to share with you.
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Privacy Act changes finally introduced to parliament

The government has introduced reforms to the Privacy Act, after releasing its initial response to the ALRC inquiry over two-and-a-half years ago
Reforms to the Privacy Act 1988 have finally been introduced to parliament, six years after the Australian Law Reform Commission (ALRC) began its inquiry.
The reforms are part of the government's first stage response to the ALRC inquiry, which began in 2006.
The changes introduced to parliament include: Increased regulation of personal information for marketing purposes; extending privacy protections to unsolicited information; restrictions on sending personal information to overseas companies; improved access for consumers to information held about them; and an increased protection of personal e-health information.
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Intel researching computers that mimic human brain

Tova Cohen
May 25, 2012
Intel is launching research in Israel into technology that mimics the human brain and develops devices that "learn" about their user.
"Machine learning is such a huge opportunity," Justin Rattner, Intel's chief technology officer, told reporters in Tel Aviv.
"Despite their name, smartphones are rather dumb devices. My smartphone doesn't know anything more about me than when I got it," he added.
"All of these devices will come to know us as individuals, will very much tailor themselves to us."
The research, to be carried out by the Intel Collaborative Research Institute for Computational Intelligence along with specialists from the Technion in Haifa and the Hebrew University in Jerusalem, is aimed at enabling new applications, such as small, wearable computers that can enhance daily life.
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NBN struggles to connect

John McDuling

KEY POINTS

  • NBN Co will deliver a revised business plan next week.
  • Chief executive Mike Quigley says the rollout allows for a change of policy after the next election.
NBN Co chief executive Mike Quigley will admit tonight the $36 billion national broadband network faces significant construction challenges as he prepares to lower official connection forecasts.
Mr Quigley is expected to tell MPs that the government business enterprise is struggling to cope with obligations to roll out fibre to greenfield developments in remote areas, during what could be an explosive Senate estimates hearing.
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The nasties of the net

Matthew JC Powell
May 20, 2012
The innocent choice to click could send your computer into a crash.
As users of technology, we're constantly bombarded with warnings about the malicious things malicious people try to do to our computers. The malicious software they use to do this has a name: malware.
Malware comes in many forms, with names meaning subtly different things. What they do, how they can affect you and how they can be avoided need not be complicated. Along with malware, there are different types of attacks for different gains.
On the theory that a little bit of knowledge can make a big difference, here's just a few of the more important terms to know.
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Chrome dethrones IE as king of browsers

Peter Pachal
May 22, 2012 - 8:50AM
Chrome has just edged out IE, according to the latest stats.
This post was originally published on Mashable.
Google's Chrome web browser just passed Microsoft's Internet Explorer to become the most-used browser in the world, says the latest data from a digital analytics service.
Although Chrome has edged out IE before for short periods, the last week marks the first time Chrome was the No. 1 browser for a sustained period of one week. Exactly 31.88 per cent of the world's web traffic was done on Chrome, according to StatCounter, while IE is a close second at 31.47 per cent.
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Enjoy!
David.

AusHealthIT Poll Number 123 – Results – 28th May, 2012.

The question was:
How Likely Do You Think It Is That The NEHRS (PCEHR) Will Suffer The Same Fate As HealthSMART And Ultimately (5 Years) Be Defunded / Cancelled?
No Way
-  4 (8%)
Unlikely
  11 (23%)
Neutral
-  0 (0%)
Likely
-  14 (29%)
Virtually Certain
-  18 (38%)
Votes 47
There is a pretty clear view here that we won’t have a NEHRS that is operational in five years from now. Two thirds of respondents see it as likely or more to be cancelled.
Again, many thanks to those that voted!
David.

Sunday, May 27, 2012

The Person-controlled Electronic Health Record. From Recommendation To Reality NOT!

I thought it would be useful to have a close look at where the NEHRS (PCEHR) sprang from and just how poor the thinking around its conception was. Here are the key message and the recommendations of an amazingly short 16 page document (removing the duplicated recommendations) that started all this:
The document is date 30 April 2009 and can be downloaded in full from here:
This document is a late addendum to the Interim Report of the National Health and Hospitals Commission and was released just before the final report in June 2009.

 Person-controlled Electronic Health Records

 Key messages

o   Health care is knowledge intensive. The timely and accurate communication of pertinent, up-to-date health details of an individual can enhance the quality, safety and continuity of health care.
o   Current health information systems are disjointed, which often results in health care professionals operating with incomplete or incorrect patient information. It is estimated that up to 18 per cent of medical errors are a result of inadequate availability of patient information.
o   As technology, work practices and medical knowledge continue to evolve in the coming years, the complexity of health care interactions will become greater, which means the need to document and readily access a patient’s health profile will become more critical.
o   A person-controlled electronic health record would enable people to take a more active role in managing their health and making informed health care decisions.
o   Investment in health IT lags well behind that of other information-centric consumer industries such as the financial and telecommunication industries, which have invested heavily over the last 20-30 years to achieve global connectivity.
o   According to recent research commissioned by the National Electronic Health Transition Authority (NEHTA), 82 per cent of consumers in Australia support the establishment of an electronic health record (EHR).
o   The implementation and widespread use of information technology in the health sector (e-health) is one of the most important enablers of personal health management and quality health care.
o   The overall economic benefit from increased productivity and reduced adverse events that would be achieved with a national individual electronic health record in Australia has been estimated to be between $6.7 billion and $7.9 billion in 2008-09 dollars over 10 years.
o   The protection of privacy and confidentiality is a key factor in winning widespread community acceptance and uptake of electronic health records.
o   Health providers and the IT industry must work together to develop open, nationally-agreed standards for the secure electronic capture and storage of personal health information.
o   The essential role of governments in a new e-health environment is to protect the public’s interest through legislative reform and ensuring people retain control over who has access to their personal health information.
Here are the recommendations.

Recommendations

1. We propose that, by 2012:
  •  every Australian should be able to have a personal electronic health record that will at all times be owned and controlled by that person;
  •  every Australian should be able to approve designated health care providers to have authorised access to their personal electronic health record; and
  •  every Australian should be able to choose where and how their personal electronic health record will be stored, backed-up, and retrieved.
2. We propose that the Commonwealth Government legislate to ensure the privacy of a person’s electronic health data, while enabling secure access to the data by the person’s authorised health providers.
3. We propose that the Commonwealth Government must introduce:
  •  unique personal identifiers for health care by 1 July 2010;
  • unique health professional identifiers (HPI-I), beginning with all nationally registered health professionals, by 1 July 2010;
  •  a system for verifying the authenticity of patients and professionals for this purpose - a national authentication service for health (NASH) - by 1 July 2010; and
  • unique health professional organisation (facility and health service) identifiers (HPI-O) by 1 July 2010.
4. We propose that Australian governments drive the national development of open technical standards for e-health, and that they secure national agreement to open technical standards for e-health by 2011-12. These standards should include key requirements such as interoperability, compliance and security. The standards should be developed with the participation and commitment of industry, health professionals, and consumers.
5. We propose that the Commonwealth Government develop and implement an appropriate national social marketing strategy to inform consumers and health professionals about the significant benefits and safeguards of the proposed e-health approach.
6. We propose that significant funding and resources be made available to extend e-health teaching, training, change management and support to health care practitioners. The commitment to, and adoption of, e-health solutions by health care providers is key to the success of a person-controlled electronic health record.
7. We propose that the Commonwealth Government mandate that the payment of public and private benefits for all health and aged care services be dependent upon the provision of data to patients, their authorised carers, and their authorised health providers, in a format that can be integrated into a personal electronic health record, such that:
  • hospitals must provide key data, such as referral and discharge information, by 1 July 2012;
  • pathology providers and diagnostic imaging providers must provide key data, such as reports of investigations and supplementary information, by 1 July 2012;
  • other health service providers - including general practitioners, medical and non-medical specialists, pharmacists and other health and aged care providers - must transmit key data, such as referral and discharge information, prescribed and dispensed medications and synopses of diagnosis and treatment, by 1 January 2013; and
  • all health care providers must be able to accept data from other health care providers by 2013.
---- End Extract.
With a month to go it is clear we are nowhere near what was envisaged a little over 3 years ago and funded to the extent of almost $1/2 billion 2 years ago.
As you read the document it seems clear to me there is confusion about just what is being recommended and what it will do.
As always the Key Messages includes problems with information access and flows causing problems but totally lacks any clarity on just how much of the problem will be fixed by what is being proposed.
It is always good to also know that 82% of the public support something that they have no clear idea as to exactly what it is - like an EHR and I won’t even comment on the benefits claimed as they were claimed in the absence of any understanding as to what the system might actually do.
As far as the recommendations and the time frames suggested they do seem just a little ambitious (verging on fantasy even). (According the .pdf the author of the document is Peter one Broadhead who is an executive in DoHA who was involved in the NHHRC process but is now not even apparently associated with e-Health (if Google is to be believed) - smart man is all I can say.)
I will note in passing NASH is still not there, identifiers are not used by the majority of patients or practitioners, hospital are not ready to transmit information to repositories and there is hardly any planned personal control of where an individual’s information is held. And just how does one ‘own’ a clinical record that is in the hands of the Government?
Essentially the PCEHR is a thought bubble that has drifted off the reservation and will never deliver what was intended then and even what was planned when funding was allocated. It really is a model bureaucratic implementation fiasco.
David.

Senate Estimates Hearings On E-Health Are Being Held 30th May 2012. Will Be Interesting.

As of Sunday May 27 2012 here is the program:

WEDNESDAY, 30 MAY 2012

Health and Ageing Portfolio

Department of Health and Ageing (DoHA)

7:15pm – 8:15pm

Outcome 10 Health System Capacity and Quality

Program 10.2: e-Health Implementation
National e-Health Transition Authority (NeHTA)
The link to the page is found here:
Here is the link to access the hearings and outcomes
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Live broadcasts
Senate estimates hearings are broadcast live over the Internet. Details can be found here.
Hansard transcripts
·         To view the current transcript production status of Senate Legislation Committees considering estimates see the Estimates Transcript Schedule.  
·         To view published Hansards please visit Parlinfo.
----- End Extract.
Enjoy the hearing. Doubtless I will have a few words to say later in the week.
David.

Saturday, May 26, 2012

Weekly Overseas Health IT Links - 26th May, 2012.

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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National report shows surge in e-prescribing among health practitioners

By Erin McCann, Associate Editor
Created 05/17/2012
ARLINGTON, VA – By the end of 2011, 58 percent of office-based physicians were using e-prescribing, with solo practitioners contributing the most significant growth, according to Surescripts, which released today “The National Progress Report on E-Prescribing and Interoperable Healthcare Year 2011.”
Included in the report is data analysis that documents the prevalence of e-prescribing adoption and use in the United States from 2008 through 2011.
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ONCHIT programs that assess HIT individual competence

Author Name : Stephen C. Burrows, DPM, MBA   |   Date : May 17, 2012
Many health professions have a mechanism for certifying individuals as to their knowledge and competence. While there have been a few to certify individuals in the field of healthcare information technology (HIT), none have dominated the field.
As part of a nationwide strategic plan for advancing the use of healthcare IT, Congress passed the HITECH Act and provided a significant amount of grant money for a number of initiatives. Included is a knowledge assessment program for HIT Professionals known as the Competency Examination Program. According to the ONCHIT, this program will “enable health IT professionals, employers, and other stakeholders to assess their own health IT competency levels or the competency of their health IT staff members, as appropriate.”
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New HL7 program seeks to spur EHR participation

By Erin McCann, Associate Editor
Created 05/17/2012
ANN ARBOR, MI – Health Level Seven International (HL7) announced Wednesday the inception of its pilot membership program and launched a website aimed at increasing caregivers’ participation in the development of electronic health record (EHR) standards.
"For several years, the HL7 leadership has voiced its concerns about the typical first encounter with the standards development process,” said Charles Jaffe, MD, CEO of HL7. However, he added, “Now we are in a better position to translate the practical clinical expertise of these caregivers into tangible improvements in the interaction with the health record technology."
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Experts get creative in protecting patient IDs in audit trails

May 18, 2012 | By Ken Terry
A body that advises the state of Massachusetts about health information exchanges has devised an unusual approach to maintaining the privacy of patient information while allowing the use of audit trails.
In a recent blog post, John Halamka, CIO of Beth Israel Deaconess Medical Center in Boston, explained that the technology workgroup of the Massachusetts State HIE Advisory Committee recently grappled with an issue that arises from the use of the Direct secure messaging protocol: When one provider sends a Direct message to another, it is surrounded by an electronic "envelope" that contains key information about senders, receivers and content in the form of metadata. While unauthorized parties cannot access that information, it is also unavailable for audit purposes.
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Hospitals enlist vendors for data analytics help

By Susan D. Hall
Created May 17 2012 - 11:55am
Providers are increasingly turning to big tech companies to help their data mining efforts, according to an article [1] at Bloomberg Businessweek.
Vendors such as Microsoft, SAS, IBM and Oracle are giving mounds of data the once-over in an analytics industry that generated more than $30 billion last year, according to research firm IDC. That figure is expected to grow to $33.6 billion in 2012--and healthcare is a leading customer.
The article gives some enticing examples.
For example, a hospital in Washington, D.C., called in Microsoft to help look at readmission rates--the data helped pinpoint the infected room.
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Google ranks high for health research, but all search engines lacking

By mdhirsch
Created May 17 2012 - 12:04pm
The top four search engines all provide "rich" health and medical information, but none of them stand out as the best, according to a new study [1] published in the Journal of Medical Internet Research.
The researchers, from the University of Missouri and China, compared the top four search engines--Google, Bing, Ask.com and Yahoo!--for usability and search validity. They noted that most people use just one search engine when conducting research on a health-related topic, and then view the websites only on the first page of the search. The researchers wondered if this was the best way to obtain information.
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JAMIA: Why do some providers use HIEs and others not?

Written by Jeff Byers
May 15, 2012
Understanding end users' perspectives towards health information exchange (HIE) technology is crucial to the long-term success of HIE, according to researchers from Vanderbilt University School of Medicine in Nashville, Tenn., who developed an in-depth understanding of HIE usage by applying qualitative methods.
Publishing their findings in the May edition of the Journal of the American Medical Informatics Association, Kim M. Unertl, PhD, department of biomedical informatics at Vanderbilt Implementation Sciences Laboratory, and colleagues conducted an ethnographic qualitative study from January to August 2009 in six emergency departments (EDs) and eight ambulatory clinics in Memphis, Tenn.
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Diabetes mobile app bolsters role of pharmacists in patient adherence

Posted By Stephanie Baum On May 16, 2012 @ 5:48 pm In MedCity News eNewsletter,SYN,  
One of the most significant factors influencing healthcare costs is patient adherence [1]or lack thereof. If diabetes patients don’t take their medications, watch what they eat and monitor their blood-glucose levels, they risk complications that can lead to hospitalization.
A semifinalist in Sanofi US’ (NYSE:SNY) Data Design Diabetes Innovation Challenge [2], iRetainRx [3] believes it can overcome that challenge by providing a cloud-based system to help patients and caregivers connect with pharmacists and providers. Using a mobile device such as a computer, iPad or smartphone, they can get a video link to their pharmacist to get answers to questions and pharmacists can call attention to issues such as risky drug interactions.
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Thursday, May 17, 2012

A Look at Social Media in Health Care -- Two Years Later

by John Sharp
Two years ago I wrote an iHealthBeat Perspective, titled, "Social Media in Health Care: Barriers and Future Trends." Let's take a look at how far we have come and whether my predictions are on target.
Online Communities and e-Patients
Since 2010, pharmaceutical companies have joined startups, patient communities and providers in the social media realm. Many startups, particularly those enabling patient communities, have matured and broadened their scope. PatientsLikeMe has expanded to more than 1,000 conditions, CureTogether has gained the attention of major press outlets and 23andMe is defining personal genomics.
In addition, both PatientsLikeMe and 23andMe have published results in medical journals, bringing further validation to social networks and social media as having legitimate contributions to medicine. A PatientsLikeMe study, titled "Perceived Benefits of Sharing Health Data Between People With Epilepsy on an Online Platform," was published in the journal Epilepsy and Behavior, and a 23andMe study, titled "Efficient Replication of Over 180 Genetic Associations With Self-Reported Medical Data," was published in  PLoS One, as well as the Journal of Medical Internet Research.
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Data-Mining in Doctor's Office Helps Solve Medical Mysteries

By Jordan Robertson on May 15, 2012
When hospitals turn to Microsoft Corp., it's no longer just for the latest office software. Some are asking the technology giant for help in diagnosing their patients.
In one instance, a hospital in Washington, D.C., asked Microsoft to examine its medical records to determine why certain patients were getting sick soon after being discharged. The company crunched the data from MedStar Washington Hospital Center and found something surprising: Patients who stayed in the same room had come down with the same infection.
"There was a bug in the room -- people were getting infected," Scott Charney, vice president of Microsoft's Trustworthy Computing group, said recently at a security conference. Such infections are often caused by bacteria on medical instruments or furniture.
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No 'bubble' for healthcare IT, analysts say

By Larry McClain, Contributing Writer
Created 05/16/2012
NASHVILLE, TN – Leading financial analysts scoffed at the notion of a healthcare IT “bubble” that could slow the pace of mergers and acquisitions this year. Speaking on a panel called “Financing The Deal” at the Nashville Health Care Council, they predicted that 2012 M&A activity would be brisk, though not superheated.
In the health IT sector, there’s currently a glut of buyers and not enough companies to acquire. There are many non-healthcare players like Lockheed-Martin wanting to buy healthcare IT companies – and many suitors for a limited number of clinical decision support companies. “There are still a lot of great opportunities for technology-enabled healthcare companies with a demonstrable ROI,” said David Jahns, managing partner at Galen Partners.
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3M Health Data Dictionary Going Open Source

MAY 16, 2012 12:31pm ET
3M Health Information Systems will release a public version of its Healthcare Data Dictionary as open source software, making it free and available worldwide.
Placing the dictionary, called HDD, in the open source market is part of a contract 3M has reached with the Departments of Defense and Veterans Affairs. The departments will use HDD to enable semantic interoperability for its integrated electronic health record initiative.
Semantic interoperability enables the exchange of data with the meaning of data preserved, such as to normalize test results, which vary depending on the lab doing a particular test and the system it uses.
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Barriers to mainstream genetic tests remain

By danb
Created May 16 2012 - 12:22pm
Although genome sequencing has shown promise as a tool for the type of preventive care that will be necessary for successful accountable care, several drawbacks--such as the potential for over-treatment--remain, according to a Wall Street Journal article [1].
In particular, over-treatment could result from unique genetic variations in each patient that could, at first, raise concerns, but ultimately might not cause any disease, Michael Watson, executive director of the American College of Medical Genetics and Genomics, told WSJ.
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Even opt-in doesn't protect data exchange privacy

By danb
Created May 16 2012 - 1:58pm
The healthcare industry still has room for improvement when it comes to health information exchange privacy, even in states that have an opt-in or opt-out option, according to a recent article [1] from Bloomberg News.
Although not all states are required to tell patients if their medical data is being used, even those that do so aren't necessarily doing a good job, according to the article. In New York, for example, a state with an opt-in option for patients, studies published in March by the state's civil liberties union and the Consumers Union [2] determined privacy "rules of the road" to be undefined, patient education efforts to be weak, and the opt-in effort to be too broad. As it stands, a one-time opt-in allows "blanket permission" by providers to release all medical information.
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May 13, 2012

Exploring the Role of Mobile Technology as a Health Care Helper

By STEPHANIE NOVAK
Two decades ago, a woman having a difficult birth in a Ugandan village would have had few options to get life-saving treatment if there was not a nearby health clinic. But today, mobile technology can help her get advice from a doctor in Kampala over the telephone, alert a community health worker about her situation, or even get her to a hospital.
Mobile technology is changing the landscape of health care delivery across the developing world by giving people who live in rural villages the ability to connect with doctors, nurses and other health care workers in major cities.
“Now, a phone call can compress the time that it would have taken before to come to that decision point and get the woman care more often and quickly,” said Dr. Alain Labrique, a professor of International Health and Epidemiology at Johns Hopkins University, in Baltimore.
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Dr. Farzad Mostashari: 5 things government can do to improve health technology

By Chelsea Conaboy

Globe Staff  
May 15, 2012
What is the government’s role in developing new technology? Some would say to stay out of the way. Dr. Farzad Mostashari, the national coordinator for health information technology, said that’s overly cynical.
But, Mostashari said in an interview, government is no longer the major producer of innovative products and services that it once was, creating things for military purposes or space exploration that work their way into the consumer market.
“That’s not the model anymore,” he said. “The investments in research and development that are going on in the consumer technology space are now dwarfing the investment and innovation that are happening in, say, the military.”
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ONC Announces Creation of CMO Role, Office of Consumer eHealth

May 16, 2012
In a blog post by the National Coordinator for Health Information Technology, Farzad Mostashari, M.D., the Office of the National Coordinator for Health IT (ONC) has announced the creation of the Office of the Chief Medical Officer and an Office of Consumer eHealth. The primary function of the Office of the Chief Medical Officer will be to infuse a clinical perspective across ONC on all activities which have clinical implications. The Office of Consumer eHealth will work on consumer engagement.
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Report: HIEs failing at true interoperability

By Mike Miliard, Contributing Editor
While some $560 million in federal health information exchange funding may soon run dry, changing reimbursement models mean market-driven growth will continue, says a new report on HIEs from Chilmark Research.
Profiling 22 HIE vendors, the study, "2012 HIE Market Report: Analysis and Trends," shows a market that's evolving, making the shift toward serving healthcare organizations of all sizes as they position themselves for payment reform, its authors say.
Increasing HIE technology adoption is spurred by two factors, say researchers. First is the need to meet proposed Stage 2 meaningful use requirements, which put a far greater emphasis on data exchange. More crucially, big changes on the horizon with regard to reimbursement means healthcare organizations are implementing HIE technology to support community-wide care coordination.
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Top 9 fraud and abuse areas big data tools can target

By Roger Foster, Senior director, DRC’s high performance technologies group, and advisory board member of the technology management program at George Mason University
Fraud and the abuse of healthcare services in the U.S. cost an estimated $125-175 billion annually. This represents the second largest component of the $600-850 billion surplus in healthcare spending. Healthcare organizations and government agencies must leverage big-data collections of patient records and financial billing to identify and eliminate system abuses.
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Web First: Q&A with Allscripts CEO Glen Tullman

By Bernie Monegain, Editor
Created 05/15/2012
CHICAGO – In real estate, it’s all about location, location, location, they say. In healthcare IT, you might say it’s about integration, integration, integration. Allscripts CEO Glen Tullman is keenly aware of how critical product integration is, he says, and he’s working on it. It’s the difficulties with integration that seem to have led to the EHR company’s recent troubles – at least it’s what Allscripts customers and analysts mention most often. Then came April 25 and the ousting of Allscripts’ board chairman, which triggered three board members to quit in protest, the departure of its CFO (for reasons unrelated, according to the company) and a dismal quarterly report, all of which led to stock price plunging 44 percent.
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Living in a box

Health minister Earl Howe launched South London and Maudsley NHS Foundation Trust’s MyHealthBox project on Tuesday. Reporter Rebecca Todd went along to hear more about the innovative online patient records scheme.
15 May 2012
“Exciting” was the word of the day for speakers at the launch of MyHealthBox. “Innovative” and “empowering” also popped up more than once as people spoke about why patient controlled records are a good idea.
MyHealthBox uses Microsoft’s HealthVault platform to create a patient record for South London and Maudsley NHS Foundation Trust’s service users.
The online portal can pull data from the trust’s Electronic Patient Journey System and from primary care - and patients can contribute to it themselves.
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Maudsley launches HealthVault-based PHR

15 May 2012   Rebecca Todd
South London and Maudsley NHS Foundation Trust is today launching personal online health records for its patients, using Microsoft’s HealthVault platform.
Director of information strategy, Mike Denis, presented on the MyHealthBox project at the Health+In4matics conference in Birmingham last week.
He told attendees the project was a partnership between the trust, the Institute of Psychiatry and service users. It aims to improve patients’ engagement in their care and the use of outcome measurements across the trust.
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Debate: Can mobile apps achieve what pills can't?

By Susan D. Hall
Created May 15 2012 - 12:47pm
In a pair of point-counterpoint articles [1] at Forbes, contributors Dave Chase and David Shaywitz face off on the question of whether mobile apps could someday be more effective than prescription drugs--a response to health app company Happtique's plans to build a platform for physicians to "prescribe" apps to their patients [2].
Chase, the CEO of patient portal and relationship-management company Avado.com, sounds a dire warning [3] that apps pose a huge threat to a lethargic pharma industry. He likens pharma execs to those of the newspaper industry 15 years ago, who saw the landscape changing around them, but did too little to adapt. 
Chase urges pharma execs to get out of the stands and put more skin in the game in terms of money and people.
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New research disputes claims EHRs improve diabetes care

By Susan D. Hall
Created May 15 2012 - 1:24pm
Contrary to previous research, the use of electronic health records failed to improve care for diabetic patients in a study [1] published in the Annals of Family Medicine.
Robert Wood Johnson Medical School at the University of Medicine & Dentistry of New Jersey researchers compared data from 16 practices in the Northeast that used EHRs and 26 practices that did not, assessing the care for 798 patients.
They found, in fact, that patients at clinics using paper records were more likely to meet all of three targets for hemoglobin A1c levels, low-density lipoprotein cholesterol and blood pressure after two years than those in practices that used EHRs.
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Berwick on Analytics: Technology Is Ready, but Doctors Need Help

Scott Mace, for HealthLeaders Media , May 15, 2012

If Marcus Welby, MD, were practicing on TV today, would he be letting data drive his decision-making? I'm on a journey to find the answer to this and related questions. Last week this journey took me to Atlanta for a HealthLeaders Media Roundtable on business intelligence and predictive analytics, and then onward to North Carolina for a conference dedicated to healthcare analytics.
While in North Carolina, I got to sit down with Don Berwick, MD, former administrator at the Centers for Medicare & Medicaid Services, and prior to that, founding CEO of the Institute for Healthcare Improvement. We talked about data analytics, but our discussion ranged far and wide around healthcare IT. Here is a portion of our conversation.
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7 common myths about data encryption

By Michelle McNickle, Web Content Producer
Created 05/14/2012
Although data encryption is becoming a valuable resource to protect against breached PHI, according to a new report by WinMagic Data Security, certain myths and misconceptions about it still exists. 
"IT professionals, at the enterprise level, frequently turn to encryption for protecting data," read the report. "Although encryption is a proven technology that delivers strong, effective data security, common myths and misconceptions about it persist, even among some people who are generally knowledgeable about computers. All too often, the myths surrounding encryption are based on misunderstanding of the technology or outdated concepts."
The report outlines and debunks seven common myths about data encryption. 
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Defense Department outlines joint EHR plans

Posted: May 14, 2012 - 4:00 pm ET
The Defense Department has released an outline of how the proposed joint electronic health-record system for use by the Military Health System and the Veterans Affairs Department's healthcare organization is to be developed.
The 55 page report (PDF), "Department of Defense Enterprise Architecture to Guide the Transition of the DoD Electronic Health Record, and Related Matters," was submitted to Congress by Dr. Jonathan Woodson, assistant secretary of defense for health affairs.
The "envisioned target state" of the joint EHR is "a coordinated, 'best-of-breed' approach that includes a mix of existing SOA (service-oriented architecture)-compliant capabilities, commercial-off-the-shelf, open-source and custom systems." The Defense Department's Manpower Data Center will be the "single identity management source," the report said, while the department's Defense Information Systems Agency will run the EHR's data centers. The EHR will have a common user interface.
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Emphasis on Support in Decision Support

Greg Freeman for HealthLeaders Media , May 14, 2012

This article appears in the May 2012 issue of HealthLeaders magazine.
Computer-based clinical decision-support systems offer great opportunities to improve care and reduce costs, but healthcare leaders have to remember who's ultimately in charge: the human operating the computer. Implementing even the best technology for decision support can become a costly, frustrating failure that ultimately degrades patient care if you don't factor in the human element.
That was one of the lessons learned when Penn Medicine in Philadelphia adopted a computerized physician order entry system. Penn Medicine used the Eclipsys Sunrise Clinical Manager to achieve 100% CPOE in the inpatient setting. In addition, 1,800 physicians actively use the Epic electronic medical record system in the ambulatory setting.
Physicians make about 15 million hits per year in Penn's internally developed physician portal to view patient information and results. All physicians have access to an internally developed data warehouse that maintains 2.4 billion rows of data to help ensure patient safety and quality care, as well as support clinical trials and research.
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ONC taps public for help on nationwide exchange

By Mary Mosquera, Contributing Editor
Created 05/14/2012
WASHINGTON – The Office of the National Coordinator for Health Information Technology is calling for public comment on proposals for rules of the road to govern the nationwide health information network (NwHIN).
ONC will use the comments to help it develop a notice of proposed rulemaking (NPRM), according to a May 11 announcement in the Federal Register preview section. Once it is officially published May 15, the public will have 30 days to offer its views.
ONC seeks help on a range of topics, including the creation of a voluntary program under which entities that enable electronic health information exchange could be validated based on meeting ONC-established “conditions for trusted exchange.” ONC also wants to hear views about the scope and requirements included in the initial conditions for trusted exchange and processes used to revise them over time.
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SaaS EMRs gaining favor, says KLAS

By Mike Miliard, Managing Editor
Created 05/14/2012
OREM, UT – More and more providers are taking software-as-a-service EMRs seriously, according to a new KLAS report. They're intrigued by the systems' lower price and easy maintenance, and reassured by advances in the security of cloud-based data storage.
The study, "SaaS EMR 2012: Is It For You?" assesses the performance of software-as-a-service EMR products from vendors including AdvancedMD, athenahealth, Bizmatics, CureMD, MedPlus/Quest Diagnostics, MIE, OptumInsight, Practice Fusion, Sevocity and Waiting RoomSolutions.
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NHS Direct to pilot GP appointment app

11 May 2012   Chris Thorne
NHS Direct is considering a pilot that will allow patients in Lincolnshire to use a smartphone app to book appointments with their GP.
EHealth Insider understands that negotiations are taking place with some GPs in Lincolnshire to start allowing practice systems to directly interface with NHS Direct, for a trial to start this autumn.
The trial would involve patients using a GP appointment booking smartphone app or the NHS Direct website to book their own appointment, linking directly into the GP system.
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Telemedicine, mHealth will connect with EHRs when providers are motivated

By kterry
Created May 14 2012 - 6:34am
In a discussion at the recent American Telemedicine Association (ATA) conference, panelists bewailed the absence of electronic health record vendors from the meeting, according to a post [1] in NHIN Watch.
"Politically, commercially--it's an issue," said Hon Park, M.D., CEO of Diversinet, which provides secure two-way connectivity for mHealth applications. Pak said that mHealth apps, EHRs, and health information exchanges must be integrated for effective care coordination, according to the post.
Michael Lemnitzer, an executive with Philips Home Healthcare Solutions, said his company is "working aggressively" with EHR vendors to develop interfaces, because 90 percent of Philips' contracts with healthcare providers require connectivity with EHRs. Lemnitzer predicted that by 2015, the majority of EHR companies would have interfaces for telemedicine applications. For that to happen, he said, more interoperability standards would be necessary, according to the post.
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Tablet Use Nearly Doubles Among Doctors Since 2011: Report

2012-05-11

With the Apple iPad the most popular mobile device, doctors have almost doubled their use of tablets in the last year, according to a new report by Manhattan Research.

Doctors have nearly doubled their use of tablets since 2011, a May 10 report by Manhattan Research revealed.
In its annual "Taking the Pulse" study, Manhattan Research found that tablet use by doctors reached 62 percent in 2012, compared with 35 percent of physician tablet adoption in 2011.
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VA's 7 steps to protect VLER data

By Mary Mosquera
The Veterans Affairs Department has described how it will protect the information of veterans and military service members that it shares as part of the virtual lifetime electronic record (VLER) program.
The VLER program enables the electronic sharing of health, benefit, disability determination and administrative data with VA, Defense Department and participants in the nationwide health information network (NwHIN) Exchange.
VA published in the May 11 Federal Register a notice of a Privacy Act System of Records, in which federal agencies detail how they will manage personal information according to federal security requirements. Robust privacy and security safeguards can increase trust and confidence in health information exchange.
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Press Release
May 14, 2012, 8:58 a.m. EDT

InterSystems Launches Next Generation of HealthShare

Strategic Informatics Platform Enables Breakthrough Solutions For Connected Care and Active Analytics

CAMBRIDGE, Mass., May 14, 2012 (BUSINESS WIRE) -- InterSystems Corporation, a global leader in software for connected care, today launched the next generation of its InterSystems HealthShare(TM) strategic informatics platform for interoperability and active analytics. Designed originally for public health information exchanges (HIEs) at regional, state and national levels, HealthShare has been extended and rearchitected to also deliver the advanced technologies needed by integrated delivery networks (IDNs).
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InterSystems' Revamped HIE Platform Mines Patient Data for Patterns

2012-05-15

InterSystems has launched a new version of its HealthSense platform that features data-modeling and enhanced analytics to allow doctors to search through unstructured data.

InterSystems, an IT vendor that powers many state health information exchange (HIE) platforms, has introduced a new version of its HealthSense record-exchange software that adds new data modeling and analytics capabilities.
Announced May 14, the latest version features InterSystems' iKnow technology, which allows doctors to search through unstructured narratives of patient histories. Most clinical data, such as images and text, are unstructured and in multiple file formats.
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Monday, May 14, 2012

Business Partners: A New Risk to Health Data Security?

by John Moore, iHealthBeat Contributing Reporter
Third-party business partners represent a significant security risk to health care providers, who may need several layers of protection to ensure the security of patient data.
The HIPAA Privacy Rule refers to third parties as "business associates" and defines them as individuals or organizations that handle protected health information, or PHI, in the course of working with a covered entity. The category may cover a range of companies, including data processing firms, IT consultants and cloud computing providers. 
HIPAA's Security Rule calls for covered entities to create contracts with business associates to ensure that the partner "will appropriately safeguard" PHI. The HITECH Act of 2009 further strengthened HIPAA's rules regarding business associates and security obligations.
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Stage 2 EHRs Require Meaningful Patient Engagement

Many of the government’s proposed Stage 2 Meaningful Use criteria for e- health records won't be easy to meet. Here's how providers are meeting the challenge.
By Paul Cerrato,  InformationWeek
May 14, 2012
For many healthcare organizations, Stage 2 Meaningful Use feels more like Stage 2 cancer: a threat to life and limb. AdTech Ad
As written, the proposed regulations will require providers to give more than half of patients e-access to their health information; make sure more than 10% view, download, or transmit their health information to a third party; and provide more than 10% with EHR-generated educational resources.
Those are high hurdles, especially for smaller hospitals and practices. Several health IT and clinical stakeholders have taken the Centers for Medicare and Medicaid Services to task on these issues.
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Health Min to scrap electronic health records

ÄŒTK |
14 May 2012
Prague, May 11 (CTK) - The IZIP patients' e-health files project, subsidised by the state-controlled VZP insurer for ten years now and widely criticised as disadvantageous for the state, will be wound up, Prime Minister Petr Necas and Health Minister Leos Heger agreed on Thursday, Heger's spokesman told CTK.
The VZP, the country's biggest health insurer whose board of managers comprises 10 representatives of the government and 20 representatives of parties in parliament, invested 1.8 billion crowns in the IZIP project in the past decade.
Heger's spokesman Vlastimil Srsen said an assessment of the project's hitherto results has shown that the IZIP does not work effectively. That is why the ministry has decided "not to protract the agony," he said.
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Enjoy!
David.