Useful and Interesting Health IT Links from the Last Week – 03/06/2007

Again, in the last week I have come across a few reports and news items which are worth passing on. These include first:

http://australianit.news.com.au/story/0,24897,21813343-16123,00.html

CSC blocks IBA's iSoft tilt

Ben Woodhead | May 29, 2007

update| GLOBAL outsourcer CSC has moved to block IBA Health's proposed 140 million pound ($339.2 million) takeover of UK medical software maker iSoft Group plc.

CSC announced its intention in a letter to iSoft's board, leading IBA to this morning request a halt to trading of its shares while it considered the development.

CSC is iSoft's largest customer and a change of ownership of the hospital software company is subject to approval by the outsourcer. CSC is rolling out iSoft's Lorenzo software as part of the UK National Health Service's £12.4 billion National Program for IT (NPfIT).

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For anyone in Health IT it is hard not to have become fascinated by the Jonah and the Whale like attempt of the Australian IBA to swallow the larger UK based iSoft. The latest as of the time of writing (June 3, 2007) according to the London Financial Times is that legal action is now planned. This looks like it might get messy and expensive. (Disclosure – being an IBA shareholder I hope not!)

Second we have:

http://www.informationweek.com/news/showArticle.jhtml?articleID=199702199

Why Progress Toward Electronic Health Records Is Worse Than You Think

Though use of E-records is growing, the hardest trick--data sharing--has barely begun. And in at least one high-profile case, it's lost ground.

By Marianne Kolbasuk McGee, InformationWeek
May 26, 2007

When people talked about the promise of electronic medical records, Santa Barbara County usually came up as a role model. In 1999, a nonprofit was created to connect hospitals and doctors' offices in the California region using interoperable e-records to share patient data across practices, with the goal of improving care and cutting costs.

The effort launched to national prominence Dr. David Brailer, a physician and former CEO of CareScience, a health care quality-measurement software provider that was the prime contractor of the project. Brailer went on in 2004 to spend two years as the first national health IT coordinator, leading the charge for electronic medical records, or EMRs. Hundreds of health care execs studied the exchange with an eye on adopting its approach.

In December, however, the Santa Barbara County Care Data Exchange quietly died. A $10 million grant ran out, and the health care community didn't see enough value to keep it going. There are still plenty of doctors using e-records in the area, but the dream of sharing data across practices, easily following patients where they're treated, has faded.

Santa Barbara serves as a reality check on the U.S. health care system's slow progress toward a real EMR network. The diagnosis: It's worse than you think.

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This series of three articles is a very useful summary of the issues in EHR adoption as seen from the USA. Much of what is said is very relevant to Australia and the articles are well worth a browse.

Third we have:

http://www.healthleadersmedia.com/technology/viewcontent/89882.html

TEPR Tantrums

Gary Baldwin, for HealthLeaders News, May 25, 2007

The presentation was called “Getting Physician Buy-in.” But TEPR Conference participant Tushar Shah, MD, a partner in a three-physician pediatric practice, wasn’t buying. Shah went to last week’s event in Dallas in search of an electronic medical record system for his small group, which is based in Abilene. He was one of one some 200-plus people who jammed into the session, which targeted small physician practices. So many participants crowded the presentation that event organizers halted it abruptly in mid-stream to move to a larger room.

They heard Paul Schadler, MD, describe how his 11-physician practice struggled through its EMR journey, which began five years ago. Unlike some EMR advocates, who are basically preaching to the IT choir, Schadler gave a warts-and-all account of his group’s experience. The EMR, he said, is a “dramatic work change” for physicians, one that creates “more work.” According to Schadler, much of the work in the paper-based practice shifts directly to the physician in the electronic world. “They billed, now you bill,” he said.

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Another article that points out the problem all who would like to see Health IT implementation face in ensuring that the users of Health IT share properly in the benefits that are obtained from implementation. This almost certainly means that to have implementations succeed there need to be incentives (probably financial) provided for those who actually have to implement and use the technology.

Fourth we have:

http://www.ehiprimarycare.com/comment_and_analysis/index.cfm?ID=180

System failure

07 Nov 2006

Fiona Barr

The use of paper-based systems for out-of-hours care and the financial pressures out of hours services face to fund IT upgrades have been highlighted following the case of a patient who died after speaking to eight different out of hours doctors over a bank holiday weekend.

Penny Campbell, a journalist, died after a series of doctors from the Camidoc out of hours service in north London failed to diagnose that she was developing septicaemia following an injection for haemorrhoids.

It became clear at the inquest that Campbell’s care had been based on a series of handwritten clinical notes rather than an electronic record system which, with the benefit of hindsight, could have alerted doctors to Campbell’s consultation history over a four day period.

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This article provides a nice case study of how paper clinical records can lead to significant patient harm.

See also

http://www.ehiprimarycare.com/news/item.cfm?ID=2721

Paper records a 'direct factor' in patient's death

Lastly we have

http://www.healthleadersmedia.com/view_feature.cfm?content_id=89918

Paper Kills

Newt Gingrich, for HealthLeaders News, May 30, 2007

The following article was adapted from the text of Speaker Newt Gingrich's introduction to Paper Kills: Transforming Health and Healthcare with Information Technology. Edited by Center for Health Transformation Project Director David Merritt, the new release from CHT Press features a collection of insights from many of the leading minds in the healthcare and health information technology fields, including providers, vendors, payers, government officials, and renowned scholars. The book includes discussion of such diverse issues as privacy in confidentiality, optimizing health IT in order to support early health, and the potential of health IT to advance clinical research and the adoption of best practices. (Release date: June 4, 2007; available at www.paperkills.net.)

When I wrote Saving Lives & Saving Money four years ago, I outlined a future in which all Americans will live active, longer, and healthier lives. This future can be achieved because the people will be at the center of a healthcare system that has been designed for them. From their doctors and hospitals to their pharmacies and insurers, every aspect of the system will be designed to maximize their health in an effective and efficient way.

In tomorrow's healthcare system, all Americans will have access to the care that they need--and everyone will have the ability to pay for it. All Americans will be empowered to make responsible and informed decisions about their own health and healthcare. Early health, prevention, and wellness will be at the core of delivery. Treatment decisions will be based on effectiveness, and reimbursement will be driven by outcomes. Consumers will own their personal data and have a right to know the cost and quality of the treatments they receive and the providers they visit. Innovation will be rapid, and the dissemination of knowledge will be secure and in real time.

All of these are fundamental changes from today's approach to healthcare. Embracing these values is absolutely necessary in order for us to build what we at the Center for Health Transformation call a 21^st Century Intelligent Health System. Health information technology is the key to getting there.

I often ask people: when was the last time you took out a pen, wrote a check for cash, and handed it to a bank teller? Most young people today have no idea what "writing a check for cash" means because online banking, debit cards, and a global ATM network is the only world they've ever known. Unfortunately, that kind of technology and that kind of reality has yet to reach healthcare. And we pay a very dear price for it.

To put it simply: paper kills.

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Newt Gingrich is a former Speaker of the United States of America’s House of Representatives. Since leaving office a few years ago he has been a passionate advocate for Health IT. The full paper and the book that is being discussed are both worth detailed review.

Other interesting URLs include:

http://www.phcris.org.au/elib/render.php?params=3700

Effect of computerisation on quality of general practice care—a comparison with quality indicators

Author(s)	Joan Henderson, Graeme Miller, Helena Britt, Ying Pan
Organisation	Family Medicine Research Centre, University of Sydney
Objectives	There is an assumption expressed in literature that computer use for clinical activity will improve quality of general practice care, but with little evidence to support or refute this assumption. This study compares GPs using a computer to prescribe, order tests, or keep patient records, with GPs who do not, using a set of validated quality indicators.

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This is an interesting paper but I have to say that without much more details on the actual functionality and level of use of the systems (which may indeed be provided in the full paper) it is hard to know just how valid the conclusion that “This study has found little evidence to support the claim that computerisation of general practice in Australia has changed the quality of care provided to patients” is. Worth keeping an eye out for the full paper I suggest.

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20070531/FREE/70530008/1029/FREE

Guest commentary: Health IT integral for reform

By: Bruce McPherson

http://govhealthit.com/article102837-05-29-07-Web

Obama, like Clinton, proposes health IT investment

BY Nancy Ferris

http://healthdatamanagement.com/html/current/CurrentIssueStory.cfm?articleId=15242

CFOs Measure the Benefits of New Technology

Financial officers are playing a lead role in assessing the value of information technology investments and then measuring the impact.

By Howard J. Anderson, Executive Editor

http://healthdatamanagement.com/html/current/CurrentIssueStory.cfm?articleId=15250

Building a RHIO, Bit by Bit

Years in the making, a modest Texas networking effort is taking off.

By Zack Martin, Managing Editor

As a special treat for the reader we now have the membership of the Australian Health Information Council. Comments on the choices are welcome. I worry there is not a strong representation of individuals with proven Health IT Strategic Planning expertise and the leaders of either the Health Information Society of Australia or the Australian College of Health Informatics are not present.

More next week.

David.

Australian Health Information Council Members Contact List

Member	Organisation
Professor James Angus (Chair)	Dean Faculty of Medicine, Dentistry and Health Sciences University of Melbourne
Ms Yvonne Allinson	Executive Director Society of Hospital Pharmacists of Australia
Professor Enrico Coiera	Director, Centre for Health Informatics
Dr Moya Conrick	School of Nursing, Griffith University Royal College of Nursing Australia
Mr Rob Durie	Durie Consulting
Mr Richard Eccles	First Assistant Secretary Australian Department of Health and Ageing
Ms Fran Thorn	Chair of NHIMPC Secretary Victorian Department of Human Services
Dr Peter Garcia-Webb	Mayne Health, Western Diagnostic Laboratory Australian Medical Association
Professor Nicholas Glasgow	Director Australian Primary Health Research Institute
Ms Heather Grain	La Trobe School of Public Health
Ms Helen Hopkins	Executive Director Consumers’ Health Forum
Professor John Horvath	Chief Medical Officer Australian Department of Health and Ageing
Professor Michael Kidd	Head Discipline of General Practice The University of Sydney
Dr Ross Maxwell	Rural Doctors Association of Australia
Dr Louis Peachey	Medical Educator Mt Isa Centre for Rural and Remote Health
Dr Andrew Perrignon	Chief Executive Officer Northern Health
Ms Rosemary Sinclair	Managing Director Australian Telecommunications Users Group