Again, in the last week I have come across a few reports and news items which are worth passing on.
These include first:
The Access Card has stalled. So now let's really talk about it
Christopher Scanlon
June 8, 2007
FORTY million dollars. Forty million dollars of taxpayers' money, $3 million of which went on an advertising campaign. That's how much this Government — a government that flaunts its reputation as a competent economic manager — just blew on a card. A card, what's more, that doesn't exist and hasn't even received parliamentary approval.
Speaking at the Australian Smart Cards Summit on Tuesday, Senator Chris Ellison conceded that the Government's trouble-prone Access Card is to be delayed, probably until after the election. The official reason is to allow for greater consultation with the states and the territories.
That's a refreshing change, given that the Government has so far shown very little interest in consultation. The Access Card was unsuccessfully rammed through the Senate in a deliberate attempt to limit debate.
The good news is that the card's delay will give the breathing space for some debate about the proposed card. Concerns about privacy ought to be uppermost. The various ministers charged with implementing the Access Card have consistently claimed that the proposed card wouldn't impinge on privacy, since it would carry only the information that is at present held on a driver's licence.
….. (more at the URL above)
This article is a good exposition of the concerns many have regarding the Access Card proposal. I have included it to remind readers that the whole proposal would appear to have unravelled in the last week or so and that there is a range of commentary that has been published recently.
Another quite useful article can be found here:
http://www.theaustralian.news.com.au/story/0,20867,21873560-28737,00.html
A question of identity on the cards
- Despite rejigs and jitters, the federal Government is pushing ahead with the nation's first ID database, reports Natasha Bita
- June 09, 2007
BY this time next year, the federal Government hopes to be interviewing and photographing 35,000 Australians each day to create the nation's first ID databank. Biometric photos, matched with names, addresses, dates of birth, signatures, sex, social security status and children's details, would be loaded into a new centralised database. Welfare bureaucrats, ASIO, the Australian Federal Police and possibly even the Australian Taxation Office would have some form of access to the unprecedented collection of identity data.
….. (more at the URL above)
The debate serves to remind just how contentious identification schemes can be and reminds me how hard it may be for NEHTA to get the legislation it suggests if needs for the proposed Individual Health Identifier through the National Parliament. Watch this space is all I can suggest!
Second we have:
http://govhealthit.com/article102804-06-04-07-Print
Smyth: One size does not fit all
It is an admirable goal of the Certification Commission for Healthcare Information Technology (CCHIT) to hold all electronic health record (EHR) solutions to the same rigorous certification standards to ensure consistent premium health care for all patients. This goal has held the health care IT community to much needed higher standards. However, in some cases, this may not be in the best interest of small to midsize doctor’s offices and, ultimately, their patients.
….. (more at the URL above)
This is an interesting article pointing out that if one plans to certify EHR functionality when trying to serve a range of user categories and capabilities a one size fits all approach may not be ideal. If we ever move to some similar system (as I believe over time we will) the issue should be addressed pre-emptively.
Third we have:
http://www.govtech.com/dc/articles/123660
"Star Trek" Communication a Reality for Medics with Wireless Technology
May 31, 2007, By News Report
Healthcare facilities across Canada are saving lives and transforming patient care using advanced mobile communications technology from IBM reminiscent of "Star Trek."
The systems provide medical professionals with instant two-way voice communication through lightweight, wearable badges -- similar to devices seen on the popular sci-fi TV show, although at a hospital the voice command is more likely to be "send the MRI images" than "Captain Picard to the bridge." The devices also can relay text messages and alerts.
In the past six months, IBM signed five services contracts totaling more $500,000 for secure, wireless networks to provide clinicians in surgical wards, emergency rooms and critical care units with hands-free, real-time voice communication technology.
The communicators, developed by Vocera Communications Inc. and supported by an IBM wireless network, can increase staff productivity, save time and improve patient care response times. Physicians and other health care professionals can quickly and easily connect, without stopping what they are doing to look for colleagues or place a phone call or page -- time that could make the difference between life and death in an emergency.
….. (more at the URL above)
For an old Star Trek addict this seems to me like a great idea and to be technology I would have loved to have access to in the Intensive Care and Emergency units is spent so much time in in the days before Health IT.
Fourth we have:
http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_034252.hcsp?dDocName=bok1_034252
The RFP Process for EHR Systems
Implementing an electronic health record (EHR) requires substantial time and money for healthcare providers of all sizes and types. During the EHR selection process, organizations must dedicate sufficient time and resources to evaluate their goals and business needs, in addition to thoroughly reviewing available EHR vendor products and services.
This practice brief guides organizations through the selection process, assisting providers as they issue requests for information or requests for proposal for EHRs or component systems. It was developed to be used in conjunction with the “RFI/RFP Template” [...].
….. (much more at the URL above)
This is a very useful contribution from the American Health Information Management Association. While not tailored for Australian conditions all those procuring Health Information Systems should ensure they have covered all the relevant material raised here. My reading suggests they have well and truly covered all the major bases!
Lastly we have:
http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20070605/FREE/70605006/1029/FREE
Rx groups' drug history database emergency-ready
By: Joseph Conn / HITS staff writer
Story posted: June 5, 2007 - 12:13 pm EDT
Two not-for-profit pharmacy trade groups and three for-profit pharmacy companies have joined with the American Medical Association to create a national database to give providers access to patients' drug histories during emergencies. The Web-based service could be activated by the groups and companies in the event of a natural disaster or other emergency, giving physicians and other providers access to the data.
ICERx, or In Case of Emergency Prescription Database, is an outgrowth of a 2005 collaboration by the same groups and companies in the wake of Hurricane Katrina. Their goal was to create a resource for physicians and other healthcare providers treating Gulf Coast patients whose medical records were destroyed or made inaccessible, an effort called KatrinaHealth.org.
….. (more at the URL above)
It seems clear that with the recent NSW storms, Cyclone Larry etc that such a service could be very useful here. I wonder has Medicare Australia considered such a capability as part of their e-prescribing initiative. I certainly hope so.
Other useful finds this week include:
http://www.chcf.org/topics/chronicdisease/index.cfm?itemID=133289
Perspectives on the Future of Personal Health Records
Christopher J. Gearon
June 2007
This is a link to a useful freely downloadable report on how Personal Health Records may evolve. In this report, six experts share their views on the future of PHRs, from the perspective of the technologist, informed patient, physician, employer, and public health professional. Worth a download.
http://www.oregonlive.com/business/oregonian/index.ssf?/base/business/1181181333174410.xml&coll=7
House OKs bill for informatics education
The House yesterday approved legislation that would help fund college and master’s level education in healthcare informatics—a move federal lawmakers say will help advance the use of electronic health records and bring greater transparency and quality to the industry.
http://www.informationweek.com/software/showArticle.jhtml?articleID=199902333&cid=RSSfeed_IWK_News
'Sustainable' E-Health Data Exchange Debuts
The new eHealth Value and Sustainability Model and related tools aim to help regional health-care providers.
By Marianne Kolbasuk McGee, InformationWeek
June 7, 2007
This is a useful resource for those exploring the implementation of Health Information Sharing.
June 08, 2007
National Health IT Network To Be Built From Bottom Up
by Kate Ackerman, iHealthBeat Associate Editor
As recent action has shown, the federal government is tapping local, state and regional health data exchanges to be the building blocks of the Nationwide Health Information Network.
The home page for the Federal US Health IT strategy and progam.
Health Information Technology Home
Health Information Technology
Health information technology (Health IT) allows comprehensive management of medical information and its secure exchange between health care consumers and providers. Broad use of health IT will:
- Improve health care quality;
- Prevent medical errors;
- Reduce health care costs;
- Increase administrative efficiencies;
- Decrease paperwork; and
- Expand access to affordable care.
Interoperable health IT will improve individual patient care, but it will also bring many public health benefits including:
- Early detection of infectious disease outbreaks around the country;
- Improved tracking of chronic disease management; and
- Evaluation of health care based on value enabled by the collection of de-identified price and quality information that can be compared.
http://www.hhs.gov/healthit/news/Accomplishments2006.html
This URL provides a useful overview of the top level US Strategy and Approach.
Summarises the prototype National Health Information Network Pilots. Written by Gartner and well worth review.
While most readers must be sick of me saying it – wouldn’t it be nice if the Australian Government e-Health Initiatives had the same degree of strategic clarity.
All in all quite an even more bumper week!
More next week.
David.
2 comments:
The access card may have stalled but pardon me interrupting.
Isn’t Christopher Scanlon’s article misleading and sensationalist?
If only $3,000,000 has been spent on an advertising campaign, even though the project may have been delayed, it is probably $3M well spent to stimulate debate and measure the mood of the electorate among other things.
The ‘inference by association’ is that $40,000,000 of taxpayer’s money has been wasted. I see no evidence for this but I would like to. Has the $40 million been earmarked or has it been spent already?
This leads one to ask ‘How is the $40 million to be disbursed - on what activities? Is there a more detailed breakdown available, say in $1M or $5 M tranches?
Hi,
Just a couple of points:
1. I hardly think an advertising campaign is a way to stimulate debate - it is more likely to be aimed to quiet it.
2. Given the project is to cost $1.1 Billion over the next 4 or so years - that $40 Million has been spent so far is not remarkable in my view -it only 4% or so of the planned spend and a lot of work has been done to date by many consultants and staff of the Human Service Department. Remember the project has been running for close to a year already.
How much of whatever has been spent is ultimately wasted depends on the overall progress and success of the program.
I happen to think the article makes some important points on the privacy and confidentiality needs of people with illnesses that may result in stigma or discrimination.
David.
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