Australian Health Information Technology: Useful and Interesting Health IT Links from the Last Week

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/0,24897,21903727-16123,00.html

SA funds $375m health IT plan

Ben Woodhead | June 14, 2007

THE South Australian Department of Health is set to launch a $375 million information technology overhaul aimed at digitising healthcare across the state.

The 10-year initiative, which includes 65 individual projects, comes in the wake of intense lobbying from Department of Health IT executives for a systematic approach to upgrading patient information systems.

The $375 million program, which was funded in last week's South Australian state budget, is also designed to dovetail into national electronic health record initiatives.

The budget highlighted an $11.5 million capital injection for patient and nursing administration systems, but the overall 10-year project will allow the Department of Health to upgrade myriad other IT platforms.

…..( see the URL above for full article)

An additional article on this topic is found here:

http://australianit.news.com.au/story/0,24897,21870527-15319,00.html

SA kick-starts e-health

Ben Woodhead | June 08, 2007

SOUTH Australia's Department of Health has been given $11.5 million to kick start a long-awaited upgrade of its patient management systems that is eventually expected to cost as much as $70 million.

Patient system funding comes after extensive lobbying by SA's Department of Health

The funding was awarded in yesterday's 2007-2008 South Australian state budget and comes after extensive lobbying by the department over the past few years.

According to a South Australian Treasury capital statement issued as part of the budget, the $11.5 million will be used to support the replacement of several IT systems, including the ageing patient administration platform.

A nursing administration system overhaul will also be at least partially funded out of the allocation.

The patient administration system (PAS) upgrade is expected to take between six to eight years to complete because it will run in parallel with a number of other computer projects such as finance and material management software updates.

…..( see the URL above for full article)

These two articles are interesting for the claim of the very large investment ($375M) over a decade and then the detail suggesting the spend will be $11.5M in 2007/8. Suggesting it will take six to eight years to renew the patient administration systems (PAS) suggests to me this whole program has an air of considerable uncertainty and un-reality about it. If it takes longer than 1-2 years to renew a PAS environment something is badly wrong.

In passing, I note blog readers have yet to hear, after almost a year, about the individual patient privacy controls and protections offered by OACIS. I would look forward to any comments those in SA might have on these plans and the privacy controls within OACIS.

Second we have:

http://www.chcf.org/topics/chronicdisease/index.cfm?itemID=133288

Privacy, Security, and the Regional Health Information Organization

Avalere Health LLC

June 2007

Regional health information organizations (RHIOs), which promote electronic exchange of patient information among participants, are grappling with a variety of privacy and security issues as they evolve. This study, based on a literature review, interviews, and an informal survey, examines some of the key issues that nine RHIOs encountered and their strategies for managing them.

The study found that privacy and security challenges are surmountable. A RHIO’s unique characteristics—the types of data shared, who participates, and its specific needs and priorities, among others—influence how an exchange addresses these challenges. Solutions are diverse and evolving.

…..( see the URL above for full article)

The report can be downloaded at the following URL

http://www.chcf.org/documents/chronicdisease/RHIOPrivacySecurity.pdf

The most interesting point that emerges from this very valuable report is the observation the nascent Regional Health Information Organisations (RHIOs) may not be doing enough in the way of consultation to understand the privacy and security concerns of their stakeholders.

The report also found that the newer RHIOs could benefit significantly from sharing examples of effective privacy and security policies and past lessons. The report recommended flexible security policies that allow for future data and participation increases over time.

There are lessons here for those planning similar initiatives in Australia.

Third we have:

http://www.nytimes.com/2007/06/11/business/businessspecial3/11save.html?_r=2&ref=businessspecial3&oref=slogin&oref=slogin

Who Pays for Efficiency?

By STEVE LOHR

SAVING money can be expensive.

Indeed, the quest to save dollars in the nation’s $2.1 trillion annual health care bill is becoming a lucrative market of its own. Thousands of companies, large and small, are pitching cost-saving ideas that range from electronic patient records to new medical devices.

It’s not all marketing hype. Experts in health policy agree that there is a real opportunity to curb health spending, which last year was the equivalent of $7,000 for every man, woman and child in the country. Studies predict a gain of as much as 30 percent in efficiency, mostly through reducing unnecessary tests and prescriptions, paperwork and medical mistakes.

Such streamlining would not cut the nation’s total medical spending, as long as there is a growing aging population with ever-increasing health needs. But certain measures are expected to help keep costs from spiraling.

…..( see the URL above for full article)

Of most importance from my perspective was the following paragraph:

“Physicians get only about 11 percent of the savings from electronic health records; the real benefit goes mainly to private and public insurers because, for one, they are paying for fewer unnecessary tests, and automated record-handling is a big cost saving for the payers, according to a study by the Center for Technology Leadership, a medical research group. “The doctors bear all the costs, and others reap most of the benefit,” said Dr. David J. Brailer, who was the national health information technology coordinator in the Bush administration from 2004 to 2006. “The incentives are totally awry.”

While Australian data to support this assertion does not exist (of if it does I would love to know about it!) it feels close to true. Working out how best to handle this reality will be an important task for all those developing health information strategies globally – noting that all those I have just reviewed recognise the importance of the issue.

Fourth we have:

http://www.govhealthit.com/article98189-04-16-07-Print&ghitnewsletter=yes

Banking on privacy

States and the federal government take contrasting approaches to building large medical record repositories

By Alan Joch
Published April 16, 2007

As the federal government continues to push for wider adoption of electronic medical records, many organizations are asking how they can efficiently distribute and safeguard all of that electronic medical information once it’s captured.

One strategy is to create banks of records from which authorized doctors and nurses can quickly pull patients’ lab tests and medical histories. Proponents contend that care will improve and medication mistakes will decline when specialists and emergency room physicians have immediate access to the same information that a patient’s primary care physician has.

“There are tangible benefits we could see right away in quality, efficiency and cost savings,” said Dr. David Gifford, director of the Rhode Island Department of Health. “There aren’t many things that both help improve quality and lower costs, so it’s a real win-win situation.”

Although EMR banks are potentially beneficial, some privacy advocates have raised concerns. Public-sector medical groups, private hospitals and payer organizations, are trying to tackle such nagging details.

…..( see the URL above for full article)

This is a useful and quite long article that explores the privacy and security imperatives in the health sector and explores parallels and cross over with the banking sector.

Lastly the iSoft / CSC / IBA Health saga continues:

http://www.e-health-insider.com/news/item.cfm?ID=2780

Granger says IBA will take control of iSoft within week

14 Jun 2007

Richard Granger, chief executive of Connecting for Health, has exclusively told E-Health Insider that IBA Health will have control of iSoft within the next week.

However, Granger also warned that he was prepared to ditch iSoft's Lorenzo software, and make arch rival Cerner's Millennium the national system across England, if the late-running software doesn't work or meet NHS requirements.

Speaking to EHI after giving evidence to the Commons Health Select Committee Granger said that he had been in consultation with iSoft’s executive chairman, John Weston, and was confident a deal would be finalised by next week.

…..( see the URL above for full article)

From this report it would certainly seem there is a lot of behind the scenes activity going on. It might have been a good idea for IBA health to report Richard Granger’s intervention to the Australian market – which at the time of writing they have not (June 17, 2007).

Late breaking news – we now find:

http://www.computerworlduk.com/management/government-law/public-sector/news/index.cfm?newsid=3529

NHS IT chief Granger quits

Head of £12.4bn programme will go before roll-out of crucial care record system

By Tash Shifrin

16 June, 2007

Other useful finds this week include:

On privacy and access control we also have:

http://www.courant.com/news/local/statewire/hc-11012731.apds.m0269.bc-ct--e-hejun11,0,4560849.story

Privacy arguments follow rollout of electronic health records

Associated Press

June 11 2007

And,

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20070611/FREE/70611004/1029/FREE

Data access control often just a mouse click away

By: Andis Robeznieks / HITS staff writer

Story posted: June 11, 2007 - 9:54 am EDT

http://masseynews.massey.ac.nz/2007/Press_Releases/06-12-07.html

Who should see our health records?

A new research project will investigate public attitudes towards the sharing of confidential personal health information held in electronic health records.

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20070613/FREE/70613005/1029/FREE