Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
Certification Commission Approves Final Criteria for Hospital-based EHR Certification Program
Seeks qualified candidates to serve on Board of Commissioners
CHICAGO -- June 28, 2007 -- The Certification Commission for Healthcare Information Technology (CCHIT) announced today that it has published its approved criteria for certification of inpatient (hospital-based) electronic health record (EHR) products and will begin taking applications for certification Aug. 1. The final certification criteria, test scripts and associated program policy documents are posted on the Commission's Web site, www.cchit.org.
The application period for the first quarterly testing batch will be open until Aug. 14 and the first certified inpatient EHR products are expected to be announced in late October.
“Thanks to a year of intensive work by our volunteer workgroups and supporting staff, we are now ready to bring the benefits of certification to the inpatient domain,” said Alisa Ray, executive director. “Besides covering foundation standards such as security, the inspection of inpatient EHR products will examine clinician electronic order writing (often called CPOE), electronic medication administration (often called eMAR), related clinical decision support, and medication reconciliation. Certified products will have demonstrated their ability to have a positive impact on the quality and safety of patient care.”
A Town Call teleconference for vendors of inpatient EHR products is scheduled for July 12, at 11 a.m. Eastern Time to discuss the inpatient certification program and application process. Details on how to participate in the teleconference will be posted to www.cchit.org.
…..( see the URL above for full article)
This is a useful release and provides access to a valuable set of documents defining the expectation the CCHIT has for inpatient EHR systems. This documents are well worth a browse for all those involved in Hospital computing.
Second we have:
http://www.health.nsw.gov.au/pubs/2007/caring_health_report.html
Caring for our health? A report card on the Australian Government's performance on health care
Summary
Caring for our health? A report card on the Australian Government's performance on health care presents a snapshot on major national health funding in an easy to understand format. This report details where Canberra is spending taxpayers' money. It focuses on Medicare, general practitioners, specialists, medicines, public hospitals, private health insurance and explores health funding needs into the future. It examines whether recent changes in Australian Government policy are directing money where it is most needed. Most of the information is national - there may be some variations in different parts of Australia.
File link : Caring for our health? A report card on the Australian Government's performance on health care
File size: 2944Kb
Type : Report
Date of Publication: 01 June 2007
This is a document developed by the State Governments which tries to demonstrate how badly under-funded the State Health System (Hospitals etc) are. Sadly, while making a few interesting points, there is no suggestion of what might be done to make the most of what resources are already available. Sadly, as would been expected I guess, there is just no mention of what e-health and other technology innovations could offer. A missed opportunity I believe.
Third we have:
http://www.infoway-inforoute.ca/en/News-Events/InTheNews_long.aspx?UID=271
Canadian Implementation of e-Health projects increases by 39 per cent
Initiatives benefiting patients in every province and territory
Toronto, ON -- Canadian patients are benefiting from a 39 per cent increase in electronic health initiatives that are modernizing the way clinicians deliver health care, announced Richard Alvarez, President and CEO, Canada Health Infoway (Infoway).
"In the past year, we've seen tremendous growth in the number of electronic health record initiatives that are delivering enhanced patient care, shorter wait times and a more productive health care system for Canadians," said Alvarez, who recently released Infoway's annual report. "While this growth is encouraging, momentum must be maintained so we can capitalize on the efficiencies generated through electronic health initiatives as our population continues to age and grow."
In 2006-07, Infoway approved investments of $518.9 million in EHR initiatives across Canada, surpassing its target of $335 million. The digitization of diagnostic imaging, Drug and Laboratory Information Systems projects and the interoperable electronic health record made significant progress.
With 227 projects complete or underway across Canada, Infoway and its partners are investing in modern health information systems that are uncovering efficiencies in healthcare settings across Canada. The result is better patient care and outcomes, reduced wait times and cost savings.
Infoway's plan for further electronic health progress is outlined in 2015 -- Advancing Canada's next generation of health care, its long-term strategic vision document. The document is available at www.infoway-inforoute.ca.
Infoway is a federally-funded, not-for-profit organization that is leading the development and implementation of electronic health projects across Canada. Infoway works with provinces and territories to invest in electronic health projects, which support safer, more efficient healthcare delivery. Fully respecting patient confidentiality, these private and secure systems provide health care professionals with immediate access to complete and accurate patient information, enabling better decisions about diagnosis and treatment. The result is a sustainable health care system offering improved quality, accessibility, productivity and cost savings.
About Canada Health Infoway (Backgrounder)
Electronic Health Records: Investments Across Canada (Backgrounder)
Electronic Health Records: Quick Facts
Electronic Health Projects: Examples of Projects Across Canada (Backgrounder)
The case for electronic health records in Canada (Backgrounder)
Infoway's Vision (Backgrounder)
Program Activity Summary (Map)
This is a useful press release that provides an update on E-Health Progress in Canada. Given the scale of investment that is now obviously underway it will be interesting to see how the Canadian Health System performs overall in the next few years as these implementations are completed.
Despite this release it is clear there is still some contention and dis-satisfaction.
http://www.theglobeandmail.com/servlet/story/RTGAM.20070624.wehealth0624/BNStory/National/home
Ontario chided over health records
Canadian Press
June 24, 2007 at 9:34 PM EDT
TORONTO — Ontario is far behind other provinces when it comes to implementing electronic health records and it's a problem in need of immediate action, says Ontario's information and privacy commissioner.
“We're the largest province, surely we should be able to figure this out and come up with an action plan,” Ann Cavoukian said in an interview with The Canadian Press.
“Don't give me more strategy on how you're going to do it. We need something right now.”
According to Canada Health Infoway, a not-for-profit agency that helps develop electronic health records, the widespread use of such records can reduce wait times, create fewer adverse drug reactions and provide better prescribing practices.
Still, the Ontario government says it doesn't know when residents can expect a full electronic system that would give every person in the province a health record that all authorized health-care workers can access.
…..( see the URL above for full article)
Fourth we have:
http://www.healthleadersmedia.com/view_feature.cfm?content_id=90581
Healthcare Crisis: EMR Non-acceptance in the U.S.
Bill Bysinger, for HealthLeaders News, Jun 27, 2007
It has been almost 20 years since electronic medical records systems were introduced into medical practices, yet we have the lowest adoption rate of all the developed countries in the world. Most of Europe, Japan, China, Australia and even Russia have adoption rates above 50 percent and in many countries above 90 percent.
We are supposed to be the world leader in adopting technology, but recent studies have put our practice EMR adoption rate at somewhere between 15 percent and 18 percent.
I submit the root cause of the problem is the culture of the healthcare industry. Healthcare in the U.S. especially at the practice level is a cottage industry. Medical practices don’t make business decisions based on productivity or process improvement, which dominates other industries. Instead, they make decisions based on how much money do they have to spend and what will it do for the providers personally (and immediately).
…..( see the URL above for full article)
This article offers one commentators view as to how EHR adoption could be accelerated in the US environment. Some of the suggestions around linking EHR use to the cost of medical liability insurance and providing higher payment for services delivered when an EHR is used bear consideration.
Lastly we have:
http://www.eurekalert.org/pub_releases/2007-06/uom-uom062707.php
U of M researchers assess effectiveness of computerized physician order entry system
Medication errors are reduced in hospitals that utilize the system
MINNEAPOLIS / ST. PAUL (June 27, 2007) — The incidence of medication errors can be reduced by implementing a computerized physician order entry (CPOE) system, according to a review of several studies conducted by researchers at the University of Minnesota.
The review, recently published in the online journal Health Services Research, analyzed 12 studies conducted between 1990 and 2005 that compared the number of handwritten and computerized medication errors made by hospital physicians. Medication errors, which include prescribing the wrong drug, ordering an inaccurate dosage, or administering a drug at the wrong time, dropped by as much as 66 percent in United States hospitals that switched to a CPOE system. Illegible handwriting and transcription errors account for more than 60 percent of medication errors.
“Patient safety is our final goal,” said Tatyana Shamliyan, lead review author and a research associate at the University of Minnesota School of Public Health. “Evidence from these studies show that computerized systems can reduce mistakes, but unfortunately less than 50 percent of hospitals have implemented these systems. There is a lot of work to be done in the future.”
The rate of medication errors experienced by hospitals has skyrocketed from only 5 percent in 1992 to nearly 25 percent today. The review found that of these hospitals, CPOE systems were most beneficial when the rate of medication errors was more than 12 percent.
The Institute of Medicine has already identified medication errors as a major threat to patient safety and has endorsed electronic prescribing of medication as an effective method in correcting the problem. “Medication errors are a central aspect of improving hospital safety. CPOE can help that process,” says Robert Kane, M.D., review co-author.
“Hospitals would be short-sighted not to use it.” Kane also notes that CPOE systems can be combined with existing computerized medical records, creating a central location for physicians to efficiently enter and view past and present patient prescriptions and medical history.
While the review found that the number of medication errors dropped as a whole, the incidence of one type of error, prescribing the wrong drug, did not decrease. In five of the twelve studies, the number of adverse events from drugs errors did not decrease. More than one-half million patients suffer injuries or death from adverse events, causing up to $5.6 million annually per hospital, according to the review.
###
The Academic Health Center is home to the University of Minnesota’s six health professional schools and colleges as well as several health-related centers and institutes. Founded in 1851, the University is one of the oldest and largest land grant institutions in the country. The AHC prepares the new health professionals who improve the health of communities, discover and deliver new treatments and cures, and strengthen the health economy.
Further coverage of the findings of the study is available here:
http://www.theglobeandmail.com/servlet/story/RTGAM.20070628.wlprescribe28/BNStory/specialScienceandHealth
Doctors' poor penmanship can have deadly results
From Thursday's Globe and Mail
June 28, 2007 at 9:50 AM EDT
The abysmal handwriting of physicians is the stuff of legend among nurses and pharmacists. But the result - frequent medication errors due to drug names and dosages misread from doctors' chicken scratch - is deadly serious.
New research has driven home just how harmful badly written prescriptions and other transcription errors can be.
The study, published in the journal Health Services Research, shows that having doctors write electronic prescriptions - by typing them into a computer rather than writing them by hand - reduces medication errors by a staggering 66 per cent.
"These medication errors are very painful for doctors, as well as the patients. Nobody wants to make a mistake," said Tatyana Shamliyan, a research associate at the University of Minnesota School of Public Health, and the lead author of the paper.
…..( see the URL above for full article)
This is a useful review and supports the urgency for the implementation of systems that can clearly reduce errors and suffering.
All in all quite an interesting week!
More next week.
David.
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