These include first:
iSOFT Shareholders Approve IBA Scheme
Sydney – Monday, 9 July 2007 – IBA Health Limited (ASX: IBA) – Australia’s largest ASX listed eHealth company advises that the iSOFT shareholders have voted overwhelmingly to approve IBA’s recommended offer for iSOFT to be effected by a scheme of arrangement. The acquisition of iSOFT is expected to be effective on 30 July 2007. The following statement was released by iSOFT Group plc on Friday, July 6 2007 on the Regulatory News Services (RNS) in the UK.
Start of iSOFT Statement
6 July 2007
Resolutions passed to approve IBA Scheme
Recommended Offer for iSOFT Group plc (“iSOFT”) by IBA Health (UK) Holdings Limited (“IBA UK”) a wholly-owned subsidiary of IBA Health Limited (“IBA”) to be effected by means of a scheme of arrangement under section 425 of the Companies Act 1985 Results of meetings
The Board of iSOFT is pleased to announce that the shareholder resolutions to approve the recommended offer for iSOFT, by a wholly-owned subsidiary of IBA, IBA UK, to be effected by means of a scheme of arrangement, were duly passed at the Court Meeting and the Extraordinary General Meeting held earlier today.
At the Court Meeting, a majority in number of iSOFT Shareholders, who voted either in person or by proxy and who together represented over 75% by value of the votes cast, voted in favour of the resolution to approve the Scheme. The resolution was accordingly passed.
At the Extraordinary General Meeting, the special resolution to approve the Scheme and provide for its implementation was also passed by the requisite majority.
COURT MEETING The voting on the resolution to approve the Scheme was taken on a poll and the results were as follows:
Number of Meeting Shareholders voting: For: 424 (97.03%) Against: 13 (2.97%)
Number of votes: For: 87,780,362 (99.97%) Against: 25,781(0.03%)
EXTRAORDINARY GENERAL MEETING The voting on the Special Resolution giving effect to the Scheme was taken on a poll and the results were as follows:
Number of votes: For: 89,717,026 (99.97%) Against: 29,814 (0.03%)
----- End Release
This is an important release as it makes it virtually certain that Australia will have its first virtually global Health IT company of significant scale. While wishing the merger and company well (their shares have been good to me!) I am concerned there are real risks associates with this merger that should not be underestimated. Integrating iSoft, which is already the made up of a range of merged companies into IBA will be a non-trivial challenge. It may be that the involvement of CSC is working with the Lorenzo future product will turn out to be a very good thing.
Further details on the two companies can be found here:
http://www.australianit.news.com.au/story/0,24897,22041396-24169,00.html
iSoft takeover bid approved
Ben Woodhead | July 09, 2007
SHAREHOLDERS in beleaguered British software maker iSoft have overwhelmingly backed IBA Health's £140 million ($328 million) takeover bid for its bigger rival.
…..( see the URL above for full article)
Second we have:
Patient Safety (which has obvious E-Health ramifications) gets a good run this week with two articles:
http://www.theaustralian.news.com.au/story/0,20867,22069490-23289,00.html
Calls for drug monitoring to tighten
- Adam Cresswell
- July 14, 2007
DRUG safety experts have called on the federal Government to tighten monitoring procedures that can detect harmful drug side-effects, saying existing methods remain relatively ineffectual.
More rigorous clinical studies and improved systems for picking up problems that only emerge after a new drug has appeared on the market should all be considered, they say amid claims that a recent controversy over a well-known brand of sleeping pill has exposed flaws in the current systems.
The criticism comes despite a move by the federal Government this week to intervene and save from closure a consumer medicines hotline which provides people with a means to report instances of suspected adverse events while taking drugs.
…..( see the URL above for full article)
http://www.theaustralian.news.com.au/story/0,20867,22069485-23289,00.html
Blunder bust
- Safety experts say too little is being done to stop patients being harmed or even killed by avoidable errors. Health editor Adam Cresswell reports
- July 14, 2007
PATRICIA Skinner has experienced the sharp end of medical mistakes. She spent 18 months with a pair of 15cm open scissors embedded in her abdomen, after doctors forgot to take them out at the end of an operation.
"It was agony ... my husband would drive over a bump in the road, and I would scream,'' recalls Skinner. "My husband would say, `What's the matter with you?', and I thought I had cancer. I said to my doctor, `I feel like I've been knocked to the ground and someone's been kicking me with steel-capped boots'.''
…..( see the URL above for full article)
These are both well worth reading. The success of the PDA based system in identifying problems and near misses in anaesthesia is especially interesting. The full report can be found here:
http://www.aihw.gov.au/publications/hse/seiaph04-05/seiaph04-05.pdf
It should be pretty clear that – given the report suggests a total of about 130 or so sentinel events occurred in the whole of Australia in 2004 / 5 – that we are still not capturing for report all such events. Given there are roughly 4.3 million hospital admissions per year it seems very likely a substantial number are still not reported. Better record keeping – especially electronic record keeping – could certainly improve the case finding and subsequent analysis.
Third we have:
Financial data systems garner attention
By: Joseph Conn / HITS staff writer
Story posted: July 9, 2007 - 10:41 am EDT
Part one of a three-part series
In recent years, particularly since 2004, when President Bush created HHS' Office of the National Coordinator for Health Information Technology, most of the federal focus on healthcare IT has been on promoting the adoption of clinical applications and the development of healthcare data exchange. Computerized financial systems have taken a back seat.
Yet the increased interest in and adoption of clinical IT systems is leading some cutting-edge healthcare leaders to take a second look at their financial systems and make plans to replace or reconfigure them, according to industry experts.
One goal is to optimize the integration of their financial systems with their clinical systems, not only to enable more accurate and timely billing, but also to gain synergy for combined clinical and financial process improvement. Additionally, the advent of consumerism and the emphasis on transparency in healthcare pricing is driving needed adaptation of healthcare financial systems to produce information not only for chief financial officers, but also for patients.
…..( see the URL above for full article)
This is a useful series of articles. The point being made in the third article regarding the need to effectively blend both clinical and financial systems to address the information needs of managing high quality care and reducing the variation in the care that is actually provided to individual patients.
Fourth we have:
http://archinte.ama-assn.org/cgi/content/short/167/13/1400
Electronic Health Record Use and the Quality of Ambulatory Care in the United States
Jeffrey A. Linder, MD, MPH; Jun Ma, MD, RD, PhD; David W. Bates, MD, MSc; Blackford Middleton, MD, MPH, MSc; Randall S. Stafford, MD, PhD
Arch Intern Med. 2007;167:1400-1405.
Background Electronic health records (EHRs) have been proposed as a sustainable solution for improving the quality of medical care. We assessed the association between EHR use, as implemented, and the quality of ambulatory care in a nationally representative survey.
Methods We performed a retrospective, cross-sectional analysis of visits in the 2003 and 2004 National Ambulatory Medical Care Survey. We examined EHR use throughout the United States and the association of EHR use with 17 ambulatory quality indicators. Performance on quality indicators was defined as the percentage of applicable visits in which patients received recommended care.
Results Electronic health records were used in 18% (95% confidence interval [CI], 15%-22%) of the estimated 1.8 billion ambulatory visits (95% CI, 1.7-2.0 billion) in the United States in 2003 and 2004. For 14 of the 17 quality indicators, there was no significant difference in performance between visits with vs without EHR use. Categories of these indicators included medical management of common diseases, recommended antibiotic prescribing, preventive counseling, screening tests, and avoiding potentially inappropriate medication prescribing in elderly patients. For 2 quality indicators, visits to medical practices using EHRs had significantly better performance: avoiding benzodiazepine use for patients with depression (91% vs 84%; P = .01) and avoiding routine urinalysis during general medical examinations (94% vs 91%; P = .003). For 1 quality indicator, visits to practices using EHRs had significantly worse quality: statin prescribing to patients with hypercholesterolemia (33% vs 47%; P = .01).
Conclusion As implemented, EHRs were not associated with better quality ambulatory care.
Author Affiliations: Division of General Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Drs Linder, Bates, and Middleton); and Program on Prevention Outcomes and Practices, Stanford Prevention Research Center, Stanford University, Stanford, California (Drs Ma and Stafford). Dr Ma is now with the Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California.
This is an important paper as it shows that implementation of EHR technology, of itself, may not make any real difference in patient outcomes. The authors make the points that at best only 40% of the EHR systems in use had any clinical decision support functionality and that the overall quality of practice in both the 18% that did use EHRs and the 82% that did not was unsatisfactory on the quality indicators being measured. A detailed read of this paper if you can access it via CIAP or a university is recommended.
The following reference from the paper offer useful, and differing, perspectives:
Doran T, Fullwood C, Gravelle H, et al. Pay-for-performance programs in family practices in the United Kingdom. N Engl J Med. 2006;355(4):375-384.
Johnston D, Pan E, Middleton B, Walker J, Bates DW. The value of computerized provider order entry in ambulatory settings. http://www.citl.org/research/ACPOE_Executive_Preview.pdf. Accessed February 14, 2007.
Lastly we have:
http://www.cio.co.uk/concern/alignment/features/index.cfm?articleid=351
Granger: The final word
Janice McGinn
Departing director general of NHS IT, Richard Granger, talks exclusively to CIO UK about the controversial programme, its progress and the bruising media coverage
“Stuff goes wrong all the time. You know, computers do fail. But what we’re seeing is a sort of hysterical coverage. What I should be judged on is whether we’re fixing it quickly and ensuring it’s as good as anything else anywhere on the planet. Measure me on those things and I know we will not be found lacking.”
For a man better known for savaging suppliers, with an apparent ‘lead me, follow me, or get out of my way’ attitude, 42-year-old Richard Granger, director general of IT, NHS, is surprisingly plaintive. We met in Whitehall a few weeks before he announced his departure at the end of this year after five years in what must be the biggest, highest profile civilian CIO job in Europe.
"“There is a little coterie of people out there who are alleged experts and who worked on this programme. They were dismissed for reasons of non-performance or in one case, for breach of commercial confidentiality”"
Richard Granger, director general of IT, NHS
…..( see the URL above for full article)
This is a long a riveting read about the NHSPfIT. Everyone gets a serve and what Richard Granger says about the problems you face in a project of this scale all rings true to me.
All in all some great reading to start the week!
More next week.
David.
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