Again, in the last week, I have come across a few reports and news items which are worth passing on. This week it seems to be, at least in part, to be follow-ups of last weeks finds
These include first:
The news that IBA seems to have been ‘pipped at the post’ in its purchase of iSoft. The best coverage I could find of the new plans comes from Forbes Magazine in the US.
An iSoft Landing For The NHS
Parmy Olson, 07.20.07, 2:02 PM ET
LONDON - Though often a slow and lumbering affair, Britain's National Health Service prides itself on offering free health care to anyone who needs it. A noble sentiment, but keeping the institution running is agonizingly complicated, and software companies like iSoft have been commissioned to help grease the wheels.
Isoft (other-otc: ISFGF - news - people )has been key to a £6.2 billion ($12.8 billion) upgrade of the NHS computer system, but it has fallen foul of investors in the past few years thanks to accounting indiscretions in 2004 and 2005. Last year, the British software firm, which makes hardware and software systems for hospitals, booked a £344 million ($707.5 million) loss.
Now it's just been swallowed up by a German software company that is paying a 18.9% premium over another offer by an Australian suitor. So enamored is iSoft with the bid by Koblenz, Germany-based CompuGroup that its chairman and acting chief executive, John Weston, said the company had "no hesitation" in recommending the 66 pence per share ($1.36), £160 million ($329 million) all-cash offer.
Shares in iSoft jumped 10.25 pence (21 cents), or 18.7%, to 65 pence ($1.34) in Friday afternoon trading in London, just below the bid price, suggesting that investors don't see a counterbid on the horizon. The deal is roughly two times iSoft's revenues, which is about average for health care software deals. IDX, another struggling software company contracted by the NHS, was acquired by General Electric (nyse: GE - news - people ) subsidiary GE Medical in 2006 for $1.2 billion, or twice revenue.
…..( see the URL above for full article)
As regular readers will know I hold a few IBA shares and was slightly surprised to see the share price rise almost 3% in the absence of any news or announcement from IBA on this to the Australian Stock Exchange on Friday.
Information appeared in the UK press late in the afternoon (16:53 July 20, 2007) that this new offer had been made and with Sydney being nine hours ahead of the UK at present was available early Saturday morning here. Certainly the breaking news section of the Sydney Morning Herald had it at 8:15 am on Saturday. It seems the information might just have leaked a little earlier to some market insiders. We will never know I guess. Of course the rise could also relate to UBS buying a greater than 5% stake in IBA the day before (19 July).
It will be interesting to see how all this plays out – given that the IBA offer has already been approved by iSoft shareholders. We will just have to wait and watch!
Late news is that the deal will result in IBA collecting a £1.3m break fee ($A3.00M) but iSoft shareholders are likely to conclude that it is money well spent says another piece of commentary that can be found here:
http://business.timesonline.co.uk/tol/business/industry_sectors/technology/article2110792.ece
It will be very interesting to see what is announced before the ASX opens tomorrow at 10am.
Still $3.0M should help defray some of the costs of the bid!
Second we have:
http://www.cio.com.au/index.php?id=1320293134&eid=-601
E-Health Starts with The Patient
The best way to implement an e-health project is to involve users from the start, and to make the patient the centre of things, says a former Saudi CIO soon to visit Australia.
Sue Bushell 19 July, 2007 10:48:49
The best way to implement an e-health project is to involve users from the start, and to make the patient the centre of things, says a former Saudi CIO soon to visit Australia.
Bassam A Al-Kharashi, deputy director general sales, marketing & business development for the Sultan Bin Abdulaziz Medical & Educational Telecommunications Program says making patients the priority has been key to the success of a major business process transformation effort underway at the 220-bed King Khaled Eye Specialist Hospital.
"(In starting this project) we looked at our customer, which is the patient, and we asked ourselves why the patient comes to hospital, comes to see a doctor. The doctor has to provide health-care, provides services to the patient.
"So we need to start with these two entities, the patient systems, and human resources because the physician is part of the human resources system. And from there we move into the other systems - the finance - and we go through the cycle of the patient - why the patient comes, and then what kind of services that help them. It makes a big difference," Al-Kharashi says.
…..( see the URL above for full article)
An interesting article showing two things. First that it is a sound approach in implementing Health IT to implement systems in a way that is optimised to support the hospital’s business processes and second just how the Saudi Health System has been improved taking advantage of all those oil dollars.
Third we have:
http://www.misweb.com/magarticle.asp?doc_id=24882&rgid=2&listed_months=0
A health-e start
By Claire Doble • Published: Monday, 1 August 2005
The vast potential benefits of IT in health care are matched only by the challenges of implementing technology in such a complex environment. Claire Doble examines Australia's burgeoning e-health sector.
One day, your mobile phone will tell you to go and see a doctor. When you arrive at the medical centre, a nurse will usher you into a sensor room that checks your temperature, heart rate, blood pressure, and other vital signs.
By the time you get to see Dr Jones, all the information just collected, as well as pertinent medical data from throughout your life, will be at her fingertips - wirelessly transmitted from a national database, your phone and the sensor room into her PC.
You may need to provide a DNA sample so that she can access the confidential parts of your file, but it will all be available. Dr Jones may not even be in the room with you, she may be treating you through a virtual patient care unit that has screens and sensors to give her all the information she would have if she was standing right there.
It turns out you need minor, keyhole surgery, so she does it straight away, with the aid of lasers and a virtual simulator at her end. When it's all over, you walk away, slightly tender, with a prescription and an extra application loaded on your mobile to monitor your post-op condition, which will electronically alert you, Dr Jones and the clinic if anything seems to be going awry.
The above scenario may still sound like science fiction, but some of it should become a reality in the next few years, and the virtual patient care concept is already in practice today. Electronic health, or e-health, is one of the next frontiers of ICT innovation.
The shift to e-health encompasses all the potential business benefits that made ICT solutions so crucial to the enterprise - it will save money, reduce errors, get results, speed delivery of critical units, and free skilled workers from menial tasks so they can concentrate on doing the important things better.
…..( see the URL above for full article)
This is a fascinating browse to see the optimism of virtually two years ago in terms of what was hoped for from NEHTA and e-Health. I leave it as an exercise for the reader to browse and consider how far we have actually come in the last two years.
Fourth we have:
Last week I pointed out this article.
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.
Interestingly we now have a article reviewing all sorts of comments on the real meaning of the report:
http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20070718/FREE/70718003/1029/FREE
Vendors dispute EHR, ambulatory-care report
By: Andis Robeznieks / HITS staff writer
Story posted: July 18, 2007 - 10:54 am EDT
A report detailing how the use of electronic health records does not necessarily lead to an increase in the quality of care may be misinterpreted by some as proof that EHRs aren’t useful. EHR vendors, consequently, are concerned.
"It's caused quite a bit of discussion in our industry—to say the least," said Hugh Zettel, director of government and industry relations for GE Healthcare. "We don't believe the reporting on it has been accurate relative to the findings of that paper."
The report, Electronic Health Record Use and the Quality of Ambulatory Care in the United States, appeared in the July 9 edition of the Archives of Internal Medicine, and concluded quite bluntly that: "As implemented, EHRs were not associated with better quality ambulatory care."
Written by prominent health information technology figures from Harvard Medical School and Stanford University, the study examined records of 50,574 patient visits collected as part of the National Ambulatory Medical Care Survey in 2003 and 2004, and compared how physicians with and without EHRs did on 17 quality measures. The researchers concluded that EHR-using physicians had significantly better scores on only two quality indicators, had no significant difference on 14, and did significantly worse performance on one.
…..( see the URL above for full article)
The article provides some interesting perspectives on the negative findings of the study. My feeling is that without real detail as to the capabilities and methods of deployment of the systems being assessed it is very hard to draw any firm conclusions. Some well planned and executed studies are needed in the real world – given the data from leading users at advanced centres is quite clear regarding benefit.
The impact of implementation of advanced systems in a “real world” environment really needs to be settled once and all.
Fifth we have:
Cover 2007 Most Wired
Ten Lessons from the Top 100
By Alden Solovy
One thing is certain: Technology is part of the process of improving care
The nation’s 100 Most Wired Hospitals and Health Systems have better outcomes than other hospitals on four key measures: mortality rates, the Agency for Healthcare Research and Quality’s patient safety measures, the Joint Commission’s Core Measures and average length of stay. This is the strongest evidence in the nine-year history of the survey of an association between the implementation and adoption of information technology and the quality and cost of patient care.
Although the analysis is compelling, chief information officers and researchers are quick to point out the limitations. The research shows that, in general, hospitals with good quality results are also dedicated to information technology. It does not show that IT caused those benefits.
“These initiatives are a combination of people, process and technology, not just technology alone,” says Mike Alverson, acting CIO, Texas Health Resources, Arlington, which makes its eighth appearance on the Most Wired list in 2007 and is an Innovator Award finalist. “Health care IT is a team sport.”
Analysts point out two general caveats to the outcomes research. First, information technology is one of many tools for achieving process improvements that lead to better outcomes. It must be used in conjunction with other tools and techniques to have an effect on care. Second, the analysis shows an association between IT adoption and key quality measures, but association is not causality. (See sidebar, “A Higher Standard”)
One thing is certain: like much of health care, CIOs and other senior executives at the nation’s Most Wired hospitals use technology as part of the process of improving care. They have measured the benefits of these changes. Disentangling the gains from using high-tech tools from the value of a skilled staff and better processes isn’t even of interest.
How are the Most Wired achieving their results? What are they doing to make technology part of their process improvement plans? Here are 10 lessons from this year’s benchmark group of top hospitals.
…..( see the URL above for full article)
The lessons provided in this long article are well worth considering carefully.
Lastly we have:
Gemalto to Deliver 35 Million e-Health Cards for German Citizens
Latest generation of patient cards will be produced in Gemalto’s site in Filderstadt near Stuttgart.
Amsterdam, the Netherlands, July 11, 2007–Gemalto (Euronext NL0000400653 GTO), the world leader in digital security, today announces it has been awarded the tender held by insurance organization AOK (Allgemeine Ortskrankenkasse) to supply and personalize e-health-cards for their insured in Germany. The contract win comes after Gemalto took part in Germany’s first healthcare pilot program based on highly secure microprocessor cards.
Gemalto’s new advanced digital healthcare solution will avoid duplicate examinations and therefore lessen unnecessary use of healthcare services. In addition, the new health card will be able to carry electronic prescriptions, which will reduce significantly paperwork. Finally, by allowing data update once the card is in the field, the new system enables insurance funds to potentially adjust their cost of ownership.
Gemalto’s latest-generation card will also act as an active security device to perform strong authentication of the patient therefore contributing to reducing fraud costs and increasing privacy. It will enable secure access to an electronic medical file that will include emergency data such as blood group, allergies alerts and ongoing treatments records. Authorized healthcare professionals can read personal information only if the patient consents by entering the card’s Personal Identification Number.
“Gemalto has been a long term partner to health insurance companies since the first generation of health cards back in the mid 90s’. We are proud and honored by the decision of AOK to get us to contribute massively to this program by providing German citizens with enhanced security and privacy management devices.” commented Jacques Seneca, Executive Vice President, Security Business Unit at Gemalto. “The quality of our product developed in our Munich R&D center, the capabilities and flexibility of our production and personalization site in Filderstadt near Stuttgart, as well as our high level of commitment to this project have provided us with a strong competitive advantage when it comes to meeting the stringent requirements of rapid large-scale deployments such as this.”
This new reference strengthens Gemalto’s positioning in the healthcare sector, following previous achievements in Algeria, Belgium, China, Finland, France, Mexico, Puerto Rico, UK, USA and Slovenia.
Note to editors
The health program the German government is launching involves 80 million patients, 350,000 doctors and dentists, 2,000 hospitals and 22,000 pharmacies.
The German health service is highly decentralized, with some 250 different insurance companies, each having their own infrastructure and supply process. The health insurance plans are either state-regulated or private. Around 90 percent of the population is covered by the state health insurance and the rest opt for private medical insurance. State health insurance beneficiaries do not have to pay for the visit to their doctor, nor for their medication (apart from a small fixed fee).
With the current system, insurance funds need to issue their customers with a new card whenever their administrative data change, whereas the microprocessor card-based system allows updating the information once the card is in the field, thus reducing operational costs. The electronic health card will carry the prescription and should make about 700 million handwritten prescriptions per year redundant.
…..( see the URL above for full article)
This provides an interesting insight into a very large “Access Card” like project which seems to be off and rolling in a much better way than the current initiative on this side of the world. Note the EHR and prescription functionality that is planned.
All in all some great reading to start the week!
More next week.
David.
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