Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
ALP returns e-health to agenda
Karen Dearne | November 13, 2007
E-HEALTH will be back on the political agenda following Labor's official campaign launch tomorrow.
Shadow health minister Nicola Roxon yesterday said e-health in Australia had failed to reach its potential.
"We recognise that a co-ordinated national approach, with national leadership, is needed to implement integrated e-health initiatives," she said.
"So far, national leadership has been lacking.
"A better connected health system will deliver benefits to patients and healthcare providers, ensuring scarce health dollars are allocated in the most cost-effective way."
Labor is yet to indicate any commitment or funding for e-health measures, despite launching a cornerstone "new directions" policy, promising to end the "blame game" on hospital funding and to slash waiting lists.
All of these programs will require a sound IT and communications foundation, but the new directions manifesto contains only one passing reference to information technology.
Indeed, any e-health announcements tomorrow seem likely to be tied to Labor's wider broadband initiative.
Continue reading here:
http://www.australianit.news.com.au/story/0,24897,22747050-15306,00.html
Sadly we now have the Coalition Policy which is an e-Health free zone and – despite these comments – I have yet to see anything solid from Labor. I look forward to hearing from anyone who spots any announcements from either side this week.
Second we have:
E-health spending $41.5m short
16 November 2007
THE Commonwealth has no interest in advancing the computerisation of healthcare, particularly general practice, following a $41.5 million underspend on e-health, experts claim.
Critics said the lack of investment meant the potential to improve patient safety was not being realised.
Of the $79 million federal e-health implementation budget for 2006-07, less than half ($37.4 million) was spent on e-health initiatives including the HealthConnect project, designed to produce a national network of electronic health records.
Dr Ron Tomlins, former chair of the General Practice Computing Group, said e-health would improve the quality of data stored by GPs as well as boost communication between healthcare providers.
“[The government] has no focus on what can be achieved in terms of patient safety and greater efficiency in the healthcare system... there is not the work being done to facilitate greater use of general practice databases,” he said.
“[We need] greater support to improve the quality of the data we have and programs to facilitate communication between healthcare providers... that will improve the health of at least 20,000 Australians per year.”
The underspend was reflected in the budget estimate for 2007-08, which was slashed to just $40 million.
Read the complete article here:
It is good to see the professional medical press reporting these issues and making sure that the profession understands just what is going on at the Governmental level. Hopefully this awareness may lead to some pressure from the professional bodies to improve what is going on. I believe improved investment and use will only flow from political understanding of the degree of professional concern with the lack of progress in the area.
Third we have:
Software for testing EHR interoperability readied for March release
The first version of a free, open-source software tool for testing the interoperability of e-health records systems is expected to be available March 21, the developers announced today.
The Certification Commission for Healthcare Information Technology and Mitre are jointly developing the tool, named Laika, in honor of the dog that was the first living animal to enter Earth orbit, paving the way for human spaceflight.
“This effort will likewise demonstrate that the grand challenge of interoperable EHRs is attainable and will inspire others to follow,” the project’s Web site states.
The tool will allow vendors to verify that their products conform to CCHIT's EHR certification criteria. The goal is to make sure that the systems used by doctors, hospitals and other health care providers can exchange information on patients treated by more than one provider.
Laika will initially support testing of the Health Level 7/ASTM Continuity of Care Document (CCD), a core set of patient information such as name, address, health problems and medications.
Continue reading the details here:
http://www.govhealthit.com/online/news/350112-1.html
The web-site for Project Laika can be found here:
I see this as an innovative approach to solving the problems in inter-operation between EHR products. I also think that taking the approach of developing interoperation at a simple level to begin with and then progressively enhancing the level of interoperation is the ideal approach. The overly complex approach being adopted by NEHTA I see as gravely flawed and highly risky.
Fourth we have:
http://www.theguardian.pe.ca/index.cfm?sid=79583&sc=98
Creation of electronic health records system could save billions in costs annually
President of Canada Health Infoway predicts huge reduction in need for diagnostic tests, fewer days in hospital
The Guardian
The old jokes about doctors having sloppy handwriting could be a thing of the past if Richard Alvarez succeeds in his work as president of Canada Health Infoway.
In fact, if Alvarez and his co-workers reach their aim, the written doctor’s note will be a historic artifact, along with many worries about drug interactions, about missing patient records and about ‘doctor-shopping’ patients abusing the system.
At the heart of the federally funded project is the inter-operable electronic health registry, a planned information-sharing system that will seen a patient’s entire health record available electronically.
“What it means is that an authorized person, an authorized person only, can see your file electronically,” he said in an interview during a recent visit to Charlottetown.
“That means not just your history but the medications you are using and more detailed information like diagnostic images and X-rays can be accessed electronically.
…..
Nationally, the federal government has invested $1.6 billion and plans to leverage a further $1.6 billion from provincial and territorial governments.
“This is a $10-billion project all told by the time it is completed and we expect that to happen over the next 10 years,” Alvarez said.
“If this works out we expect to see a much more efficient health system and better patient care.”
Alvarez said the financial payoff from more effective information handling would be marked and immediate, trimming between $6 billion and $7 billion from national health costs each year.
Those savings would come from many sources, including thousands of days of hospitalization blamed on drug interactions and a huge reduction in the need for diagnostic tests.
“Right now we know that when it comes to tests, 10 to 15 per cent of those that are ordered are duplicates,” said Alvarez. “They’re being done because someone can’t find the results or doesn’t even know the first test even existed.
Continue reading here:
http://www.theguardian.pe.ca/index.cfm?sid=79583&sc=98
Yet again we have a useful set of figures on the expectations for the benefits flow that Canada expects from a relatively full implementation of E-Health applications throughout their health system in a planned and strategic way.
Lastly we have:
Gartner Ranks the Records Vendors
HDM Breaking News, November 13, 2007
Although seven major vendors of enterprisewide computer-based patient records systems all are making progress, only two have reached “third generation” status, which represents no change since 2005, according to a new report from Gartner.
The Stamford, Conn.-based consulting firm determined in 2005 that the records systems from Epic Systems Corp. and Cerner Corp. had achieved third-generation status, and since then, none of the five other companies it tracks have reached this status, says Barry Hieb, M.D., research director. To achieve this status, vendors must have clients that are out of the testing phase and actually using all aspects of the advanced software, he explains.
The most significant differences between second-generation and third-generation systems are decision support capabilities, workflow components and the use of a common medical vocabulary, Hieb says. “In our next study in 12 to 18 months, we expect several more companies will move to generation three,” Hieb says.
Based on their “ability to execute” their software in the real world, Gartner now ranks the companies in the following order: Epic, Cerner, Medical Information Technology Inc. (Meditech), Eclipsys Corp., McKesson Healthcare Systems, GE Healthcare and Siemens Corp.
Continue reading here:
http://www.healthdatamanagement.com/news/EHR25183-1.html
This is a fascinating commentary. Essentially what this says is that for those in Australia there is at present only one viable Hospital Information System choice (Cerner) as EPIC to date does not seem to have any ambitions outside the US – being pretty fully engaged with a large range of US customers.
It will become much more interesting if EPIC starts to look outwards, or others move to the more advanced state.
IBA / iSoft need to move forward rapidly if they are not to find themselves with a range of pretty competent competitors both here and in Europe.
All in all some interesting material for the week!
More next week.
David.
3 comments:
Permit me to look at the ehealth issues from the politician’s perspective.
Delivering faster broadband to the community is well understood by voters. Cutting hospital waiting list is well understood by voters. Training more doctors and nurses and providing more training places in hospitals is well understood by voters. Even, putting Boards back in charge of hospital policy and establishing 24 hour super clinics is well understood by voters, irrespective of whether or not you agree with these policies.
Ehealth is not well understood by voters. And when eminent people like Richard Alvarez of Canada say things like “if this works out we expect to see a much more efficient health system and better patient care” a politician could be excused for thinking ‘so this might not work? What is the political downside if it doesn’t? Why do I want to be associated with spending billions of dollars on something that might not work?
And when Dr Ron Tomlins, says “e-health would improve the quality of data stored by GPs as well as boost communication between healthcare providers”, politicians could be excused for asking “why don’t the doctors do something about improving the quality of care and service they deliver?”
It is all well and good to say “[government] has no focus on what can be achieved in terms of patient safety and greater efficiency in the healthcare system………. .. there is not the work being done to facilitate greater use of general practice databases”. This is just not so. Government has spent hundreds of millions of dollars over the last few years, at the behest of doctors to help improve healthIT. They asked for the money, they got the money and what have they got to show for it today? This is not an issue voters understand.
From a politician’s perspective - where are the votes in all of this? Where are the votes? Broadband, new hospitals, new clinics, computers in schools - it is clear where the votes lie. But with ehealth ……………………… where are the votes?
As the voter votes the votes lie with the voter. As the voter is the consumer then it follows that ehealth will become a political issue in which the politicians can see votes when the consumer makes it so. Hence until consumer demand for access to an electronic health record takes hold there will be no votes in ehealth.
Or maybe when the voter wakes up to the level of preventable errors in our healthcare system and realises that e-Health can help bring the number of errors down. That to me is the line that will convince voters..e-Health can make you safer.
David.
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