Useful and Interesting Health IT Links from the Last Week – 26/11/2007

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

E-health fails as election issue

Karen Dearne | November 20, 2007

THE election campaign is still an e-health-free zone as the major parties continue to duck the issue at the Australian General Practice Network's forum in Hobart last weekend.

Opposition health spokesperson Nicola Roxon said Labor's $2.5 billion reform plan would "kickstart investment in immediate improvements in the healthcare and hospital systems". Labor would also establish a national commission to develop a blueprint for health reform, she said.

Mr Abbott told delegates "not to hold your breath" for more Coalition promises on rural, IT or indigenous health.

He said he was frustrated nothing had come out of the Government's investment in IT, and he wasn't handing over any more money until outcomes were guaranteed, an industry journal reported.

Mr Abbott's frustration is unlikely to exceed that of industry players who have watched e-health programs and spending stall under his leadership. Tellingly, the Coalition did not claim credit for any e-health initiative in its health policy after 11 years in office.

…..

Meanwhile, the Health Informatics Society of Australia released its own vision for transforming healthcare last week.

Society president Michael Legg said there was little sign of understanding of the value of e-health at the federal level.

"Perhaps politicians are frightened because it's so hard to do and so easy to fail at," he said.

…..

Read the whole article here:

http://www.australianit.news.com.au/story/0,24897,22786526-15306,00.html

The election is over and we no longer have to put up with the e-Health incompetence of Minister Abbott – frankly all I can say is good riddance and thanks for absolutely nothing!

The wood is now on whoever becomes the new health minister to do a great deal better the previous incumbent.

Second we have:

Lost in mail: data of 25m people

Julia May in London

November 22, 2007

NEARLY half of Britain's population is on alert to the threat of identity theft after the Chancellor of the Exchequer admitted that the personal records of 25 million people had been lost in the mail.

A Scotland Yard investigation is under way and the Government braced for a wave of censure after Alistair Darling told Parliament on Tuesday that two compact discs containing bank details and addresses of 9.5 million parents and the names, dates of birth and National Insurance [social security] numbers of all 15.5 million children in the country went missing after a junior Revenue and Customs employee put them in the post.

MPs gasped as Mr Darling revealed the scale of the security breach. He said that police had discovered no evidence of fraudulent activity, but added: "I recognise that millions of people across the country will be concerned about what has happened. I deeply regret this and apologise for the anxiety that will undoubtedly be caused." He warned the public to monitor their bank accounts for unusual activity.

On October 8, in breach of security rules, the discs were burnt and sent by the unnamed tax office worker via unregistered courier to the National Audit Office for statistical sampling. The information was never meant to include addresses, bank information or parent details.

Read the complete article here:

http://www.smh.com.au/news/world/lost-in-mail-data-of-25m-people/2007/11/21/1195321867124.html

This is really a fiasco of the first order. This sort of managerial incompetence that exposes records of this sensitivity to copying or theft is beyond belief. As I have said previously such ‘stuff ups’ risks the credibility of all attempts to make the sharing of sensitive information possible and makes progress in the e-Health domain just so much harder.

Third we have:

http://www.computerworld.com/action/article.do?command=viewArticleBasic&taxonomyName=government&articleId=303858&taxonomyId=13&intsrc=kc_feat

Denmark's Health Portal Reaches 5.3 Million Residents

Mary K. Pratt

November 19, 2007 (Computerworld) Denmark, like most countries, faced a serious health-related quandary: how to deliver efficient, effective and affordable care at a time of escalating costs and increased demand for services.

But unlike many others, Denmark harnessed IT to create a national health portal to help drive improvements in its health care system. This portal, called Sundhed.dk (sundhed means “health”), has increased communication among doctors and between doctors and patients, increased collaboration among health care providers, boosted efficiencies and even improved the quality of care.

The Danish National e-Health Portal is attracting attention from around the globe, thanks to its innovation and success. It’s also the 2007 winner in the health care category in Computerworld’s annual Honors Program.

“There are very few regions or countries of the world that have done anything like what Denmark has done. They’re all talking about it, how nice it would be to have something like this,” says Jonathan Edwards, a London-based analyst at Gartner Inc.

The idea of a portal isn’t unique to Danish health officials. Businesses and other institutions were already using them while Sundhed.dk was still in its infancy in the early 2000s.

Continue reading here:

http://www.computerworld.com/action/article.do?command=viewArticleBasic&taxonomyName=government&articleId=303858&taxonomyId=13&intsrc=kc_feat

This is a long and interesting report reviewing the progress the Danes have made with e-Health over the last six to seven years. Very well worth a read.

Fourthly we have:

Medical records pioneer maintains research path

By Sandy Kleffman, STAFF WRITER

Article Last Updated: 11/19/2007 08:16:56 AM PST

WALNUT CREEK — At age 94, Dr. Morris "Morrie" Collen still shows up to work one or two days a week at Kaiser Permanente's Division of Research in Oakland.

At other times, he is busy writing his fifth book.

Collen is so unassuming that fellow residents in the Sunrise assisted-living complex in Walnut Creek probably have no idea of the pivotal role he has played in modern health care. He is considered one of the pioneers of electronic medical records, now being implemented in hospitals and doctors offices throughout the nation.

Collen had a computerized medical record system in use in San Francisco in 1969. It was one of the first in the nation and was developed at a time when computers took up nearly an entire room and the input was done with punch cards.

He also is one of the founding members of the Permanente Medical Group, which later became part of the large Kaiser Permanente health system.

Continue reading this fascinating article here.

http://www.insidebayarea.com/argus/localnews/ci_7504485

The Electronic Health Record of the 1960’s is a fascinating story indeed and well worth a browse!

Fifthly we have:

Survey shows waning support for the UK’s NPfIT

20 Nov 2007

Waning enthusiasm from doctors for the National Programme for IT (NPfIT) is recorded in a Medix survey of medical opinion prepared for E-Health Insider and other media.

Only 30% of GP respondents say the programme is an important priority, compared to an all-time high of 70% in a similar survey in November 2004. A parallel decline is recorded among non-GPs whose rating of the programme as an important priority has dropped from a high of 80% to 45%.

Although 23% and 35% of GPs and non-GPs respectively said they were enthusiastic about the programme, the ratings stood at 56% and 75% four years ago.

Asked to rate the programme’s progress, the vast majority (71%) scored it as poor or unacceptable. No respondent checked the box for ‘excellent’ and only 1% thought NPfIT was making good progress.

Connecting for Health, the agency responsible for the programme, says the results of the survey do not appear to reflect the general picture on the ground or chime with other recent comprehensive surveys.

The Medix survey is the latest in a series that started over four years ago. It was conducted at the end of October and beginning of November, gathering the views of 1,064 doctors - just over 1% of the medical profession in England - comprising 44% GPs and 56% doctors practising in other areas, predominantly hospitals.

Continue reading here:

http://www.e-health-insider.com/news/3228/survey_shows_waning_support_for_npfit

If ever there was a message about the complexity of successful change in large scale projects this is it. This lesson should be noted very carefully by NEHTA as it plans an Australian Shared EHR.

Lastly we have:

Tele-treatment - Monitoring from afar, 'eICUs' fill medical gap

By Liz Kowalczyk, Globe Staff

|

November 19, 2007

WORCESTER - On a recent Saturday night, Dr. Craig Lilly studied a wall of video screens, monitoring the heart rates, urine output, and breaths per minute of fragile patients in the intensive care unit. One patient was clearly in trouble.

Franklin Sisler, a retired Air Force master sergeant, was suffering from an aggressive infection in his left knee that had reached his lungs. A blue line tracking Sisler's kidney function was climbing, a warning that his organs were failing, and Lilly decided he needed an operation right away.

He advised a junior doctor to give Sisler more fluid and antibiotics immediately, call in an infectious disease expert, and make sure Sisler got the next available surgery slot to clean out his knee. "It might make the difference between him walking out of the hospital or not," Lilly told a colleague.

Lilly is an intensive care specialist, but he was seated not in the intensive care unit, and for that matter, not even in Sisler's hospital.

Rather, he was working out of a low-rise office building in downtown Worcester - 3 miles from where Sisler lay at UMass Memorial Medical Center.

From this carpeted, fluorescent-lit support center, called an "eICU," Lilly and nurse practitioner Joanne Lewis were supervising the care of 109 of UMass Memorial's sickest patients, scattered among eight ICUs at three of the system's hospitals. They are part of a new program that aims to cope with the soaring number of ICU patients, a problem exacerbated by a shortage of intensive care specialists.

There are 20 percent more ICU beds nationwide now than there were 10 years ago, and too few doctors trained to care for the patients filling them. The vast majority of hospitals do not have an ICU specialists working at night or on weekends, despite studies showing that when intensive care doctors manage or help manage ICU patients, the patients' chances of dying in the hospital decrease by 30 percent.

Continue reading this interesting article here:

http://www.boston.com/business/globe/articles/2007/11/19/tele_treatment/

As some-one who in a former live spent five years as an intensive care specialist I would make two points. The first, rather self serving one, is that I for one am convinced of the thesis that ICU specialists to make a positive difference for the patients they care for and second that it would be great fun to work in a unit equipped at the level discussed here!

All in all some interesting material for the week!

More next week.

David.