Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Monday, January 14, 2008

Useful and Interesting Health IT Links from the Last Week – 13/01/2008

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

These include first:

Microsoft admits Office 2003 'mistake'

By Richard Thurston

Story last modified Mon Jan 07 10:41:01 PST 2008

Microsoft has acknowledged it made a mistake over a security advisory it released concerning Office 2003.

The advisory, posted in December, told users that dozens of file formats had been blocked in the latest service pack for Office 2003--Service Pack 3 (SP3)--because they were insecure.

It provided a workaround for users who wanted to unblock the formats, but made the process complicated, requiring changes to the registry which could have made users' PCs inoperable if they were applied incorrectly.

On Friday, Microsoft admitted that the information it had provided was wrong, and that it had underestimated how many users had been affected. It now says that, instead of the file formats themselves being insecure, it is the parsing code that Office 2003 uses to open and save the file types that is less secure.

Speaking to ZDNet.co.uk on Friday, Reed Shaffner, worldwide product manager for Microsoft Office, confirmed that the advisory provided by Microsoft was incorrect, and that manual registry fix which Microsoft had provided had been difficult to implement by end users.

Continue reading below

http://www.news.com/Microsoft-admits-Office-2003-mistake/2100-1012_3-6224917.html

Can I say this sort of monopolist behaviour really got up my nose. Especially so as I have considerable archives of older Powerpoint and occasional MS Word files that I can now no longer access in Office 2007.

This sort of behaviour should be easily managed at the level of user options. I resent having to muck around with ‘trusted directories (which do not seem to solve the problem) and such like workarounds.

Frankly one more reason to hope OpenOffice or Google can knock the arrogant jerks off their dominant spot.

Note also

Microsoft: No new tools to unblock files in Office 2007

'Trusted locations,' other work-arounds, are sufficient, says Microsoft manager

Gregg Keizer 11/01/2008 08:33:59

Microsoft will not post new tools that would allow users of Office 2007 to access blocked file formats, as it has done for customers running Office 2003 Service Pack 3 (SP3). It cited a lack of interest in such tools and said existing work-arounds accomplish the same thing.

Last week, after some users complained that Office 2003 SP3 had changed the suite's security defaults so that applications would no longer open numerous file formats -- including one used by Corel's CorelDraw graphics software -- Microsoft apologized to Corel and posted downloads that let users unblock formats without manually editing the Windows registry.

The company also said it was sorry. "We recognize that we have not made any of this as usable as we'd like, and we apologize that this hasn't been as well documented or as easy as you need it to be," David LeBlanc, a senior software development engineer with the Office team, said last Friday.

Continue reading here:

http://www.computerworld.com.au/index.php/id;1450884221;fp;;fpid;;pf;1

Second we have:

Technology that exposes your dirty linen

January 7, 2008

Once-wary Australians accept their daily lives being monitored, writes Damien Murphy.

BIG BROTHER is washing you.

The washing machine of the future may not only wash garments according to the instructions on the clothes but secretly collect information for telemarketers, political parties and anybody else with an interest in people's dirty linen.

The Australian Law Reform Commission says washing machines could be fitted with radio frequency identification equipment, known as RFID, which stores information and transmits it to a data-processing system.

A discussion paper by the commission on a review of Australian privacy law lists the "bugged" washing machine as one of the myriad controversial technologies that are stealthily shaping the way we live.

Continue reading here:

http://www.smh.com.au/news/national/technology-that-exposes-your-dirty-linen/2008/01/06/1199554485298.html

This is quite a useful review of all the ways we are all now being tracked and monitored. I suspect that a backlash against all this is not far off.

As I have remarked previously a gradually eroding sense of control of one’s personal information is not likely to assist develop the trust required for e-Health initiatives to succeed.

Third we have:

Doctors 'failing to use' report system

Natasha Wallace Health Reporter
January 12, 2008

A STATEWIDE incident reporting system designed to improve patient care in public hospitals is barely used by doctors and only a fraction of adverse events or "near misses" are even recorded, the NSW branch of the Australian Medical Association has said.

Failings in the system were raised at the recent inquiry into the Royal North Shore Hospital.

The president of the NSW AMA, Andrew Keegan, said he strongly supported the system, but said most doctors did not know how to use it or, if they did, did not have the time to make entries or could not get access to a computer.

"Only about 5 per cent of the reports were from doctors," Dr Keegan said. "The rest are from all the other staff - the nurses, administrative staff. But if it's something that's supposed to be helping the patient quite often the only people who know what's going on with the patient, from a medical point of view, are the senior registrar and the consultant."

Continue reading here:

http://www.smh.com.au/news/national/doctors-failing-to-use-report-system/2008/01/11/1199988590143.html

This is hardly a surprise. Not only is there not easy access to the systems to undertake the reporting but NSW Health is hardly famous for the way it treats those who suggest there may be systemic problems that need to be addressed.

The mechanisms for reporting I would suggest are much less important that fostering a learning and supportive culture within NSW Health – something the recent RNSH inquiry suggested was not even being seriously attempted.

Interestingly the same topic is being addressed in the US in the same week with similar conclusions.

Physicians find medical error-reporting systems inadequate

By Molly Merrill, Contributing Writer 01/10/08

Physicians are willing to report on medical errors, but find current error-reporting systems inadequate, according to the Agency for Healthcare Research and Quality.

A new AHRQ study says poor error-reporting systems lead physicians to depend on discussions with colleagues rather than reporting to the hospital or health organization, and important information regarding medical errors and prevention is lost.

The study was funded by the Department of Health and Human Services' Agency for Healthcare Research and Quality and appeared in the January/February issue of Health Affairs. Between July 2003 and March 2004, authors polled more than 1,000 physicians and surgeons practicing in rural and urban areas in Missouri and Washington State.

The survey reported that 56 percent of physicians had prior involvement with a serious error, 74 percent were involved with a minor error and 66 percent reported a "near miss." More than half, 54 percent, agreed with the statement that "medical errors are usually caused by failures of care delivery systems, not failures of individuals."

According to the survey, few physicians believe they have access to a reporting system designed to improve patient safety, and 45 percent don't know if one exists at their organization. Only 30 percent of those surveyed agree that current systems to report patient safety events are adequate.

Physicians said that in order to formally report error information, the following would be needed:

• Information must be kept confidential and non-discoverable (88 percent);

• Evidence should be made available that such information would be used for system improvements (85 percent) and not for punitive action (84 percent);

• The error-reporting process must take less than two minutes (66 percent); and

• The review activities must be confined to their department (53 percent).

Continue reading here:

http://www.healthcareitnews.com/story.cms?id=8377

Fourthly we have:

http://biz.yahoo.com/bw/080107/20080107005539.html?.v=1

Spectrum Health Collaborates With Cerner and Microsoft to Implement Technologies That Empower Patients


Monday January 7, 8:30 am ET

Innovative System Allows Patients to Access Personal Health Information, Entertainment at the Bedside

GRAND RAPIDS, Mich. & KANSAS CITY, Mo.--(BUSINESS WIRE)--Spectrum Health announced today its strategic relationship with Cerner and Microsoft Corp. in developing the Cerner Care Console™ solution, a consumer-centric technology that empowers patients to take an active role in their care. The new technology will be displayed today in the Microsoft booth at the Consumer Electronics Show in Las Vegas, Jan. 7-10.

By integrating Spectrum Health’s knowledge about the patient experience with the Cerner Millennium® healthcare information technology (HIT) computing platform, and Microsoft Windows Media Center, the Care Console system keeps patients informed about their condition, medical care and provider team during their hospital stay. In addition, Cerner also has incorporated separately the use of Xbox 360 retail consoles into this system to offer patients gaming and entertainment experiences. Spectrum Health is piloting implementation of the Care Console system in one of its units at its 750-bed Butterworth Hospital in Grand Rapids.

“Our goal is to engage patients in a full partnership with us so we can provide the highest quality care and best experience possible,” said Matt VanVranken, executive vice president, Spectrum Health System/president, Spectrum Health Grand Rapids. “Informed and involved patients are essential to providing exceptional experiences in our hospitals.”

With input from patients, nurses and physicians, Cerner worked with Spectrum Health to develop a consumer-oriented system that allows patients to actively participate in their care. Cerner and Spectrum Health found that patients could benefit from communication tools easily accessible at the bedside that range from access to their daily care plan to reviewing radiology images to diversional activities such as e-mail, movies and video games.

“Our strategic relationship with Spectrum Health and Microsoft utilizes the power of healthcare information technology to deliver a better patient experience,” said Trace Devanny, Cerner president. “By pulling information from the Cerner Millennium computing platform to educate patients about their care, we’re able to improve satisfaction, and create an informed dialogue between patients and providers.”

Continue reading here:

I found this quite a surprising press release. We must assume the motivation is to try and improve profitability in ‘for profit’ hospitals in the US – rather than any obvious need for such technology. With the patient turnover being what it is in most hospitals it is hard to imagine just how much use a Hospital Information Connected X-box would receive!

That said I am aware of such facilities in organisations trying to attract rich medical tourists to come to places like Thailand and Malaysia for their elective surgery!

Fifthly we have:

Taunton go-live with Cerner Millennium

07 Jan 2008

Taunton and Somerset NHS Foundation Trust has become the eighth site in the South of England to go-live with the Cerner Millennium patient administration system under the National Programme for IT.

The trust went live with Millennium Release 0, delivered by local service provider Fujitsu, on the weekend of 15-16 December.

In a statement the trust said the software has now “been successfully introduced at Musgrove Park Hospital, Taunton.”

Musgrove Park is the largest general hospital in Somerset, serving a population of over 340,000. The hospital has over 700 beds and employs around 4000 staff.

The trust is the first site to go live with a version of Millennium which is compatible with direct booking to the national Choose and Book electronic appointments systems.

In a statement to E-Health Insider the trust said: “Cerner Millennium updates the old system and forms a secure base for future developments. It makes patient information even safer than before and will allow for much quicker and efficient use of information.”

Hospital consultant, Dr Tim Jobson, said: “This paves the way for the implementation of sophisticated clinical systems, which will bring about significant improvements in patient care. We have transferred over 660,000 sets of patient records, over 60,000 future appointments and all our waiting list information.

Continue reading here:

http://www.e-health-insider.com/news/3357/taunton_go-live_with_cerner_millennium

This seems to be further evidence that we are seeing major infrastructure being progressively phased in within the UK NHS with quite large organisations now being addressed.

Lastly we have:

Strengthen privacy protections for e-health data, top panel recommends

By Nancy Ferris
Published on January 7, 2008

In a new report, the National Committee on Vital and Health Statistics calls for stronger privacy protections for individuals’ health records as those records are digitized and delivered over networks.

It recommends less reliance on the Health Insurance Portability and Accountability Act of 1996 and the rules issued to implement HIPAA. Instead, the committee calls for “a transformation, in which the focus is on appropriate data stewardship for all uses of health data by all users, independent of whether an organization is covered under HIPAA.”

The committee, a longstanding advisory committee to the Health and Human Services Department, prepared the report in response to a request from the Office of the National Coordinator for Health Information Technology.

The report was supposed to examine issues relating to secondary uses of health data – that is, uses other than caring for the patient. But the committee determined that “secondary uses” was an often-misunderstood label and also potentially a pejorative. The report uses it only sparingly.

The report, “Enhanced Protections for Uses of Health Data: A Stewardship Framework for ‘Secondary Uses’ of Electronically Collected and Transmitted Health Data,” offers more than 20 specific recommendations, most of them for HHS officials.

It notes that careful use of health data can increase patient safety, improve coordination of patient care, increase understanding of diseases and drugs, and have other benefits for patients and society. At the same time, it states, “there is potential for harms that may arise from uses of health data enabled by” health IT and the exchange of health records.

Continue reading here:

http://www.govhealthit.com/online/news/350163-1.html

The useful report can be downloaded from here:

NCVHS report

This report will be mandatory reading for all those interested in ensuring patient information is properly protected no matter who has to use it and for what purposes

More in next week.

David.

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