Quote Of The Year

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

Sunday, February 03, 2008

Useful and Interesting Health IT Links from the Last Week – 03/02/2008

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

These include first:

Gartner's top 10 IT predictions for 2008 and beyond

Open source, Apple, green technology and 3-D printing highlighted

Jon Brodkin (Network World) 01/02/2008 08:41:41

Open source, Apple computers, green technology, the rise of users and the proliferation of three-dimensional printing are among the hot trends IT shops should look out for in the next few years, according to Gartner.

The analyst firm on Thursday highlighted 10 key predictions of developments that will affect IT and business users in 2008 and beyond. Here's a detailed look at the list, culled from more than 100 predictions Gartner has made based on its research:

  • Apple will double its market share for computers in the United States and Western Europe by 2011. "Apple's gains in computer market share reflect as much on the failures of the rest of the industry as on Apple's success," Gartner says. A focus on interoperability between the iPod, iMac and other devices is one of the keys for Apple.
  • By 2012, half of all workers will use devices other than their laptops when they travel. "Even though notebooks continue to shrink in size and weight, traveling workers lament the weight and inconvenience of carrying them on their trips," Gartner states. "Vendors are developing solutions to address these concerns: new classes of Internet-centric pocketable devices at the sub-US$400 level; and server and Web-based applications that can be accessed from anywhere."
  • 80% of commercial software will contain open source code by 2012, providing "significant opportunities for vendors and users to lower their total cost of ownership and increase returns on investment."
  • Software-as-a-service will account for at least one-third of business application spending by 2012. "Endorsed and promoted by all leading business applications vendors (Oracle, SAP, Microsoft) and many Web technology leaders (Google, Amazon), the SaaS model of deployment and distribution of software services will enjoy steady growth in mainstream use during the next five years," Gartner writes.

Continue reading here:

http://www.computerworld.com.au/index.php?id=818517154&eid=-255

This is an interesting list of the technology trends Gartner thinks will be important in 2008. Well worth the browse.

Second we have:

Age does not weary Medicare system

Karen Dearne | January 29, 2008

MEDICARE's claim processing systems are largely accurate despite being handled by an outdated IBM mainframe computer and a 35-year-old flat file format, the Australian National Audit Office says.

New claim and payment methods, such as Medicare Online, have forced the retrofitting of legacy systems to allow connection with the internet.

Medclaims, the bulk-billing system based on electronic data interchange technology, is being phased out in favour of Medicare Online.

In 2006-07, 25 per cent of claims were submitted via Medicare Online, up from 19 per cent the previous year. During the year, $11.8 billion in benefits were paid for almost 258 million Medicare services.

Overall processing accuracy was 98 per cent. Almost 99 per cent of scanned or electronically lodged claims were handled without human intervention.

Continue reading here:

http://www.theaustralian.news.com.au/story/0,25197,23122867-23289,00.html

This comment on page 14 of the report is of some concern.

“The focus was on the mainframe based common assessing processing system, and the supporting processes, that are used to assess all Medicare claims irrespective of what method was used to submit or pay the claim. The validity of the Medicare Consumer Database, which is used to determine whether a patient is a ‘valid Medicare’ patient, was not tested by this audit.”

If the audit has not checked the validity and accuracy of the Consumer Database how can they know anything about the levels of fraud etc. Accurately processing payments for an invalid client is hardly an achievement.

Of course, it is this database NEHTA plans to download as the starting point for their Individual Health Identifier. Knowing reliably its accuracy seems to me to be vital. A missed opportunity I would suggest.

Third we have:

http://www.theaustralian.news.com.au/story/0,25197,23141570-23289,00.html

Roxon rules out league tables for hospitals

Milanda Rout and Patricia Karvelas | February 01, 2008

FEDERAL Health Minister Nicola Roxon has ruled out using league tables to form a national reporting system for public and private hospitals.

Ms Roxon yesterday encountered fierce opposition from the states for a national hospital league table during negotiations on how a reporting system might work at the meeting of health ministers in Melbourne.

NSW was one of the most vocal opponents to the federal government initiative, saying league tables would have a negative rather than positive impact on hospitals.

"We do have reservations about the concepts of league tables for hospitals, and in fact it could provide quite a disincentive to providing good quality care," NSW Health Minister Reba Meagher said.

"All the clinicians tell us that league tables aren't an accurate reflection of what kind of care and quality of care (are) being delivered in a hospital setting."

Ms Meagher said she was pleased Ms Roxon had ruled out league tables as part of the national reporting system.

Continue reading here:

This outcome is really condemns the quality of the health care policy debate in Australia. Research in the US and elsewhere has identified reliable non-discriminatory indicators of quality, safety and efficiency and implementing these in Australia is not a technical issue – it is a matter of will and of ensuring the medical lobby and jurisdictional pride do not block developing a clear view of how our health systems are performing.

A few good places for Ms Roxon to visit to understand what is possible include:

http://www.jointcommission.org/

and

http://www.ahrq.gov/

Fourthly we have:

Cable break downs web services

Matthew Rosenberg in New Delhi | February 01, 2008

AT least for a while, the world wide web wasn't so worldwide.

Two cables that carry internet traffic deep under the Mediterranean Sea snapped, disrupting service Thursday across a swath of Asia and the Middle East.

India took one of the biggest hits, and the damage from its slowdowns and outages rippled to some US and European companies that rely on its lucrative outsourcing industry to handle customer service calls and other operations.

"There's definitely been a slowdown," said Anurag Kuthiala, a system engineer at the New Delhi office of Symantec, a security software maker based in California. "We're able to work, but the system is very slow."

While the cause of the damage was not yet known, the scope was wide: Traffic slowed on the Dubai stock exchange, and there was concern that workers who labour for the well-off in the Mideast might not be able to send money home to poor relatives.

Although disruptions to larger US firms were not widespread, the outage raised questions about the vulnerability of the infrastructure of the internet. One analyst called it a "wake-up call," and another cautioned that no one was immune.

The cables, which lie undersea north of the Egyptian port of Alexandria, were snapped Wednesday just as the working day was ending in India, so the full impact was not apparent until Thursday.

Continue reading here:

http://www.australianit.news.com.au/story/0,24897,23143232-15306,00.html

Funny that a news item last week explored what one would do without the Internet and a good fraction of the Middle-East experienced just that this week. The lesson is clear – we need multiple redundancies in our network services as we become increasingly dependent for much of our daily work and productivity on these services.

I must say some of the consequences of the service interruption were unexpected initially to me and shows the depth of transformation and dependency the Internet has achieved.

Fifthly we have:

HIMSS Analytics Releases ‘Health IT Sanity Check’

January 22, 2008 | Despite all the perceived progress toward the wiring of America’s hospitals, a new study suggests there remain some serious misunderstandings between provider-side health-IT executives — chief information officers — and top marketing officials at technology vendors.

In the first “Healthcare IT Sanity Check,” released Tuesday by the HIMSS Analytics division of the Chicago-based Healthcare Information and Management Systems Society (HIMSS) and marketing firm O’Keeffe & Co. (Falls Church, Va.), only 2 percent of health-IT executives gave an A to marketing executives, while the marketing people were heavily self-critical, with only 7 percent giving themselves the top mark.

The survey, which includes 100 IT professionals and 100 vendor representatives, has a margin of error of roughly eight percent.

“What this survey was for was to put some numbers behind the anecdotes,” HIMSS Analytics executive vice president Michael Davis told Digital HealthCare & Productivity. “We found some disconnects,” he adds.

A majority of vendors still believe price is among the top factors in a purchasing decision, but only 44 percent of CIOs agree. Far and away the most important criterion for CIOs was functionality, named by 77 percent of IT professionals. For vendors, functionality tied with price, at 57 percent each.

An unnamed IT professional quoted in the report advised, “Tone down the sales pitch and focus on functionality.” “Take the time to understand our specific organizational culture, requirements, and expectations,” said another.

“I think enough people have been burned by picking the lowest bidder,” Davis says. As Exhibit A, he points to the British National Health Service, which largely chose its vendors by negotiating for rock-bottom prices, and now is struggling to implement a massive health-IT network to serve the 52 million people in England. However, Davis adds, “I think the market is learning.”

Continue reading here:

http://www.health-itworld.com/newsletters/2008/01/22/healthcare-it-sanity-check

This is an absolutely fascinating report showing just how large the disconnect seems to be between Health System CIOs and Health IT Vendors. This must be a wakeup call to all those involved to improve their communication between each other.

The success of Health IT initiatives is surely dependent on the vendors delivering software that satisfies the needs of the clinical users. The vendors ignore this fact at their long term commercial peril!

Lastly we have:

National media attention for anti-smartcard group

30 Jan 2008

In Germany this week doctors and civil rights activists joined forces to organise a boycott of the German smartcard programme, attracting huge media interest, including national TV.

The new alliance went public last Friday with a joint press conference at which it proclaimed the explicit goal of halting the smartcard health programme and move to centralised systems, citing privacy worries.

The alliance’s opposition extends to all efforts to digitally communicate in the German healthcare system on a supra-regional level.

“We do not need a national communication infrastructure for the healthcare system”, said Silke Lüder, a Hamburg-based GP and one of the speakers of the alliance.

“We are fed up with feeding industry with money just for prestige projects of politicians without any benefit for the patient”, added Martin Grauduszus, head of the doctor’s body ‘Freie Ärzte’ (Free Doctors).

The event made its way through German media on Saturday, Monday and Tuesday. The national news agencies dpa and Reuters reported, as did one of the two main channels of national public television, at least two private channels, a number of national and regional newspapers and a broad spectrum of special interest magazines, including ‘Computerwoche’ (Computer Week), a leading weekly IT title.

The two main issues of criticism are concerns about privacy and about costs. The new alliance claims that smartcards in healthcare are the first step towards a system of national “mega-servers” which contain aggregated patient data in centrally stored shared electronic patient records.

Continue reading here:

http://ehealtheurope.net/news/3426/national_media_attention_for_anti-smartcard_group

Does all this remind anyone of the recent Access Card debate in Australia?

More next week.

David.

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