Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
Ten Hospitals Now Complete with KP HealthConnect Electronic Medical Records
Posted : Mon, 25 Feb 2008 17:01:14 GMT
Author : Kaiser Permanente
OAKLAND, Calif., Feb. 25 /PRNewswire-USNewswire/ -- Kaiser Permanente today announced that ten of its California hospitals have completed their inpatient deployments of Kaiser Permanente HealthConnect(TM), the organization's electronic health record.
Kaiser Permanente has long been a pioneer in implementing health information technology. KP HealthConnect is the world's largest civilian electronic health record and this week's milestone puts the organization well ahead of hospital-based organizations. A recent report from the California HealthCare Foundation indicated that less than 13 percent of California hospitals (including Kaiser Permanente's), had fully implemented an electronic health record.
Now, nearly a third of Kaiser Permanente's California hospitals are fully deployed ensuring that 2.4 million members are ensured full access to their comprehensive health information, regardless of how and when they need medical care -- whether in the exam room, online, or in the emergency room.
"With the completion of 10 hospitals, more than 2.4 million Kaiser Permanente members are covered completely by an electronic medical record, which means that their records are instantly available at their hospitals and doctor's offices, so they can receive the care they need, when and where they need it," said Andrew Wiesenthal, MD, national physician lead for KP HealthConnect and Associate Executive Director of The Permanente Federation. "This is a significant shift from the paper world, where health records are virtually never available prior to admission."
Kaiser Permanente's electronic health record is expected to improve quality, service and patient safety. With KP HealthConnect in place, nearly all Kaiser Permanente members are already routinely treated with an electronic chart in the outpatient setting, and all of Kaiser Permanente's 8.5 million members have access to My health manager -- KP's personal health record -- where they can manage their health online. My health manager provides critical time-saving features, including online appointment scheduling and prescription refills. In addition, users have 24/7 online access to lab test results, eligibility and benefits information, and even their children's immunization records.
Kaiser Permanente's aggressive implementation schedule will continue in 2008, with 14 additional hospitals slated to roll out KP HealthConnect's inpatient capabilities by the end of the year.
Continue reading here:
It seems to me this is an important milestone that shows just how far a determined execution of a well thought out strategic plan can make substantial headway. It is looking increasingly likely that the KP HealthConnect project will be major contributor to safety, quality and efficiency of the care delivered for the 8 million plus individuals whose healthcare they manage and deliver.
I find it re-assuring that such a large organisation can successfully implement advanced systems that are already making a demonstrable difference to the care being provided by KP.
It is a pity the Australian Government’s HealthConnect project did not work out as well.
Second we have:
OPINION
Associate Professor Ron Tomlins, Discipline of General Practice, Western Clinical School, University of Sydney
29 February 2008
WHY can you get money from an ATM in another country but not see whether your patient was treated at your local hospital?
Not because of the failure of GPs to adopt electronic clinical records, as the BEACH report indicates. More than 80% of GPs are using computers for clinical purposes.
And it is not because of the lack of enthusiasm of GPs and computer software developers to make it happen.
The General Practice Computing Group (GPCG), the AMA, the colleges and the Medical Software Industry Association have been working hard for more than 10 years to build the necessary ‘infostructure’.
Continue reading here:
There is no doubt there are substantial expectations in the e-Health Community that there will be some substantial co-ordinated activity over the first term of the Labor Government. It is clear that more than your humble scribe think the time has truly come.
Third we have:
IBA Health vows better days ahead
Ben Woodhead | February 27, 2008
MEDICAL software maker IBA Health has pledged to deliver a full year net profit after costs associated with its acquisition of Britain's iSoft Group dragged the company into the red during the first half.
IBA Health has pledged to deliver a full year net profit after costs associated with its acquisition of iSoft dragged the company into the red during the first half.
IBA today reported a $1.2 million net loss for the six months to December 31, down from $11.8 million a year ago as it devoured iSoft, which it bought for $408 million in October.
Revenue jumped from $36.3 million to $102.8 million as sales contributions from the purchase flowed through to IBA's top line.
"The integration of our business is well on track and substantial synergies have already been extracted," Mr Cohen told analysts and shareholders at the company's half-year results presentation.
"We're beginning to capture the significant growth opportunities that are available for our extended group. The financial year forecast is in the range of (revenue of) $380 million to $400 million, with 80 per cent already contracted or expected.
Continue reading here:
http://www.australianit.news.com.au/story/0,24897,23284314-16123,00.html
This next year is where the rubber is really going to hit the road for IBA / iSoft. If the merger can be successfully bedded down and LORENZO delivered in some reasonable shape a very bright future lies ahead. However both these are major caveats and only time will tell. This time next year we will know.
The following is a good first step.
ANNOUNCEMENT TO THE ASX
iSOFT preferred vendor in $6.8m Tasmanian projects
Sydney – Friday, 29 February 2008 – IBA Health Group Limited (ASX: IBA) – Australia's largest listed specialist information technology company, today announced that its iSOFT subsidiary has been named as preferred vendor for a $4.6 million contract to provide a state wide patient administration system and has also reached preferred vendor status for delivery of a $2.2 million state-wide pharmacy clinical and dispensing system for Tasmania.
State-wide patient administration system
The Department of Health and Human Services (DHHS), Tasmania is now in final negotiations with iSOFT for the five year contract after placing an initial order for an implementation planning study. iSOFT’s i.Patient Manager (i.PM) PAS will provide the foundation for an electronic patient record, which the DHHS plans to have in place within five-to-ten years. Meanwhile i.PM will integrate patient information across all of Tasmania’s public hospitals including the Royal Hobart, Launceston General, and North West Regional acute hospitals.
State-wide pharmacy, clinical and dispensing system
The five year contract for pharmacy clinical and dispensing system is worth $2.2 million. The Department of Health and Human Services (DHHS), Tasmania has now placed an order for an implementation planning study which is due for completion in April 2008.
The new system is for pharmacy dispensing at all of Tasmania’s public hospitals, but will also provide a single, state wide repository of information on patient medications enabling the DHHS to build common patient medication profiles and apply common business rules. Based on iSOFT’s i.Pharmacy solution, it will offer intuitive decision support to prevent medication errors and enable the delivery of medication at the bedside through web-based information. It also caters for public hospital dispensing of Pharmaceutical Benefits Scheme (PBS) prescriptions, PBS on line claiming and reimbursements, non-PBS prescriptions and integrated dispensing, manufacturing and enterprise inventory management. Future plans include full electronic prescribing and electronic administration.
i.Pharmacy is already installed at 218 sites throughout Australia making it the country’s market leading hospital pharmacy system.
DHHS Tasmania’s chief information officer, Max Gentle, said: “iSOFT is offering significant experience and a proven ability to implement comprehensive state wide patient administration and pharmacy management systems. It has a clear understanding of key business processes, healthcare delivery, and how information will support our future aspirations. iSOFT’s patient administration and pharmacy system will be the cornerstone of our strategy for an full electronic patient record.”
Gary Cohen, executive chairman & CEO of IBA Health Group, said: “the selection of iSOFT as preferred vendor for both the Patient Management System and Pharmacy Management System further consolidates our position as the key supplier of health information technology to all the major Australian State Governments and lays the foundations for iSOFT to participate in National E-Health initiatives.”
(The usual disclaimer that I have a few IBA shares applies)
Fourthly we have:
IBM Rolls Out New Mainframe
February 27, 2008 - 3:14AM
IBM Corp. rolls out a new mainframe computer Tuesday boasting a 50 percent performance boost and dramatically lower energy costs than its predecessor.
The new System z10, with a starting price at about $1 million, comes as IBM focuses on lowering the price tag for running its storied line of data-crunching workhorses.
The Armonk, N.Y.-based company said it designed the new machine to help companies and government agencies that rely on mainframes _ usually for critical data processing such as bank transactions or census statistics crunching _ save money on energy bills and better handle a flood of Internet information.
The size of IBM's investment _ the company spent five years and $1.5 billion developing the new mainframe _ also underscores its commitment to the long-term viability of the mainframe and efforts continue adapting the decades-old product line to the Internet age.
For years some IT experts predicted the demise of the mainframe, bulky and expensive machines that face competition from smaller, less-expensive servers. But IBM says mainframe revenue is growing, rising in 5 out of the last 7 quarters, thanks in part to interest from emerging markets like Brazil, China, India and Russia.
IBM says it incorporated a number of technological upgrades into the new machine to appeal to cost-conscious companies looking to consolidate the number of servers in their data centers.
The z10's capacity is equivalent to 1,500 servers based on the popular x86 design, IBM says, though it has 85 percent lower energy costs and takes up 85 percent less space than the batch of x86 servers.
Continue reading here:
http://news.smh.com.au/ibm-rolls-out-new-mainframe/20080226-1ux9.html
This is a fascinating little note – and just reminds us how often technological predictions fall flat. People have been saying for decades the mainframe is dead! The energy efficiency is interesting. Of course the reliability of these systems makes one wonder why we all put up with PCs and Windows!
Fifth we have:
Governments suppress health research: report
Desi Corbett
29 February 2008
GOVERNMENTS are withholding potentially vital public health information giving a distorted picture of the Australian health system, a damning report has revealed.
On 142 occasions between 2001-2006 government agencies had attempted to suppress research and had been successful in 87% of cases, according to public health academics, who report that the practice is on the rise.
In the survey of 302 public health academics from 17 health research institutions, respondents said suppression of research protected government interest in 81% of cases (Aust NZ J Public Health 2007;31:551-57).
“This paper tells us we in Australia should be expressing... outrage over being given a distorted picture about our health and healthcare system,” experts from University of Western Australia’s School of Population Health Consumer and Community Advisory Council wrote in response to the findings.
They argued that most research was publicly funded and belonged to the community.
Continue reading here:
http://www.medicalobserver.com.au/displayarticle/index.asp?articleID=9073&templateID=105§ionID=1
This is an alarming report that points out how bad things had got under the previous Government. There is no doubt that in the Health IT area NEHTA and the State and Commonwealth Governments have raised secrecy to an art-form. I really hope this will change with the new Government in Canberra – but given the behaviour of the States one can’t be all that optimistic.
Lastly we have:
Roxon agrees to publish health data
Samantha Maiden, Online political editor | February 29, 2008
HEALTH Minister Nicola Roxon is to deliver a new era of transparency in public health, agreeing to publish performance data on state hospitals and commonwealth programs.
The reforms will allow patients to get information on hospital performance across the nation and force the commonwealth to publish data on access to GPs by region.
The states had also asked for up to $22 billion in extra health funding but the health ministers’ conference chair, Queensland’s Stephen Robertson, said today negotiations were continuing and the states were not going to get “hung up” about the commonwealth not agreeing to a figure at this stage of the talks.
Speaking after a meeting of the health ministers in Sydney today, Ms Roxon said she had agreed to the states' request that the commonwealth also publish performance data, rather than simply demand the states do so.
"This means there's going to be more transparency for the public and mutual obligation. The states requested that of the commonwealth, we thought that was a fair request,’’ she said.
“For the first time ever, across the country it will allow bureaucrats, it will allow academics, it will allow others to make an assessment about how the commonwealth is spending on health.
Continue reading here:
http://www.theaustralian.news.com.au/story/0,25197,23296742-23289,00.html
If done well (i.e. with proper information management and KPI definitions used) this could be a very useful initiative. What is needed is that there be fair, objective and comparable measures used to make comparisons between the States valid and useful to motivate improvement.
The following was also interesting:
Doctors fall foul of Medicare
March 2, 2008
A CRACKDOWN on dodgy doctors meant more than $1.7million was repaid last financial year for rorting the Medicare system.
Using sophisticated data mining, the Medicare watchdog reprimanded 20 practitioners for prescribing drugs to addicts, ordering excess pathology tests, fake consultations, performing unnecessary procedures and claiming expensive item numbers for simple problems.
Continue reading here:
http://www.smh.com.au/news/national/doctors-fall-foul-of-medicare/2008/03/01/1204227049560.html
Good to see technology is being used to detect fraud – but given the funds that pass through Medicare it is hard to understand how the sum detected can be so little.
More next week.
David.
3 comments:
DHHS Tasmania has opted for the devil they know rather than the one they don’t. They had little choice. Tasmania has a small number of hospitals serving a population of approx. 500,000. iSoft (IBA) securing Tasmania in this way is significant in more ways than one.
Firstly it is a common sense decision which minimises risk. IBA will most likely encounter some pretty rough waters ahead as a result of its recent takeover of iSoft. Even so, in a state as small as Tasmania, replacing the existing vendor with solutions from an alternate provider would probably increase the risks to unacceptable levels. IBA is a major player in the Australian and world markets and the decision stay with that vendor is simply common sense. Tasmania had no choice, it must now hope that IBA and its subsidiary iSoft will deliver, even if the actual delivery is some way into the future.
Secondly, this decision should suggest that all the other little itty-bitty projects which have been dragging along and nibbling round the edges for some time now, like HealthConnect-TAS, should be swept aside to give iSoft/IBA a clean sweep to get on with the job without the distraction and environmental disruption caused by such projects.
Thirdly, and probably far more significant, is the fact that, when looked at in the cold light of day, the outcome in Tasmania would have been just the same irrespective of whether NEHTA did or did not exist! What NEHTA has done and what it will do is of little material consequence to Tasmania. A decision had to be made and it has been made.
If IBA embraces NEHTA’s policies and outputs so be it - whenever that might be - but that decision is IBA’s to make not NEHTA’s. IBA’s job is to remain viable and to service and hold onto its customer base worldwide. The same will inevitably hold true throughout Australia - the states will make their IT decisions as Tasmania has done and if NEHTA has anything useful to contribute the vendors will decide whether or not to make use of it, within their product offerings, at the appropriate time.
Tasmania’s decision predicates the question, yet once again: What is it that NEHTA has got to offer all of us in the vendor community today and what has it got to offer our client base that is of any practical use to them and to us?
We will continue to conduct our business activities as we have always done, and we will continue to watch with interest what NEHTA is doing. Should it deliver something of practical use we will embrace it, if it’s affordable and commercially sensible to do so. That however seems to be a very long way off. As vendors we will continue to work closely with our clients and prospective customers as we have always done. Tasmania has lit the way ahead without fear or favour - well done Tasmania.
Ron Tomlins asks WHY can you get money from an ATM in another country but not see whether your patient was treated at your local hospital?
The answer should be obvious: My bank empowers me, the health system disempowers me.
Banks have customers and they need to hold on to them. They develop products which make the customer increasingly dependent on the bank. In the banking industry we call it ‘stickiness’. The stickier the customer becomes the harder it is for them to move to a competitor. The more of our products they use the stickier they become. This is goodness as far as we, the service provider, is concerned.
Health has customers and they are very many service providers. The closest analogy to the ‘bank’ is probably the health insurance fund. Every fund wants to keep its customers but they haven’t yet devised a really good way to make them sticky. Another example is a large pathology or radiology group. But the stickiness that they try to impose is focused on the doctors not the consumer, and its messy and not very successful.
So the banks have a commercial imperative driving them to embrace ATM’s and provide their customers with easy access to their money wherever it is held and in whichever accounts. If they don’t, and if it’s not too difficult (sticky) the customer will move to another bank.
There is no clear analogy in health. A doctor should be able to see whether one’s patient was treated at the local hospital. But the commercial imperative is not there to make it happen. This is because of the fragmented nature of health services, the cultural complexity of the environment, the testy political forces at play and a host of other factors.
There is only one constant in the entire system. As with the banks it is the ‘customer’ and in health that means ‘the consumer, the patient, call them what you will’. The banks well know that until they make their ‘customers’ really sticky they could go elsewhere.
But how does one achieve that in health? Perhaps when the electronic health record, or maybe the consumer-controlled personal health record, takes hold in the market some extensions of either of these applications may let Dr Tomlins see when and where I was treated in hospital. But he wants more than that, he wants access to the details of all his patients treated at the local hospital.
It’s possible the hospital could provide that information (at some time in the future - online), but more than likely they will be reluctant to do so without the express permission of the patient.
I, as a consumer and a patient, may give Dr Tomlins access to that information about me or I may not. It should be my decision, not his and not the hospital’s. But I don’t have control over my health information - so what’s the use.
The ‘health system’ is one of disempowerment. The ‘banking system’ is one of empowerment. Until I, as a consumer and a patient, can be empowered by the health system nothing much will happen. One thing is certain - I won’t be giving my doctor access to my bank account!
Ron Tomlins replies:
Anonymous has pointed out that there are commercial factors that have driven IM in the banking industry, and I agree. And he/she makes my point – finance, not technology, is the rate limiting step. The health sector is a mixture of public and private funding, with the major infrastructure being largely publically funded. Yet the government underspent its IT budget by $40 million. BTW, I am not advocating access to people's private health information without their consent. But even with their consent, I cannot access their information. Let's move on!
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