Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
AHRQ Awards $5 Million To Help Integrate Clinical Decision Support Technologies into Health Care Delivery
Press Release Date: March 13, 2008
The U.S. Department of Health and Human Services' (HHS') Agency for Healthcare Research and Quality (AHRQ) has awarded $5 million for two new health information technology contracts that will focus on the development, adoption, implementation and evaluation of best practices using clinical decision support. Clinical decision support helps health professionals make informed patient care decisions.
The Brigham and Women's Hospital in Boston and Yale University School of Medicine in New Haven, CT, have been selected to incorporate clinical decision support into widely used health IT products, demonstrate cross-platform utility, and establish lessons learned for clinical decision support implementation across the health IT vendor community. The projects will focus on translation of clinical guidelines and outcomes related to preventive health care and treatment of patients with multiple chronic illnesses. Clinicians' use of clinical decision support also will be evaluated.
"These projects build on AHRQ's investment in health IT and the lessons that we have already learned from our grantees and contractors," said AHRQ Director Carolyn M. Clancy, M.D. "We hope that important lessons from this body of work will further enhance the nation's efforts to make evidence-based clinical knowledge more readily available to health care providers."
Researchers will build on rapidly evolving knowledge from development and implementation activities to define effective clinical decision support tools and identify preferred methods and processes for incorporating these tools into electronic medical records and in busy practice settings. The projects will implement clinical decision support tools in products certified by the Certification Commission for Healthcare Information Technology and will apply guidelines set by the American National Standards Institute's Healthcare Information Technology Standards Panel.
The research will assess potential benefits and drawbacks of clinical decision support services, including effects on patient satisfaction, measures of efficiency, cost and risk. Researchers also will evaluate methods of creating, storing and replicating clinical decision support elements across multiple clinical sites and ambulatory practices.
For more information on AHRQ's health information technology program, visit: http://healthit.ahrq.gov/.
The release is found here
http://www.ahrq.gov/news/press/pr2008/clindescpr.htm
This is very good news as such an investment is likely to be re-paid handsomely in terms of patient safety and quality of care as the experience of these two major expert groups is brought more into the main stream of installed products. Good stuff!
Second we have:
Kaiser, Microsoft agree to fund PHR study
Kaiser Permanente and Microsoft Corp. have agreed to sponsor a study to determine the value of personal health records, conducted by the Center for Information Technology Leadership, the research center announced.
Both organizations have invested in PHRs; Microsoft has HealthVault and Kaiser unveiled its online record, My Health Manager, in November 2007.
Continue reading here:
http://modernhealthcare.com/apps/pbcs.dll/article?AID=/20080317/REG/359252967
This is really more grist to the mill as the work is undertaken to work out just what the place of the PHR should be in the health system. The PHR has the possibility to become a truly disruptive technology in e-Health over the next few years and needs to be carefully watched by all players.
Third we have:
Australian healthcare lags in IT, service providers critical
By Lilia Guan
14 March 2008 01:29PM
The recent provision of $17 million by the South Australian Government to add another level to the State’s electronic health records seems like a big spend, however the Australian healthcare sector overall is lagging behind other markets in IT spending. IT service providers are critical in helping to educate healthcare providers on the needs and function of IT.
According to IDC, the Australian healthcare sector is a late adopter sector. Phillip Allen, research manager for vertical markets said the healthcare sector struggles with the reallocation of budgets to raise sufficient funds for new spending initiatives. As a result, providers remain classified as late adopters and have under-invested in technology for a decade.
"What is worse is that the healthcare sector has historically focused their technology strategies on cost reduction. In the next five years we are not expecting a big improvement, the health sector spending on technology is forecast to remain at $2,030 million by 2011, which is a very similar level of spending to now," he said.
The majority of IT budgets are consumed by hardware, with spending on IT Services forecast to be relatively modest at 462 million in 2008, however there is definitely growth in this segment.
Continue reading here:
http://www.crn.com.au/News/72047,australian-healthcare-lags-in-it-service-providers-critical.aspx
Further information is here:
Investment in health freezes over
Ben Woodhead | August 14, 2007
INVESTMENT in health information systems has stalled at $2 billion a year despite an increase in spending on medical care and claims that new technology could save thousands of lives.
Analysts say budgetary constraints are preventing spending on life-saving systems
Market researcher IDC reports that information technology spending in the health sector will remain flat until 2011, even as Australia's ageing population puts a heavier burden on scarce resources.
The report, IDC Analysis, Australian Healthcare ICT Market 2007, says spending on information and communication technologies in the health sector will total $2.03 billion in 2011, down from $2.06 billion this year.
In contrast, total investment in healthcare is increasing at more than 3 per cent a year after inflation, and IDC estimates the Australian IT and communications market is growing at 2.3 per cent annually.
IDC research manager Phillip Allen said budgetary constraints were among the main impediments to spending on potentially life-saving information systems.
"Healthcare providers view ICT as critical to the future of healthcare and part of the solution to the impending ageing of the population and the soaring cost crisis," Mr Allen said.
"Still, cost constraints ensure that budgets remain largely fixed and devoted only to necessary expenses in problem areas such as security and compliance. Although innovation is a growing interest of healthcare providers, they struggle with the reallocation of ICT budgets to raise funds for new spending initiatives."
IDC's analysis shows that almost half of all health sector spending on IT this year - $948 million - is allocated to hardware, followed by telecommunications at $583 million, services at $438 million and software at $86million.
More here:
http://www.australianit.news.com.au/story/0,24897,22239776-15306,00.html
There projection – despite minor discrepancies are a bit depressing with regard to the firm message of basically zero growth!. I must say I wonder where that 1 billion dollars in hardware actually goes!
Fourthly we have:
IBA wins $670,000 project in Tonga
18 Mar 2008
Sydney – Tuesday, 18 March 2008 – IBA Health Group Limited (ASX: IBA) – Australia's largest listed specialist healthcare information technology company today announced a contract with the Ministry of Health in the Kingdom of Tonga for a web-based hospital information system (HIS) valued at over $670,000.
The agreement with IBA comprises initial licence and service fees of $574,000 together with support and maintenance fees of over $95,000 in the first year.
The new system is being installed at the 190-bed Vaiola Hospital in Tonga’s capital Nuku’alofa and is targeted to be fully operational by March 2009. Central to the new HIS is the company’s web-based patient administration system (web-PAS) with modules for outpatients, inpatients, medical records, theatres, maternity, A&E, billing, and results reporting.
The solution, a key component of Tonga’s Health Sector Support, will give doctors and other carers at the Vaiola Hospital, three district hospitals and outlying health centres and maternity clinics, point-of-care access to vital patient information. The web-based applications enable ready access to patient information. IBA’s solution will also improve the Tongan Ministry of Health’s capacity to collect, manage and use health information effectively to assist future decision making.
IBA is pursuing several opportunities in the Pacific region as preventative health and health promotion have become major priorities for island governments and world health organisations alike. IBA’s executive chairman and CEO, Gary Cohen said: “With an expanding regional presence which provides a unique understanding of the regions needs we are well placed to capitalise on these opportunities both from a geographic and technology perspective.”
Continue reading here:
http://www.ibatech.com/html/iba_wins_670_000_project_in_tonga.cfm
Now, this is what I call a serious commitment to e-Health. The Tongan population is about 112,000 so this contract is for about $5 per head for hospital computing, given the GDP is only $US 8,000 p.a.
See: http://en.wikipedia.org/wiki/Tonga
I would be keen to see such investments happen in other developing countries. It could really help.
Fifth we have:
Privacy reforms to cause industry shake-up
Civil action likely as Australian consumers realize privacy rights.
Darren Pauli 20/03/2008 12:49:13
Australia could see its biggest data breach yet when tough privacy laws clash with lax security culture.
Amendments to the Privacy Act include a range of sweeping new powers allowing the Privacy Commissioner to enforce the mandatory reporting of new data breaches.
Industry will react when someone has a big breach and is served a large fine.
Melbourne-based law firm Holding Redlich special counsel Lyn Nicholson said businesses may face a rude awakening when tough privacy enforcement clashes with a blase attitude to security.
"Online retailers not subject to significant regulation will be the ones hardest hit; their assumptions that a bit of security is enough will be tested," Nicholson said.
"We haven't had big data breaches in Australia and it is easier for companies to keep people quiet.
"Industry will react when someone has a big breach and is served a large fine."
The changes could see Australia heading down the US path where data breaches attract hefty fines and civil action, according to Nicholson.
She said the turning point will be after the prosecution of a high-profile privacy breach.
"I don't expect the Privacy Commission to start handing out draconian fines, but infringement penalties could be followed by civil action. Australians are not as aware as Americans of their privacy rights, but this will change when the new laws settle in."
An Australian Law Reform Commission (ALRC) discussion paper detailing 301 privacy reforms is expected to go to parliament in June after it was delayed past its March 31 deadline.
More here:
http://www.computerworld.com.au/index.php?id=242271242&eid=-6787
This is just an alert that privacy laws are going to change nationally in the next year or so and it will be important for all those in the health sector to know what the implications of these changes will be. It is certain that there will be some significant impacts emerge.
Sixth we have:
Google CEO coughs up Australia Health plans
Liam Tung - 2008/03/19 15:18:01
Google CEO Eric Schmidt said yesterday he hopes to deliver Google Health to Australia by the end of the year -- but local representatives say discussions haven't even started yet.
Australia's various state-based e-health record initiatives could be set for a shake up this year if Schmidt's plans for Google Health in Australia are realised.
Yesterday the Google head acknowledged tough regulatory hurdles would need to be overcome first, but said he hoped to bring the service to Australia by the end of the year.
"Because of the way health regulations work, we have to roll out Google Health on a per country basis. And so we would hope to bring it to here later this year, subject to us meeting regulatory requirements," Schmidt said.
Continue reading here:
It is interesting that Google is thinking of coming ‘Down Under’. I suspect they might find the variable regulations regarding health information handing in the different States and Territories a bit of a challenge. Consistent Federal law – as planned by the ALRC may help in this regard.
Last we have
Research by a Kentucky HIE found that area health care consumers support the HRB concept.
By Jim Boyle
Last August, the Louisville Health Information Exchange, Inc. (LouHIE), a nonprofit community organization based in Louisville, Ky., in association with the Noblis Center for Health Innovation, launched an eight-week e-health research initiative. LouHIE and Noblis worked together to assess the readiness of 1.2 million consumers, their health care providers and related health information product and services (HIPS) firms to support a community-wide health record banking (HRB) system.
LouHIE conducted the study to prepare for the launch of the community health record network and determine which methods would be most attractive to potential consumers.
"We conducted phone surveys, online and paper surveys and held several focus groups," said Barbara Cox, national practice director of the Information Management & Systems practice at Noblis. "We touched base with about 1,200 people from the community and received valuable perspectives."
The research identified several common themes pertaining to overall community interest in participating in an HRB service. These include the need for a trusted not-for-profit community organization to establish the service, a trusted environment, as well as privacy and security.
According to Cox, an HRB network would be treated similarly to any regular neighborhood financial bank. When an individual enrolls into the bank, he/she has complete control over what information is deposited into the account and who can withdraw the information.
"The information is stored in a centralized depository within the community, staffed by people in the area," Cox said. "That maintains a certain amount of trust if you know who is working behind the counter."
Continue reading here:
http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=110054
An interesting approach to having people become comfortable in sharing their health information electronically. Worth following up!
More next week.
David.
3 comments:
In the US it is likely Google's partners will be Walgreen, Aetna, Wal-Mart Stores, the University of California at San Francisco, the American Heart Association and others. Could the equivalent in Australia be Bunnings, Coles, Woolworths, AMP, RACGP, and the Pharmacy Guild?
What sort of service is Google likely to provide?
(i) Will it be similar to what Microsoft envisages or distinctly different?
(ii) will it be linked with an existing PHR vendor? Is this where the Cleveland Clinic project fits in - ie. Cleveland develops and supports the working model and Google does the marketing and distribution worldwide?
(iii) or will Google try to position itself as the ‘honest broker’ - by not being the holder of the repository but by being some kind of go-between - offering a number of PHR solutions like Cleveland Clinic, MyMedicalRecords, Patientrack, MyNetRecord, MedicAlert, HealthRecordsOnline, Healthe and others?
Most likely it will be a combination of (ii) and (iii) - promote the Cleveland solution and some others 'equally'. Maybe even subsidise the Cleveland solution to help stimulate the market and if, or more likely when, some of the 'others' get the wobblies - take them over.
Australia is perhaps the most logical place to test GoogleHealth outside the US. Greg Schmidt knows Australia is a fast adopter of new technology and he also knows clinical systems have a high penetration in general practice by comparison with the US. During his visit he gleaned a little insight into some of the complexities and hurdles which must be overcome to succeed in the Australian market. He knows that if the strategic approach is right those obstacles will not impede progress and therefore should not prevent Google from getting started today. As Google has the wherewithal to do the job the next step is to define a failsafe strategy which overcomes the entry barriers and points to where and when to invest.
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