Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
HIT Terms Project Calls For Final Comments On Proposed Definitions
To enable widespread participation in this project for U.S. Department of Health and Human Services’ Office of the National Coordinator, the Alliance is holding a second public comment period from March 24th to April 9th on the work completed so far in defining the five terms: electronic medical record (EMR), electronic health record (EHR), personal health record (PHR), health information exchange (HIE) and regional health information organization (RHIO).
The deadline for finalizing the definitions is approaching and now is the time to be heard and to provide input on the definitions. The final definitions will provide an important reference point for policy evaluation and standards development activities and they will help explain health IT concepts in language that consumers can readily understand. As an industry we need to quickly reach clarity and certainty about these terms so we can move forward with the important business of improving health care through health IT.
Committed to creating consensus-based definitions, the project’s Records Work Group and Network Work Group have already weighed and incorporated feedback received during two public forums and the first public comment period.
To review the updated version of the draft definition and provide please click here or browse to the Comments section of this web site.
Continue reading here:
This interesting project is still underway and seeking further input.
The working document – some 33 pages is well worth a download and read.
http://definitions.nahit.org/doc/HITTerms_DraftReport_032408_Final.pdf
Comments are welcome until April 9, 2008.
Second we have:
Can you keep a medical secret?
Move to online records pits your privacy against a doctor's need to know
By Daniel Lee
daniel.lee@indystar.com
Does a doctor treating you for a broken leg need to know you had an abortion 20 years ago?
Should your dentist have access to information about your visit to a psychiatrist?
Such questions are moving center stage as patients' medical records increasingly are transferred from manila folders to the Internet, allowing easier access to medical history that the patient may not want known.
In one of the latest examples of the debate over how much patient history doctors should have access to, Dr. Marc Overhage, chief executive of Indiana Health Information Exchange, cast the lone dissenting vote as a 17-member federal panel recommended that patients get more control over electronic health records.
Overhage is a member of the National Committee on Vital and Health Statistics, which sent its recommendations to the U.S. Department of Health and Human Services last month. The panel encouraged HHS to give patients the power to sequester from their online medical records certain sensitive information such as domestic violence-related treatment, reproductive health and genetic information.
"I certainly believe it's a patient's right to protect and control their information," said Overhage, a professor at the Indiana University School of Medicine.
However, he said physicians, in order to provide the best care possible, also need access to information -- sometimes including information that is more personal in nature. The fact that a woman takes birth control pills, he said, could have an effect on how a doctor would prescribe other medications.
He also said the recommendations he voted against leave too many unanswered questions and contain initiatives that could cost hundreds of millions of dollars to implement.
Continue reading here:
http://www.indystar.com/apps/pbcs.dll/article?AID=/20080323/BUSINESS/803230394/1175/LOCAL0102
This is an excellent summary of the differing view that exist in the US (and here) as to how the privacy of electronic health records should be best addressed.
More discussion is also found here:
http://www.healthleadersmedia.com/content/208205/topic/WS_HLM2_TEC/Privacy-Where-Are-We-Headed.html
Privacy: Where Are We Headed?
Gary Baldwin, for HealthLeaders Media, March 25, 2008
Let it be said that I am no big fan of legislating healthcare privacy. After all, many people among us willingly blab about the very health conditions that privacy advocates insist are sacrosanct. And the laws that attempt to regulate access to privacy can quickly become confusing and burdensome--just look at the massive industry attempt to comply with HIPAA and its disclosure requirements for personally identifiable health information. But I understand that the burdens of legalese and human nature are not ample reason to throw privacy to the wind. Other than my doctor, it's really nobody's business what my diagnosis is, or was, or could be.
Third we have:
Practicing Patients
By THOMAS GOETZ
Todd Small was stuck in quicksand again. It happened, as always, on the floor of the Seattle machine shop where he worked. His shift complete, Small was making the 150-yard walk from his workstation to his car, when he realized that his left leg was sinking deep in the stuff. Though this had happened before — it happened nearly every day now — he stopped and glanced down at his feet. His Nikes looked normal, still firmly planted on the shop’s concrete floor. But he was stuck, just the same. His brain was sending an electrical pulse saying “walk,” but as the signal streaked from his cerebellum and down his spinal cord, it snagged on scar tissue where the myelin layer insulating his nerve fibers had broken down. The message wasn’t getting to his hip flexors or his hamstrings or his left foot. That connection had been severed by his multiple sclerosis. And once again, Small was left with the feeling that, as he described it, “I’m up to my waist in quicksand.”
For the 400,000 Americans with multiple sclerosis, Todd Small’s description will most likely ring true. Muscle stiffness is a hallmark of the disease, and “foot drop” — the term for Small’s quicksand feeling — is a frequent complaint. The condition is usually treated, as it was in Small’s case, with baclofen, a muscle relaxant that works directly on the spinal cord. Every day for 14 years, he took a single 10-milligram pill. “My neurologist always told me if you take too much it will weaken your muscles. So I never wanted to go over 10 milligrams.” It didn’t seem to have much effect, but he carried on as best he could.
Small would have continued just as he was had he not logged on last June to a Web site called PatientsLikeMe. He expected the sort of online community he’d tried and abandoned several times before — one abundant in sympathy and stories but thin on practical information. But he found something altogether different: data.
More here:
http://www.nytimes.com/2008/03/23/magazine/23patients-t.html?_r=1&oref=slogin
This is a very useful review of the impact of Web 2.0 on the health sector. I see these sort of innovations are very important in the drive to assist patients get more involved in the planning and delivery of their health care.
Well worth a browse!
Fourthly we have:
E-health on the mend
March 25, 2008
Health care is one of Australia's biggest social and political issues. From monitoring the aged to remotely performing intricate surgery, electronics and the internet are vitally involved. Nick Miller reports.
SIR Jonathan Michael loves the big-time, showy end of e-health. There's the time he watched a kidney operation done robotically in Guy's Hospital in London - controlled by a surgeon in the US.
"That's very much the high-tech, dramatic end of the spectrum," says the deputy managing director of health care at BT Health, who visited Australia last month.
The first time he was impressed by the potential of combining IT with clinical care was more prosaic, but profoundly effective. It was when he was working as a clinician in a kidney unit in Birmingham.
"We were using electronic prescriptions in the kidney unit," he says. "Patients with kidney disease have real risks with drugs that they should not be prescribed because of the dangers associated with reduced kidney function. With constantly changing junior doctors not knowing the details of individual patients, there was a real risk the wrong drugs could be prescribed to patients with kidney failure.
More here:
http://www.smh.com.au/news/biztech/ehealth-on-the-mend/2008/03/24/1206207011913.html
Nice to see the views from an enthusiast from the UK. The commentary later in the article regarding things that are happening in Australia did not really make me think the headline is all that valid.
Fifth we have:
Nurse's job to cook the books: doctors
Natasha Wallace Health Reporter
March 25, 2008
NSW Health appointed a nurse whose job was to massage triage data in the emergency department of a Sydney hospital to make it look favourable, emergency doctors say.
The nurse, appointed just before the state election, was there specifically to ensure computer data met triage targets, the vice-president of the Australasian College of Emergency Medicine, Sally McCarthy, said yesterday.
This follows revelations in the Herald yesterday that managers at Gosford and Ryde hospitals were so under pressure by the health department to meet targets that some had falsified "time seen" data - the record of when treatment began on a patient.
On the nurse, Dr McCarthy said: "They had somebody looking at that, basically harassing other staff and putting in data themselves. That's not somebody to provide care for patients. That's simply someone to click off on the computer to basically show that patients were seen within benchmark times. It was really just an attempt to get the data looking good."
While the NSW Minister for Health, Reba Meagher, insisted the Gosford case was isolated, Dr McCarthy said the doctoring of data was more widespread and was made easier after the department about 18 months ago widened the definition of when treatment began to include nursing care in several instances.
An emergency physician at Prince of Wales Hospital, who could not be named because she was prohibited from speaking to media, said yesterday that "there have been numerous verbal directives from hospital administrators to change data".
More here:
If true, and as far as I can tell there has not been any denial, this is just an awful story. Having any staff falsify records has very worrying medico-legal and ethical implications. The NSW Health Department really seems to be utterly and disturbingly out of control.
Sixth we have:
Database to link patients and doctors
Leo Shanahan
March 25, 2008
PATIENTS could find out about the performance of hospitals and doctors under the Labor Government's plan for a national health database.
The database would end a "ridiculous" system of information collection on patients and hospitals, federal Health Minister Nicola Roxon said. It might also mean that doctors in interstate hospitals could study a patient's care history when necessary.
Ms Roxon said the National Health and Hospital Reform Commission, along with the Health and Welfare Institute, were working towards a national database of hospital and patient information.
"Jointly they are now working on how we get that data collection consistent across states, what could be publicly available and working on how we are able to compare not just as consumers, but as governments, about what's working," she said.
"It's ridiculous given the high quality of the system we have, we could vastly improve it, but that we don't know these things is very frustrating and inadequate."
National data collection on patient care and hospital performance is almost non-existent because states hold varying types of information on different databases that cannot be viewed by hospitals or governments interstate.
The federal database is likely to contain information on patient care and history, performance of hospitals and doctors in the public and private system, waiting lists and performance of area health services.
Continue reading here:
Given the previous article, one really has to wonder just how reliable any statistics generated by state governments will be. Quality assurance of this data will clearly be vital!
This quote from later in the article is also a bit of a worry.
“Ms Roxon said she agreed with many of the recommendations on data collection coming from a report released last week by the Australian Centre for Health Research, which included an ID number that would enable hospitals to read information on patients in other states.”
Has anyone told this research centre or the minister that work to deliver this has been underway for the last 18 months via NEHTA. What nit-wits.
Last we have
The Web's best free stuff
There's a wealth of downloadable software and online services, but free doesn't necessarily mean good. Here's some of the best of the bunch
By Preston Gralla and Erik Larkin, PC World, IDG News Service
March 24, 2008
Free: It's the magic word for an ever-expanding wealth of downloadable software and online services. Free doesn't necessarily mean good, however, and hunting for freebies can mean sifting through a lot of junk.
That's where we come in. We surfed, clicked, and installed to find sparkling free gems capable of planning your time, keeping you in touch, and tuning and securing your PC, not to mention glitzing up your desktop, helping you stay productive, and entertaining you with music, videos, photos, and games. We paid special attention to programs and services you may not have heard of before.
We also singled out two free offerings--one download and one online service --as the best of the bunch. We want to hear your picks for the best freebies, too, whether they appear in this article or not. Please let us know by joining our forum discussion.
Continue reading this very long article here:
http://www.infoworld.com/article/08/03/24/The-Web-best-free-stuff_1.html
This is an amazing collection of free and useful downloads and services. Well worth a browse for those interested in what one can do for free with your PC.
More next week.
David.
No comments:
Post a Comment