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, April 06, 2008

Useful and Interesting Health IT Links from the Last Week – 06/04/2008

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

These include first:

Europe-wide project to detect drug reactions

31 Mar 2008

QResearch, the not-for-profit research partnership between EMIS and the University of Nottingham, is supporting a new European-wide initiative, the ALERT project, to detect adverse drug reactions (ADRs) faster.

The project will involve a consortium of 18 leading European research institutions using clinical data from the electronic healthcare records (EHRs) of over 30m patients from European countries, including the Netherlands, Denmark, UK and Italy.

ALERT has received €5m funding from the European Community's Seventh Framework Programme – Europe’s research programme for supporting innovations in core EU initiatives such as e-health.

In the UK, academics from the University of Nottingham will use the QResearch database, which houses anonymous data from around 10m patients. Other institutions including the Arhus University Hospital in Denmark, Erasmus University Medical Center in the Netherlands, and the University of Santigao de Compostela in Spain, will analyse their own respective databases to try to identify common drug reaction trends.

Continue reading here:

http://www.ehiprimarycare.com/news/3600/europe-wide_project_to_detect_drug_reactions

This is really a fantastic initiative and I hope one day soon we will be able to collect appropriate data from Australian Prescribing Systems in Australia to achieve the same end. There are many barriers but the value is so high in terms of patient safety such a project should be top of the list!

Second we have:

Smartphone Computing Moving Into Docs' Offices

by Mohammad Al-Ubaydli

More and more doctors are using smartphones -- essentially PDAs that can make phone calls -- in their daily lives, yet few of them are integrating the devices into their clinical practice. New clinical software designed specifically for smartphones is helping to overcome some barriers, yet there are other roadblocks preventing smartphones from becoming much more common in medicine than they are now.

As the average cell phone becomes "smarter" and telecommunications companies aggressively expand mobile networks, consumers in both developed and developing countries increasingly have a wireless computer in their pockets, according to Joel Selanikio, a pediatrician in Washington, D.C. Selanikio's not-for-profit company DataDyne.org makes open-source public health data collection software for PDAs and cell phones. The software is used by the World Health Organization, the World Bank and other organizations around the globe.

Unlike laptops and tablet PCs, smartphones are small enough to carry everywhere, their battery life lasts longer than a clinical shift and they have no standby or hibernation waiting times.

Yet, however convenient, many physicians are reluctant to carry and learn how to use smartphones in their medical practice. Others find it difficult to enter data into the devices using handwriting recognition. A further barrier is that hospital IT departments must provide support for doctors using the devices.

Continue reading this long article here:

http://www.ihealthbeat.org/articles/2008/3/31/Smartphone-Computing-Moving-Into-Docs-Offices.aspx?ps=1&authorid=1590

This seems to me to be a trend that is worth keeping an eye on. Those hand-held devices are really amazingly capable these days and seemingly getting smarter every day.

Third we have:

PCs a cause of Medicare abuse

Health editor Adam Cresswell | April 05, 2008

COMPUTERISATION of medical records is a wonderful thing, reducing errors, speeding up communication and - in theory, at least - ensuring the patient's history is apparent to the treating doctor, whether the patient is in their hometown or on holiday.

But just as sensible use of technology can improve patient care, the latest report from Medicare's official watchdog, the Professional Services Review, makes clear that it can also allow the lazy or incompetent doctor to achieve exactly the opposite by cutting corners.

Take one Queensland GP, who became so fond of the lucrative management plans funded by Medicare that in 2005-06 his use of them placed him in the top 3 per cent of GPs in terms of the number of these services that he claimed.

As the management plans were then relatively new and still little used, the numbers themselves were not enormous: the doctor provided 125 GP management plans (Medicare item 721), in that year worth $122.40 each. He also provided 52 reviews of existing management plans (item 725), then worth $61.20 (a rate that put him in the top 1 per cent of GPs).

Though small, these numbers were still large enough to ring alarm bells at Medicare Australia, which referred "Dr A" to the Professional Services Review, which investigates cases of suspected inappropriate practice.

The PSR found much more to be concerned about, as it disclosed in the agency's Report to the Professions, published this week.

More here:

http://www.theaustralian.news.com.au/story/0,25197,23479920-23289,00.html

Sometimes headline writers have a lot to answer for! It is crooks not Personal Computers that are causing abuse of Medicare.

The full report is downloadable from this page:

http://www.psr.gov.au/Publications/

Fourthly we have:

HISA NSW - 17th Annual Health Informatics conference - 2008

Friday, 14th March 2008.

This was an interesting conference and there are a range of very interesting presentations available from the site. Well done to the organisers!

More here:

http://www.hisansw.org.au/conference/14march08

Fifth we have:

Coles loses e-pharmacy case

Karen Dearne | April 04, 2008

THE Pharmacy Guild has won a victory in its ongoing campaign to keep supermarkets out of the $9 billion pharmacy business, with a NSW court ruling that Coles' 2006 purchase of online chemist, Pharmacy Direct, breached ownership regulations.

Coles, now wholly owned by Wesfarmers, paid around $50 million for the independent, Sydney-based chemist warehouse and online distribution business which had an exemption to the pharmacy act's requirement that only qualified pharmacists may own pharmacies.

Coles held Pharmacy Direct through a subsidiary company, Now.com.au, which defended the legal challenge brought by the NSW Attorney-General on behalf of the Guild.

More here:

http://www.australianit.news.com.au/story/0,24897,23483705-15306,00.html

This is a very bad decision from the courts in my view. The convenience of obtaining prescription medicines from a properly run Australian Internet Pharmacy is valuable to many people – especially those with mobility problems – and the option should remain available.

Sixth we have:

Royal Perth Hospital dump computers, patient details

Article from: PerthNow

EXCLUSIVE: Paul Lampathakis

April 04, 2008 10:00pm

CONFIDENTIAL patient details are being left on old computers dumped in an open skip bin in a busy laneway at Royal Perth Hospital.

Personal information, including patient names and addresses, dates of birth, medical conditions and patient numbers, was accessed with ease by The Sunday Times this week.

Sources say up to 500 computers have been dumped in the bin, pending collection, since November.

Sources also claimed computers had been sent to auction yards in the past without their hard drives wiped clean.

The hospital yesterday denied this, saying the computer hard drives were cleaned and the computers were collected every day by contractors to be crushed.

Health Minister Jim McGinty last night accused The Sunday Times of stealing the computers and hacking into their contents.

The Sunday Times editor Sam Weir rejected the allegations. He said The Sunday Times observed the computers in the bin for several days, easily available for anyone to pick them up.

Continue reading here:

http://www.news.com.au/perthnow/story/0,21598,23490713-948,00.html

I must say this is really yet another instance of a silly lack of security with personal information. When will hospitals do the work to develop proper Security Policies to make sure the public are comfortable with the way their private information is handled?

Last we have

Demo project shows IT, best practices cut medication errors

By Bernie Monegain, Editor 03/28/08

A demonstration project at the University of California San Francisco has reported a 56.8 percent reduction in medication administration errors. As a result, participating hospitals have increased the accuracy of their medication administration to 93 percent.

The 18-month program trained front-line clinicians, primarily nurses, to take a leadership role in developing clinical protocols, reporting tools, metrics and administrative procedures. Measurable improvements were achieved at all participating institutions.

The Integrated Nurse Leadership Program (INLP), one of the core research and professional development programs of UCSF's Center for Health Professions, developed the demonstration.

The gains were achieved through adherence to a set of six best practice procedures for medication administration identified by the California Nursing Outcomes Coalition (CalNOC).

The study also reported a reduction in procedural errors of 78.5 percent - increasing adherence to these best practice procedures to 95.6 percent after 18 months.

The study is the first to directly validate a specific set of best practices for medication administration, according to program officials.

Continue reading this very interesting article here:

http://www.healthcareitnews.com/story.cms?id=8947&page=1

This is an important study as it shows just the level of difference that can be made by the use of technology and providing nurses with protocols that have been shown to make a major difference.

More next week.

David.

14 comments:

Anonymous said...

It should be apparent that the Guild wants to be at the centre of every “Australian Internet Pharmacy”. Why else would it own half of a pharmacy software company which itself provides dispensing software to more than half of all pharmacies in Australia?

Anonymous said...

The Guild has been fighting off the supermarkets for many years. It will continue to do so, whatever the cost. The Guild’s win last week will not go unchallenged. Coles will appeal and may in time even be enjoined by the Consumers’ Association to take this matter to a higher authority. This is the calm before the storm.

Anonymous said...

Does this mean we are witnessing the emergence of some form of monopoly in the e-prescribing software space? Surely Government and the consumer (as taxpayer) should be able to exercise a substantial voice in the ownership and the development of this kind of technology?

Anonymous said...

If the Guild cannot protect the community pharmacy sector from being invaded by others ready and waiting to provide ALL consumers with new services and new models of health care delivery then the Guild’s iron-grip in the primary care space will be weakened forever. The Guild knows this.

Anonymous said...

Very true. Pharmacists are represented by a powerful lobby group in the Guild. It is intent on invading and securing increasing amounts of the turf currently occupied by the doctors despite public protestations to the contrary. Doctors can do nothing about it because their lobby groups are too disorganised and riddled with infighting and in no position to defend themselves against the powerful pharmacy lobby.

Anonymous said...

Where do power, control, and greed fit in all of this?

Anonymous said...

Wait till the guild’s members get older and want to retire and leave the business. They will find the party best able to offer a reasonable price for their business will not be able to. Why - because the Guild has bricked up the EXIT.

Anonymous said...

You must believe in the fairies if you really believe the wealthy pharmacy owners who control the political levers at the top of the Guild will not see fit to have the legislation changed when it suits them to make a handsome EXIT their business? Is there anything quite like that available to the doctors? Not really.

Anonymous said...

I' like to get out now. If I had to work for a Coles pharmacy for three more years so I can then walk away free I'd love to. My standards won't drop I'm still a professional pharmacist. Becasue I'm not a member of the Guild I'm stuck in the middle and I don't like it.

Anonymous said...

If they do change the legislation guess who will be at the front of the queue ready to negotiate the sale of their businesses to a supermarket chain. Will it be the independents who aren't members of the guild or will they be pushed aside to the end of the queue?

Anonymous said...

Government should introduce legislation to permit free market forces to operate in the consumers’ interests. It does not do so because it has been bluffed by the Guild.

Anonymous said...

Government fears the political power the Guild exercises over consumers through its 5,000 shopkeepers. Consumer choice is therefore controlled by the Guild. The Guild is preventing free market forces from being allowed to operate.

Anonymous said...

It might have frightened the politicians last year when the election was underway - but hey - no more elections for a few years so let the consumer decide.

Anonymous said...

David, I don’t understand. If the “Sydney-based chemist warehouse and online distribution business (which) had an exemption to the pharmacy act's requirement that only qualified pharmacists may own pharmacies” …………….. then why is it that …………… “Coles, now wholly owned by Westfarmers” is not allowed to operate Pharmacy Direct through its subsidiary company, Now.com.au?

Did the Legislation get changed to reverse the exemption? If so when did it get changed? If it was changed - was it in some way made retrospective?

This has a nasty smell about it. Surely the Coles lawyers looked at this transaction in every detail before making the acquisition. Do you know where we can get a precise ‘summary’ of why the Judge found in favour of the Guild?