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.