Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
Brailer's Health Evolution Partners makes its first investment
By Bernie Monegain, Editor 04/28/08
Health Evolution Partners, the investment management firm founded by the nation's former national healthcare information technology chief, has made its first investment - an undisclosed amount - in e-prescribing company Prematics.
As a result of the funding, David J. Brailer, MD, will join Prematics board of directors.
Brailer, founded Health Evolution Partners in 2007 after he resigned from his post as national coordinator for healthcare information technology, appointed by President Bush.
Health Evolution Partners Innovation Network (HEPIN) led the Series B round of funding.
"The time is right for investing in electronic prescribing," Brailer said. "We looked at numerous ways for Health Evolution Partners to enter this market, and Prematics was by far the best choice. We have committed the financial resources and expertise that Prematics needs to be the nation's leading electronic prescribing company."
More here:
http://www.healthcareitnews.com/story.cms?id=9112
A report on the value and utility of e-prescribing is found here:
http://www.healthevolutionpartners.com/eprescribing_Outlook_0428.pdf
It is interesting to the Dr David Brailer invest in e-prescribing. He clearly thinks these approaches have a big future.
Second we have:
Patient identifier key to health system reform
29-Apr-2008
By Megan Howe
The development of a unique patient identifier is absolutely essential to achieve successful reform of the Australian health system, according to a peak lobby group, which claims the government’s e-health body is floundering.
Releasing three position papers calling for wide-ranging reform of the health system, the Australian Healthcare and Hospitals Association (AHHA) said a unique patient identifier was the “most important undertaking which underpins all other recommendations, requiring immediate implementation”.
AHHA policy project officer Ms Cydde Miller said privacy concerns about the patient identifier needed to be addressed, but without its introduction, reform was impossible.
“We can’t do large-scale population health analysis and find out what is going on with the health of Australians [without it],” she said.
“People are mobile and to have one national patient identifier will reduce the amount of work clinicians do because they can go into the system and get a full medical history from everyone.”
The association criticised the government body charged with developing the nation’s e-health system, the National E-Health Transition Authority (NEHTA).
“The AHHA is concerned that progress in Australia on improving information within and about the health system has been waylaid by a lack of focus and direction in the national work program led by NEHTA. Due to a range of impeding factors, this process is struggling to maintain the engagement of all necessary partners in such a significant undertaking,” it stated.
Continue reading here if you have access:
http://www.australiandoctor.com.au/articles/fb/0c055ffb.asp
It is good to see the professional press picking up some e-Health suggestions. The full documentation is found here:
http://www.aushealthcare.com.au/publications/publications_by_group.asp?id=3
Third we have:
Austin Health completes phase one of rollout under HealthSmart program
System currently used by 400 staff
Sandra Rossi 30/04/2008 12:29:56
Victorian health care provider, Austin Health, has just completed phase one of a HR rostering and payroll system that has reducing processing time by 70 per cent.
The workforce planning and management system, which was first piloted last year and is currently being used by 400 employees, is being rolled out under the Victoria government's HealthSmart program.
This system will be integrated with other HealthSmart systems across the state.
The standardised platform from Kronis Incorporated provides award interpretation, time and attendance, employee pay conditions and rostering.
In coming weeks Austin Health will begin the second phase of the project to automate roster generation.
The generation process will take into account both employee requests and skills to meet clinical and patient care requirements.
Austin Health's HR systems project manager, Leslie Bell, said the system reduces the amount of time taken by line managers to prepare and manage rosters and by payroll staff to process pay.
"The system has reduced the time required to enter the data for payroll processing by 70 per cent, and reduced the errors and warnings by delivering accuracy in excess of 99.5 per cent, which was unheard of previously," Bell said.
"All the payments made to employees in the pilot areas have been checked and verified, with the system exceeding expectations."
More here:
http://www.computerworld.com.au/index.php?id=1855751830&eid=-6787
It is good to see HealthSMART is having some success. Of course it is very early to claim success with only 400 staff being paid by the system – given the number of staff in the Victorian Health System. As an example there are 6,000 doctors and 30,000 nurses in the Vic Public Health System. Again, while important, we see success with administrative systems when what is really needed is clinical system success.
Fourthly we have:
Hospital worker 'sold celeb details'
April 30, 2008 08:51am
Article from: Agence France-Presse
US federal prosecutors have charged a former employee of a Los Angeles hospital over selling information from celebrities' medical files to the media.
Lawanda Jackson, 49, was an administrator at UCLA Medical Centre, which recently announced it had taken action against several staff for peeking at the private records of singer Britney Spears and actress Farrah Fawcett.
She was indicted on April 9 for "accessing the private medical records of celebrity patients at the UCLA Medical Centre and selling information obtained from those files to a national media outlet," the prosecutor's office said.
More here:
http://www.news.com.au/story/0,23599,23621512-23109,00.html
Good to see such behaviour is taken seriously in the US. We must be alert to make sure there are sufficient disincentives in place in Australia as well.
Fifth we have:
Cancer Council drops legal action
April 28, 2008 05:19pm
Article from: AAP
THE fight against cancer in Queensland is set to benefit after the Cancer Council Queensland and the State Government ended a dispute over access to case records.
The council announced today it was dropping a Supreme Court action it launched earlier this month against Queensland Health in which it sought routine access for researchers to statistics from the Queensland Cancer Registry.
The Council wanted better access for researchers to analyse data and assess the effectiveness of cancer screening and prevention programs. The Government had resisted the request due to concern over possible breaches of patient privacy.
But last week Queensland Health Minister Stephen Robertson said the Government had received updated legal advice that the release of the information would not breach the Public Health Act.
More here:
http://www.news.com.au/story/0,23599,23610935-29277,00.html
It is good to see this silliness resolved with sanity prevailing.
Sixth we have:
How Personal Health Records Could Make Care Less Efficient
Posted by Jacob Goldstein
High hopes are afoot for personal health records, online homes where patients can store their medical information to take from doctor to doctor and keep track of things like prescriptions and test results. Microsoft and Google, among others, are jumping in the patient-controlled record pool.
But on a visit to Health Blog HQ yesterday, Steve Leiber — who runs Healthcare Information and Management Systems Society, the trade group for health IT — pointed out a potential downside to the patient-centric records.
“Physicians aren’t going to trust it,” he said.
That could be trouble if patients opt for the personal records and try (because of privacy concerns, say) to keep their medical information off of a doctor or hospital’s electronic medical record.
Patients could show up and hand over their memory stick or a Internet address for the files, but doctors on the receiving end might be wary of believing what the records says. “It’s outside a protected chain,” Leiber says. “The second doctors are going to repeat those tests.”
Still, he said, there are potential benefits to the approach. Many trips to the emergency room would go much more smoothly if the patient or a family member could direct the ER staff to a record that lists a patient’s allergies and current meds.
And they could work as a complement to (rather than substitute for) electronic medical records kept by doctors and hospitals. “I see you’ve been seen for X,” a doctor might say to a patient after reviewing his or her personal electronic files, Lieber said. “May I contact this practitioner [to get your medical record]?”
Continue reading here:
This blog triggered a useful set of comments that are well worth reading by those interested in the potential of the PHR.
Last we have:
Technology that saves children's lives
Teleconferencing paired with medical diagnostic equipment helps save children's lives worldwide
Mary K. Pratt 29/04/2008 09:38:24
Frank Brady expects to celebrate a significant milestone in June: His Medical Missions for Children charity will treat its 30,000th child that month.
That's an impressive record for the nine-year-old nonprofit organization, which connects leading US doctors with doctors and their pediatric patients all over the world.
MMC uses telecommunications technology and other IT tools to bridge gaps in knowledge, treatment and geography. The organization has created what it calls the Global Telemedicine & Teaching Network to enable US-based doctors to consult with foreign pediatric physicians through a distance-medicine network called the Telemedicine Outreach Program so they can help diagnose and treat children worldwide. Technology also has allowed MMC to expand its services to include educational content for health care providers and patients in multiple countries.
"MMC fulfills a host of health- related needs throughout the world," says Alberto Salamanca, the Mexico-based president of MMC's Latin America region. "Technology has proven to be the most important tool to carry the mission and vision of MMC."
In some ways, Brady, 65, has spent his whole life readying himself for this mission. After he contracted spinal meningitis as a 1-year-old, the doctors told his parents that their son had only three weeks to live. But a week later, they suggested trying penicillin -- at the time, an experimental drug that hadn't been tested on pediatric patients.
The treatment worked, convincing Brady's mother that the boy was spared so he could do something special with his life. Brady's path thereafter wasn't unusual. He spent most of his 35-year career working in international business.
More here:
http://www.computerworld.com.au/index.php?id=929483641&eid=-255
This is a heart-warming story to start the week with. Good to see some real successes with telemedicine and good to see how some initiative can have it happen. Well worth a read!
More next week.
David.
5 comments:
It looks as though David Brailer has been able to distinguish the wood from the trees at last. Perhaps his experience in charge of the Office of the National Coordinator for Health Information Technology (ONC) showed him the futility of the top down approach. Given that the penetration of clinical desktop computing is very low in the US (some say 10% to 15%) David Brailer will have his work cut out for him getting the nations prescriptions transferred electronically from the desktop to anywhere at all for a very long time.
Good to see Brailer giving priority investment to an electronic prescribing initiative. One of the most important system solution decisions will be where to store the prescription after it has been dispensed. There needs to be some kind of repository for holding the prescription after it has been dispensed. Should there be a centralised repository established which holds all prescriptions or should they be held on the doctors desktop or in the pharmacy or should they be held in the consumers’ personal health record. Patients often shift around between doctors and go to many different pharmacies which defeats any attempt to build a comprehensive medication record at either location. One centralised repository might be a possibility despite its enormous size. The increasing acceptance of consumer-owned personal health records seems to indicate that this might be the most logical place to store the dispensed prescription. Then whichever pharmacy or doctor the patient goes to next dispensed prescriptions would be available to all health practitioners.
The leadership of the National E-Health Transition Authority (NEHTA) lacked insight. This led to NEHTA thinking it could do everything but achieving very little of any benefit, although it did spend a lot of money doing so.
It not only bears worth repeating but the message should be printed and boldly sent to every state and federal politician in the nation……….. without introduction of the patient identifier health sector reform will be impossible. This simple message must be understood and accepted as the fundamental starting point.
A patient-centric records is a very sensible development for health IT despite Steve Leiber saying the downside is that “Physicians aren’t going to trust it.”
The problem of physician trust does not lie in the concept of a patient-controlled record but rather in the concept of who can and cannot write to the record.
Surely it should be possible for the record to be structured so that ‘patient-entered-data’ is in some way ‘filed separately’ from data submitted by a qualified and identifiable health service provider. The patient should not be able to tamper with data submitted by a health service provider be that data pathology results, radiology reports or a prescription written by a doctor and dispensed by a pharmacist. If it can be tampered with it will not be trusted and on that point no-one would disagree with Steve Lieber. Personal health records that provide such facilities have yet to be developed.
As for the issue that some patients who opt for the personal health record might want “(because of privacy concerns, say) to keep their medical information off of a doctor or hospital’s electronic medical record” all I can say is ‘bollocks’. If they don’t want their information on a doctor or hospital’s electronic medical record then all they need to do is deny access and keep doing what they do today.
It shouldn't be too difficult for a consumer's PHR to be divided into patient entered data and health provider entered data. Doctors, pharmacists, physiotherapists, could still 'maintain' their own records whilst at the same time updating the consumer-held record just as long as the updating can be done in parallel, at the push of a button, without requiring any extra time or incurring any additional cost. Provided there is a PHR available ready to accept such data then it should be a technically relatively straightforward exercise .
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