Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
Institute attempts health IT investment comparison
By: Joseph Conn / HITS staff writer
Story posted: May 12, 2008 - 5:59 am EDT
A dearth of common terminology has long been recognized as a barrier to clinical data analysis and exchange.
Similarly, the lack of a common accounting scheme to report on investments in health information technology has limited the ability of one healthcare organization to compare its level of investment in IT with that of its peers.
In the past 18 months or so, the 53-member, not-for-profit Scottsdale Institute has made two stabs at overcoming that latter impediment, according to Shelli Williamson, executive director of the institute, which has been gathering IT investment data using a common language in a survey instrument developed by Patrick O'Hare, senior vice president and chief information officer of Scottsdale Institute member Spectrum Health, a four-hospital system in Grand Rapids, Mich. The survey done in cooperation with IT market researcher Klas Enterprises, Orem, Utah.
For example, some hospitals and healthcare systems include telephone costs in their IT department budgets while some do not, Williamson said. Some allocate capital and operating expenses for picture archiving and communication systems/radiology information systems, or PACS/RIS, in their radiology departments while others book those expenditures as IT department costs. Depreciation is a jump ball, too, landing sometimes in IT department budgets, and sometimes it is lumped into the overall corporate budget.
More here:
http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20080512/REG/903660099/1029/FREE
This is a very interesting project and a project that should be replicated in Australia to allow a real understanding of just where we are in hospital computing. An idea the Commonwealth Department of Health could consider – and which could be conducted by NEHTA given its links with all the jurisdictions.
Second we have:
EMR deadline does not compute: Falling short of 2014 goals
Although individual physicians have embraced electronic medical record systems, the nation is far from an interconnected, interoperable network. Costs, hassle and a lack of congressional action are among the factors slowing health IT development.
By Dave Hansen, AMNews staff. May 19, 2008.
In 2004, President Bush set a goal of most Americans using an electronic medical record by 2014. In his vision, doctors by then would be using EMR systems with interoperable standards that would allow them to share lab results, images, computerized orders and prescription information with hospitals and other health facilities.
So how much progress has been made in the past four years? Not nearly enough, many EMR experts say.
The nation's medical community is not substantially closer to an interconnected, interoperable EMR system now than it was in 2004, concluded a January California HealthCare Foundation report based on interviews conducted last summer with 22 health information technology experts from across the country.
The reasons for the insufficient progress are many, according to the report, "Gauging the Progress of the National Health Information Technology Initiative." They include slow adoption of EMRs by physician practices, the impractical nature of a national health information network, the difficulty of creating interoperability standards and Congress' failure to pass legislation addressing health IT roadblocks.
Only 14% of physicians have minimally functional EMR systems, found a July 2007 survey conducted by the Office of the National Coordinator for Health Information Technology. The office, created by Bush to guide the work on EMR standards and coordinate public and private efforts, defines minimally functional systems as those on which doctors can record and manage progress notes, order tests, record test results and electronically prescribe medications.
More here:
http://www.ama-assn.org/amednews/2008/05/19/gvsa0519.htm
This quite long article provides a useful collection of statistics and information on the current state of EHR deployment and use in the USA. A good one for the files.
Third we have:
Government plans central citizen database
Mahesh Sharma | May 13, 2008
THE federal Government has moved to establish a centralised database to host and manage all Australian citizens' personal details, so this information can be easily shared and accessed by any department.
The Australian Taxation Office, Department of Immigration and Citizenship, Customs, Centrelink, and other departments, are discussing the possibility of establishing a common registration process to improve information sharing.
The project was being led by the Australian Government Information Management "and it's in respect of a common registration process," ATO chief information officer Bill Gibson said.
"That's exploratory at the moment. There's nothing that exists right now that is a manifestation of this, but we are working with Centrelink, Customs, and other agencies, facilitated by AGIMO.
"That is to work out what would be a common registration process, so that you as a citizen interact with Centrelink, and the registration you go through with Centrelink would be appropriate to be shared with, say, the Tax Office, so we don't have to put you through the same registration process."
He said the discussions were in their "very early" stages.
"There's nothing formally that has been approved it's really in the design and exploration phase at the moment."
A spokesman for AGIMO wasn't aware of the discussions and said the only formal project the department had embarked on in this area was to establish a $42.4 million portal, the Australian Government Online Service Point.
However, this online portal is mainly designed for logging into government websites, as opposed to managing a citizen's identity from a central location, but there are already elements of information sharing between departments.
More here:
http://www.australianit.news.com.au/story/0,24897,23687001-5013040,00.html
Here we go again, yet another attempt at a national electronic identity management system! When are Governments of either hue going to develop a national unified strategy for electronic ID management. One wonders where exactly Medicare Australia and the NEHTA UHI initiative is left in all this.
Fourthly we have:
IBA's eHealth network now connects 30 Australian health funds
14 May 2008
Sydney – 14th May 2008 – IBA Health Group Limited (ASX: IBA) – Australia's largest listed health information technology company today announced two additional Australian private health insurance funds will connect to its expanding eHealth network for real-time, point-of-care electronic health claiming and payment services.
These latest agreements are with HBF and GMF Health funds. With more than 900,000 members, HBF is the leading provider of health insurance in Western Australia. Also based in Western Australia, GMF Health provides health insurance to more than 60,000 members across Australia.
IBA now has agreements with 30 health funds, which collectively represent 98% of privately health insured Australians. Privately insured Australians can settle their accounts on the spot with their health insurer and health care professional through connectivity to IBA’s HealthPoint claiming service.
HealthPoint gives healthcare professionals and their patients an efficient, easy-to-use single point solution for EFTPOS, patient claims to health funds and, where appropriate, Medicare claims. By automating and streamlining the entire health claim and payment process, IBA’s solutions are enabling health fund insurers to lower costs while providing more efficient and effective services to their members.
Both HBF and GMF are expected to go live with IBA’s HealthPoint service from August/September this year with claiming for optometrists, dentists, chiropractors, physiotherapists and podiatrists.
More here:
http://www.ibahealth.com/html/iba_s_ehealth_network_now_connects_30_australian_health_funds.cfm
This network was a little under my radar I must say. The level of coverage seems to be quite impressive and it is at least one example of an national e-Health related system actually working. More details are found here. http://www.ibahealth.com/html/electronic-health-claims.cfm
ICS Global with its Thelma environment offers similar services. See http://icsglobal.net/thelma.html for information on that system.
The usual disclaimer about ownership of a few shares in these companies applies.
Fifth we have:
ICT Transforming Health Sector
New Era (Windhoek)
NEWS
9 May 2008
By Catherine Sasman
Windhoek
Africa should spruce up its e-health services to ensure improved access to health services as a fundamental human right, argued delegates at the IST-Africa Conference in Windhoek, New Era reports.
It is estimated that more than 33 million people are HIV infected, and that 90 percent of these people are living in settings with limited resources. In Africa, this health pandemic is considered the most important health challenge.
By December 2003 the World Health Organisation (WHO) and the Joint United Nations Programme on HIV/AIDS launched the '3-by-5' initiative to help low- and middle-income countries provide treatment to three million people living with the disease by the end of 2005.
According to Maria Zolfo from the Institute of Tropical Medicine (ITMA) in Belgium, although the '3-by-5' target has not been met yet, the global efforts to scale up access to anti-retroviral treatment (ART) has brought positive changes worldwide.
At the end of 2006 more than two million people living with HIV are treated with ART in low- and middle-income countries.
"Telemedicine is a way to assist delivery of care in remote areas," said Zolfo.
Telemedicine is considered as one of the fastest growing areas of information, communication and telecommunication (ICT) applications that are used in the health sectors for services enhancement.
It started in the 1920s, but has since evolved, and its use in developing countries is reported to be on the increase.
More here:
http://allafrica.com/stories/200805090735.html
It is good to see growing awareness of such needs in Africa. There are a number of quite encouraging success stories with EHR’s making a difference with AIDS management in Africa.
Sixth we have:
Telemedicine a Cost-Effective Alternative to ER Visits
Friday, May 9, 2008; 12:00 AM
FRIDAY, May 9 (HealthDay News) -- Telemedicine is a cost-effective way to replace more than a quarter of all visits to the pediatric emergency department, according to a community-wide study conducted in New York.
Ailments, such as ear infections or sore throats, that virtually always prove manageable by telemedicine made up almost 28 percent of all pediatric ER visits in Rochester, N.Y., during one year, according to investigators from the University of Rochester Medical Center.
Their findings were presented recently at the 2008 Pediatric Academic Societies annual meeting, in Honolulu.
"We learned that more than one in four local patients are using the pediatric emergency department for non-emergencies," lead investigator Dr. Kenneth McConnochie, a professor of pediatrics at the University of Rochester's Golisano Children's Hospital at Strong, said in a prepared statement. "This mismatch of needs and resources is inefficient, costly and impersonal for everyone involved."
McConnochie and his colleagues, who direct a Rochester-based telemedicine program that provides interactive, Internet-based pediatric health-care service to the area, analyzed data for all pediatric visits to the largest emergency department in the city. Based on their experience, they determined at least 12,000 visits were ones they routinely treat with success via telemedicine.
Continue reading here:
http://www.washingtonpost.com/wp-dyn/content/article/2008/05/09/AR2008050901866.html
This is an interesting study and certainly point the way of the future as to how better care could be delivered in remote areas and possibly make a difference for the Aboriginal Community.
Last we have:
Nagging via text messages to help teens remember meds
By LAURAN NEERGAARD
The Associated Press
Monday, May 12, 2008; 3:25 PM
WASHINGTON -- 4gt yr meds? Getting kids to remember their medicine may be a text message away. Cincinnati doctors are experimenting with texting to tackle a big problem: Tweens and teens too often do a lousy job of controlling chronic illnesses like asthma, diabetes or kidney disease.
It's a problem long recognized in adults, particularly for illnesses that can simmer without obvious symptoms until it's too late. But only now are doctors realizing how tricky a time adolescence is for skipping meds, too.
Of necessity, parents start turning over more health responsibilities to their children at this age. It's also an age of angst, sometimes rebellion, and when youths may most hate feeling different from their friends because of medication, special diets or other therapy.
"It's a time of so much change in these kids' lives," says Dr. Marva Moxey-Mims, a specialist in pediatric kidney disease at the National Institutes of Health. "It's very difficult when you've got a life-threatening illness to say, 'Let them make their mistakes.'"
More here:
http://www.washingtonpost.com/wp-dyn/content/article/2008/05/12/AR2008051201430.html
This seems like a sensible idea for that difficult period when compliance is likely to be low (Age 12-18) and mobile phone ownership is high! Will be interesting to see the outcomes of the year long trial.
More next week.
David.
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