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, August 03, 2008

Useful and Interesting Health IT Links from the Last Week – 03/08/2008

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

These include first:

E-prescribers see Medicare bonus, but late adopters will face pay cut

Meanwhile, the government proposes new rules that would lift the ban on e-prescribing of controlled substances.

By David Glendinning, AMNews staff. Aug. 4, 2008.

The Bush administration is running a full-court press on physicians to get them to embrace electronic prescribing well ahead of a new Medicare mandate that is a little more than three years away.

Under the Medicare payment bill that became law in July, doctors who prescribe electronically for Part D patients in 2009 will get an incentive payment equal to 2% of all the Medicare services they provide for the year. This bonus will phase down over five years and disappear at the beginning of 2014.

Starting in 2012, physicians who are still paper-only will see a cut in their total Medicare payment for the year.

A physician may be eligible for an exemption from the penalties if Medicare determines that compliance would represent a significant hardship. The law cites an example of a doctor who practices in a rural area that has insufficient Internet access.

The Bush administration did not support the measure as a whole but is moving forward aggressively to implement the e-prescribing provision, which President Bush did endorse. The Centers for Medicare & Medicaid Services will issue rules later this year that will determine exactly how the incentive system will work and when bonuses will be paid.

Plans also are in the works for a CMS conference this fall that will educate physicians about what technology to use and how to use it. The agency wants to take advantage of its "bully pulpit" to get as many doctors on board with this technology as soon as possible, said Kerry Weems, CMS acting administrator.

Much more here:

http://www.ama-assn.org/amednews/2008/08/04/gvl10804.htm

It is good to see the details and the positive reaction of the AMA. This will be seen as major initiative in time I believe.

Second we have:

iPhone health applications have just about everything but the cold stethoscope

Julie Deardorff |

July 27, 2008

Cell phones can't actually get hot enough to pop popcorn, regardless of what you may have seen on YouTube. But some do have other unexpected abilities that just might help improve your quality of life.

Dozens of new health and fitness Web applications are now available for use with the Apple iPhone, which combines a mobile phone, a widescreen iPod and an Internet browser into one gadget. The apps, which likely will eventually be available on other phones that will run on a Google-based operating system, enable third-party software developers to create a new breed of health services.

These programs can literally put all your health records—including digital images such as ultrasounds and echocardiograms—into the palm of your hand. Or they can administer eye exams or keep track of your calories and exercise.

More here:

http://www.chicagotribune.com/features/lifestyle/chi-0727-health-cell-phone-sidejul27,0,3379444.column

This article provides an excellent list of over 10 applications in the health domain that are now available on the iPhone. It is fascinating to see just how quickly applications are emerging for this device – as I am sure they are with the other big contenders. We live in interesting times for device applications.

Third we have:

Twisted privacy laws to be opened up, says commission

August 01, 2008

PRIVACY laws in NSW are "unnecessarily convoluted" and require a complete revamp, according to the state Government's principal adviser on legal reform.

The NSW Law Reform Commission released yesterday a third consultation paper on privacy reform that argues it is "extremely difficult to identify which State Government agencies are covered by all or some of the privacy principles that underpin the legislation".

It also says problems exist in deciding which agencies and activities have complete or partial exemptions.

"Indeed, the current exceptions and exemptions run to several pages," said the commissioner in charge of the project, Professor Michael Tilbury.

"The current state of confusion surrounding this suggests it is the complexity of the provisions that is undermining their effectiveness."

He said the commission was proposing to:

* Amend the Health Records and Information Privacy Act 2002 (NSW) to transfer the handling of health information by private sector organisations to the Commonwealth.

* Consider doing away with a separate health information privacy Act so that the remaining health information held by public sector agencies is regulated under the Privacy and Personal Information Protection Act 1998 (NSW).

* Limit the numerous exemptions in the legislation, particularly exemptions to the definition of "personal information".

* Facilitate the exchange of information between agencies and organisations to improve the provision of services to vulnerable people, particularly in the area of child protection.

Much more here:

http://www.theaustralian.news.com.au/story/0,25197,24109007-17044,00.html

This is a very sensible idea – as long as the Commonwealth powers are appropriate and robust. We don’t need the railway gauge problem in E-Health in OZ!

Fourth we have:

E-health discussion paper ahead of its time, literally: expert

Elizabeth McIntosh - Friday, 1 August 2008

A NATIONAL e-Health Transition Authority discussion paper on an e-health patient and provider identification system has been labelled as premature by a health IT expert.

The paper, E-Health ID, has been released ahead of a $1.3 million government funded report from consultancy firm Deloitte, which is expected to indicate what NEHTA’s future direction should be.

Health IT consultant Dr David More said while NEHTA was under pressure, it had to “deliver results on what’s needed, not what they think should be needed”.

However, AMA e-health committee chair Dr Peter Garcia-Webb said unless Deloitte returned with anything hugely unexpected, it was time the authority started informing people on how a new e-health system could work.

More here (Subscription Required):

http://www.medicalobserver.com.au/News/0,1734,3021,01200808.aspx

I am sorry but Dr Garcia-Web is just wrong on this. It is virtually certain the National Strategy will not recommend a centralised national IEHR and so this money is being spent in educating people about something that is very unlikely to happen.

Fifth we have:

Canberrans to get health cards in $1b overhaul

BY DAVID STOCKMAN

29/07/2008 12:00:00 AM

A hospital for women and children, an electronic health card and a health centre in Gungahlin are the first projects announced under the ACT Government's $1 billion plan to redevelop the health system.

The Stanhope Government has launched a week-long advertising campaign to ''sell'' the $300 million package to the public.

The balance of $700 million will be spent on projects to be outlined over the next 10 years.

Health Minister Katy Gallagher detailed the initial spending yesterday, which had been announced in last month's budget.

It includes a plan to introduce health cards for Canberrans that will enable them to access a database of patients' medical histories.

More here:

http://www.canberratimes.com.au/news/local/news/general/canberrans-to-get-health-cards-in-1b-overhaul/1228839.aspx

More coverage is found here:

http://health.act.gov.au/c/health?a=sp&did=10241971

It is clearly a good thing to see the ACT planning some serious Health IT, but one has to worry where the idea of Health Cards fits – given we have a national e-health strategy process underway. Such ideas have been floated frequently but have seldom come to anything.

I must say that $47 Million over 4 years seems a reasonable sum to invest to upgrade the ACT systems.

Sixth we have:

How secure is secure enough?

Are your information security plans too big, too small or just right? Here are five steps to help you decide.

Jaikumar Vijayan 29/07/2008 07:44:00

If there is a Holy Grail in the information security industry, it surely is the answer to the question, "How secure is secure enough?"

It's a question that many security managers have either avoided answering altogether or tried to quickly sidestep by throwing a fistful of mainly pointless operational metrics at anyone who cared to ask.

But with a faltering economy beginning to put the squeeze on IT budgets, and security managers being asked to justify every dollar they spend, there is a growing need to come up with a better answer to the query. Increasingly, there is pressure on IT managers to demonstrate how exactly their security investments are helping them manage threats to their businesses. Companies want to know if the money they are spending on security is too much, too little or just enough.

Answering the question with any degree of accuracy involves art and luck as much as it does science, say security managers. But by adopting the right approaches, it is possible to arrive at a better answer than some might expect, they say.

Here are five steps to help you determine whether your company is secure enough.

Much more here:

http://www.computerworld.com.au/index.php?id=1271919968&eid=-255

An ever present issue in the Health IT domain, this is a useful framework to assist in considering just what the objectives of one’s security plans should be and how much should be invested in making it happen.

Last we have our slightly technical note for the week:

Hello, Cuil world

July 28, 2008

Anna Patterson's last internet search engine was so impressive that industry leader Google bought the technology in 2004 to upgrade its own system.

She believes her latest invention is even more valuable - only this time it's not for sale.

Patterson instead intends to upstage Google, which she quit in 2006 to develop a more comprehensive and efficient way to scour the internet.

The end result is Cuil, pronounced "cool." Backed by $US33 million ($A34.6 million) in venture capital, the search engine was set to begin processing requests for the first time today.

Cuil had kept a low profile while Patterson, her husband, Tom Costello, and two other former Google engineers - Russell Power and Louis Monier - searched for better ways to search.

Now, it's boasting time.

For starters, Cuil's search index spans 120 billion web pages.

Patterson believes that is at least three times the size of Google's index, although there is no way to know for certain. Google stopped publicly quantifying its index's breadth nearly three years ago when the catalog spanned 8.2 billion web pages.

Cuil won't divulge the formula it has developed to cover a wider swath of the web with far fewer computers than Google. And Google isn't ceding the point: Spokeswoman Katie Watson said her company still believes its index is the largest.

More here:

http://www.smh.com.au/news/biztech/hello-cuil-world/2008/07/28/1217097137646.html

Having given this a try I can say I believe this is not a bad effort – but won’t expect to see Google knocked of the throne anytime soon. It is different enough to have bookmarked of a search for a particular piece if information is just not yielding what you need.

The history of search and the size of Google’s market share make this an interesting read.

More next week.

David.

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