Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
Kathryn Mackenzie, for HealthLeaders Media, September 2, 2008
Now that the presidential nominees have chosen their running mates, the buzz surrounding the upcoming election has intensified. As the three senators and the governor from Alaska enter the final leg of the race, I thought I'd take a look at how the contenders could impact the role technology plays in healthcare.
Their overall healthcare reform plans pretty much follow party lines. The Democratic nominee is promising healthcare for all and the creation of a National Health Insurance Exchange that will act as a watchdog group and help reform the private insurance market. The Republican nominee stresses the role of personal responsibility in reforming the healthcare system and emphasizes prevention and offers tax credits as an incentive to help people buy insurance.
Both candidates have a plan for wider adoption of healthcare information technology—though Barack Obama's plan is more detailed than John McCain's.
Obama says he would invest $10 billion a year over the next five years to move the U.S. healthcare system to broad adoption of standards-based electronic health information systems, including electronic health records. He will also phase in requirements for full implementation of health IT. Just as an aside, when Democratic vice presidential candidate Sen. Joe Biden was running for president, he proposed spending $1 billion per year on a similar plan. Obama also promises to appoint the nation's first chief technology officer who would coordinate the government's technology infrastructure, work on issues of transparency, and "employ technology and innovation to solve our nation's most pressing problems."
McCain's plan is a bit more vague. "We should promote the rapid deployment of 21st century information systems and technology that allows doctors to practice across state lines," according to his Web site. Experts say that addresses one of the biggest barriers affecting wider adoption of telemedicine. His running mate, Alaska Gov. Sarah Palin already has experience in that arena. Earlier this year, she introduced the Alaska Health Care Transparency Act, which aimed to increase access to healthcare in rural areas through telemedicine and telehealth.
This is a useful summary for us on the other side of the pond on what each of the major parties have in mind for Health IT. Worth a read.
Second we have:
Long-distance health care
By Chris Birk
SPECIAL TO THE POST-DISPATCH
On a dresser next to the bed, a small electronic box is helping Ovelet Coates stay healthy.
Twice a day, the device instructs Coates, 91, to step on a scale and then to take her blood pressure. The scale and pressure cuff are connected to the box, which, in turn, is connected to the phone line in her spotless Bethesda Orchard apartment.
After Coates takes her vital signs, the information is transmitted to her home health nurse, who monitors the data daily to look for problems or patterns.
"It took a little while at first until I got used to it," Coates said. "It doesn't take but a couple of minutes."
Heralded as both time and money savers, telemonitoring and telehealth services are gaining a greater foothold in the increasingly costly health care market.
Telemedicine, which combines traditional health care services and telecommunications technology, can range from a surgeon operating on a patient hundreds of miles away to a nurse checking vital signs from the comfort of her home, according to the American Telemedicine Association.
The burgeoning field has spurred a growing interest in home-health strategies that can help curb costs by minimizing office visits and hospitalization — and may lead to better patient outcomes.
It is important to note how these technologies are being progressively implemented around the world with active thrusts underway in Australia, Canada, UK and the US.
Third we have:
Author: Tony Collins
Posted: 16:58 01 Sep 2008
Barts and The London NHS Trust said today [1 September 2008] it had underestimated the impact of going live with a new system under the NHS's £12.7bn National Programme for IT [NPfIT].
Difficulties in scheduling patients for appointments have led to operating theatres and clinics being unused at times, despite high demand for them.
The trust is funding nearly £1m for extra temporary staff relating to the NPfIT go-live from its reserves. And it faces a further £1.5m shortfall in income because it may not be able to bill its local primary care trust for the patients it sees and treats.
A spokesman for Barts and The London NHS Trust told Computer Weekly an "intensive programme of measures is in place" which "will allow us to return to our previous performance levels as quickly as possible".
The trust has "apologised publicly to patients, GPs and staff for the difficulties they have experienced," he said.
The spokesman was responding to Computer Weekly's questions after the trust published board papers on its website describing "significant" ongoing problems after the implementation of the Care Records Service,
The trust has had difficulty maintaining an overview of which patients have been treated for what following roll-out of the system. It is paid according to the information it provides to the local primary care trust on the patients it sees and treats. But the trust warns in its latest board papers that income may be much less due to difficulties gathering accurate information on who has been seen for what and when.
This report shows just how hard system implementation can be and how the impacts can be quite significant for patients and budgets. Careful planning, especially in large and complex teaching hospitals.
Sounds like some system providers are about to be sued.
Fourth we have:
- Jill Stark
- September 5, 2008
PREGNANT women may be able to know if they are at risk of a premature birth with the development of technology normally used to predict the path of hurricanes.
Melbourne researchers are developing a world-first program that they believe could halve the premature birth rate and reduce newborn deaths. About 17,000 babies are born prematurely each year in Australia but doctors have little way of knowing which women will be affected.
Now, engineers from the University of Melbourne and doctors from the University of Newcastle are developing a computerised system that can predict who is at high risk.
The technology works by tracking the hormone levels of pregnant women to look for patterns that might identify differences between those who will give birth at term and those who will give birth before 37 weeks.
Other variables such as the woman's age, weight, previous pregnancy history and whether she is a smoker, are fed into a computerised system to assess risk. The forecasting system is similar to that used to predict the paths of hurricanes and is believed to be the first time it has been used in a medical setting.
This is a very interesting piece of work indeed. It seems the team have identified the key determinants of premature birth and given the options available to now delay delivery and save young lives a worthwhile piece of work indeed!
Fifth we have:
More accurate than existing methods
Rodney Gedda (Techworld Australia) 02/09/2008 16:14:00
New software developed by the Australian e-Health Research Centre claims to assist hospital emergency medical staff to better gauge demand on their services.
The Patient Admission Prediction Tool (PAPT) uses historical data to allow hospital staff to see what the patient load will be like in the next hour, that day, the next week, or even on holidays with varying dates, like Easter.
PAPT was developed in collaboration with clinicians from Gold Coast and Toowoomba Hospitals, Griffith University and Queensland University of Technology.
Director of emergency medicine at Gold Coast Hospital Dr David Green said accurate forecasting will assist many areas of health management – from basic bed management and staffing to scheduling elective surgery.
Green also believes PAPT will reduce stress for staff and improve patient outcomes.
Australian e-Health Research Centre research director Dr David Hansen said PAPT has so far improved prediction of patient presentation and admission in two hospitals with “very different populations”.
This is an interesting idea but I really wonder just how predictable demand in A&E can really be. Having run a large metropolitan Accident and Emergency Department (Royal North Shore) for a number of years I know it only took one occasional major accident or medical crisis to totally derail any efforts at consistent patient flow and load throughout the department.
I would be curious to know what mechanisms were built in to handle the inevitable unexpected (Do I sound like Mr Rumsfeld?)
Last we have the slightly more technical article for the week:
Mike Harvey | September 02, 2008
GOOGLE will today launch its own web browser called Google Chrome in another expansion by the search giant into the building blocks of the internet.
News of the beta launch of the product in 100 countries came with the leaking of a 28-page comic book by Google to a blog, Google Blogoscoped, which outlined the specifications and innovations in the new browser with a series of illustrations.
It said that Chrome -- www.google.com/chrome -- would feature a new format for tabs, the ability to view web pages as thumbnails and better features on the address bar.
There have been rumours about a Google browser for years and reports suggested that Chrome has been in development for at least two years.
Google confirmed the launch in the blog and said: “We can add value for users and, at the same time, help drive innovation on the web. We realised that the web had evolved from mainly simple text pages to rich, interactive applications and that we needed to completely rethink the browser. What we really needed was not just a browser, but also a modern platform for web pages and applications, and that’s what we set out to build.”
Initially it will be for Windows users, but versions for Mac and Linux will be available soon, the blog said.
This is clearly the technical news for the week! I wonder just how far Google plans to extend its reach. My initial impression is that it works very well indeed but still has a way to go to surpass Firefox. Will be interesting to see its evolution of the new browser war over the next year or so.
More next week.