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, November 23, 2008

Useful and Interesting Health IT Links from the Last Week – 23/11/2008

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

These include first:

Medicare pushes e-health system

Karen Dearne | November 19, 2008

MEDICARE Australia wants medical specialists who have largely resisted online connectivity to come on board with Eclipse, its e-claiming system for hospitals.

The Electronic Claims Lodgement Information Processing Service Environment allows privately insured hospital patients to pay their doctors bill by lodging a single claim to both Medicare and their insurer.

It also gives the patient warning of any out-of-pocket expenses.

Only 40 per cent of medical specialists have computers and IT infrastructure to support online claiming, compared with over 90 per cent of GPs who use computers in their practices, and almost 100 per cent of pharmacists.

As an incentive, medical specialists in metropolitan areas will receive a one-off $750 payment to cover start-up costs and $1000 for those in rural and remote areas.

In addition, practices will receive an incentive payment of 18 cents every time a claim is sent electronically.

Medicare's executive general manager, business operations, Mark Jackson has been out selling the benefits of the organisation's shift from "cash to e-health" - mainly from improved real-time analysis and compliance.

"The next challenge lies in getting specialists who will be the key provider users of Eclipse into the electronic claiming and, hence, connectivity world," he said.

More here:

http://www.australianit.news.com.au/story/0,24897,24674390-15306,00.html

It is interesting to see that again Medicare is resorting to financial incentives to encourage e-Health adoption. It would be preferable if the benefits of the use of their systems were sufficient that they actually sold themselves to the non-users. Wishful thinking I guess.

Second we have:

IBA planning to make $400m Lorenzo a healthcare standard

Karen Dearne | November 18, 2008

IBA Health has invested $400 million in building its Lorenzo clinical information platform, and is aiming to make it a new standard for healthcare applications.

'By the time we've finished developing Lorenzo, we will probably have spent more than $600 million on it,' says IBA's Gary Cohen

Gary Cohen, executive chairman and chief executive of Australian-based IBA, launched Lorenzo Acute Care as a global product in Sydney last week.

"By the time we've finished developing Lorenzo, we will probably have spent more than $600 million on it," he said.

"This is more money than any country could afford to invest in developing health IT. Australia certainly couldn't afford to support a company investing that much money on its own.

"So building a global product has been very important and now we need to use it."

Mr Cohen said Lorenzo could be used to deliver national healthcare.

"That's where we should be focusing. It's nice to talk to the various state governments about what's happening in their health departments, and our people are doing that," Mr Cohen said.

"The bigger story is how we can connect up Australia, and we have something to say about that."

More here:

http://www.australianit.news.com.au/story/0,24897,24665203-15306,00.html

IBA is enunciating a pretty ambitious strategy here. It will be a year or two yet before the reality emerges – but if they succeed it could be quite exciting. I will be watching closely as they move forward. (The usually disclaimer that I have a few shares in IBA applies)

Third we have:

The cost of losing yourself

Conrad Walters

November 16, 2008 - 11:07AM

Privacy breaches are shaping as the new pandemic infecting business stability, reports Conrad Walters.

The lapses came at a rate of one a week: hundreds of credit card receipts from a Bondi Junction chemist are strewn across Mascot Oval; names and dates of birth for 3500 customers of a Sydney restaurant are inadvertently attached to a mass email; detailed financial records for Aussie Home Loans customers are dumped in an unsecured bin; and, most worrying, a Tax Office CD of documents about 3122 taxpayers vanishes after reaching a courier.

And those losses of personal information, all from last month, were the ones made public.

October, though, was not alone as a bad month. A recent survey by the computer security company Symantec found 79 per cent of Australian businesses know they have lost sensitive information about themselves or their customers.

The survey of nearly 200 businesses with more than 100 employees shows data loss is anything but rare. Forty per cent of companies that lost information acknowledged six to 20 losses in the previous year. Eight per cent admitted 100 or more instances. Data losses cost one industrial company $8 million.

What is going astray? Everything from customer and financial details to employee records and competitive intellectual property. The biggest causes: lost laptop computers and mobile phones, and human error. Lower on the list, but still statistically alarming, are corporate espionage, hacking and insider sabotage.

"What the survey results show is this is not hype," Craig Scroggie, regional managing director of Symantec, says. "This is a real and present challenge."

Certainly it will assist the bottom line for Symantec, a seller of software to monitor documents and protect data, but the risks to companies and consumers are enormous.

Australia does not require companies or government departments to reveal breaches of personal information to the people affected. It is not possible, therefore, to know precisely the number of stuff-ups and the number of people affected, but there are clues from overseas.

Much more here:

http://www.smh.com.au/news/technology/biztech/the-cost-of-losing-yourself/2008/11/16/1226770228519.html

This is a useful summary of the current state of the globe in mislaying private sensitive data. The article correctly points out we need strong laws regarding notification of data loss to ensure people are confident all data custodians (including the custodians of health information) take their responsibility seriously.

Fourth we have:

IT ushers Next Generation care for roaming nurses

RDNS preps for e-health with 3G

Darren Pauli 17/11/2008 09:51:00

The Royal District Nursing Service (RDNS) has connected its 1200 mobile staff on Telstra's Next G mobile network.

The RDNS provides nursing and healthcare across Melbourne and its northern suburbs to people in their homes and workplaces.

Some 1100 Fujitsu tablets are in use by staff and contractors to send patient reports back to a central repository and access the Medical Information Management Systems (MIMS) drug information database which assists with the drug administration.

RDNS information services general manager Ian Cash said the upgrade from 2G services to Telstra's 3G will allow the company to use more data intensive applications.

“We are everywhere in the field and you could never guarantee connectivity with GPRS and [the now defunct] CDMA," Cash said.

“We don't consider that we have an always-on network but we are confident we will have access within most homes.

“There has been a gradual growth in the number of transactions and the next step is to take advantage of new technology. Our use of mobile computing is built to make life easier for our nurses.”

Cash said the natural progression of mobile computing will extend the reach of RDNS into more remote areas.

More here:

http://www.computerworld.com.au/article/267578/it_ushers_next_generation_care_roaming_nurses?eid=-6787

I would be interested to see an evaluation of this investment in a couple of years to see the impact this planned step on the quality, speed and safety of the care delivered by the RDNS.

Fifth we have:

Spinal implants offer hope to paralysed

Nick Miller

November 17, 2008

AUSTRALIA's bionic ear experts may hold the key to perfecting a technique that will allow paraplegics to walk again.

A Canadian researcher has been working for 15 years on bionic implants that use electrical signals to command "lifeless" limbs to stand and walk.

Dr Vivian Mushahwar of the University of Alberta, who arrived in Melbourne yesterday, said her work had been proved in animals and she was about three years from the first human trials.

But there remains a significant hurdle before it becomes widely available. A web of electrodes finer than a human hair must be placed exactly in the "spinal control centre" in the small of the back.

More here:

http://www.smh.com.au/news/specials/science/spinal-implants-offer-hope-to-paralysed/2008/11/16/1226770256748.html

We have often heard of these sort advances – I wonder how close workable systems in this area actually are? Given the disability caused by spinal injuries the sooner the better.

Last we have the slightly more technical article for the week:

http://www.healthdatamanagement.com/news/standards_HL727316-1.html?ET=healthdatamanagement:e686:100325a:&st=email&channel=systems_integration

HL7 Issues Four Implementation Guides

Standards development organization Health Level Seven has released four new guides for implementing its Clinical Document Architecture (CDA) in specific settings.

.....

The new implementation guides cover diagnostic imaging, consultations, quality reporting and home health monitoring. The home health guide is available for downloading now at www.hl7.org/dstucomments/index.cfm. The other three guides should be ready by December.

Full article here:

It is good to see work continuing in these areas. What is not clear to me is just where the CDA approach fits in the plans NEHTA has in this area. As far as I can tell NEHTA is not following the HL7 CDA direction, in terms of development of implementation guides rather than publishing very detailed specifications, consistently which is a pity I feel.

See here for the latest I have seen from NEHTA.

http://www.nehta.gov.au/index.php?option=com_content&task=view&id=182&Itemid=144

More next week.

David.

2 comments:

Anonymous said...

DoHA and Medicare use financial incentives to gain traction until there is sufficient uptake, at which time they progressively withdraw the incentives.

This may well be a valid marketing tool to encourage adoption, however, problems arise when the ‘product’ is faulty and the ‘motives’ are questionable. Also, there is also another more fundamental problem to be considered.

It is the simplistically crude way in which Medicare and DoHA conceive and use incentives to get results. Added to this is the nagging question of trust.

No amount of incentives will encourage uptake if the product is faulty, and if the motives are ‘questionable’, that will quickly serve to destroy any semblance of credibility and trust.

Can Medicare and DoHA be trusted to play fair and do the ‘right thing’?

Anonymous said...

Just a minute there - hold the horses. What do you mean "Can Medicare and DoHA be trusted" to do the right thing (?) - stop right there. Your whiskey bottle must be half empty. Mine is half full. How about asking "Can doctors and and pharmacists be trusted to do the thing"?

Medicare has professional practice audits to catch the cheats (at Medicare we use the 'C' word and the 'F' word. The latter stands for FRAUD, the former for ..... COMPLIANCE!!! That applies to doctors and pharmacists.

At Medicare we are responsible for spending many billions of dollars which goes to doctors and and pharmacists. Whether they want better and more efficient monitoring and auditing systems is a discussion for another day, suffice to say that if they did we would more than likely get more support and cooperation.

We do our best to keep them honest and we are accountable!!!!