Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Thursday, March 12, 2009

International News Extras For the Week (08/03/2009).

Again there has been just a heap of stuff arrive this week.

First we have:

IHE's Connectathon shows interoperability 'coming of age'

February 27, 2009 | John Andrews, Contributing writer

CHICAGO – After 10 years, the North American Connectathon is hitting an impressive stride, Integrating the Healthcare Enterprise organizers say. As the size of the IHE interoperability demonstration continues to grow, this year's participants won the admiration of event leaders because they were "confident, well-prepared and cooperative."

The 2009 Connectathon Conference on Feb. 24 featured 350 engineers and technical support staff from 72 vendors and three universities sitting shoulder-to-shoulder at long tables in a basement show hall of the Chicago Hyatt Regency. The interoperability demonstration tested more than 170 profiles, compared to just one the first year and 12 in 2003.

"The vendors were better prepared this year - this group hit the ground running," observed Stephen Moore, demonstration coordinator and research assistant professor with the Mallinckrodt Institute of Radiology in St. Louis. "In previous years they had more questions about the network than the applications and that wasn't the case this year."

To be sure, "there is more confidence" this year, agreed Charles Parisot, manager of architecture and standards for GE Healthcare and board member for the Electronic Health Records Vendor Association.

"Tremendous progress has been made and it will only accelerate," he said. "This is the real coming of age for interoperability, the result of a lot of hard work."

IHE co-chairs Elliot Sloane and David Mendelson, MD, oversaw the proceedings. Sloane, assistant professor with the Villanova School of Business, used a cruise ship analogy to compare the Connectathon and the Interoperability Showcase at HIMSS09, April 4-8, in Chicago.

"The Connectathon is the 'coal room' tour while the Interoperability Showcase is the 'leisure deck,'" he said. More than half of the participating vendors - 49 - will take part in the Interoperability Showcase.

More here:

http://www.healthcareitnews.com/news/ihes-connectathon-shows-interoperability-coming-age

It is good to see we have continuing improvement and interest in having systems integrate and communicate easily. It is also good to know we now have a formal Australian IHE Chapter to further develop such work in Australia.

See here for details and to get involved.

http://www.ihe.net.au/

Second we have:

National health IT network ready for first exchanges

By Jean DerGurahian / HITS staff writer

Posted: February 27, 2009 - 5:59 am EDT

The first practical data exchange begins tomorrow for some participants in the national health information network after more than a year of testing and demonstrations.

The Social Security Administration on Feb. 28 will begin receiving medical records of patients at Bon Secours Richmond Health System from MedVirginia, the regional health information organization serving central Virginia, so it can more quickly determine disability benefits. The go-live comes after basic exchange and specific data testing began in September 2007, when nine RHIOs first began to implement the national network using a $22.5 million federal award.

MedVirginia is the first of the nine to go live. Acting as the intermediary, the RHIO will take disability requests from Bon Secours Richmond Health System, which can receive 2,500 requests from Social Security at a time, and repackage the health data into information for the Social Security system. The federal agency will be able to process that information faster than if it had received the patients' medical records directly from the health system, said Michael Matthews, chief executive officer of MedVirginia. “We’ll be responding on behalf of the provider,” he said. Bon Secours is a partner in the RHIO.

Much more here:

Here we have the first really concrete examples of how the US’s ground up development of the National Health Information Network is starting to pay off. Maybe 2014 is not as ambitious as a nearly there date as we have always though – it is after all 5 years away!

Third we have:

E-health won't be complete this year

Published Monday March 2nd, 2009

FREDERICTON - New Brunswick is on schedule to have its electronic health record system online by the end of 2009, but the system will be missing some vital information in its early days.

Lise Daigle, who speaks for the Department of Health on the electronic health record system, said that when the records are launched physicians working in emergency rooms across the province will be able to access information about their patient's previous hospital visits.

But those doctors won't be able to review information about the patient's medications or any data from their family doctor's files - at least not yet.

Daigle said that's the plan for the future, but it takes time to roll out a program of this magnitude.

"We should not think that every single thing we will need will be there (by the end of this year)," she said. "You have to start by developing and implementing some foundational pieces."

She said many things must be considered when you're dealing with confidential information.

"You're trying to provide clinicians around the province with the best possible information on the patients they are providing services to," she said. "On the other hand, you have to make sure this is done in an environment that will protect the information of the patient."

She said about $12 million has been spent on the system so far - much of the money coming from federal programs.

Some of it was used to help create the two main pieces of the province's electronic health record system: the client registry and the clinical viewer.

More here:

http://telegraphjournal.canadaeast.com/front/article/588921

It is good to see New Brunswick pressing forward. Their plans are consistent with the directions being taken all over Canada under the guidance of Canada Infoway. Would be nice if Australia had this level of co-ordination that has a great deal of similarity to the NEHTA plan as far as they go but also accounts for local funding etc of the needed extra applications etc.

Fourth we have:

The Manufactured Outrage over Comparative Effectiveness Research

Elyas Bakhtiari, for HealthLeaders Media, February 26, 2009

What if physicians could make decisions about which drugs, devices, and treatments to use based on objective research into which options were most effective?

The concept is called comparative effectiveness research, and many physicians believe it could improve quality and loosen the stranglehold the device and drug industries have on healthcare. The American Medical Association has endorsed the idea, as have several other physician organizations. In fact, it's difficult to find many doctors who consider it, in concept, a bad idea.

Here's how one physician blogger explains its value: "As a physician I really want unbiased comparative data. I love new drugs, when they provide a significant advance over older drugs. Without [comparative effectiveness research] we can only guess about the relative benefit of a new drug, or a new diagnostic technique, or a new operation."

Yet the $1.1 billion allocated to comparative effectiveness research in the economic stimulus package sparked one of the most vitriolic political debates over healthcare reform in a while. Why?

The controversy began when Betsy McCaughey—the same Betsy McCaughey who laid the groundwork for the rally against Bill Clinton's healthcare reform efforts in 1993—wrote an op-ed implying that the comparative effectiveness research provision would lead to healthcare rationing, and it reached fever pitch when the Washington Times ran an editorial, complete with an accompanying photo of Adolf Hitler, suggesting that it might lead to Nazi-style euthanasia.

More here:

http://www.healthleadersmedia.com/content/228896/topic/WS_HLM2_PHY/The-Manufactured-Outrage-over-Comparative-Effectiveness-Research.html

A great editorial – as always track the money and the vested interest when a good idea is the victim of hysterical outrage!

Fifth we have:

How to Make Electronic Medical Records a Reality

By STEVE LOHR

IN the world of technology, inventors are hailed as heroes. Yet it is more subtle forms of innovation that typically determine the impact of a technology in the marketplace and on society. Clever engineering, smart business models and favorable economics are the key ingredients of widespread adoption and commercial success.

History abounds with evidence. For years, much of what was known as “Yankee ingenuity” was, in fact, the American ability to pursue commercial applications of British inventions, from the Bessemer steel process to the jet engine. Even in computing, which we regard as made-in-America technology, the first stored-program computer, simple programming language and reusable code were pioneered in Britain.

But, of course, computer technology and the industry really flowered in the United States. That happened in no small part because the federal government nurtured the market with heavy investment, mainly by the Defense Department, and by choosing standards, like the Cobol programming language.

Today, Washington is about to embark on another ambitious government-guided effort to jump-start a market — in electronic health records. The program provides a textbook look at the economic and engineering challenges of technology adoption.

More here:

http://www.nytimes.com/2009/03/01/business/01unbox.html?_r=2&th&emc=th

A good article from the NY Times on just how hard getting Health IT to work in the US is likely to be!

What Stimulus Does For Medical Technology

  • Establishes Office of National Coordinator for Health Information Technology.
  • Charges the national coordinator to develop standards by 2010 for secure nationwide electronic exchange of health information.
  • Provides $2 billion for infrastructure, training, technology education for clinicians and state grants to promote use.
  • Strengthens federal privacy and security protections for health information, including requiring notification to patients if an unauthorized person accesses their records. Patients must give permission before their personal health information could be used for marketing purposes.
  • Gives $17 million in Medicare and Medicaid bonus payments and financial incentives to physicians, hospitals and federally qualified health centers for use of EMRs.
  • Enacts Medicare and Medicaid payment penalties for physicians and hospitals not using EMRs by 2014.
  • Is expected to generate savings of more than $12 billion.

Source: CHIME, College of Healthcare Information Management Executives.

More here (with much talk of a very ill Kemit the Frog):

http://www.theday.com/re.aspx?re=75321671-d6af-42d8-8858-7cab663d8e6a

What is fascinating is the breakdown – with most of the funds going to incentivize adoption and use, while developing co-ordination and standards. A sensible approach I must say.

Seventh we have:

Successful EHR Programs turn to Orion Health to Solve the Challenge of Interoperability

The Obama administration American Recovery and Reinvestment Act 2009 outlines goals and grants for health IT investments to spur rapid adoption of electronic medical and health records and to facilitate the electronic exchange of health data. Orion Health is in a unique position to help hospitals, governments and healthcare communities meet the challenges that arise from the Obama administration's goal to implement EHRs for every American by 2014.

Santa Monica, CA (PRWEB) March 2, 2009 -- Interoperability holds the key to effectively transitioning to an electronic health record (EHR) system and active Health Information Exchanges (HIE) between healthcare organizations.

The Obama administration American Recovery and Reinvestment Act 2009 outlines goals and grants for health IT investments to spur rapid adoption of electronic medical and health records and to facilitate the electronic exchange of health data.

One of the greatest challenges in the implementation of an EHR is the ability to exchange data between the numerous, disparate, health information systems (HIS) typically found at every healthcare facility.

Orion Health is a leading provider of clinical workflow and integration technology for e-health. The New Zealand-based company with North American headquarters in Santa Monica provides solutions to help integrate patient health data and histories that form the basis of an EHR. Orion Health is in a unique position to help hospitals, governments and healthcare communities meet the challenges that arise from the Obama administration's goal to implement EHRs for every American by 2014.

Paul Viskovich, Orion Health North America and EMEA President, says interoperability is one of the key challenges facing healthcare facilities today. "These monolithic hospital systems can't share data with one another and as a result, health information is held hostage within that system, which is often specific to a single department within the hospital," Viskovich says. "Inefficiencies run from needing to enter data multiple times, backlogs of data entry increasing the length of time to obtain test results and security and privacy issues. The issue of interoperability must be addressed before a complete health record can be created."

More here:

http://www.prweb.com/releases/2009/03/prweb2197374.htm

We can expect to see more such press releases as providers tout their capacity to provide what is needed and capture their share of the $20 Billion – only natural I guess! Good to see NZ in there and swinging!

Eighth we have:

Obama's HIT will likely be a miss

By Examiner Editorial
- 3/1/09

There is a provision of the $878 billion stimulus package rushed through Congress for $20 billion to develop a centralized national health information technology (HIT) system. Proponents claim HIT will save $77 billion over the next 15 years and greatly reduce medical errors. Who could possibly object to that?

Well, for starters, ask medical care providers in Britain’s National Health Service (NHS), who have been trying to get their HIT system to work properly for the past five years. The cost of NHS’ HIT has escalated to six times the original estimate – the U.S. equivalent of $18.4 billion - to serve just 30,000 physicians in 300 state-run hospitals, a fraction of the medical care providers in the United States. In January, Public Accounts Chairman Edward Leigh reported to fellow members of Parliament: “Essential systems are late or, when deployed, do not meet expectations of clinical staff.” HIT is such a mess that Leigh recommended funding “alternative systems” if things don’t improve within the next six months. But even if HIT is eventually junked, British taxpayers will still have to pay for it.

Full article here:

http://www.dcexaminer.com/opinion/Obamas-HIT-will-likely-be-a-miss-40512247.html

Just so we present a balanced coverage – what a turkey of an editorial is all I can say!

Ninth we have:

IT Spending: When Less Is More

Financial-services providers outspend the health-care industry on information technology, but they haven't made good use of all that data

By Dr. John Halamka

When it comes to information technology spending, I've often been told companies in the health-care industry should behave more like banks.

During the decade I've been a chief information officer, IT operating budgets have been 2% of my organization's total budget. That proportion is typical for health care. During the same period, IT budgets for the financial-services industry have averaged 10% or higher.

Given the recent troubles of AIG (AIG), Lehman Brothers, Merrill Lynch, Washington Mutual, and others, you have to wonder whether those IT budgets represent money well spent.

Of course, financial-services firms have had great systems for handling such tasks as share trading, disaster recovery, and data storage. But did they have the business-intelligence tools and dashboards that could have alerted decision makers about the looming collapse of the industry?

Much more here:

http://www.businessweek.com/print/technology/content/mar2009/tc2009032_882571.htm

A much more balanced perspective..we need to do things smart not expensive!

Tenth we have:

Coalition launches health IT security plan

By Jean DerGurahian / HITS staff writer

Posted: March 3, 2009 - 5:59 am EDT

The Health Information Trust Alliance released its common security framework to help vendors and providers implement security measures that protect electronic information.

.....

Users can access the framework for a licensing fee through an online community dubbed HITrust Central.

More here:

http://www.modernhealthcare.com/article/20090303/REG/303039964

For those who may be interested in the area.

Eleventh for the week we have:

e-Health record system proposed *

The Food & Health Bureau proposes developing a Hong Kong-wide electronic patient record-sharing system as part of the Government's healthcare reform.

The eHR system enables different healthcare providers in both the public and private sectors to enter, transfer and retrieve data, with procedures for obtaining patients' consent, and mechanisms for authenticating and controlling data access.

In July 2007, the Secretary for Food & Health established the Steering Committee on eHR Sharing comprising healthcare professionals from both the public and private sectors.

Last July, the committee put forward its initial recommendations for an eHR programme, from which the bureau formulated a 10-year planning roadmap.

More here:

http://www.news.gov.hk/en/category/healthandcommunity/090303/html/090303en05004.htm

Hong Kong on the move it would seem!

More on the project here:

http://www.ehealtheurope.net/news/4624/hong_kong_plans_e-health_records

Hong Kong plans e-health records

Twelfth we have:

Scottish e-prescription claims hit 60 per cent

03 Mar 2009

More than 60% of payment claims for acute prescriptions in Scotland will be made electronically by May, according to the Scottish Government.

The health department’s primary care division has released details of its latest incentive scheme for community pharmacies, to encourage take up of electronic claims.

Pharmacists will be able to claim £450 when more than 30% of claims are made electronically in a month and a further £450 when more than 60% of claims are made this way.

Dr Jonathan Pryce, deputy director of the primary and community care division, said that he expected all community pharmacists to claim for more than 60% of prescriptions in the month of May.

Scotland is rolling out electronic transmission of prescriptions in two stages, with acute prescriptions delivered via the Acute Medication Service (eAMS) and services to patients with long term conditions delivered via the Chronic Medication Service, which is due to go live later this year.

More here:

http://www.ehiprimarycare.com/news/4619/scottish_e-prescription_claims_hit_60_per_cent

Good to see the Scots powering ahead!

Second last for the week we have:

Introducing Lorenzo to Asia

By JO TIMBUONG

iSOFT GROUP Plc has brought its next-generation healthcare solution, Lorenzo, into the Asian market. Currently used by healthcare providers in Europe, including Britain, the Netherlands and Germany, iSoft claims Lorenzo is able to improve the delivery of healthcare services to patients.

Lorenzo stores patient records ­electronically, helping healthcare providers to easily access the information they need in order to properly treat a patient and can be used in all segments of the healthcare industry.

“The system can handle anything from 100 records in a private practice to about 90 million records in hospitals,” Gary Cohen, iSoft executive chairman and chief executive officer, said in Kuala Lumpur recently.

More here:

http://star-techcentral.com/tech/story.asp?file=/2009/3/3/corpit/3356337&sec=corpit

It seems LORENZO is spreading! (Or at least the marketing is!)

Last for this week we have:

Telemedicine: Miles Don’t Matter

By Lindsey Getz

For The Record

Vol. 21 No. 5 P. 20

From remote monitoring to simple phone consultations, connected health is becoming more ingrained in the healthcare landscape.

Telemedicine (or connected health) is transforming the traditional view of medicine. It’s essentially the delivery of some form of healthcare (information or services) via telecommunication—whether by telephone or via the Internet. This can include myriad components, including video conferencing, where a patient and a doctor can see and talk to one another despite not being physically present in the same location. Or it may mean the use of remote medical devices that track and transmit health data from patient to physician. Some patients even use telephone services to communicate with their doctor instead of scheduling an in-person visit.

The primary benefit of any connected health program is that patients don’t have to leave their home—even those with a chronic illness can be monitored from their desired location. Also, various forms of telemedicine can help patients determine whether a trip to the doctor or emergency department (ED) is necessary. This is especially beneficial considering it’s been found that patients often overuse their local EDs. In fact, in any given year, more than one half of ED visits are for nonemergencies. Typically, patients know it’s a nonemergency but feel there is no better option.

Very much more here:

http://fortherecordmag.com/archives/ftr_030209p20.shtml

A nice short review of the various possibilities

There is an amazing amount happening (lots of stuff left out). Enjoy!

David.

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