Quote Of The Year

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

Friday, June 12, 2009

International News Extras For the Week (08/06/2009).

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

First we have:

Cerner finds a treasure in data mining

Kansas City Business Journal - by Mike Sherry Staff Writer

Cerner Corp. is looking for big things from what is now a small corner of its business.

The North Kansas City-based health care information technology company, known mostly for the health-record software sold to hospitals and clinics, is leveraging the billions of anonymous patient records it has at its disposal as marketable information to pharmaceutical companies and researchers.

Cerner said the data operation is a big reason revenue for its LifeSciences Group has increased by roughly 20 percent during each of the past five years.

Mark Hoffman, the company’s life sciences solutions vice president, predicted that annual growth will be greater still in the future.

“This is just the beginning for us in the life sciences,” he said.

Included in Cerner’s data warehouse are 1.2 billion lab results. It also has smaller numbers of medication orders and other data.

The company collects the information through data-sharing agreements with roughly 125 of its software clients.

Much more here:

http://www.bizjournals.com/kansascity/stories/2009/06/01/story5.html?b=1243828800^1835382

I wonder what people think about this? My view is that it is simply not a good idea and can only erode the confidence of the public in e-Health. That is enough to have me feel it is a very bad idea.

I wonder what the Australian Federal Privacy Commissioner would think. I plan to ask her.

More here:

http://www.fiercehealthcare.com/story/cerner-markets-patient-data-pharma-researchers/2009-06-02?utm_medium=nl&utm_source=internal

Cerner markets patient data to pharma, researchers

June 2, 2009 — 1:45pm ET | By Anne Zieger

Second we have:

Health care groups outline plan to save money

By CARRIE BUDOFF BROWN | 6/1/09 3:12 PM EDT

Updated: 6/1/09 6:18 PM EDT

Six major health care organizations submitted a 28-page proposal Monday to President Barack Obama detailing how they could save $2 trillion over 10 years.

Some of the savings proposed Monday mirror ideas already under consideration in Congress, including reducing the number of hospital readmissions, increasing the use health information technology and preventing chronic diseases. They also propose streamlining administrative processes, reducing medical errors and promoting comparative effectiveness research.

“We have convened seven all-day meetings and multiple conference calls to discuss what we can contribute, both individually and collectively, to help achieve that challenging goal,” the groups said in a joint letter. “We have made solid progress. Individually and together, our organizations have developed initiatives that will help move the nation toward achieving the Administration’s goal and we intend to keep working.”

The groups represent key sectors in the health care reform debate, including physicians, hospitals, workers, insurers and pharmaceuticals.

Much more here:

http://www.politico.com/news/stories/0609/23180.html

Good to see continuing organisational support for more Health IT deployment. They are talking serious dollars here!

Third we have:

"Meaningful Use" Criteria Out Soon?

HDM Breaking News, June 1, 2009

The HIMSS Electronic Health Record Association, a trade group for EHR software companies, has learned that the federal government by June 16 may publish criteria for the definition of "meaningful use" of electronic health records software.

The definition is important because the Medicare and Medicaid financial incentives mandated under the American Recovery and Reinvestment Act require meaningful use of certified EHRs.

Publication of the criteria for the definition may be followed by a brief public comment period, during which time the federal government will be undergoing the rules development process. There is no indication yet when the rule will come out, but industry stakeholders have been expecting the rule by late summer or early fall, says Justin Barnes, chair of the association and vice president of marketing and government affairs for physician software vendor Greenway Medical Technologies Inc., Carrollton, Ga. ARRA mandates publication of a final meaningful use rule by the end of 2009.

Full reporting continues here:

http://www.healthdatamanagement.com/news/stimulus-38420-1.html?ET=healthdatamanagement:e895:100325a:&st=email

Given the money attached to this definition it will be interesting to see what is finally decided.

Fourth we have:

Slipshod health-records system puts welfare of inmates at risk

by JJ Hensley and Yvonne Wingett - Jun. 1, 2009 12:00 AM
The Arizona Republic

Among experts in correctional health, the test of any system is how well it can collect and manage patients' data.

Faced with a constantly changing, high-risk population, jail health-care staff must quickly diagnose, track and treat a variety of medical conditions. Knowing which inmate has what condition, the risks involved, treatment regimens and where that inmate is at any given time is a huge challenge.

Maricopa County's Correctional Health Services department has failed for years on that basic standard of collecting and managing medical data. The solution is a central, electronic medical-records system to replace the county's scattered paper files and limited computer files.

The county's Board of Supervisors has not acted on repeated recommendations to install such a system, even when faced with hundreds of lawsuits and the loss of accreditation for CHS operations.

An Arizona Republic investigation into Correctional Health Services reveals a system with chronic problems and top county officials who seem unwilling to fix them. Today, in the second of a two-part series, The Republic explores the value of an electronic records system and what the old system costs Maricopa County taxpayers.

CHS' problems with managing inmate health data have been repeatedly blamed by family members, inmate advocates, hired consultants and numerous lawsuits for unnecessary suffering and deaths in the county jails

Since 1998, the county has paid out $13 million in legal fees, settlements and jury verdicts to inmates and families for injury and death claims against CHS.

Dozens more lawsuits are pending against the county. The lack of an electronic records system was a factor in January when CHS lost its accreditation, after almost three years on probation. And loss of accreditation makes CHS even more vulnerable to lawsuits by inmates or their families who claim poor health care.

The Board of Supervisors has spent at least $250,000 on three consultants seeking solutions to CHS problems. All three recommended installing an electronic records system. The board twice sought bids on a system. Two years ago, there was a contract to install the system, but the board canceled.

Much more here:

http://www.azcentral.com/arizonarepublic/news/articles/2009/06/01/20090601chs-database.html?&wired

Interesting source of a stimulus to discussed EHRs!

Fifth we have:

Interview: Mayo Clinic forges its mobile strategy

Sunday - May 31st, 2009 - 01:30pm EST

by Brian Dolan

mobihealthnews recently caught up with Scott Eising, director of product management for Mayo Clinic Internet Services, to discuss his group’s strategy and pain points for moving Mayo Clinic’s online offerings to the mobile platform. Every major provider of health services and information is trying to figure out how best to go mobile. Eising offered a peek behind the curtain at Mayo to discuss how the not-for-profit, integrated medical practice is planning to do just that.

Mayo Clinic employs 3,300 physicians, scientists and researchers as well as 46,000 allied health staff at its three sites in Rochester, MN, Jacksonville, FL, and Phoenix, AZ. Mayo treats more than 500,000 people each year.

mobihealthnews: In general, what kind of opportunity does Mayo Clinic have to capitalize on mobile platforms?

Eising: It depends on the audience. Our group serves a number of audiences. On the consumer side, we have a presence MayoClinic.com on the Web, we certainly think providing a mobile experience for accessing health information is going to be paramount. We really don’t do that today at all. How we optimize our content for mobile is kind of a question for us. Do we do the m.mayoclinic.com approach and offer a narrow subset of content that we share with that audience? We have so much content so that could be challenging. I think in the near term we will probably go in the consumer app direction, just because with the browser capabilities on these newer smartphones the experience isn’t too bad when you can pinch and expand and get at the content you want. First on the mobile side, we will look at smartphones for consumers and some apps. We are a user-centric design shop though, and we need to do more research about what are the mobile needs and habits of our customer base on the consumer side. We have a lot of data about the Web and their habits there, but our user research group isn’t convinced that those habits will transfer over. From a general standpoint, that seems to be a real gap out there in the health area, anyway, about what things do consumers want to do from a health perspective on mobile. Beyond the obvious — symptoms, first aid or find-a-doctor. We are going to do some fundamental user research with several audiences to get a sense of how they are using their mobile phone today in general — calls, text messaging, mobile browsing. Then get to what are the potential opportunities or pain points from either an information or health management standpoint that would be better served via mobile versus tethered to a desk.

Much more here:

http://mobihealthnews.com/2469/interview-mayo-clinic-forges-its-mobile-strategy/

An interesting article on how a major and technology literate health organisation is approaching the mobile e-health world.

Alive and clicking

The healthcare space is ticking with promise for technology players battling spending cuts by clients..

The healthcare industry is investing in new technologies that will enable it to cut costs in the long run and provide more efficient care.

Paromita Pain

When was the last time you actually celebrated a fever? Years ago when it helped you escape a dreaded Hindi or Maths test?

For grownups too, health and its associated areas are a cause for celebration in these recession-affected times.

Going by the recent Nasscom and McKinsey study titled Perspective 2020: Transform business, transform India, by 2020, 80 per cent of the industry’s incremental growth and 50 per cent of the total opportunity will come from untapped verticals such as the public sector and healthcare.

The economic turmoil has impacted IT spending in key verticals such as banking, financial services and insurance, retail and manufacturing, where customers have delayed or postponed investments on deploying new technology applications. However, the IT budgets in healthcare industry are largely unaffected as service providers continue to invest in newer technologies to meet the rising demand for services, and improve their efficiency while keeping costs under control.

John-David Lovelock, Research Vice-President, Gartner, says in a February 2009 release, that “Internal spending, hardware and system integration in the financial sector were particularly hard-hit in 2008 and will continue suffering through 2009. In contrast, healthcare grew at 8.3 per cent worldwide in 2008.”

The slowdown is a reality but in this space new research is being commissioned, recruitments being made and plans set in motion to do even better. In a chat with some key stakeholders, eWorld checks out the scene.

Some positives

IT vendors focussed on the healthcare segment continue to see traction as players look to leverage technology to control costs while trying to be efficient. Indian vendors, who earn about 5 per cent of their revenues from the healthcare practice, are bullish about the prospects and continue to enhance their offerings.

Wipro Technologies, for instance, recently set up a separate healthcare practice by re-grouping its different units offering healthcare solutions. “We are seeing a strong level of momentum as healthcare players look to adopt technology to cut costs and improve their efficiencies,” says Rajiv Shah, head of healthcare practice at Wipro Technologies, adding the regrouping of units to carve out a separate practice was to complete solutions, by focussing on the entire industry in a holistic manner.

The product engineering group at Wipro works with healthcare equipment makers while the BPO unit works with both healthcare payers and providers. Besides, Wipro also offers healthcare solutions such as hospital information management systems and data centre services through Infocrossing.

A survey by analyst firm Datamonitor has revealed that the healthcare industry will significantly increase IT spending in 2009 as growing demand for healthcare services from the aging ‘baby boom’ generation in Western Europe, the US and Japan leads to rising costs for national and private health systems in these countries.

In an attempt to address this, the healthcare industry is currently investing in new technologies that will enable it to cut costs in the long run and provide more efficient care.

“The economic crisis is not affecting us in any form” Gary Cohen, executive chairman and CEO of iSoft, an IBA Health Group Company, one of the largest healthcare software solutions providers, said in Bangalore late last year. iSoft earns the bulk of its revenues from the public sector, in countries such as the UK, the US, Australia, Spain, Germany and Italy, where healthcare is a focus area for the government. iSoft stands to benefit from the rising spends on healthcare in developed countries that varies between 9 and 12 per cent of the GDP, Cohen said.

Debashis Ghosh, Vice-President & Global Head - Life Sciences and Healthcare ISU, Tata Consultancy Services, says, “The healthcare sector is one of the highest-ranked industries for year-over-year growth. The global healthcare technology (hardware, software, IT Services) spending is expected to grow from $56 billion in 2008 to $92 billion in 2013 at a CAGR of 10.5 per cent. The healthcare provider BPO market is expected to grow from $16 billion in 2008 to $24 billion in 2013 at a CAGR of 8.15 per cent.”

K Vinayambika, Vice-President, Healthcare Practice, Cognizant, seconds this view. “Our estimate on the healthcare market is quite bullish with an estimate of $100 billion, globally for IT/BPO services, by 2010. In Q4 2008 (quarter ended December 31, 2008), our healthcare practice represented 25 per cent of our revenues. For the year 2008, healthcare grew at 36 per cent.”

Much more here:

http://www.thehindubusinessline.com/ew/2009/06/01/stories/2009060150010100.htm

Interesting long article from an Indian perspective.

Seventh we have:

Jun 01, 2009 08:00 ET

Cisco and Karos Health Unveil Next Generation of Healthcare Information-Sharing Technology

Cisco Medical Data Exchange Solution Gives Health Professionals Highly Secure Access to Medical Records

News@Cisco Canada

QUEBEC--(Marketwire - June 1, 2009) - e-Health Conference -- (NASDAQ: CSCO) In addressing the evolution of healthcare delivery, one of the principal challenges is the seamless exchange of medical data across multiple health organizations. Healthcare enterprises and regional authorities are growing quickly and looking to improve their productivity and the quality of patient care. They also face tremendous challenges in connecting their IT and legacy clinical systems in order to share disparate medical data across health organizations

"Healthcare information will be the cornerstone to our moving forward with longitudinal health records, and this solution provides a solid platform to move the information in a safe and highly secure manner," said Mark Farrow, chief information officer and assistant vice president, Information and Communication Technologies, Hamilton Health Sciences Centre.

To help address current challenges, Cisco and Tiani Spirit integrated Cisco's Application Extension Platform (AXP) and Cisco's Integrated Services Routers (ISRs) with Tiani Spirit's IHE platform to enable a more simplified and more secure exchange of medical information across a range of healthcare disciplines. Karos Health and Cisco are jointly introducing the Cisco® Medical Data Exchange Solution (MDES) into the North American market to provide healthcare professionals from multiple institutions with access to patient data from previously disconnected information systems using incompatible formats and disparate medical terminology.

The Cisco MDES provides the collaborative tools necessary to improve cross-facility communication and patient care. MDES utilizes the Integrating the Healthcare Enterprise (IHE®) technical frameworks to establish a standards-based approach to interoperability and data exchange. MDES addresses two key challenges: formulating a common patient reference, and being able to share and access patient records across disparate systems. In addition, the solution conforms to the IHE security framework to support authorized access and to deny unauthorized access to records. The MDES's interoperability capabilities also reduce costs by eliminating costly manual transport and proprietary data exchanges and interfaces.

As a member of Cisco's AXP Developer Partner and Cisco Technology Developer Programs, Karos Health works with Cisco to customize and deploy the MDES solution. With the MDES platform, the complexity of medical data integration is greatly simplified, providing a high level of security and simplifying deployment for healthcare entities with multiple hospitals, distributed clinics and labs, and remote practices.

"With the Cisco MDES, clinical information exchanges can be gradually deployed. For example, the process can start with two hospitals, then encompass their referral base and ancillary services, then expand to a whole regional health authority and, potentially, to a national grid of connected health providers and patients," said Rick Stroobosscher, president of Karos Health. "Clinical information exchange grids are the stepping stone to electronic health records (EHRs), providing their users with all information generated along multi-provider patient care pathways."

"The Cisco network architecture makes MDES a hardened resilient platform, which can be deployed as a set of appliances and centrally configured and monitored," said Brantz Myers, director, Healthcare Business Development for Cisco Canada. "With MDES, the network becomes the healthcare platform for collaborating, decreasing costs and risks, and simplifying IT management."

.....

Links / URLs:

More here:

http://www.marketwire.com/press-release/Cisco-NASDAQ-CSCO-997285.html

This is an interesting release with a useful set of links. Certainly the sort of standards based approach that has a good chance of success.

Eighth we have:

Maryland Telemedicine Project Begins

HDM Breaking News, May 29, 2009

An ambitious telemedicine project in Maryland has kicked off at one hospital. Calvert Memorial Hospital in Prince Frederick is the first of six participants to go live in the Maryland eCare project.

Intensive care unit staff at Calvert Memorial now can connect with a remote monitoring center at Christiana Care in Wilmington, Del., to consult with critical care physicians and nurses.

Christiana Care uses eICU technology from VISICU, a unit of Philips Healthcare, Andover, Mass. The technology enables voice, video and data connectivity.

Full article here:

http://www.healthdatamanagement.com/news/Telemedicine-38405-1.html

More information is here:

marylandecare.org

It is interesting the system is being paid for by an insurance company. Shows the technology must really work.

Ninth we have:

New York City paves way on health IT extension centers

The Primary Care Information Project uses health IT to chart personal care and population health

Now that the Office of the National Coordinator has published a description of its plan to set up a system of regional health IT extension centers to help providers install and use electronic health records, a New York City technical assistance project already in operation could offer some best practices.

The Primary Care Information Project (PCIP), a program started in 2007 by the New York City Department of Health and Mental Hygiene, supports the adoption of health IT among primary care providers who tend to the city’s underserved populations.

“There’s a sense that we’re in this together, they’re not alone,” said Farzad Mostashari, assistant commissioner and director of the PCIP. “They’re not in the technology business. They didn’t go to med school to implement an electronic health record,” he said.

The New York project has already received nearly universal buy-in from the city’s under-automated clinics and providers, according to Mostashari, who estimated a
99 percent implementation success rate among 1,700 providers involved.

“We have been able to reach Medicaid providers in the city’s poorest neighborhoods in Harlem, the South Bronx, central Brooklyn, he said. “With the smallest practices that nationally have a 2 percent implementation rate of electronic health records, 53 percent of them are in our project.”

Among the PCIP’s more critical services is project management assistance. “Many practices don’t have the experience or resources to manage an IT project. And many vendors don’t pay sufficient attention to clinical practice workflows and the need to change workflow processes,” Mostashari said.

PCIP also keeps track of IT project timelines and milestones for practices and troubleshoots when problems arise.

Much more here:

http://govhealthit.com/articles/2009/06/01/new-york-city-paves-way-on-health-it-extension-centers.aspx

An example of the strength of diversity in the US. An example of how national Health Information Network has been running for a couple of years to help provide lessons and reduce risk

Tenth we have:

Weigh Your Risks When Protecting Electronic Records From Fire

Scott Wallask, for HealthLeaders Media, June 2, 2009

Hospitals protect paper medical records from fire by installing sprinkler systems and building features that enclose storage rooms.

But with electronic recordkeeping growing more prominent, the strategies for safeguarding patient data are shifting to systems that protect electronic equipment.

"As the healthcare industry transitions from file storage to electronic storage of personal medical records, the fire hazards associated with medical record storage will also change," says Anthony Gee, a product manager for Victaulic in Easton, PA, which manufactures grooved pipe joining systems used in fire protection.

Start with a well-known approach
At the heart of electronic medical record protection is the common strategy of conducting risk assessments, says Lance Harry, PE, director of sales for Chemetron Fire Systems based in Matteson, IL.

As Harry views it, hospital CEOs and administrators must ask themselves these questions:

  • What is the value of medical records?
  • What is the risk of losing those records?
  • How can we best protect them?

More here:

http://www.healthleadersmedia.com/content/233879/topic/WS_HLM2_TEC/Weigh-Your-Risks-When-Protecting-Electronic-Records-From-Fire.html

Certainly an issue to be thought about carefully – timely reminder.

Eleventh for the week we have:

Interoperability after ARRA

  • By Dr. Peter Elkin
  • May 28, 2009

The goal of interoperability is improved health and patient care. In healthcare patients put their trust in us, and we in the informatics community should feel compelled to provide our patients with the best informatics methods and solutions.

Our national goal in spending the funds from the American Recovery and Reinvestment Act (ARRA) should be first to ensure that there is ubiquitous availability of electronic records for care purposes. This should be true whenever a patient is cared for and regardless of where they obtain their usual care.

The other major objective that must be made possible by the financial incentives included in the ARRA stimulus package is to ensure that the electronic health record (EHR) sent between healthcare organizations be capable of driving clinical decision support systems in order to support the care of the patient at the receiving healthcare organization.

That should be a priority regardless of the EHR vendor used by each organization to create and store and use their electronic health record data.

The problem is that a significant proportion of patients receive their care from multiple healthcare organizations and often travel great distances to obtain the care they desire. In order for there to be continuity of care, the records from their medical home – indeed any of their encounters with the healthcare system – should be available to other clinicians caring for that patient.

More here:

http://govhealthit.com/Articles/2009/05/28/Interoperability-after-ARRA-letter.aspx?s=GHIT_020609&p=1

There is no doubt this is a major issue – and needs to be addressed carefully and thoroughly.

Twelfth we have:

Patient told no electronic record, no care

02 Jun 2009

A North London Mental health trust has said that any patients who refuse to have their data entered onto electronic patient records will not be able to receive treatment.

Barnet, Enfield and Haringey Mental Health Trust told a patient who asked not to have an electronic patient record that it would be impossible to provide care without using an electronic record.

The trust says that its RiO EPR system has entirely replaced paper patient records, making it impossible to provide care without using the system apart from in the most exceptional circumstances.

A trust spokesperson confirmed that the director of strategy and performance had written to a patient explaining that the trust had a legal requirement to maintain local patient records, and now only did this electronically.

The upshot, the letter explained, was no electronic record, no care: “If a service-user refuses to have the necessary information recorded in the electronic care record then, due to the above legal requirement and duty of care the trust would be unable to provide treatment.”

The trust told EHI, “CSE Servelec's RiO is the care records system we now use. It is part of the national programme for IT, but currently we do not share patient’s demographic details across the NHS through use of the ‘Spine’ provided by BT.”

A spokesperson said that the concerns most patients had related to fears about their record being held on the planned national care records system, rather than the local RiO system.

“People confuse the national record system being developed by NHS Connecting for Health with RiO the system we now use. We don’t keep paper records anymore.” The spokesperson said when the difference between the two was explained patients were almost always happy to have a local electronic record. They acknowledged though that the eventual plan was to connect the local system to the national care records system.

More here:

http://www.ehiprimarycare.com/news/4894/patient_told_no_electronic_record_no_care

The headline is a bit of a beat up – until such time as information sharing with the “NHS Spine” becomes a reality. There is, however, an issue of it really being the providers choice how the provider keeps their records – and that may have to be made pretty clear to patients. As noted most are quite happy as long as records remain local.

Thirteenth we have:

Legal advice on SCR and Spine

29 May 2009

GPs have been given medico-legal advice about the implications of using the Summary Care Record and uploading information to the Spine.

A series of more than 40 frequently asked questions prepared by NHS Connecting for Health and the Medical Protection Society have been published on the CfH website.

Dr Stephanie Bown, MPS director of policy and communications, said: “The Summary Care Record represents a fundamental reform of the way that patient records are stored and accessed.

"It is understandable that this could feel very challenging and it is of crucial importance that doctors are supported.

"MPS has, therefore, worked with NHS Connecting for Health to provide information and answers to some of the dilemmas doctors will face, in order to help them effectively deal with these changes.”

The advice covers key areas such as the implications of using an SCR which is incorrect, how to handle uploads involving Gillick competent children, and the medico-legal significance of adding additional information to the SCR.

The advice says that if the SCR is inaccurate or out-of-date the responsibility lies with the person who made the record - although a health professional would be expected to be alert to potential inconsistencies.

It says failure to use an NHS smartcard during patient encounters would mean that updated patient information would not be sent to the Spine.

It adds: “This could mean that clinicians using the SCR will not have timely, relevant information about your patient. This could adversely impact on the care your patient receives and they could be put at risk as a result.”

More here:

http://www.ehiprimarycare.com/news/4882/legal_advice_on_scr_and_spine

The FAQ is well worth a browse – just to see how complex things become if you do not adopt a full consented opt-in model to record sharing.

Fourteenth we have:

NHS told to secure patient data

27 May 2009

The Information Commissioner has written to the permanent secretary of the Department of Health demanding immediate improvements to the lax treatment of personal data within the NHS.

The demand for urgent action by Information Commissioner, Richard Thomas, comes in the wake of a string of recent incidents where the institute has been forced to take action against 14 NHS organisations for breaching data regulations.

According to the Information Commissioner’s Office between January and April this year, 140 security breaches were reported within the NHS – more than the total number from inside central Government and all local authorities combined.

E-Health Insider has reported many of the breaches, including Camden Primary Care Trust, which dumped computers containing medical notes of 2,500 patients in a skip near St Pancras Hospital.

Other incidents reported by EHI and EHI Primary Care have included a GP who downloaded a complete patient database, including the medical histories of 10,000 people, on to an unsecured laptop that was subsequently stolen.

Lots more examples here:

http://www.ehiprimarycare.com/news/4874/nhs_told_to_secure_patient_data

Oh dear, oh dear...what else can one say!

Fifteenth we have:

Models’ Projections for Flu Miss Mark by Wide Margin

By DONALD G. McNEIL Jr.

In the waning days of April, as federal officials were declaring a public health emergency and the world seemed gripped by swine flu panic, two rival supercomputer teams made projections about the epidemic that were surprisingly similar — and surprisingly reassuring. By the end of May, they said, there would be only 2,000 to 2,500 cases in the United States.

May’s over. They were a bit off.

On May 15, the Centers for Disease Control and Prevention estimated that there were “upwards of 100,000” cases in the country, even though only 7,415 had been confirmed at that point.

The agency declines to update that estimate just yet. But Tim Germann, a computational scientist who worked on a 2006 flu forecast model at Los Alamos National Laboratory, said he imagined there were now “a few hundred thousand” cases. (At their peaks, epidemics are thought to double in as little as three days, which could drive the number into the millions, but Dr. Germann said he would not use such a rapid doubling rate unless it was a cold November and no countermeasures, like closing schools, were being taken.)

What went wrong?

The leaders of both the Northwestern University and Indiana University teams seemed a bit abashed when they were asked that last week.

Much more here:

http://www.nytimes.com/2009/06/02/health/02model.html?_r=4&ref=health

Shows how hard modelling is early in epidemics. Hopefully some lessons were learned and we can do better next time.

Sixteenth we have:

How Safe Are Your Medical Records?
Rebecca Ruiz, 06.03.09, 4:00 PM ET

In October 2008, hackers broke into a data goldmine at the University of California, Berkeley. They infiltrated 20 separate databases kept on a server at the health services center and over a span of six months, stole Social Security numbers, birth dates and addresses. In some cases they lifted immunization records.

Shelton Waggener, the university's associate vice chancellor and chief information officer, suspects the thieves had been scanning millions of IP addresses looking for a weak link and stumbled into the server. On April 21, administrators learned of the break-in when they discovered a taunting message hinting at the hackers' accomplishment. "It was a version of 'Kilroy was here,'" says Waggener.

The security breach affected 160,000 people, most of them current and former students. I was one of those unlucky alums. Along with my name, sex, place of birth, address, birth date, Social Security number and former student ID number, the thieves also got the date of my first doctor appointment and the medical record number for that visit.

The violation of privacy is unsettling, but it could have been worse. More specific medical information, such as a policy number, could have enabled someone to receive medical care in my name or commit insurance fraud by billing a nonexistent doctor for services never received.

Stealing medical data has become more attractive to hackers and identity thieves as banks and individuals have become more sophisticated about protecting credit-building information. "They're trying to find data anywhere they can," says Waggener.

There have been more than 260 million security breaches since 2005, according to Privacy Rights Clearinghouse, a nonprofit consumer advocacy organization. DataLossDB, a Web site that collects information on data theft, has found that 12% percent of all data-loss incidents occur in the medical industry.

Much more here:

http://www.forbes.com/2009/06/03/health-identity-theft-lifestyle-health-medical-records.html

The overall scale of data loss is pretty amazing. It seems like health is a bit better than other sectors in the US..but that might be because computer use is low!

Fourth last we have:

QHR's EMR Division First Approved EMR Vendor in Manitoba

KELOWNA, BRITISH COLUMBIA -- (Marketwire) -- 06/02/09 -- Mr. Al Hildebrandt, President and CEO of QHR Technologies Inc. ("QHR" or the "Company") (TSX VENTURE: QHR) is pleased to announce that its electronic medical records (EMR) division, Optimed has been announced by Manitoba eHealth as the first vendor to achieve 'Approved EMR Vendor' status. This means that Optimed's Accuro® EMR is the first solution to complete the provincial conformance testing to verify that it meets all core requirements of Manitoba, including contractual arrangements of the RFQ process, to provide Manitoba primary care providers and community physicians with a set of Approved EMRs.

Three other 'Candidate Approved EMR Vendor's are still engaged in the EMR qualification process.

For more information, visit the Manitoba eHealth web site, www.manitoba-ehealth.ca, go to the 'Physicians' tab then click on 'Electronic Medical Record (EMR) Qualification Process'.

The RFQ process is intended to address the needs of all physicians (both family physicians and specialists) who provide care in the community. To the extent that it is in Manitoba's control, Manitoba will require that Regional Health Authorities (RHAs) select any new EMR systems for the use of RHA-operated and RHA-funded clinics from among the Approved EMRs.

Much more here:

http://in.sys-con.com/node/986151

Seems Manitoba has got the basics of its EHR Certification Process in place. Follow link in text.

Third last we have:

A Change Adoption Strategy in Practice

One health care system shares how it implemented CPOE technology, and how it managed the adoption process.

By Judith Wall RN, MSN; Sharon Elder, RN, MSN; and Jacob Kretzing

When Atlantic Health in Morristown, N.J., one of the state's largest non-profit health care systems, decided to implement computerized provider order entry (CPOE) in 2006, failure was not an option. In an effort to convey this sense of urgency and lay a foundation for acceptance, Atlantic Health worked with Greencastle Associates Consulting, of Malvern, Pa., on a range of implementation measures designed to manage change for technology adoption.

A key step toward introducing an electronic health record (EHR) system and a closed-loop medication administration framework, CPOE is central to Atlantic Health's ongoing patient safety strategy. Even so, Atlantic Health faced challenges such as resistance to change from clinicians and lack of a shared vision.

Readiness assessment

As a first step, Atlantic Health and Greencastle undertook a comprehensive readiness assessment, nearly a year before project kickoff and almost two years before the first pilot would go live. The assessment focused on questions such as technology and infrastructure, capacity for project sponsorship from hospital leaders, clinicians' perceptions of CPOE, willingness to promote CPOE and likelihood of resistance.

Based on one-on-one interviews, surveys, working sessions and other inputs, Greencastle and the steering committee produced a 30-page report that would guide implementation planning. One key finding, for example, was that Atlantic Health lacked a project sponsor strong enough for such a complex implementation. As a result, Atlantic Health's CIO and CEO became project champions and began using every speaking opportunity to remind stakeholders that CPOE was a strategic goal. The chief medical officer also joined the cause as a co-sponsor.

In addition, the findings presented a logical roadmap for rollout by gauging which departments and facilities were most receptive to CPOE. The committee identified a pediatric hospital as the ideal candidate for the pilot, due to its highly standardized order sets and its relatively self-contained patient population. Conversely, cardiology's preference was to be the last department to make the transition, given current projects such as construction of a new building to house Atlantic Health's Cardiovascular Institute.

Though primarily a measurement activity, the readiness assessment proved useful as a vehicle for communicating the CPOE value proposition internally. A review of the literature is part of the assessment, and this information both alleviated concerns and helped set the stage for data collection surrounding the expected efficiency and patient safety gains.

Much more here:

http://health-care-it.advanceweb.com/Editorial/Content/Editorial.aspx?CC=200655

Well worth a browse to learn of one organisations experience and lessons.

Second last for the week we have:

FDA needs comprehensive IT plan, says GAO

  • By Kathryn Foxhall
  • Jun 02, 2009

Food agency lacks thorough plan or architecture to modernize its information systems, accountability office reports

The Food and Drug Administration does not yet have a comprehensive plan to modernize its information technology systems and infrastructure, a new Government Accountability Office report states. The FDA responded that a plan is in development.

The GAO report released on June 2 states the agency does not have an architecture that can be used to guide and constrain its modernization efforts. The GAO also said the agency is not strategically managing its IT human capital by determining its skill needs or the gaps between what it has and what it will need in the future.

The report lists 16 FDA modernization projects, from automated employee processing to its system for reporting adverse events from drugs and other products.

FDA said it agreed with most of the report’s recommendations, but noted it is currently developing an information management strategic plan under the auspices of its bioinformatics board.

FDA’s Science Board said in 2007 that the agency lacked the IT capability and infrastructure to fulfill its regulatory mission.

More here:

http://govhealthit.com/articles/2009/06/02/fda-needs-comprehensive-it-plan.aspx

Last, and very usefully, we have:

Professional services cost billions

03 Jun 2009

Healthcare IT professional services are now generating revenues of more than $2.2 billion (€1.5 billion) a year, according to Frost and Sullivan.

In a report on the Healthcare IT Professional Services Markets in Europe, the analyst and consulting company estimates that this could reach $3.6 billion (€2.5 billion) by 2015.

However, it warns that the high demand for professionals and their high pay cheques could impose constraints on market expansion; especially as end-users look to trim costs as a result of the global economic downturn.

“The revenue potential of professional services in healthcare IT markets is significant because it can create a recurring revenue stream for vendors,” said a Frost and Sullivan senior researcher.

Much more with link here:

http://www.ehealtheurope.net/news/4899/professional_services_cost_billions

No that is real money!

There is an amazing amount happening. Enjoy!

David.

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