Just an occasional post when I come upon a few interesting reports that are worth a download or browse. This week we have a few.
First we have:
Quality forum seeks e-health quality specs
National Quality Forum is developing data set for Holy Grail of health IT: quality measurement
- By Kathryn Foxhall
- Jun 18, 2009
A National Quality Forum panel is seeking comments on draft data set for quality measurement in health care, saying that current quality measurement specifications are not designed to make use of electronic health records and rely on administrative rather than clinical data.
“Performance assessment requires consistent measurement across conditions, settings, and providers,” according to the NQF committee, which noted that clinical information needed for reliable quality measurement is often missing in EHR systems.
NQF is an organization of hundreds of health professional organizations, health delivery groups, government agencies, payers, business groups and other entities. Over the last several years it has selected a number of sets of quality measures of care, some of which have become accepted as requirements through Medicare and other entities.
The NQF committee -- the Health Information Technology Expert Panel -- last year recommended priority performance measures for better electronic data capture of quality measures. That information has been used by the Healthcare Information Technology Standards Panel (HITSP) and the Certification Commission for Health Information Technology, two leading national health care standards groups.
.....
The draft, “Health IT Enablement of Quality Measurement – the Quality Data Set (QDS) and Dataflow,” is posted on the NQF Web site, www.qualityforum.org, under “HITEP-II.” Comments are due by June 30.
About the Author
Kathryn Foxhall is a freelance writer based in Hyattsville, Md.
More here:
http://govhealthit.com/articles/2009/06/18/national-quality-forum-quality-measurement-specs.aspx
The draft report is found here:
http://www.qualityforum.org/projects/ongoing/HITEP2/comments/
Second we have:
Drug errors hit 10% of GP patients
Catherine Hanrahan - Friday, 19 June 2009
AN overhaul of the systems for managing and recording medication use may be essential if Australia is to reduce its current rate of medication errors, experts say.
However, health professionals are at odds over the primary cause of errors and which strategies will reduce their occurrence.
A literature review conducted by the National Prescribing Service (NPS) showed 10% of general practice patients in Australia reported an adverse drug event in the past six months.
And up to 25% of high-risk patients experienced an event in the previous three months.
Poor communication between patients and health professionals, between GPs and pharmacists, and between health professionals when care was transferred, were identified as key problems. Inadequate staffing levels and workplace systems were also contributing factors.
Despite these findings, NPS CEO Dr Lynn Weekes (PhD) said Australia seemed to be performing well compared to many other countries, although our data was limited.
“Currently we don’t have routine monitoring of medication errors,” she said. “We do in hospitals but not in primary care. I think having this sort of system would allow people to learn from the problems... Seeing where the causes are means you put systems in place in education or wherever they’re needed.”
The report identified medication reviews as the most important intervention for the prevention of medication errors.
More here (registration required):
http://www.medicalobserver.com.au/News/0,1734,4728,19200906.aspx
The full press release is found here:
The report is downloadable from here:
Important stuff, and technology is important in enabling improvement.
Third we have:
Survey: Long-Term Providers Mixed on Stimulus
HDM Breaking News, June 12, 2009
A survey of more than 300 home health care and nursing home organizations finds 52% of respondents believe the economic stimulus law will have little or no effect on their businesses.
Still, more than a third of respondents expect the law to increase use of health care information technology. Further, nearly 70% of respondents say electronic health records will have a positive effect on their own business. Fifty-six percent have begun to implement EHRs or plan to within a year.
More here:
http://www.healthdatamanagement.com/news/stimulus-38473-1.html
For a summary of survey results from all 500 respondents, click here.
Sounds like this sector is seeing the need for ‘change’.
Fourth we have:
Group Health Cooperative Shows Investing in More Primary Care Pays for Itself
Medical home model leads to less emergency room costs and avoidable hospitalizations
SEATTLE, June 17 /PRNewswire-USNewswire/ -- An evaluation of recent innovations in delivering primary care at a Group Health Cooperative medical center shows significant success and rapid return on investment. The data led to a decision to invest in these best practices in all of Group Health's 26 medical centers by 2010.
"Group Health has for many years focused on delivering quality, coordinated primary care, supported by fully integrated electronic medical records," said Group Health President and CEO Scott Armstrong. "This was an effort to bolster primary care further -- and really test what we believe: that excellent, proactive primary care will lead to better health outcomes at lower cost."
"At a time when resources are tight, we are so confident in our findings that we are hiring more primary care doctors, physician assistants, and nurses, because we believe this is the best way to achieve our goal of excellent affordable care," Armstrong said.
More here:
http://news.prnewswire.com/ViewContent.aspx?ACCT=109&STORY=/www/story/06-17-2009/0005045958&EDATE=
Press release and site here:
http://www.ghc.org/news/news.jhtml?reposid=/common/news/news/20090618-medicalhome.html
This approach to care seems to be gathering favour in the US. Will be interesting to see what the NHHRC makes of this trend – given the high dependency such approaches have on e-Health.
This paragraph from the release makes that clear.
“The Patient-Centered Medical Home pilot placed more emphasis on doctors and care teams proactively engaging patients in their health and investing more in care coordination. This resulted in more proactive phone visits, secure e-mailing, and more detailed face-to-face visits.
- Physician panel sizes (the number of patients for whom each doctor is responsible) were reduced from 2,300 patients to 1,800 patients.
- Appointment times were extended to 30 minutes from 20 minutes.
- Group Health increased its primary care staff by 30 percent to reduce physician-panel size and expand multidisciplinary clinical teams: doctors (family doctors and general internists), physician assistants, nurses, medical assistants, and clinical pharmacists.
- Proactive staff-to-patient outreach increased, including clinical team analysis of each patient's needs, communication with the patient days before appointments, and detailed follow-up after it.
- Use of e-health technology was maximized, including electronic medical records and increased contact with patients through secure e-mail and phone.
- Decreased downstream utilization led to return on investment.”
Fifth we have:
Digital Medicine: Health Care in the Internet Era (Hardcover)
17th June 2009
Information technology has dramatically changed the way we live our lives in areas ranging from commerce and entertainment to voting. Now, policy advocates and government officials hope to bring the benefits of information technology to health care.
Governments, hospitals, doctors, and pharmaceutical manufacturers have placed a tremendous amount of medical information, data, and services online in recent years. Many consumers can visit health department sites and compare performance data on health care providers. Some physicians encourage patients to use e-mail or web messaging as opposed to phone calls or in-office visits for simple medical issues. Increasingly, medical equipment and prescription drug manufacturers are making their products available online. Yet despite this growth in activity, the promise of e-health remains largely unfulfilled.
Much here:
http://www.hc2d.co.uk/content.php?contentId=11801
Sounds like an interesting book.
Orderable here from Amazon in the UK
Sixth we have:
Bar Code Administration Systems Can Reduce Medication Errors
- By Nicholas Infusino
- June 12, 2009 at 08:02 AM
Since the Institute of Medicine (IOM) published its groundbreaking 1999 report To Err is Human, medication errors have been a primary concern in health care. Medication errors are not only dangerous, accounting for between 44,000 and 98,000 deaths per year, but also extremely costly. Several studies in the mid-1990s reported annual medication error costs at individual hospitals of $1.5 million or more. In 1995, Johnson and Bootman reported that drug-related morbidity and mortality cost an estimated $76.6 billion in the US ambulatory setting.
Bar code medication administration (BCMA) is one tool being adopted by hospitals to help reduce medication errors. BCMA technology involves labeling individual medicine doses with unique bar codes at their point of entry into the pharmacy (if not already done so by the manufacturer), and then tracking these medications as they move throughout the hospital. The labeled medications are scanned at various points of transit to ensure that the proper medication is being dispensed to the proper patient by the proper caregiver. Bar codes are typically scanned before they leave the pharmacy, when they are stocked in automated cabinets, carousels or nursing stations, and before they are administered to patients.
More here (free registration required):
http://members.sg2.com/content-detail-standard/default.aspx?contentid=2388543
Report is downloadable from here:
http://rm.awarenessnetworks.com/5839926644335723402.pdf
This is important technology and it is useful to have an up to date review.
Seventh we have:
16 June 2009
eHealth Worldwide
Roshan, the leading telecom operator in Afghanistan, today announced the expansion of its first-of-its-kind Telemedicine solution in Afghanistan beyond Kabul to include provincial hospitals. Bamyan Provincial Hospital will be the first provincial medical facility linked to the innovative Telemedicine project, which uses broadband technology, wireless video conferencing and digital image transfer, to provide hospitals in Afghanistan with real-time access to specialist healthcare diagnosis, treatment and training expertise from abroad.
Many more articles etc at the site
http://www.who.int/goe/ehir/2009/16_june_2009/en/index.html
Last we have:
Privacy Impact Assessment Handbook Version 2.0
INFORMATION CCOMMISSIONER'S OFFICE
PIAs and other processes
Compliance checking and data protection audit
A PIA must be seen as a separate process from compliance checking or data protection audit processes. Often organisations ask whether a PIA can be conducted on a project that is being implemented or has been up and running for some time. The nature of the PIA process means that it is best to complete it at a stage when it can genuinely affect the development of a project. Carrying out a PIA on a project that is up and running runs the risk of raising unrealistic expectations among stakeholders during consultation. For this reason, unless there is a genuine opportunity to alter the design and implementation of a project, the ICO recommends that projects which are already up and running are not submitted to a PIA process, but to either a compliance check or a data protection audit, whichever is more appropriate.
More here:
http://www.ico.gov.uk/upload/documents/pia_handbook_html_v2/index.html
The handbook can be found here:
More at http://www.ico.gov.uk/upload/documents/pia_handbook_html_v2/index.html
NEHTA should have a close read!
Enough for one week!
Enjoy!
David.
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