Quote Of The Year

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


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Friday, July 17, 2009

International News Extras For the Week (13/07/2009).

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

First we have:

Paperless health care? A hospital's long journey

By LAURAN NEERGAARD, AP Medical Writer Lauran Neergaard, Ap Medical Writer Mon Jul 6, 3:29 pm ET

PITTSBURGH – Baby Riley Matthews wheezed noisily on the exam table. "He's belly-breathing," the emergency-room doctor said worriedly — Riley's little abdomen was markedly rising and falling with each breath, a sign of respiratory distress.

In most emergency rooms, the doctor would grill Mom: Has he ever been X-rayed? Do you remember what it showed? But in the new all-digital Children's Hospital of Pittsburgh, doctors just clicked on a COW — a "computer on wheels" that rolls to each patient's side. Up popped every test and X-ray the 6-month-old has ever had.

This is the eerily paperless hospital of the future, what the "electronic medical record" that President Barack Obama insists will transform what health care looks like.

No chart full of doctors' scribbles hanging on the bed. No hauling around envelopes full of X-rays. No discharge with a prescription slip. Even the classic ER patient list has changed from the white-board of TV-drama fame to a giant computer screen.

By the best count, only 1.5 percent of the nation's roughly 6,000 hospitals use a comprehensive electronic record.

Even that statistic belies how hard it will be for health care to jettison its 19th-century filing system by 2014, the federal government's goal — despite the $19 billion that the economic stimulus package is providing to help doctors start. It took Children's seven hard years and more than $10 million to evolve a system that lets its doctors check on patients with a few mouse clicks from anywhere and use speedily up-to-date records in directing their care.

"Sometimes before I even see the ER patient, the X-ray is in here and finished and read," said Dr. Jonathan Bickel, the ER attending physician who whipped out his laptop to check on Riley's overnight stay. Not too long ago, "I had to take mom's word for it."

Look, he pointed: An outpatient lung specialist tested Riley for cystic fibrosis just before his mother brought the 6-month-old to the emergency room. The specialist's detailed exam notes hit the ER computer in hours, not the days it takes to transcribe into a paper chart. Cystic fibrosis didn't cause his wheezing; quick, test for something else.

Still, Children's evolution isn't finished.

Pages more here:


This is a good short review of the reasons why we need this stuff and how hard it can be.

Second we have:

Important steps forward at health ministers’ meeting

“We can free up millions of hospital beds and avoid millions of incorrect prescriptions. There is an enormous potential in eHealth”, said Minister for Health and Social Affairs Göran Hägglund at a press conference on the second day of the informal ministerial meeting in Jönköping on 7 July. Also taking part in the press conference were Minister for Elderly Care and Public Health Maria Larsson and Commissioner Androulla Vassiliou, responsible for health issues at the European Commission.

Minister for Health and Social Affairs Göran Hägglund, Minister for Elderly Care and Public Health Maria Larsson, and Commissioner Androulla Vassiliou took part in the press conference

What is known as ‘eHealth’ involves investment in modern IT systems in order to improve both patient safety and quality of care, as well as accessibility and efficiency within healthcare.

Besides eHealth, other issues on the agenda for the two days were antibiotic resistance, preparedness for pandemic influenza, patients’ rights when seeking healthcare in other EU countries, and prevention of alcohol related harm.

More here:


Seems like e-Health is top of the Health Agenda for the Swedish Presidency of the European Union – and a good thing too!

Third we have:

Patient records should be given to Microsoft or Google, say Tories

NHS patient records would be outsourced to Microsoft or Google under Tory plans, instead of being held on a central government database.

By Chris Irvine
Published: 7:00AM BST 06 Jul 2009

The Conservatives, who have close links with Google, argue that developing a database would be unnecessarily expensive, and it would be more beneficial to hold the information on secure systems which already exist, such as Microsoft Healthvault or Google Health. Patients would be given the choice of storing their records with private companies, although it is not yet clear what would happen to the notes of patients who do not consent.

The Tories estimate that if data were outsourced to sites such as these, the country would save half of the £1.65 billion it spends on IT annually.

Under the plans, which emerged yesterday, medical staff with appriopriate access would log on when necessary, although it does raise issues over security.

David Cameron, leader of the Conservatives, has previously singled out the "Electronic Patient Records system" as an example of the government's wasteful spending.

Winning a contract for medical records would guarantee revenue for Google or Microsoft for years, while it would also help increase the use of their technology in healthcare.

Reporting continues here:


I will leave others to comment on the value of this proposal.

Fourth we have:

Saving the healthcare industry: EMRs are the 'beginning, not the end'

July 01, 2009 | Chip Means, Web Editor

CAMBRIDGE, MA – Economically healthy industries empower workers to make decisions, compensate based on productivity and use a lot of information technology. The healthcare industry doesn't do any of this – yet.

Stimulus funds for IT could save the day and the economy, according to Harvard economics professor and Obama campaign advisor David Cutler, who spoke at the Tuesday afternoon session of the HIT Symposium at the Massachusetts Institute of Technology in Cambridge.

Every industry except healthcare has figured out how to become more efficient by replacing administrative work with information technology, he said. Nurses spend a third of their time documenting – a procedure Cutler said often involves printing digitized information and re-entering it into another IT system.

With the right IT systems and processes, he said, the business of healthcare could change to focus more on compensation and empowerment, making hospitals and practices more profitable.

Much more here (registration required):


You would not be surprised to hear I think young Cutler is onto something!

Fifth we have:

Telethinking and the Nigerian health sector

By Olajide Adebola

OVER the past decade medicine has witnessed a substantial change in technological complexity and the reduction in cost of information communications technology (ICT) has resulted in a symbiotic relationship between the healthcare and ICT sector. Globally, the information age has transformed how we rethink, redesign and rework how businesses and public services operate, aimed at improving productivity, effectiveness and efficiency both internally and in external relationship with clients, customers, suppliers and partners. Recent advances in information and communication technology and the dissemination of networked data processing have led to widespread access to information resources and globalisation of communications, businesses and services.

Internet-based ICT solutions have brought about the greatest impact and they are rapidly changing the way health organisations, providers, care plans, payers, regulators and consumers access information, acquire health products and services, deliver care and communicate with each other. In the health sector, this trend is expressed by the growing consolidation of 'eHealth'- an area rapidly growing in health today distinguished by the utilisation of electronic communication and information technology to transmit, store, and retrieve digital data for clinical, educational and administrative purposes at the local and distance site.

The essence of eHealth is reliable transaction delivery in a fast changing environment involving people, processes and a service or business infrastructure focused on the ill or healthy citizen. Emerging eHealth applications are oriented to professional networking, integration of the clinical care process management and provision of web-based health information and patient care including remote monitoring and healthcare. This expanded view of ICT in health sector has been promoted as the final stage in bringing online the entire healthcare industry. eHealth solutions have emulated e-commerce and e-government strategies and experiences in using internet-based networked technologies to provide healthcare services.

Today in Nigeria, the use of e-commerce and e-business strategies is already being deployed in major sectors like Banking, Oil & Gas, Manufacturing etc while the health sector is yet to fully witness the emulation of these tools to provide efficient health services. The health sector is an enterprise characterised by the use of information for every decision taken. eHealth deployment in our health sector will provide opportunities for individuals, medical professionals and healthcare providers to obtain information, communicate with professionals, deliver first-line support especially where distance is a critical factor (telemedicine) and promote preventive medicine programmes.

Our health system in Nigeria faces so many challenges which can be summarised as: a lack of resources; poor utilisation of the resources available; a high disease burden, driven by HIV/AIDS, malaria and other infectious diseases, contributing to high infant and maternal mortality and morbidity; poverty driven by poor health that robs the society of its most productive sectors, while driving up the birth rate, robbing families of a chance to get out of poverty; shortage of educational capacity in the rural health care settings, exacerbated by the brain drain of talent to the urban centres and abroad; a lack of capacity to gather and process health statistics with which to target health spending and resources. Traditional healers and birth attendants are outside the health care system, but they have closer relationships with the patients at the village level than do the western-oriented doctors and nurses. The combination of these factors makes the achievement of MDG and the national health sector reform goals unlikely without some creative approaches.

Much, much more here:


Nashville: The New Hotbed for Health IT Innovation

Carrie Vaughan, for HealthLeaders Media, July 7, 2009

There are only a handful of regions in the United States that have the knowledge base, capital access, local leadership, and infrastructure to be the innovative leader in health IT. And Nashville, TN, is a "tremendous contender," said David Brailer, MD, PhD, chairman of San Francisco, CA-based Health Evolution Partners, during the Nashville Health Care Council's forum on health information technology and the economic stimulus held nearly two weeks ago.

It has been awhile since we've heard from Brailer, the former National Coordinator of HIT. He joked how arriving in Nashville on Southwest Airlines was a completely different experience than his last visit when he arrived on Air Force One. Brailer was joined by William W. Stead, MD, associate vice chancellor for strategy and transformation at Vanderbilt University Medical Center, Don E. Detmer, MD, president and CEO of the American Medical Informatics Association, and Dave Goetz, Jr., commissioner for the department of finance and administration for the State of Tennessee.

Jonathan B. Perlin, MD, PhD, who is the chief medical officer and president of clinical services at HCA and was recently named chair of the Department of Health and Human Services Health Information Technology Standards Committee, moderated the panel.

The panel focused on three questions:

  • How to make the HIT investment in the stimulus package the most effective?
  • Are the goals realistic?
  • Will the increased regulation of the HITECH Act stifle innovation?

Much more here:


Not something I had ever thought of when thinking of Nashville!

Seventh we have:

Lawsuit claims stimulus act puts privacy in jeopardy

July 02, 2009 | Molly Merrill, Associate Editor

WHITE PLAINS, NY – A class action lawsuit claims the stimulus act jeopardizes the privacy rights of the 65 percent of Americans who aren't on Medicaid or Medicare by requiring healthcare providers to create an electronic health record of every person in the United States. The lawsuit seeks an injunction to protect personal health information and to prevent the defendants from disbursing the $22 billion budgeted for the electronic health records systems.

Lead plaintiff Beatrice M. Heghmann, a healthcare professional who has never been covered by Medicare and Medicaid, says because Title XIII of the stimulus act aims to have everyone's medical histories in the system by 2014, their personal health information would be a "mouse click away from being accessible to an intruder."

Heghmann has sued Secretary of Health and Human Services Kathleen Sebelius, White House Office of Health Reform Director Nancy-Ann Deparle and Administrator of the Centers for Medicare and Medicaid Services Charlene Frizzera.

Much more here:


As they say – only in America!

Eighth we have:

Medical center seeks 'Holy Grail' of mobile devices

Mount Sinai needs voice capability, access to medical records

Matt Hamblen

July 1, 2009 (Computerworld) Andrew Pizzimenti is in search of the Holy Grail of mobile devices.

Pizzimenti is senior director for voice and data services at Mount Sinai School of Medicine, part of the Mount Sinai Medical Center in Manhattan. His mission is to find the ideal personal computing and mobile phone device for health practitioners.

Pizzimenti said he isn't sure whether this device is a smartphone, an e-book reader or a netbook, and he thinks it might take a while to find the right one.

"I'm seeking the Holy Grail now," Pizzimenti said in a virtual interview from the Cisco Live user conference in San Francisco today. He said he wants a device that would give health professionals access to electronic patient records, but also give them one phone number, instead of the several numbers on several devices they already have.

Full article here:


Certainly one total device that does it all makes sense. Might be a complicated little beast however!

Ninth we have:

CDC launches public health tracking Web site

By Jessica Zigmond / HITS staff writer

Posted: July 7, 2009 - 10:00 am EDT

The Centers for Disease Control and Prevention has launched a Web-based tool that allows scientists, health professionals and members of the public to track environmental exposures and chronic health conditions. Known as the National Environmental Public Health Tracking Network, the site brings together environmental information from across the country—including air and water pollutants, as well as information for certain chronic conditions, including asthma, cancer, childhood lead poisoning and heart disease—in one resource.

“The ability to examine many data sets together for the first time has already resulted in faster responses to environmental health issues,” said Howard Frumkin, director of the CDC's National Center for Environmental Health, in a news release. “We believe the Tracking Network holds the potential to shed new light on some of our biggest environmental health questions.”

More here (registration required):


This certainly looks like a very useful initiative.

Tenth we have:

Data-miners claim marketing used to improve quality

By Gregg Blesch / HITS staff writer

Posted: July 7, 2009 - 10:00 am EDT

The courts delivered new setbacks to companies that mine prescribing data and sell information about the habits of individual physicians as a marketing tool for pharmaceutical companies, a practice banned by laws passed in three Northeast states. But the industry will continue to make its case that the bans are bad policy regardless of whether they ultimately prove constitutional.

On June 29, the Supreme Court declined to review a case challenging a pioneering 2006 New Hampshire law that banned the use of prescriber-specific data for marketing. In the previous week, the 2nd U.S. Circuit Court of Appeals declined to stop a similar Vermont law from going into effect July 1 pending the outcome of the industry's appeal of an April decision upholding the law.

A ban in Maine was struck down by a district court, but that case is on appeal in the 1st U.S. Circuit Court of Appeals, the same court that previously upheld the New Hampshire law after it was similarly judged by the lower court.

More here (registration required):


I certainly this all presages the beginning of the end for these people!

Eleventh for the week we have:

Care Card Technology Improves Health System's Patient Flow and Waiting Time

Sarah Kearns, for HealthLeaders Media, July 6, 2009

At Heritage Valley Health System in Beaver, PA, patient flow was a major concern, as it has been for many facilities nationwide.

The facility was well aware of the long process patients had to go through to be seen by a physician. In 2006, it implemented electronic kiosks along with a Care Card to help the registration process move more efficiently and maintain constant patient flow.

"Modeled in part on successful implementations in both the airline and hospitality industries, the board and senior management of Heritage Valley developed a strategic plan for enabling and promoting greater consumer participation in the healthcare process through various self-service initiatives," says Robert Swaskoski, director of enterprise resource systems at HVHS.

The Care Card, a plastic ID card that comes in two sizes, one to put in your wallet and the other to snap on a keychain, uses a bar code with a unique identifying number that assists in patient identification at the initial point of registration. The card also functions as a portal that patients use to access their personal care records for HVHS.

Upon scanning the Care Card at a kiosk, the patient is reminded of any tests or exams scheduled for the day. Also, the patient can give any required information at the kiosk.

More here :


And – as the article explains – it also saves money!

Twelfth we have:

eHealth scandal reaches Premier's inner circle

Sarah Kramer received a bonus of $114,000 five months after starting her job as eHealth CEO.

For $327 an hour, one former aide wrote to another former aide

June 11, 2009

Tanya Talaga

Robert Benzie

Rob Ferguson

Queen's Park Bureau

Key members of Dalton McGuinty's inner circle are surfacing in the eHealth Ontario spending scandal, documents obtained by the Star show.

Premier Dalton McGuinty's former health adviser was paid $327 an hour by eHealth to, among other tasks, correspond with McGuinty's former chief of staff in his new capacity at a polling firm on "eHealth Ontario priorities," billing records demonstrate.

Karli Farrow was paid $10,646 for 32.5 hours of eHealth work as a Courtyard Group consultant over a period of three weeks in January.

Farrow, a one-time chief of staff to former health minister George Smitherman, had previously served as McGuinty's health policy adviser and was an architect of the Liberals' health-care platform for the 2003 election. She has worked with McGuinty periodically since 2000, including a stint as his director of policy and research, beginning in 2004. She left Smitherman's office in 2007.

More here:


This really is the scandal that just keeps on giving!

Thirteenth we have:

Most Wired survey shows hospitals are tightening their IT belts

July 07, 2009 | Molly Merrill, Associate Editor

CHICAGO – The economy is forcing hospitals to consider delaying or scaling back their IT projects, according to a survey of America’s “most wired” hospitals and health systems.

The Most Wired Survey, conducted annually by Hospitals & Health Networks magazine, the journal of the American Hospital Association, found that even with incentives being made available to implement IT, hospitals still have a long way to go.

Officials at the hospitals surveyed said they are torn between building on their IT successes while also being aware of their budgets.

“The economic slowdown is forcing hospitals to look closely at IT spending,” said Alden Solovy, executive editor of Hospitals & Health Networks. “Most Wired hospitals are doing their best to stay the course.”

“Hospitals clearly recognize that in spite of smaller budgets they still need to invest in IT and position themselves for the future,” said Sunny Sanyal, president of McKesson Provider Technologies. “We’re seeing hospitals reprioritize. For example, instead of continuing with plans to build a new data center extension, a hospital now may choose to redirect funds to other technologies.”

More here:


Hardly a surprise – and good to see they are pushing on as best they can!

Fourteenth we have:

Will Providers Bite Off More Than They Can Chew When It Comes to CPOE?

Lisa Eramo, for HealthLeaders Media, July 7, 2009

If you had to begin implementing computerized physician order entry (CPOE) today, how many years do you think it would take for you to reach 100% adoption? This was one of several questions that the College of Healthcare Information Management Executives posed to 335 of its CIO members in a June CPOE survey.

Of the 316 respondents who answered the question, only 8.5% of the respondents said full adoption could be achieved in a year. More than a third (34.5%) of respondents estimated a three-year timeframe.

These survey results hint at the challenges that many hospitals hoping to take full advantage of the EHR incentives outlined in ARRA are facing. Providers must implement CPOE for "all order types, including medication [inpatient and outpatient]" by 2011, according to the proposed meaningful use matrix that the Health Information Technology Policy Committee released last month. The specific measure that hospitals must report is the percentage of orders entered directly by physicians through CPOE.

And it all goes back to the very first goal outlined in the matrix: improve quality, safety, and efficiency of healthcare as well as reduce health disparities. The idea is that CPOE will help to get the ball rolling toward many of these important patient care goals.

Much more here:


A good question indeed. Well referenced article.

Fifteenth we have:


is dedicated to point of care and mobile health news and resources.

On Demand: Boost Nurse Efficiency with Voice over Wireless LAN


This Web seminar will explore how leading hospitals throughout the world use Voice over Wireless LAN (VoWLAN) technology to save nurses time throughout their day, attract and retain top nursing talent and optimize workflows throughout the facility. Read »

Video: Stimulus Package for Telehealth


The U.S. government is now making millions of dollars in grant funding available for organizations that implement technology-based solutions including telehealth. Remote patient monitoring (RPM) provides measurable financial and clinical benefits, including enabling patients to receive in-home care, which is a more efficient use of healthcare system resources; reducing hospitalization and readmission rates because clinicians can identify changes in patients' health before conditions become acute; decreasing the frequency of in-home visits, which also reduces staff travel time; and increasing patients' compliance with their care plans, leading to lower costs and improved efficiencies. Learn what's possible with future RPM technologies. Read »

Vastly more here:


Lots of interesting links and articles.

Sixteenth we have:

Wi-Fi Health Care Systems to Hit $4.9B

Driven by $20 billion in stimulus funds for digital medical records, a research firm sees a boom for Wi-Fi RTLS hardware and software, access points, managed services, and pure Wi-Fi and dual-band handsets.

Worldwide sales of Wi-Fi-enabled health care products will hit $4.9 billion in 2014, according to ABI Research, an increase of nearly 70 percent over 2009 levels. The predicted boom is based on the $20 billion of stimulus funds dedicated to the digitizing of medical records and Congress' pending health care reforms.

Increased Wi-Fi penetration in hospitals and health care systems is expected to result in reductions in operating costs, a theme stressed by the Obama administration in its health care initiatives.

"It’s a pretty big business,” ABI Research Vice President Stan Schatt said in a statement. "The strong uptake of Wi-Fi in the health industry is underpinned by its need for improved asset management, staff mobility, transfer of digitized records, and standardized administration of medications. In addition, government security requirements including HIPAA often mean replacing older wireless equipment with modern versions."

Much more here:


Sounds like a lot of growth!

Fourth last we have:

Panasonic breaks into robotics with medical robot

TOKYO (AP) — Panasonic said Tuesday has developed a medical robot that dispenses drugs to patients, the Japanese electronics giant's first step into robotics.

Panasonic will sell the robot to Japanese hospitals next March and will market it in the United States and Europe later. Panasonic spokesman Akira Kadota said the robot will cost several tens of millions of yen (hundreds of thousands of dollars).

"This robot is the first in our robotics project. It sorts out injection drugs to patients, saving time for pharmacists," said Kadota.

The robot does not look humanoid. "It looks like a cabinet with lots of small drawers," he said.

Much more here:


These robots just keep coming!

Third last we have:

Kaiser Permanente Project Proves Electronic Health Information and Care Coordination Improves Chronic Disease Management

Posted : Thu, 09 Jul 2009 15:01:18 GMT

Author : Kaiser Permanente

Category : Press Release

News Alerts by Email ( click here )

News | Home

Proactive E-Consults by Specialists Reduce Late Nephrology Referrals HONOLULU, July 9

HONOLULU, July 9 /PRNewswire/ -- Specialty care physicians can improve the health of high-risk patients by reviewing electronic health records and proactively providing e-consultations and treatment plan recommendations with primary care physicians, according to a Kaiser Permanente paper published online in the British Medical Journal.

The quality improvement project at Kaiser Permanente demonstrated that specialists can take a more active role in managing the health of populations with chronic illness - in this case, kidney disease - by using electronic health records to coordinate care among primary and specialty care providers. In the project, nephrologists (kidney specialists) proactively consulted remotely with primary care doctors to help manage patients at risk for end-stage renal disease.
Much more here:


Very interesting. Pity the BMJ has locked the article from non-subscribers.

Second last for the week we have:

Story claims proprietary EMRs could 'screw up' health reform

July 9, 2009 — 12:13pm ET | By Neil Versel

Washington Monthly, an influential magazine among left-leaning, inside-the-Beltway types, offers a bombshell of an indictment of major EMR vendors in its July cover story, provocatively titled, "Code Red -- How software companies could screw up Obama's health care reform." Author Phillip Longman, who wrote a book about the VistA EMR at the Department of Veterans Affairs, makes the case for open-source software in the coming stimulus-driven EMR spending frenzy by comparing the experiences of Midland (TX) Memorial Hospital and Children's Hospital of Pittsburgh.


The story isn't up yet on the Washington Monthly site, but we can't wait to hear what Cerner and its big-name brethren have to say about this story. Meantime:

- check out the blog of open-source booster Dr. Scott Shreeve, who includes the full text of the article
- read this Forbes interview with the CIO of Midland Memorial
- have a look at this Associated Press story that paints Children's in a much more favorable light

More here:


I can see this setting the hares running!

Last, and very usefully, we have:

System failure?

The £12.7bn NHS computer programme is five years behind schedule and beset by criticism, viruses and fears over patient privacy. So should the world's biggest IT project be scrapped? Andy Beckett investigates

At some point last November, an infection began to spread unnoticed through the three hospitals that make up Barts and The London NHS Trust in east London. This was not MRSA but the Mytob worm, a common but potent computer virus. It steadily slowed and choked the 4,700 PCs of the trust's network. By noon on 17 November, a Monday, the network was effectively crippled.

The following day, the trust declared an "internal major incident". Ambulances carry-ing accident and emergency patients were diverted to other hospitals. Operations were postponed. The appointments system was suspended. Access to clinical information - usually quick and electronic - was maintained only by the slowest and most old-fashioned of methods: "runners" drafted in from the trust's administrative departments pounded the hospitals' endless twisting corridors with paper notes and printouts.

Scores of computer technicians from the private sector and from other London NHS trusts were brought in to eradicate the virus, but the PCs had to be decontaminated one by one. It was a week before the crisis was officially declared over, and a fortnight before the hospitals, some of the busiest in the capital, returned to normal. Afterwards, an official report found the virus had been able to infiltrate them because their anti-virus software "did not reach all [their] PCs and ... was configured incorrectly on some". The whole episode, the report concluded, had been "entirely avoidable".

Much more here:


This gives a good flavour of the concerns that are out and about in the UK at present.

There is an amazing amount happening. Enjoy!


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