Sunday, September 13, 2009

Useful and Interesting Health IT News from the Last Week – 13/09/2009.

The Australian E-Health Press provided a good serve this week. It included these:

First we have:

Why health reform?

Steven J Lewis and Stephen R Leeder

MJA 2009; 191 (5): 270-272

Abstract

· Traditional health care is fragmented, marred by quality and safety defects, with a failure to provide evidence-based care, and huge and unjustifiable variations in practice.

· There is abundant evidence that traditional means of delivering health care are obsolete.

· Concerns are deepening about persistent and widening gaps in health status that health care cannot overcome.

· Increased spending on health care has never definitively solved the problems of access, quality, or equity.

· Non-medical determinants of health indicate that the solutions to health problems lie mainly outside health care.

· The current financial crisis may create the urgency and courage to both eliminate the fundamental problems in health care delivery and reduce health disparities.

More here:

http://www.mja.com.au/public/issues/191_05_070909/lew10514_fm.html

Thos six points give a better analysis that I have seen in a while regarding the issues that we need to address. Addressing at least 3 of them are distinctly e-Health dependant.

Second we have:

Electronic patient discharge summaries finally take shape

Elizabeth McIntosh - Friday, 11 September 2009

ELECTRONIC discharge summaries are finally on the horizon, with the release of new standards from the National E-Health Transition Authority (NEHTA), but a leading IT expert has questioned the complexity of the specifications.

The electronic discharge summaries have long been touted as a measure that would improve continuity of care, and the new blueprint now outlines their design and content.

Under the standards, the discharge summaries will contain a patient’s personal identification, medical history, procedures carried out and medications prescribed.

.....

NEHTA’s clinical lead Dr Mukesh Haikerwal dismissed the criticism, saying the standards needed to be robust enough for future e-health technology leaps.

“We’ll try it now and get it ready for the future – for when people can use unique patient identifiers and correct [e-health] terminologies,” he said. “It’s better to start with too much rather than too little. That way, we’re building for the future rather than the past – if they’re not enough, we’re already out of date.”

More here:

http://www.medicalobserver.com.au/News/0,1734,5268,11200909.aspx

All I can say about these comments is that I disagree. Walking before you run is by far the best incremental way forward in e-Health in my view.

Third we have:

GPs unite to safeguard data

by Michael Woodhead

Primary care groups have united to form a governing body that will oversee how data generated by GPs is collected, managed and disseminated.

The RACGP-hosted General Practice Data Governance Council is chaired by former AMA president Dr Mukesh Haikerwal and includes members from organisations representing practice managers, divisions, practice nurses and rural doctors.

…..

“Any collection of data in general practice needs to be mindful of patient privacy and confidentiality. We need to be assured of the security of practice data provided by GPs to other agencies. The medicolegal impacts of data sharing must be clarified. The General Practice Data Governance Council is committed to exploring these issues and developing profession led initiatives in these areas. This is a very exciting time for general practice,” said Dr Haikerwal.

More here:

http://www.6minutes.com.au/articles/z1/view.asp?id=497852

This can’t be altogether a bad thing, but might have some implications. I will write in detail in the next few days on it. The areas to be addressed are all important but it is a pity there is not a mention of data quality.

Fourth we have:

Breakthrough e-health tool launches free to Australian families

YourChildsHealthRecord.com is the breakthrough e-health tool that offers parents and guardians peace-of-mind by enabling them to independently control and manage their child’s personal health and medical records, in a safe, secure and convenient online environment.

A great way to store scattered medical information, the site helps users build an online journal of their child’s key health and developmental milestones. This includes recording results from all health appointments; maintaining an accurate immunisation record; updating health check outcomes from birth to 4 years as well as monitoring asthma, sleep patterns, height and weight. Parents will also be able to record allergies, medications and any current health conditions to ensure a full summary of their child’s health at all times.

Featuring an intuitive data-entry system and an easy to use interface, parents are instantly empowered with the knowledge that all of their child’s personal health information is instantly accessible, for an emergency or if they should move, travel, or change doctors. Printing out information for school excursions or health insurance is as simple as ‘point-and-click’. So the next time families go on holiday, or move, having their child’s accurate medical records instantly accessible is no longer something that will keep parents up at night.

Lots More here:

http://ourkidz.com.au/content/view/490/294/lang,en/

Interesting development – I wonder what sort of uptake it will achieve?

Fifth we have:

Queensland Health appoints Ray Brown as CIO

Internal candidate will lead the state's e-health agenda

Tim Lohman (CIO) 07 September, 2009 11:48

Tags: queensland health, e-health, cio, careers

Queensland Health has appointed acting CIO, Ray Brown, as its new CIO as the government body moves to implement the State’s e-health agenda.

Brown, who has been acting in the role for the past eight months following the departure of then CIO, Richard Ashby, said e-health was one of several important IT strategies at Queensland Health.

“E-health will deliver information and communications technology that will enable clinicians to find the information and equipment they need to communicate and work together to improve patient outcomes,” he said in a statement.

According to Brown, the benefits of the state’s four-year, $243 million IT project were already being realised with the recent rollout of a state-wide electronic discharge summary system.

The system electronically forwards information to a patient’s GP following their discharge from a hospital.

“Already, more than 55,000 discharge summaries have been sent from about 56 hospitals across the State and by June next year this will be occurring from over 120 Queensland Health facilities,” Brown said.

Brown said another system, the Queensland Radiology Information System, is also up and running in 12 rural and remote hospitals, allowing diagnostic images to be taken in one area and diagnosed by specialists in another.

A spokesperson for Queensland Health said Brown would be responsible for "arguably the largest and most complex ICT environment in Queensland", with more than 65,000 staff using a complex suite of software for both business and medical requirements.

As CIO, Brown's top three ICT priorities will be implementation of an electronic medical record, the enterprise discharge summary and Queensland radiology information system, the spokesperson said.

Full article here:

http://www.computerworld.com.au/article/317550/queensland_health_appoints_ray_brown_cio?eid=-6787

All we can do is wish Ray luck. There has been a bit of a revolving door syndrome at Qld Health, where it seems bureaucracy is pretty byzantine.

Sixth we have:

5 free project management applications you must try

Putting together a project plan can sometimes seem more daunting than completing the project itself. When you need to track each step of a project, along with your costs, staff, and other factors, you probably need a project management application.

Howard Wen (Computerworld (US)) 08 September, 2009 14:19

Tags: project management

Project management applications are usually centered around Gantt charts, where each step in a project is represented as a bar in the chart. These visuals are linked to lists of the resources tied to each task (such as the person, team, company or another entity responsible for doing any given job). Everything is synchronized to a calendar, which updates you on the progress that your project should have achieved at any given time during its life cycle.

It's a simple idea, actually. Yet project planning can be intimidating, especially if you're unfamiliar with the methodologies behind it. As a result, learning to use project management applications can be a project in itself -- and you have to pay for the privilege.

For example, because of its brand and its place in the market, Microsoft Office Project is a popular choice for beginners. But at US$600, Office Project is expensive, especially if you just want to use it for some simple projects, or if you're not sure you really need a project management app.

For this roundup, I'll take a look at five free alternatives to using Microsoft Office Project. None of these are from major software companies -- four out of the five are open source while the fifth, jxProjects, is advertising-supported. On the one hand, this means that you don't get the amount of hand-holding that you would from a commercial product. On the other hand, these products often employ more innovative methods than commercial software.

In this roundup, I'll examine what each of these applications offers, how easy each is to use and how useful each choice may be for those unfamiliar with project planning.

Gantter.com

Although Gantter.com is Web-based, it has no online collaboration features. Rather, Gantter.com is meant to be used like a standalone desktop application.

Like a desktop application, Gantter.com loads up in only a few seconds; feedback from clicking through its menus and functions was so snappy I hardly noticed that I wasn't using a standalone application.

The user interface resembles the look and feel of Google Docs -- so much so that I found myself instinctively looking for the ability to save my plan to my Google Docs account.

Gantter.com doesn't have nearly as many features as for-pay applications such as Microsoft Office Project, which includes collaboration, synchronizing with different calendars across several resources, networking and additional enterprise-worthy features. In fact, it pretty much operates at a beginner's level of charting; it focuses simply on planning, and time and budget estimation of your project via Gantt charting in the most elementary, quickest and simplest manner possible. With this in mind, a standout feature of Gantter.com is that you can easily create custom calendar templates, in which you can, for example, mark any day (other than the traditional weekend) as a non-working day.

Microsoft Office Project files can only be imported into Gantter.com if they are first exported to XML. Gantter.com cannot directly read the proprietary Office Project file format. So information and formatting may be lost exporting to XML and then loading the file into Gantter.com. Not surprisingly, Gantter.com cannot save your plan to the Office Project file format.

Another drawback: You cannot print your plan from within Gantter.com. Its developer, Volodymyr Mazepa, says he plans to add print functionality in the future. But for now it's best to use this project management app to create XML-based project plans from scratch.

I really like the tutorial that the site provides. Don't know what Gantt charts are, what a "resource" is, what a "task bar" represents, or how these elements are compiled and brought together when formulating your project plan? Check out gantter.com and follow the tutorial. You'll learn the basics in less than an hour, if even that. And the general rundown also works as a good primer for anyone unfamiliar with the way a traditional project management program works and how a plan is put together.

So if you're new to the world of project management and the use of Gantt charts, I recommend checking out Gantter.com first to teach yourself the fundamentals.

Read about the other 4 here:

http://www.computerworld.com.au/article/317716/5_free_project_management_applications_must_try?eid=-6787

Project planning is a key part of the delivery of e-Health. It is useful to know where tools can be found to assist with the process. There is no doubt at least some e-Health projects of the last decade may not have been as well planned as might have been desired.

Seventh we have:

Firefox 4.0 to arrive late 2010

Mozilla recently released a product roadmap with a number of new details on what the foundation is hoping to release between now and the end of 2010

Chris Brandrick (PC World (US online)) 08 September, 2009 05:19

Tags: web browsers, mozilla firefox, mozilla, firefox

Mozilla recently released a product roadmap with a number of new details on what the foundation is hoping to release between now and the end of 2010, including information on when to expect the next major iteration of Firefox.

The report details that Firefox 4.0 is due to arrive in either October or November of 2010 and will bring with it a range of new features, such as a new slick user interface and multi-touch gesture suppport. But take note that this report is currently classed as a 'draft' and could be open to any number of changes.

For those existing Firefox users, a plentiful number of changes can be expected prior to the late 2010 release date of 4.0, with both 3.6 and 3.7 lined up for debut before then. These new releases will offer such improvements and features as faster javascript handling, improved form completion tools, bookmark synchronization and pageload enhancements.

Mozilla also revealed that when Firefox 4.0 does hit, it will take a leaf out of Google Chrome's book, as each tab will function with it's own separate process, reducing the instances of losing your precious browser session.

More here:

http://www.computerworld.com.au/article/317641/firefox_4_0_arrive_late_2010?eid=-255

This sounds good for those who use Firefox.

Lastly the slightly more out there article for the week:

Powering the search for answers

September 10, 2009

WolframAlpha is often mistakenly compared with Google but it is about getting the responses you are after. By Kevin Anderson.

WOLFRAM Research launched its "computational knowledge engine" Alpha to mixed reviews in May. However, founder Conrad Wolfram says the launch of Alpha is the first step of a multi-decade project.

Alpha already draws on more than two decades of work on the technical computing application Mathematica (bit.ly/mathematica2), the flagship product of Wolfram Research. The application is well-known in academic circles, where it is used to perform complex calculations, manipulate data and create graphs and visualisations, but the average internet user is probably not aware of it.

Many reviews compared Alpha unfavourably with general search engines such as Google but that is like saying a screwdriver is a bad hammer.

The contributing editor at the blog Search Engine Land, Greg Sterling, writes: "By juxtaposing itself with Google or positioning itself as superior to Google in a number of ways, Wolfram created some confusion (and disappointment) in the market."

Alpha and Google are different tools that do different things. Alpha is best thought of as an answers engine rather than a search engine.

Alpha doesn't search the web; it queries and performs calculations on about 10 trillion pieces of mathematical, geometric, financial, chemical, historical and astronomical data. The data sets are curated by Wolfram Research and have been available in Mathematica since version six, which launched in May 2007.

More here:

http://www.smh.com.au/technology/biz-tech/powering-the-search-for-answers-20090909-fg6k.html

This is fascinating stuff we should all keep an eye on. The health implications may be quite important.

More next week.

David.

3 comments:

  1. I agree regarding the lack of emphasis on quality control of clinical data within practices data collections. Security is also important, but if there are large amounts of erroneous data, there are obvious risks to the patients involved. This particularly the case where records from various practices are merged, amalgamated or aggregated.

    In one case which I'm aware of, the merging of five practice datasets into a single practice dataset resulted in a patient, on first day of presentation, being told by the receptionist that, according to their records, he was deceased and had been so for some time.

    This is a valuable secondary use of clinical reporting tools such as the PEN reporting Tool - it becomes immediately obvious which data is either erroneous or simply not being collected.

    Secondly I join you in wishing the new CIO of Queensland Health the very best of British - he's certainly going to need it!

    Thirdly, I've used a free software package called Project In A Box since 2007, which has all the Prince2 functionality built into it. Unfortunately I've found the Price2 methodology, whilst no doubt useful for projects such as launching communications satellites, doesn't tend to scale downwards very well for smaller projects.

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  2. Of course "Dr Mukesh Haikerwal dismissed the criticism" he doesn't have the knowledge and practical grassroots experience of basic IT projects (let long complex ones)that would give him the much needed insight to enable him to accept the criticism. He is a GP and a politician. He is not a health informatician. He is beholden to the NEHTA gaggle.

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  3. Although I have to agree with your previous commentator I would like to add the rider that by comparison with his shortcomings in healthIT experience Mukesh is well suited to chair The RACGP-hosted General Practice Data Governance Council representing practice managers, divisions, practice nurses and rural doctors. I'm sure most would agree.

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