Quote Of The Year

Timeless Quotes - Sadly The Late 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, October 16, 2009

International News Extras For the Week (12/10/2009).

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

First we have:

Readers back reformed NPfIT

05 Oct 2009

The National Programme should not be scrapped although it should be reformed, a major survey by E-Health Insider and Doctors.net.uk has concluded.

The poll on the future of electronic health records in England was run last month in response to the publication of the Independent Review of Health and Social Care IT and the Conservative Party's response.

Although the Conservatives did not call for the programme to be scrapped, they called for much of its central architecture to be "dismantled" and for its multi-billion pound local service provider contracts to be renegotiated in favour of more local control over IT decision making.

Respondents to the survey, which has been released today to coincide with the start of the Conservative Party conference in Manchester, broadly backed this approach. EHI readers, in particular, backed interoperability rather than centrally purchased systems as the way forward.

Jon Hoeksma, editor of E-Health Insider, said: "The support given to the national programme was surprising, but it probably reflects a growing recognition that the NHS needs to get good IT systems in place.

"Doctors, NHS IT professionals and suppliers all want a national programme. Just not the one that they have got."

Doctors were keener than IT managers and suppliers for the national programme to be scrapped. Indeed, more than half (54%) of the GPs who took part through Doctors.net.uk agreed that the programme should be ended, in comparison with 43% of consultants and just 25% of junior doctors.

Much more here (including links):


This is an important survey as it is virtually certain the Conservatives will come the Government in the UK next year.

Second we have:

Blumenthal Stresses Need for Training

HDM Breaking News, October 7, 2009

David Blumenthal, M.D., the federal government’s national coordinator for health information technology, says his office will announce “within weeks or months” what he calls a “workforce training initiative” to educate more health information management professionals with expertise in electronic health records and related technologies.

“We know there are at least 50,000 new jobs that are needed in this field,” Blumenthal said Oct. 6 at the American Health Information Management Association convention in Grapevine, Texas. Health information professionals, he added, will prove essential to the task of making sure hospitals, physician groups and others become meaningful users of EHRs.

Reacting to Blumenthal’s comments, Linda Kloss, CEO of AHIMA, stressed that the task of training 50,000 more professionals should primarily be handled by the existing 270 health information management academic programs. “We must avoid a rush to start new programs” that lack adequate oversight on the quality of the education offered, she stressed. AHIMA will play a role by educating its 54,000 members about information technology, she added.

More here:


That is a lot of jobs e-Health could foster!

Third we have:

Wednesday, October 07, 2009

Optimism Trumps Glitches at Health 2.0 Conference

By George Lauer, iHealthBeat Features Editor

SAN FRANCISCO – Optimism about patients engaging online met its ironic match on the largely disconnected first day of the Health 2.0 Conference Tuesday. A room full of almost 1,000 would-be tweeters and Internet surfers was forced to pay more attention to speakers because Wi-Fi connections were frustratingly unreliable all day long. Many conference attendees had to hike a block or two to tweet or get their Web fix.

"We don't know what the problem is but I can tell you I'm not happy about it," said Matthew Holt, co-organizer of the annual conference showcasing new ideas and products designed to promote "user-generated health care." Anticipating heavy use, Health 2.0 organizers arranged for five wireless feeds in the cavernous Concourse Exhibition Center. The connections faded in and out -- mostly out -- all day.

"The most important thing, though," Holt said, "is that the presentations are working, and people are paying attention."

Another layer of irony: A good argument could be made that more attention was directed toward the podium when handhelds and laptops failed to captivate.

Despite the glitches, the first-day mood was largely positive, starting with keynote speaker Aneesh Chopra's urging health entrepreneurs to "invest together in the building blocks of innovation." Chopra, President Obama's hand-picked chief technology officer, said the government "needs to hear from you on the ground about how to make innovations work. We need to ask what is the realm of the possible."

He said the Obama administration is committed to "open government. We want to make sure we shift the culture of government to one that supports openness and transparency. Tell me what data sets you'd like to get your hands on, not a year from now, but within a month," Chopra said.

Chopra recounted his experiences as secretary of technology in Virginia, "which is a commonwealth, not a state," Chopra pointed out. "We need to embrace the spirit of commonwealth." He stopped short of calling the health 2.0 movement common health, but the pun was dangling there -- implied if not implicit.

Chopra appears to be a graduate with honors from the Obama school of public speaking. He delivered his keynote unfalteringly, without a glance at notes.

Much more here (with links):


This is an emerging are we all need to keep a close eye on.

Fourth we have:

Mary Hawking honoured

06 Oct 2009

Dr Mary Hawking, a GP in Bedfordshire and a long-standing healthcare IT campaigner, has been awarded the 2009 John Perry Prize by the British Computer Society’s Primary Health Care Specialist Group.

The prize was given to Dr Hawking for behind the scenes work that led to the creation of shared record guidance that was published earlier this year.

It was presented to Dr Hawking by John Perry’s widow, Joan, at the PHCSG’s annual conference.

Dr Hawking told EHI Primary Care that she was “extremely honoured and very happy” to receive the award, which is made in recognition of an outstanding contribution to primary care computing.

Roz Foad, chair of the PHCSG, said Dr Hawking had been an enthusiastic member of the group for many years and it was delighted to recognise her efforts.

She added: “Mary has campaigned tirelessly to maintain the integrity and confidentiality of GP and primary care records over the years, and is continuing to campaign for improvements in data quality across all healthcare environments.”

More here :


Mary Hawking has worked hard on GP computing in the UK, and the shared record work has been critical as it has provided clinician input to what the UK has planned.

Fifth we have:

Hospitals Find Way to Make Care Cheaper -- Make It Better


HARRISBURG, Pa. -- Be it cereal or cars, buyers usually have an idea of how good the products are and how much they cost before they buy them.

That's not how U.S. health care works. Patients rarely know which hospitals offer top-quality lung or aortic surgery, and which are more likely to harm them. Hospitals don't compete on price and rarely publish measurements of their quality, if they measure it at all.

Except in Pennsylvania. For two decades, a state agency has published "medical outcomes" -- death and complication rates -- from more than 50 types of treatments and surgery at hospitals. The state has found that publishing results can prompt hospitals to improve, and that good medical treatment is often less expensive than bad care.

One reason is that high-quality treatment usually results in shorter hospital stays and fewer readmissions. The state has had less success in publishing hospital prices and has drawn criticism from hospitals that disagree with its reporting methods. But companies or unions in Pennsylvania that have agreed to work only with the best-performing hospitals say they have been able to drive down medical costs.

"High-quality care costs less -- always," says David B. Nash, a medical-quality expert and dean at Thomas Jefferson University's School of Population Health in Philadelphia. "If the federal government could behave like a savvy shopper, that would change the health-cost game overnight. But the government is a bill payer, not a savvy shopper."

The Senate Finance Committee could vote late this week on its sweeping health bill, seen as the backbone for any final legislation. That bill would make available $75 million annually for the U.S. Department of Health and Human Services to develop methods of improving quality, including potentially publishing outcomes.

Lots more here (subscription required):


CCHIT to Certify Home-Grown EHRs

HDM Breaking News, October 6, 2009

Health care organizations that developed their own electronic health records systems likely will be able to get them certified as being compliant with the meaningful use requirements of the federal EHR incentive program next year.

The Certification Commission for Health Information Technology next year plans to develop a "site certification" program for hospitals and physician groups that use self-developed EHRs or a mix of commercial and proprietary applications, says Mark Leavitt, M.D., chair of the Chicago-based organization. The effort also will offer certification for those organizations that use an older, commercial clinical system that's been heavily customized, he notes.

Although it has not yet been officially designated as an official EHR certifying body under the incentive program called for in the American Recovery and Reinvestment Act, CCHIT already is developing a new certification program designed to measure whether software is compliant with the yet-to-be-finalized federal "meaningful use" EHR standards. The site certification component will feature sliding-scale pricing to make it affordable to providers of various sizes, Leavitt says.

"Site certification is designed to help the early adopters who were EHR pioneers," Leavitt adds.

An interesting step forward for ‘meaningful use’ certification.

Seventh we have:

HITS@AHIMA: Speaker urges groups to create legal EHR committee

By Joseph Conn / HITS staff writer

Posted: October 6, 2009 - 11:00 am EDT

The challenge of producing one completed and defensible legal medical record from a hybrid of paper and electronic record-keeping systems has been a recurring theme for the American Health Information Management Association. Not surprisingly, it was a topic of discussion at AHIMA's 81st annual convention in Grapevine, Texas, Monday.

Debi Nelson, director of information management and privacy officer for Trinity Health, Minot, N.D., drew hundreds of conferees to her session, “Are You on Track with Your Legal EHR?”

Since new trial rules of discovery are now in play, it is important for healthcare organizations to redefine in writing what a legal e-health record means. Nelson's counsel was for health information management professionals to be proactive in getting started, but insist on a collaborative process within their healthcare organizations in creating the new definition by forming a legal EHR committee.

More here:


This is an issue that to date has not received enough attention in Australia – and elsewhere in the world as well.

Eighth we have:

Insurers announce e-initiative to ease paperwork

By Jennifer Lubell / HITS staff writer

Posted: October 6, 2009 - 11:00 am EDT

Major health insurers have launched an initiative in Ohio to help establish a single-source, electronic-transactions system between insurers and providers.

Physician office staff members currently spend too much time and money accessing multiple channels to get the information needed to complete basic requirements for confirming eligibility, billing and referrals, according to a written statement from America's Health Insurance Plans. The Ohio initiative aims to simplify the work associated with patient visits by providing a new tool to physician practices to check patient eligibility, benefit coverage and claim status from one source.

Full article here:


This is certainly something needed in the US!

Ninth we have:

Bury outlines scope of Lorenzo R1.9

06 Oct 2009

NHS Bury’s implementation of Lorenzo will change the working practices of 600 of its 800 staff, across 31 community services.

The primary care trust has issued a statement to E-Health Insider that expands on the announcement that it will implement Lorenzo Regional Care Release 1.9 (LRC R1.9) in November, when it will migrate off its current patient administration system.

NHS Bury says staff are testing the product and working with local service provider CSC to make sure it is fit for purpose.

In April, director general of informatics Christine Connelly set the National Programme for IT in the NHS’s remaining local service providers, CSC and BT, deadlines for “significant” progress with the ‘strategic’ systems they are due to deliver.

She said that CSC must get iSoft’s Lorenzo into a care setting by November and working smoothly in an acute setting by March.

More here:


More signs of progress in the UK with Lorenzo.

Tenth we have:

Despite all the problems more delay is not an option

October 07, 2009

Bernard Courtois


Information and communications technology has, in a remarkably short period of time, utterly transformed virtually every dimension of modern life.

When we think about the way we conduct business, pay bills, educate and inform ourselves, engage family and friends or spend our leisure hours now compared to as few as 10 years ago, the changes are astonishing. And the pivotal point for this change has generally been some advance in technology.

Canadians are early and avid adopters of technology in all its dimensions – from cashless retail transactions to online dating. We're proud of our connectedness and view our capacity to bridge our vast geography with sophisticated networks and devices as a central part in our ongoing task of nation building.

This pride is justifiable in virtually ever dimension of modern life with one glaring exception – our adoption of information and communications technology in health-care delivery.

We have pockets of excellence in e-health all across the country. But the overall picture of the state of our e-health network still positions Canada as a laggard in comparison to other nations.

Lots more here:


Despite all the problems – some in Canada seem keen to push on!

Eleventh for the week we have:

Guest Commentary: Start with common framework on IT security

Posted: October 6, 2009 - 11:00 am EDT

On Oct. 16, states will submit their health information exchange, or HIE, grant applications in order to receive their incentives under the American Recovery and Reinvestment Act of 2009.

The stimulus act essentially leaves each state to adopt its own information security and privacy framework for the protection of personal health information. Without a common language between states, healthcare organizations looking to connect across multiple HIEs will be subject to more regulations, ambiguity and audits that could lead to higher costs and complexities—effectively diminishing the aim of today's healthcare reform and resulting in no guarantee of greater trust in our healthcare system.

The first set of national standards for the protection of individually identifiable health information came to fruition with the enactment of the Health Insurance Portability and Accountability Act's privacy and security rules in 1996. But what was not broadly understood at the time of its enactment—and is still not understood by many today—is that the intent was to provide organizations flexibility in how they implement information privacy and security programs and was not intended to provide prescriptive guidelines for compliance.

More here:


This is a useful commentary – and it is hard to disagree. The same issue applies in a smaller way in Australia.

Twelfth we have:

Genetic Info Privacy Rules Published

HDM Breaking News, October 7, 2009

Two new federal rules adding additional protections to patient privacy under the Genetic Information Nondiscrimination Act of 2009 were published Oct. 7 in the Federal Register. The rules were made available for viewing a week ago; publication starts the clock for submitting comments or complying.

The Departments of Labor and Treasury, and the Centers for Medicare and Medicaid Services, have published an interim final rule to prohibit group health plans and health insurance issuers in the group market from:

* increasing premiums for the group based on the results of one enrollee's genetic information,

* denying enrollment,

imposing pre-existing condition exclusions, and

* conducting other forms of underwriting based on genetic information.


The rules are available at gpoaccess.gov/fr/index.html.

--Joseph Goedert

More here:


Worth knowing about.

Third last we have:

Dutch health system tops Euro survey

06 Oct 2009

The Netherlands has the best healthcare system in Europe, according to the annual Euro Health Consumer Index.

The index compares 33 national healthcare systems across 38 indicators. It is published by Health Consumer Powerhouse in co-operation with the European Commission DG Information Society and Media.

The Netherlands has come out in first place two years running, after performing strongly in all categories of the survey.

These include patients’ rights and information, e-health, waiting times for treatment, treatment outcomes, range and reach of services provided, and access to medication.

Countries are ranked using a combination of public statistics, patient polls and independent research.

Denmark came second, performing strongly in providing patients with access to information and enforcing patient rights. Sweden was ranked third because of its good health outcomes, although it lost points for weak investment in e-health.

Much more here:


Seems the top performers are doing reasonable amounts of e-health.

Second last we have:

nCircle, HITRUST launch new security scanning service

October 06, 2009 | Eric Wicklund, Managing Editor

SAN FRANCISCO – A new healthcare auditing program is designed to help smaller physician practices ensure that their electronic healthcare records are safe and secure.

Developed by San Francisco-based nCircle and the Health Information Trust Alliance (HITRUST), the HITRUST Security and Configuration Auditing Service is designed to scan a provider’s IT systems for known vulnerabilities, identifying the highest risks in the network, and provide guidance on how to bring the systems up to date.

“It’s a simple scan that’s very low-cost and easy to set up,” said Abe Kleinfeld, nCircle’s CEO. “Most smaller (healthcare providers) haven’t been doing anything at all to protect their systems, and we’re reaching a point where that’s just not acceptable.”

The Web-based software is designed to bring healthcare providers into compliance with such industry standards as the federal HITECH Act and HIPAA, as well as establishing HITRUST certification against the Common Security Framework. HITRUST developed the CSF to provide healthcare organizations with a consolidated accountability standard.

Much more here:


Seems like a pretty useful service for small practices.

Last, and very usefully, we have:

Little health industry speech recognition competition

By Joseph Conn / HITS staff writer

Posted: October 7, 2009 - 11:00 am EDT

Part two of a two-part series (Access part one):

There has been a significant shakeout in the once crowded market for speech recognition technology in healthcare.

While many companies outside of healthcare remain active in the speech recognition field, including software giant Microsoft Corp., few healthcare industry competitors remain. Privately held M-Modal is one notable exception. The Pittsburgh-based developer supplies speech-recognition technology to the medical transcription industry and for picture archiving and communication/radiology information systems.

Publicly traded Nuance Communications, however, has become “sort of the 800-pound gorilla of speech recognition” in healthcare, according to informaticist Robert Budman, the physician-executive liaison to electronic health-record system developer Medsphere Systems Corp., Carlsbad, Calif. Nuance continues to market its Dragon NaturallySpeaking line of speech-recognition products and offers several other speech recognition products for radiology branded under different names.

Last fall, Nuance acquired Philips Speech Recognition Systems, a unit of Royal Philips Electronics of the Netherlands, for $96.1 million, buying up a major competitor in radiology. And in January, Nuance announced it had entered into a joint development and marketing relationship with another healthcare industry competitor, IBM Corp.

According to a joint company statement, the two former rivals agreed to share each other's speech-recognition technology. As part of the deal, the two companies also agreed to incorporate IBM technology into Nuance's speech solutions, with the first products featuring the combined technology expected to be available within two years. While IBM said it will continue to service its own speech-recognition product customers, as part of the deal IBM agreed to sell speech-related patents to Nuance.

Keith Belton, senior director of product marketing at Nuance, says both the speed and accuracy of the company's Dragon systems for medicine have increased dramatically in the past two years. The Version 8 family of medical products produced in 2005 and 2006 had accuracy rates in the 80% to low 90% range and included medical vocabularies targeted toward eight medical specialties, Belton says.

Version 10, the latest in the series, released last October, “is 20% more accurate than Version 8 and twice as fast,” Belton says, and is optimized for more than 20 medical specialties. It also includes several new “regional accent wizards” that enable non-native English speakers and Americans with regional accents to more quickly “train” the software, creating individual “voice profiles” that improve system speed and accuracy.

Much more here:


This technology has been knocking on being ready for prime time for a long while now. I wonder how close it has now moved. It seems serious progress is being made. The fusion of the Philips, IBM and Dragon technologies must soon make a real difference.

There is an amazing amount happening. Enjoy!


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