Sunday, October 04, 2009

Report and Resource Watch – Week of 28, September, 2009

Just an occasional post when I come upon a few interesting reports and resources that are worth a download or browse. This week we have a few.

First we have:

HISA - Health Informatics Workforce Review

A Review of the Health Informatics Workforce in Australia has been recently undertaken by the Society. The major findings were:

1. There are too few health informaticians for the current workload and unless addressed these workforce and skills shortages will be a major barrier to implementing the National E-Heath Strategy and likely to health reform more generally

2. Too little is known about the health informatics workforce - we know neither how many we have now, nor how many we need, and there is no indication that it is yet part of any national health workforce strategy or the remit of the National Health Workforce Agency

3. There is a fundamental breakdown in the market between employers, education providers and potential workforce entrants - while there is a strong demand by employers for workers, there has been a failure to attract students leading to the closure of well-regarded university courses

4. Because it is an emerging field, health informatics does not have wide recognition as a discipline in its own right; there is a poor general understanding of the knowledge domain in Australia; and many of the workers in clearly related jobs do not yet self-identify

5. There is no career structure for health informaticians in Australia; there is no standardisation of job names or job descriptions and there is no widely adopted set of competencies

6. There will be a long lag time to produce new health informaticians because of the multi-disciplinary nature of the education and the complexity of the discipline - the workforce we do have must be used optimally

7. A contributing factor to the lack of needed recognition and action on health informatics workforce issues is the fragmented representation of those in the discipline

The following documents are now available for download:

A Review of the Australian Health Informatics Workforce - Full - 4.7MB

A Review of the Australian Health Informatics Workforce - Summary - 365kb

Very important Australian work on what is needed.

Second we have:

The Center for Improving Medication Management

serves as a center for excellence. The Center is a collaborative forum that establishes project specific priorities to demonstrate the value of pharmacy interoperability with both patients and physicians for the purpose of improving the medication management process. The aspects of the medication management focused on are

  • Best practices as it relates to processing prescriptions electronically and
  • Improving patient compliance with physician medication orders by utilizing electronic communications between the patient, pharmacist, and physician.

The Center educates clinicians and their staff on the best approaches to implementing prescribing technology and integrating it with the day-to-day workflow. The Center implements programs that accelerate the automation of the prescribing process. Core to automating the prescribing process is the adoption and use electronic prescribing technologies with physician-pharmacy interoperability as well as the testing of innovative approaches to improve patient compliance with prescribed medications. Targeted research projects overseen by The Center will evaluate and establish best practices in support of these purposes.

More here:

http://www.thecimm.org/index.htm

Although they have an agenda there are some useful insights and reports into how medication management is evolving in the US to be downloaded.

Third we have:

Survey: 'Connected health' could cut healthcare costs by 40 percent

September 18, 2009 | Bernie Monegain, Editor

CAMBRIDGE, MA – A patient-centered and coordinated approach to healthcare could save billions, according to a survey of leading healthcare providers, patients, payers and technology leaders.

The survey, released today by the Massachusetts Medical Device Industry Council (MassMEDIC) and Cambridge Consultants, a technology product design and development firm, shows that a focus on patient well-being will improve overall health outcomes. In addition, the survey indicates care coordination will reduce wasteful spending in defensive medicine, inefficient claims processing, medical errors and emergency room services.

The findings come on the heels of an August report issued by PriceWaterhouseCoopers' Health Research Institute, which found that wasteful spending in U.S. healthcare is estimated at $1.2 trillion annually, comprising more than half of the $2.3 trillion spent in total.

The greatest areas of excess, according to the report:

  • $210 billion in defensive medical practices such as redundant, inappropriate or unnecessary tests and procedures;
  • $210 billion caused by inefficient healthcare administration; and
  • $100 billion for the care necessitated by preventable conditions.

In many cases, the report says, healthcare specialists are motivated to employ tests or procedures based on concern over liability or increasing their income over the needs of a patient.

Of the survey respondents who were familiar with the connected health approach, 75 percent predicted that this new preventative practice could cut healthcare costs by up to 40 percent.

An integrated connected health approach advocates an end-to-end solution, giving patients control as well as responsibility and connecting them with a wide network of healthcare professionals and online applications. This integration can be achieved through a range of technologies, beginning with electronic medical records and expanding outside clinical settings via connected devices such as glucometers and inhalers.

More here:

http://www.healthcareitnews.com/news/survey-connected-health-could-cut-healthcare-costs-40-percent

Here are the links to the various documents and reports.

Fourth we have:

States lack e-systems for managing pandemic: report

By Jessica Zigmond / HITS staff writer

Posted: September 21, 2009 - 11:00 am EDT

Before the World Health Organization declared a global flu pandemic in June, a sampling of states and localities showed they had not implemented an electronic medical system for managing medical volunteers in a surge, says a new report from the inspector general's office.

The study reviewed the preparedness levels of five states and 10 localities as of late summer 2008—an entire year before the pandemic—using data from the Assistant Secretary for Preparedness and Response, or ASPR, and the Centers for Disease Control and Prevention, both of which are a part of HHS. The report focused on five essential components of a medical surge, which were based on guidance from both the ASPR and CDC: coordination among stakeholders; recruitment and management of medical volunteers; acquisition and management of medical equipment; development of alternate care sites; and identification of guidelines for altering triage, admission and patient care.

More here (registration required):

http://www.modernhealthcare.com/article/20090921/REG/309219966

Link in text. Not a great set of answers. I wonder where OZ would be in comparison.

Fifth we have:

U.S. Lags Behind in Health IT, Says Study

Sep 22, 2009, News Report

While some countries have made dramatic progress in advanced health IT systems, the United States has struggled to make progress and is far behind international best practices, according to a study released today by the Information Technology and Innovation Foundation (ITIF).The study: Explaining International IT Application Leadership: Health IT, identifies elements contributing to success with health IT, including strong national-level leadership, the use of incentives and mandates, and the deployment of shared IT infrastructure in the health-care sector, and recommends strategies for policymakers to jumpstart progress on health IT adoption.

More here:

http://www.govtech.com/gt/726410?topic=117677

The report can be downloaded from the link in the text.

A very useful report – with some lessons that should be taken careful note of here.

Sixth we have:

Expert: eHealth may have 'disruptive impact'

Published: Tuesday 22 September 2009

The potential of technology to fundamentally change how health care is delivered could help curb runaway medical inflation, but some doctors and hospital managers view it as a threat, eHealth expert Dr. Michael Tremblay told EurActiv in an interview.

Dr. Michael Tremblay is an eHealth expert and principal at Tremblay Consulting .

He was speaking to Gary Finnegan.

There has been considerable momentum in political and industry circles about the promise offered by eHealth in making health care more efficient. Is this optimism justified?

Yes. Efficiency in health care though can drive up costs - for instance, if you reduce the amount of time a patient stays in a hospital bed, you can of course increase the number of patients who can use that bed and hence increase your costs. The eHealth question is whether you want the patient in the hospital bed in the first place, and whether care can be provided through an eHealth service. eHealth creates the option of keeping patients out of higher cost hospitals, managing care from home, or enabling easier monitoring of patients from a distance. The eHealth promise for me is location-independent, real-time health care – anywhere, anytime care.

We have to be mindful, though, what parts of health care we are referring to when we speak of making health care more efficient. It is evident that much is done daily to improve the way health care, as it is currently organised, is delivered, but perhaps not as much as the public thinks. eHealth, though, changes the paradigm in many respects, by enabling remote sensing, embedded intelligent diagnostic equipment, integrating clinical/patient information, and so on. It can remove steps in clinical pathways, as well as make some clinical work itself obsolete. This is not something that sits easily within professionally demarcated clinical work.

We can learn a lot from looking at other industries that have introduced information technology to alter service structures, such as banking, airlines, online shopping, etc. Health care, though, is still very much a hands-on activity, and so eHealth, which purports to alter this, is seen by many as only part of the solution, while for others it is seen as the next generation of care itself. We hope eHealth will be as good as we think it can be.

Much more here:

http://www.euractiv.com/en/health/expert-ehealth-may-disruptive-impact/article-185669

This is an interesting long interview. Worth a read.

Lastly we have:

IHI's Improvement Map houses research, resources

By Jean DerGurahian / HITS staff writer

Posted: September 23, 2009 - 11:00 am EDT

The Institute for Healthcare Improvement has launched a new Web-based quality and safety tool it believes will become the foundation for its hospital programs in the future.

The Improvement Map includes research around best practices, links to external resources and explanations of compliance requirements and tips for how best to reduce costs and improve outcomes on 70 care processes. It is being touted by the organization as a comprehensive source for hospitals seeking quality and safety plans.

“What we're finding is people are elated to have all this information in one place,” said Andrea Kabcenell, a vice president at the IHI.

The map looks at a range of issues, such as fall prevention and clinical nutrition, and breaks down information on the regulations and financial aspects of each. The map's 70 processes make up the majority of hospital services that lead to the best care, Kabcenell said. The quality organization built its tool using research compiled from its two initiatives targeting safety measures, the 100,000 Lives and the 5 Million Lives campaigns, as well as clinical processes studied by Intermountain Healthcare, Salt Lake City, and leadership processes. “We wanted to make sure we had in there all the things that are common” as well as flexibility to include emerging practices, she said.

Much more here:

http://www.modernhealthcare.com/article/20090923/REG/309239958

I think this is an important resource for all Hospitals.

Visit the Improvement Map here:

http://www.ihi.org/IHI/Programs/ImprovementMap/ImprovementMap.htm?TabId=0

Enjoy!

David.

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