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."

Wednesday, December 23, 2009

The Happy Christmas and Have a Great New Year Blog.

Just a short blog to wish all those who drop by the Season’s best.

It has been quite a year and much of the hope we stated it with has really yet to actually come to fruition, sadly.

The saddest things to me have been the consistent lack of leadership in the e-Health space and the persistent stupidity of the belief held by some really hopeless bureaucrats that something can happen without both quality leadership, some effective governance and some reasonable seeding investment.

The amount of time and effort that has been wasted because these three things were missing is terrible and the denial that is actually matters in terms of patient’s lives and limbs borders on the criminal in my view.

The good things this year have all been about the hardy souls in the commercial e-Health space who have been prepared to chance their arm and just go for it! They all know who they are so there is no point providing a list as I would be certain to leave some good guy or gal out!

I really hope 2010 can be a much better year for all concerned.

As a really amazing note, this is blog post number 1100. At least I hope I get a few points for effort!

Go well, be safe and have a great break.

I plan to be back typing away on January 4, 2010.


Tuesday, December 22, 2009

NSW Health Takes A Hit from the Australian Financial Review.

The following appeared today.

Fears for patients amid e-record troubles

The NSW government and senior health bureaucrats have been accused of putting the lives of patients at risk by ignoring the concerns of clinicians over the troubled deployment of the FirstNet electronic patient records and administration system.

The key points of the article are:

1. Some departments have reverted to using paper for patient records.

2. The concerns centre on the time it takes to enter and retrieve details.

More here (subscription required)


Those who have been watching will know this issue was covered a while ago on the blog.



and here:


and here:


The opposition Health Spokesman in NSW (Ms Jillian Skinner) has apparently also been briefed on issues in the metro hospitals as well as the known issues at more regional hospitals.

As always the silence from NSW Health is deafening.

The mess just continues unfixed it seems.

Let me know if things are better anywhere so we can let people know.


Weekly Overseas Health IT Links 23-12-2009

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.



Physicians support EHR use, but privacy breaches remain an issue

16. December 2009 03:19

Although physicians support the use of electronic health records, concerns about potential privacy breaches remain an issue, according to two research articles published in the January 2010 issue of the Journal of the American Informatics Association (JAMIA), in its premiere issue as one of 30 specialty titles published by the BMJ (British Medical Journal) Group, UK.

One published study is based on views of more than 1,000 family practice and specialist physicians in Massachusetts who were asked whether they thought electronic health information exchange (HIE) would drive down costs, improve patient care, free up their time and preserve patient confidentiality. They were also asked whether they would be willing to pay a monthly fee to use the system.



Decision on tougher lab data standards put off to January

By Mary Mosquera

Tuesday, December 15, 2009

If the Department of Health and Human Services publishes a rule defining the meaningful use of electronic records this month, as expected, health providers will still have to wait for a key policy decision on standards to use to exchange lab test results.

Dr. David Blumenthal, the national coordinator for health IT, yesterday asked the advisory Health IT Policy Committee to defer until January a decision on whether to allow temporary variations in those standards to be used.



What Makes HIEs Viable?

HDM Breaking News, December 17, 2009

Results from a national survey of regional health information organizations show simplicity and early funding commitments from participants improve viability of the initiatives.

Researchers from Harvard University, Brigham and Women's Hospital and Boston Veterans Affairs Hospital surveyed all known RHIOs in the United States in mid-2008. They examined two main outcome measures: whether the RHIO was operational and the percent of operating costs covered by revenue from participants.



New technology a 'push' toward EHR future

By Joseph Conn / HITS staff writer

Posted: December 18, 2009 - 5:59 am EDT

There is a push going on for push messaging, a likely first step in rolling out a proposed national health information network in time for healthcare organizations to use electronic health-record systems in a “meaningful manner” and qualify for federal EHR subsidy payments under the American Recovery and Reinvestment Act of 2009.

In late October, David Blumenthal, head of the Office of the National Coordinator for Health Information Technology at HHS called for pause in the planning of the NHIN.

Earlier this week, in testimony before a federal healthcare IT advisory panel, on blogs and postings to online discussions, what is beginning to emerge is the outline of what the healthcare IT world was put on hold to wait for, an outline of a “lighter” NHIN than has been the focus of much planning and development work in the past.



EHRs deliver soft benefits for hard cash

16 Dec 2009

Electronic health record and e-prescribing systems deliver benefits such as safer and more convenient services, but only over long periods of time and with a net increase in spending, a major European study has concluded.

The final report of the European Commission EHR IMPACT study pulls together more than 700 indicators of cost and benefit derived from detailed case studies of 11 EHR and e-prescribing systems in use in Europe, the US and Israel.


Keeping a SHARP Focus on Innovation

December 18, 2009

A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology

Today the Obama administration announced the availability of $60 million in Recovery Act funds to support the development of the Strategic Health IT Advanced Research Projects (SHARP) program. SHARP awards will fund research focused on identifying technology solutions to address well-documented problems impeding broad adoption of health information technology (health IT). By helping to overcome key challenges, the research will also accelerate progress towards achieving nationwide meaningful use of health IT.



Stalis standalone e-discharge summary

11 Dec 2009

Stalis has launched a clinical e-discharge solution to allow NHS trusts that do not have discharge summary functionality built into their patient administration system to produce immediate summaries for patients.

The company has made the CareXML/eDS product available after finding that many trusts are unlikely to hit the government’s April 2010 target for delivering discharge summaries to GPs within 24 hours.



15 December 2009

eHealth Worldwide

:: China - E-health in China, our practice and exploration. (8 December 2009 - IEEE Engineering in Medicine and Biology Society)
China started to pay more attention to regional and national health information network construction after the SARS epidemic outbreak in 2003. The Chinese government marks the public health system construction as the most urgent part of national medical reform, with information and computer tech-nology(ICT) being considered as the key of deploying regional collaborative medical service(RCMS), which is also known as e-Health. In this paper, we firstly analyze the difficulties of carrying out e-health projects in China and then present the active attempts, finally a case representing current progress is presented and studied.

Heaps more follows.



Are HIEs the Answer?

Alternatives to regional health information exchanges are emerging

Information Management Online, December 9, 2009

Joseph Goedert

The numbers are daunting. Nearly two decades after the advent of community health information networks and more than five years after the Bush Administration starting pushing for electronic health records and health information exchanges, only 28 states have one or more operational HIEs. And operational doesn't mean everyone in a region, much less a state, is active in the HIE.

In a nation of 300 million residents over 3.5 million square miles, there are 193 HIEs in various stages of development, according to eHealth Initiative, a Washington-based industry advocacy organization. By self-attestation, 57 of the HIEs are operational. Most HIEs don't have a sustainable business model, and getting a critical mass of regional stakeholders to cooperate in exchanging their data remains an extremely difficult proposition.



Top 10 Smartphone App Trends for 2010

Cynthia Johnson, December 11, 2009

Many chief information officers have smartphones on the top of their 2009 wish list. The compact mobile devices combine online access to information with PDA (personal digital assistant) functionality, making them perfect for on-the-go clinicians.

According to a report by market-research firm Manhattan Research, the number of physicians who own smartphones will increase from 64% to 81% by 2012. The October 2009 report states that the ability to complete tasks remotely will become even more indispensible to physicians in the future.



Facilities Use Cloud Computing to Share Radiology Images

Carrie Vaughan, for HealthLeaders Media, December 15, 2009

It started with a simple goal: to send radiology images to healthcare facilities throughout Montana in a manner that was cheaper and more efficient than using FedEx to mail CDs overnight. About 30 healthcare organizations in Montana joined the grassroots organization called the Image Movement of Montana.

The group needed a solution that would work not only for more tech savvy facilities with picture archiving and communications systems, but also for folks who don't have PACS and would need to access images on a PC, says Gayle Knudson, radiology manager at Great Falls Clinic and IMOM co-founder.



Tuesday, December 15, 2009

Nurses Claim Their Seat at the Health IT Decision-Making Table

Many of the policy discussions about health IT appear to focus almost exclusively on how such systems might affect physicians and physician workflow. We're hearing a lot about computerized physician order entry systems, physician performance measurement and physician incentives for electronic health record adoption.

But what about nurses?

Although they might not get as much press time, nurses are actively taking a seat at the table and participating in federal discussions about best practices, standards and the meaningful use of EHRs.


Patient consent and 'granular' privacy control ties

By Joseph Conn / HITS staff writer

Posted: December 14, 2009 - 11:00 am EDT

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

The online culture is changing, shifting toward affording individuals more control over their personal information, as evidenced by the rollout last week of revisions to the privacy and security policies and technological framework by Facebook, a popular personal media site.

Privacy and IT industry experts interviewed for this story say the fine-grained levels of personal control incorporated by Facebook demonstrate a "proof of concept" that a similar, so-called "granular" consent-management system could provide a template for personalized privacy protection in the healthcare industry.



Sens. move to block drugmakers from mining Rx data

By MATTHEW PERRONE (AP) – 4 days ago

WASHINGTON — Drug companies would no longer be able to mine pharmacy records to track which doctors are prescribing their medications, under a proposal unveiled Thursday by two Senate Democrats.

The amendment to the Senate health care bill would effectively ban pharmaceutical data mining, the drug company practice of buying prescription records to target sales pitches to doctors.



Missouri hospital saves lives with virtual ICU technology

December 11, 2009 | Diana Manos, Senior Editor

JEFFERSON CITY, MO – St. Mary's Health Center, an SSM Health Care facility in Jefferson City, Mo., reports success with the use of a virtual ICU program, used in conjunction with its in-house program.

At the Institute for Healthcare Improvement National Forum, Dec. 9-12 in Orlando, Fla., executives from St. Mary's announced results of its virtual use of ICU technology to improve mortality rates, lengths of stay and quality measures. Since St. Mary's launched its use of virtual ICU technology in 2006, ICU mortality dropped by 24 percent after one year; cardiac arrests plunged by 69 percent; ICU patient total length of stay fell by 14 percent; and there were no cases of ventilator-associated pneumonia (VAP) since the program's inception.



Electronic health records not a panacea, researchers say

December 14, 2009 | Diana Manos, Senior Editor

LONDON – Large-scale electronic health record projects promise much, but sometimes deliver little, according to a new study.

In a study published Monday in the U.S. journal Milbank Quarterly, researchers at the University College of London (UCL) said they identified fundamental and often overlooked tensions in the design and implementation of EHRs. The study was based on findings from hundreds of previous studies from all over the world.



Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method

Trisha Greenhalgh, Henry W.W. Potts, Geoff Wong, Pippa Bark, and Deborah Swinglehurst

University College London

Context: The extensive research literature on electronic patient records (EPRs) presents challenges to systematic reviewers because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches.

Methods: Using the meta-narrative method and searching beyond the Medline-indexed literature, this review used “conflicting” findings to address higher-order questions about how researchers had differently conceptualized and studied the EPR and its implementation.

Findings: Twenty-four previous systematic reviews and ninety-four further primary studies were considered. Key tensions in the literature centered on (1) the EPR (“container” or “itinerary”); (2) the EPR user (“information-processer” or “member of socio-technical network”); (3) organizational context (“the setting within which the EPR is implemented” or “the EPR-in-use”); (4) clinical work (“decision making” or “situated practice”); (5) the process of change (“the logic of determinism” or “the logic of opposition”); (6) implementation success (“objectively defined” or “socially negotiated”); and (7) complexity and scale (“the bigger the better” or “small is beautiful”).

Conclusions: The findings suggest that EPR use will always require human input to recontextualize knowledge; that even though secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper may offer a unique degree of ecological flexibility; and that smaller EPR systems may sometimes be more efficient and effective than larger ones. We suggest an agenda for further research.

Keywords: Systematic review, electronic patient records, innovation.



Medco to pay pharmacists for closing medication loop

December 14, 2009 — 3:19pm ET | By Neil Versel

Pharmacy benefits manager Medco Health Solutions will deliver electronic alerts to pharmacies for patients who may not be following their doctors' orders and pay as many as 100 pharmacists in Illinois for coordinating care with physicians and counseling patients with chronic conditions. Medco also will work with the Illinois Pharmacists Association, the University of Illinois at Chicago (UIC) College of Pharmacy and Mirixa, a pharmacy-based patient care network, to study the efforts to close gaps in medication adherence over the course of a 26-week trial period.



Quaid draws attention to health IT, but do people really care?

December 14, 2009 — 11:52am ET | By Neil Versel

Editors Choice

I've been thinking for some time now that in our celebrity-driven culture, it would take a big Hollywood name to latch on to health IT in order to get the masses--and the mainstream media--to make the connection between information technology and patient safety. A few candidates had been involuntarily brought to the fore with regards to EMR security breaches--Britney Spears, George Clooney and the dearly departed Farrah Fawcett come to mind--but I've been waiting for Dennis Quaid to make a splash.



Health smart card progress stalls

By Audra Mahlong, Journalist

Johannesburg, 14 Dec 2009

Health MEC Qedani Mahlangu has instructed lawyers to appeal the court's decision and prevent any payouts to the private consulting firm.

The Gauteng Health Department has been instructed to pay over R40 million to 3P Consulting for breach of contract and outstanding payments – delaying any decisions on the progress of its R609 million health smart card tender.

Health MEC Qedani Mahlangu noted that she would fight the decision of the Gauteng South High Court, and added that the money the department would have to pay 3P consulting would affect other projects.



iSoft ORMIS for Leicestershire provider

16th December 2009

NHS Leicestershire County and Rutland Community Health Services has implemented a wireless electronic patient record system which will provide paper-free processes in operating rooms across five of its hospitals.




Monday, December 21, 2009

Latest Additions to the NEHTA December 2009 Information Barrage.

Passed on without comment.

Go here and be informed - or whatever else you derive from what they provide.



A Really Important Piece of Commonsense Many in Health IT Miss.

The following interview appeared a few days ago.

One-on-One With Virtua Health CIO Al Campanella,

Part I

Virtua is a multi-hospital healthcare system headquartered in Marlton, N.J. A non-profit organization, it employs 7,900 clinical and administrative personnel and has 1,800 physicians as medical staff members. Virtua is an early adopter of clinical and digital technologies, led on the IT side by CIO Al Campanella. Recently HCI Editor-in-Chief Anthony Guerra caught up with Campanella to see if HITECH was changing his strategic plans.

GUERRA: Can you give me the 10,000-foot overview of Virtua?

CAMPANELLA: Sure. Virtua has four hospitals with a little over 1,000 beds. We have a little over $1billion in revenue. We own 150 physician practices. We also have two nursing homes, a very large home health agency with 400 nurses, and we have two large ambulatory care centers.

GUERRA: And I would imagine there’s a large population of physicians down there that are independent and refer to the hospitals?

CAMPANELLA: Yes. We have 1,100 office-based physicians who are completely voluntary, and then we have another 600 that are employed by other health systems that also admit here, or they are hospital-based physicians such as anesthesiologists and pathologists, so roughly, 1,700 altogether. And then, separately, we have 150 employed physicians.

GUERRA: The employed physicians – the office-based physicians that are owned – are they allowed to refer patients to other hospitals or do they have to refer inside the Virtua network?

CAMPANELLA: No, they don’t have to refer to us. If we offer the service, then they’re encouraged to refer the patient here, but if we don’t offer the service, then of course, they can refer elsewhere.

Read the rest of the long and really spot on interview here:


If ever there was a truer word spoken about obtaining physician buy-in and adoption - this is it!

“Al Campanella says physicians aren’t opposed to the concept of EMRs, they just don’t want to make less money because of them.”

This is absolutely central to getting physician adoption in countries that have ‘fee for service remuneration - as Australia does.

The bottom line is that you hit the bottom line you loose - improve it you win with all but the tiny handful of zealots for technology who simply don’t care and love blinking lights!

And to provide maximum value as we go onto the new year here is the best paragraph I have seen for all of us who have staggered through the recent - and ongoing, believe me, GFC.

From Alan Kohler in the Eureka Report a day or so ago.

“I’m not suggesting that not losing money and diversifying to protect your capital from ignorance is a new idea. In 1933 Will Rogers famously said: “I'm not so much concerned about the return on my money as the return of my money.” And, of course, Warren Buffet’s two big rules of investing are: “Rule No. 1: Never lose money. Rule No. 2: Never forget Rule No. 1”

The core lesson here is to never take one’s eye off the ball - and with health IT the ball always has major elements of making sure the clinicians can feed the nippers!

And as another wise person once said - How do you get doctors to do what you want? Simple, stuff their mouths with silver!

The inevitable implication here is that you have to spend up front to get things to happen. Ms Roxon and Ms Halton seem to have missed that fundamental point.

Not hard at all really - and never to be forgotten.


Weekly Australian Health IT Links - 21-12-2009

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.



Security for e-health data

INSURANCE companies and employers will be locked out of the national health database planned to start next year.

Every newborn, as well as every Australian holding a Medicare card or Veterans Affairs card, will automatically be allocated a "healthcare identification" number that privacy groups have branded a de facto national ID card.

The number may eventually be linked to patients' medical records, but anyone who misuses the information will face two years' jail, under draft legislation released by Health Minister Nicola Roxon on Friday.



Medical professionals ask for clarity on e-health

A BROAD coalition of health professionals believes it made progress in its quest for $6.3 billion in federal funding at the government's massive broadband conference in Sydney last week.

The Coalition for e-Health's hopes have been buoyed by strong indications it has support from Kevin Rudd, Health and Ageing Minister Nicola Roxon and Communications Minister Stephen Conroy.

Michael Legg, president of the Health Informatics Society, which convenes the CeH, said the group had been asked to hang tight.

Professor Legg said the group had been strongly encouraged by comments made by Department of Health and Ageing deputy secretary Jane Halton at the conference that indicated the department was behind the group.



Old age problem gets new age solution

by Beverley Head

Monday, 14 December 2009

With 13.3 per cent of the Australian population now aged 65 or over, iSoft’s decision to launch its first end-to-end information system for aged care providers seems smartly timed.

The largest listed health IT provider in Australia launched its Aged Care – Enterprise Wide Health system, on the same day as the Australian Bureau of Statistics revealed that the median age of the Australian population had risen by more than five years to 36.9 over the last two decades.



PSA partners with GPs on e-health

17 December 2009

The Pharmaceutical Society of Australia (PSA) has joined forces with general practitioners to push forward the uptake and implementation of electronic prescribing.

During collaborative partnership talks in Canberra, PSA and the Royal Australian College of General Practitioners (RACGP) reaffirmed that electronic prescribing of medications could provide substantial benefits to consumers through better medication management and reduced medication errors.



Health Professions United On E-Health, Australia

17 Dec 2009

A high-level meeting of health organisations in Canberra has scoped the development of a robust, patient-centred e-prescribing system through a collaborative partnership between doctors and pharmacists.

The roundtable, hosted by the Pharmaceutical Society of Australia and the Royal Australian College of General Practitioners, reaffirmed that e-prescribing of medications can provide substantial benefits to consumers through better medication management and reduced medication errors, as well as improved communication between doctors, pharmacists and patients.


$15.5m boost for rural NT health

17 Dec, 2009 03:51 PM

REMOTE health service delivery is set for a $15.5 million boost under joint Territory and Federal Government funding, Minister for Information, Communications and Technology Policy Karl Hampton announced last Friday.

"This is one of the largest ICT milestones in the Territory's history that will help deliver life-changing services for thousands of remote Territorians," Mr Hampton said.

"Improved health service delivery in remote Territory towns such as Lajamanu, Dagaragu and Papunya will go a long way towards Closing the Gap in Indigenous Disadvantage.



Mandatory ISP-Level Filtering report released

Enex TestLab finds that a "technically competent user" can circumvent filtering technology based on ACMA’s blacklist

Tim Lohman 15 December, 2009 16:32

After much delay the Federal Government has released the results of Enex TestLab’s test pilot into mandatory ISP-level content filtering, finding that a technically competent user could circumvent filtering technology based on ACMA’s blacklist.

According to the report, initially all filters had issues with loading the ACMA blacklist indicating a need for routine checking to ensure the blacklist is filtered correctly with each update.



Internet censorship plan gets the green light


December 15, 2009 - 11:13PM

The Federal Government has announced it will proceed with controversial plans to censor the internet after Government-commissioned trials found filtering a blacklist of banned sites was accurate and would not slow down the internet.

But critics, including the online users' lobby group Electronic Frontiers Australia and the Greens communications spokesman Scott Ludlam, said the trial results were not surprising and the policy was still fundamentally flawed.



Health service fined for info leak


December 14th, 2009

A TERRITORY health service has been charged thousands of dollars after a patient's private information was mistakenly released to his employer three times.

The information commissioner said the errors caused "embarrassment, hurt and humiliation" to the patient.

"On each occasion ... the complainant had been questioned about matters to do with the complainant's health status by staff at the complainant's employer," the commissioner's case note said.



GPs to get prescribing feedback

by Jared Reed

Almost 200 GP practices have signed up for a divisions-run scheme that will provide instant feedback on the quality of their prescribing decisions.

The pilot project, run by the National Prescribing Service and divisions, will analyse GPs’ prescription for chronic heart failure and hypertension against eight clinical indicators. These conditions were chosen because of evidence indicating under-prescribing of first-line recommended treatments.



Privacy must be addressed, for innovation's sake

Liz Tay | Dec 18, 2009 11:50 AM

Privacy the only road-block to IT triumphs.

Unresolved privacy issues may be limiting technological and scientific progress, according to a prominent U.S. computer scientist.

Tom M. Mitchell of Carnegie Mellon University believes the rise of machine-learning algorithms during the past decade has yielded compelling potentials for mining and analysing real-time data.

Mitchell heads up Carnegie Mellon's Machine Learning Department, where he is researching uses for real-time location data from smart phones.



Feds to deliver digital reform agenda within six months

Dec 14, 2009 2:48 PM

Conroy calls for cross-Government, industry cooperation.

Cooperation between the various levels of Government and industry bodies will be required to drive forth digital economic reform, Communications Minister Stephen Conroy has said.

Speaking at the closing of the Realising our Broadband Future forum in Sydney, Conroy outlined the Government's plans for ideas and content generated in the two-day physical and virtual gabfest.



Gaming to fight cancer

Monday, 14 December 2009


CSIRO is using the latest in computer gaming technology to help reduce the incidence of one of the most common cancers in Australia – bowel cancer.

According to CSIRO Preventative Health Flagship scientist, Dr Trevor Lockett, on average 90 Australians die from colon cancer each week.

"As such, early diagnosis has become a national health priority," Dr Lockett said.

He said timely and effective colonoscopy follow-up for National Bowel Cancer Screening Program subjects who test positive for blood in the stool is critical to helping this national initiative save lives.



Cochlear pioneer: Canberra must listen


December 15, 2009

THE inventor of the bionic ear, Professor Graeme Clark, has called for the Government to fund cochlear implant replacements, saying it would be cruel to deprive deaf people of sound.

Professor Clark said he was shocked to learn last week that deaf people over the age of 21 who had a Government-funded cochlear implant did not receive funding to have it replaced when it stops working 10 to 15 years later.



NBN leaves business baffled

GOVERNMENT departments and bureaucrats were the main beneficiaries of last week's broadband gabfest, as keynote speakers failed to explain what business applications could be made possible by a national broadband network.

Australia Post corporate development manager Samantha Hannah-Rankin was one of a handful of local keynote speakers at the Realising our Broadband Future summit in Sydney, and the only speaker to really address how the government's $43 billion project could benefit business.



Department of Health and Aging to launch indigenous health site

Aims to address chronic disease among indegenous Australians

Tim Lohman 14 December, 2009 11:49

The Department of Health and Ageing (DoHA) is to launch a new Web portal aimed at providing an improved resource for managing chronic disease in indigenous Australians.

The site works toward achieving a measure under the Federal Government’s November 2008 $805.5 million Indigenous Chronic Disease Package aimed at supporting and promoting individual primary health care workers in the mainstream and Indigenous sectors to prevent and manage chronic disease in indigenous Australians.




Sunday, December 20, 2009

Anonymous Speaks Out Again and I Have to Agree!

Yesterday John Johnson of Pen Computing (a respected provider and developer of e-Health software) posted the following comment on the blog:

John Johnston said...

Pen Computer Systems IS NOT in the messaging business. We are in the business of providing ehealth solutions that are useful to providers and patients. Often we find that we have to build or collaborate to get something that is blocking the way. Our direction, of course, demands web services and our interest in WSMA is consistent with that. If WSMA is required by something we are doing we will use it. The main frustration for us is that NEHTA still has not got to a point where it can EASILY say "we need a tool to do X...who can we work with to build an X?" There are signs of this breaking down but there are sections within NEHTA who do not have the leadership to do this and it is holding us all up.

Sunday, December 20, 2009 7:45:00 AM

His post stimulated the following:

Anonymous said...

John Johnston said “there are sections within NEHTA who do not have the leadership to do this and it is holding us all up”.

Well if that isn’t stating the bleeding obvious I don’t know what is. For years the vendor community has mumbled and grumbled away about NEHTA but never been prepared to come out and state their views in the public arena for fear it might have negative consequences for their businesses. So nothing changes, NEHTA does what NEHTA wants and the doona mumbling continues unabated and nothing much changes.

This blogspot has consistently called for changes in NEHTA. Their current modus operandi is, as John says, “holding us all up” because “there are sections in NEHTA who do not have the leadership” required to fix this debilitating issue. So the whole system suffers and pays a high price in the process - government, developers, health providers, patients. Thank you John for having the courage to bring this issue into the open.

Sadly, you are but one lonely voice among the vendor community. When are your colleagues going to speak up?

Until that happens your business along with every other business will continue to be frustrated. If you want change to happen then insist on change, demand it and drive it home - because if you don’t you will just have to keep scratching your heads and asking yourselves “how can we get round these obstacles that are holding us up if we don’t do something to change the way things are being done”.

Oh, and one other thing - it is not appropriate to point the finger at “some sections within NEHTA”. Surely to goodness you understand that senior management determines the way NEHTA operates. That is the CEO’s job. He needs to know about these problems areas in NEHTA of which you speak, and he needs to seek help to fix them if he can’t fix them himself.

But until you find colleagues of like mind and courage to join you to insist on getting the leadership problems fixed then no improvements will be seen, the barriers to progress will remain and the outcomes for progress will not eventuate.

Sunday, December 20, 2009 10:58:00 AM

It is good to see such articulate, well informed and accurate commentary on the blog. All power to Anon for another really worthwhile effort.

Separately I am hearing that we now have NEHTA internally deciding that the “Year of Delivery” is to be taken as the financial and not calendar year - providing an extra bit of wiggle room. Additionally 2009 is to be the termed the year of “Internal Delivery”(all those .pdfs) and 2010 FY the year of “External Delivery”! What a giggle!

Additionally word is that - as we saw in the responses to the poll - there is not much confidence in the delivery of the IHI. To quote an informant (who I hope is sufficiently anonymous that they will not be hauled before the bosses as has happened to others who have now left the organisation) “None of the people in the trenches at NEHTA actually believe the IHI will get off the ground”. We will see in time I guess. Certainly if I was involved in the e-Health industry I would want to see a good deal more clarity about just what is going on before spending any money to integrate with what may be on offer!

Second lastly it was sad to hear the Karen Gibson has left NEHTA. She did some really good work over the years to get the Australian side of SNOMED off the ground. I am sure she will be missed.

Lastly have a look here:


Seem stakeholders are not being talked to much in the last 5-6 months!

What a tangled web NEHTA weaves! Surely reform can’t be far off, can it?


Vale Emeritus Professor (Louis) Charles Birch.

Charles Birch was the professor who in 1966 introduced me to the wonders of biology and ultimately was a catalyst of my studying Zoology, Biochemistry and Physiology which led me naturally to Medicine. The rest is now history.

He was an astonishing polymath and Australia has I believe lost a genuine living treasure. In 1990 he won the Templeton Prize (which is like a Nobel Prize in the area of Science and Religion).

He died this weekend at St Vincent’s Hospital in Sydney.

More details here:


I, for one, feel I have lost a link to all sorts of threads of my past. Go well Charles.


Saturday, December 19, 2009

Global Ranking for The Blog. – Surely they are Joking!

I checked this out today and was gobsmacked!


Check your Geoblogosphere ranking

NOTE: You must have Feedjit's Live Traffic Feed installed on your blog or website to be listed in the Geoblogosphere. You must not be an adult website and your site can not be web spam or contain any malware.

Enter your site hostname or URL below and hit "Check" to see where you rank in the Geoblogosphere. We also check if your site has been listed as spam, adult, containing malware or if you have been listed as a dangerous site with Google or any other companies

Blog: Aushealthit.blogspot.com.

You Rank #37 in: Sydney, Australia

You Rank #88 in: Melbourne, Australia

You Rank #113 in: Brisbane, Australia

You Rank #113 in: Adelaide, Australia

You Rank #116 in: Canberra, Australia

You Rank #303 in: Winnipeg, Canada

You Rank #456 in: Perth, Australia

Note: We analyze the cities that have sent you the most traffic recently. You may rank in many other cities in the Geoblogosphere.

----- End Extract.

A joke I am sure but fun!


AusHealthIT Man Poll Number 3 - Results

The question was:

What Chance to You Give NEHTA / Medicare of Successfully Implementing Health Identifiers by July 2010


100% Chance of Success

- 14 (21%)

75% Chance of Success

- 8 (12%)

50% Chance of Success

- 5 (7%)

25% Chance of Success

- 13 (20%)

0% Chance of Success

- 25 (38%)

Total Votes 65


Again, obviously blog readers are trying to tell NEHTA something here! I think NEHTA needs to do a little more work to convince the HI Community that they know what they are doing – and more than that that they have all the issues addressed.

Right now 65% of readers give this a 50% or less chance of happening on time.

We will see if anyone is listening.

Thanks to all who voted.


Friday, December 18, 2009

Weekly Overseas Health IT Links 15-12-2009

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.



Why open source may win the electronic health record market

By Dana Blankenhorn | Dec 11, 2009

Electronic Health Records (EHRs) are the trend of the day.

Starting with its stimulus package, the Obama Administration has been pushing EHRs as the solution to all that ails health care. The idea is that the data they collect can drive change, change can drive efficiency, and efficiency can reduce costs.

There are literally dozens of EHRs to choose from. The vast majority are proprietary.



White paper outlines healthcare interoperability goals

December 09, 2009 | Kyle Hardy, Community Editor

SAN FRANCISCO – A new white paper outlines national healthcare goals on healthcare information exchange, regional health information organizations and leveraging stimulus money to achieve “meaningful use” of electronic health records.

“Fulfilling ARRA: A Collaborative Approach to Connected Health,” a white paper released by San Jose, Calif.-based Axolotl as part of the Healthcare Stimulus Exchange National Roadshow 2010, outlines efforts to educate healthcare organizations on how to optimize the use of healthcare IT to receive stimulus money allocated by the American Recovery and Reinvestment Act.



Groups Far Apart on Online Privacy Oversight



IF online privacy was once an obscure policy subject, it has come front and center. That much was apparent at the standing-room-only roundtable on privacy and technology that the Federal Trade Commission held here on Monday.

The commission had brought in academics, consumer advocates and executives from Google, Microsoft and Wal-Mart to debate what needs to change to address privacy issues online.

It was not just a theoretical question. The commission has been examining whether online privacy should be regulated. The debate has grown louder as technology companies are tracking and profiling people in new ways, Congress is showing an interest in the subject, and companies are trying to avoid government intervention.



Facebook privacy revisions ‘sign post' for healthcare

By Joseph Conn / HITS staff writer

Posted: December 11, 2009 - 11:00 am EDT

Part one of a two-part series:

Facebook, the global phenomenon in Web-based social media, rolled out a massive overhaul of its privacy protection policies and technology this week—and in so doing may have drawn up a playbook for healthcare as well, industry experts say.

The privacy upgrade gives its 350 million worldwide users increased control over who has access to some of, but not all, the information on their personal pages. These new, so-called “granular” controls—specifically those embedded in the site's “publisher” function, which enables a user to post new material to his or her Facebook pages—reach down to the level of discrete data elements. The new controls, for example, allow a user to restrict who gets to see each newly posted photo or typed comment.



December 7, 2009

Never Say Good-Bye?

By Greg Goth

For The Record

Vol. 21 No. 23 P. 10

A proposal to create a 10-year nationwide records retention policy has produced differing opinions on the merits of such a plan. Should healthcare organizations hold on to what they’ve got?

The retention and preservation of paper- and film-based medical records isn’t the sexiest topic, especially as so much emphasis across the healthcare industry is currently being placed on selecting and implementing EHR systems. However, the fate of decades’ worth of records on paper and film is receiving increased scrutiny precisely because the healthcare delivery system has reached a critical transition point between storing patient information on paper and in digital formats.



RSNA: Visage Imaging introduces all-inclusive workstation

Visage Imaging promoted its new diagnostic imaging solution, the unified viewer Visage 7 platform at the Radiological Society of North America (RSNA) annual conference in Chicago last week.

“[The Visage 7] allows the end-user to view 2D, 3D and 4D images all on one screen and all on a thin client,” explained Diane Clifford, director of global marketing for Visage.



Obama Dedicates $88M More for Health IT

As part of the new Recovery Act funding, President Obama pushes health information technology systems for community health care centers.

President Obama is seeding the health care industry with another $88 million in funding for health care centers to adopt new health information technology systems to manage their administrative and financial matters and transfer old paper files to electronic medical records. The initiative is part of $600 million in stimulus money that will go toward improving community health centers across the country.



Security, privacy breaches plague healthcare in '09

By Joseph Conn / HITS staff writer

Posted: December 10, 2009 - 11:00 am EDT

It has been a bad past couple of months for healthcare information security.

In October and November, multiple healthcare organizations announced patient data losses that made headlines in their communities, and national news in a few of the most egregious instances in which of breaches involved hundreds of thousands of records.

Healthcare security experts, however, say the breaches, while shocking to some, come as no surprise to industry security cognoscenti. These experts attribute the heightened publicity to federal breach notification provisions in the American Recovery and Reinvestment Act of 2009 that went into effect in September.



Design, implementation of Manitoba's secure health record now underway: Oswald

December 9, 2009 (Winnipeg, MB) - The province’s electronic health record (EHR) project continues to move forward with the design and implementation of a system that will offer authorized health care providers immediate access to selected patient information, Health Minister Theresa Oswald announced today.



December 4, 2009

Health-care tip: Investing in information technology saves lives

By Robert Bell

Special to Globe and Mail Update

Manitoba, Newfoundland and Ontario are working together to create a tele-pathology system

In the long history of medicine, innovations in technology - from antibiotics and vaccines to X-rays and MRIs - have steadily improved our ability to save lives, preserve health and improve the quality of life for patients. But not every life-saving innovation can be seen in doctors' offices or operating theatres. Some of the most important technological advances in health care are only found behind the scenes.



Survey: Those with EMRs more likely to report drug errors

December 10, 2009 — 11:55am ET | By Neil Versel

We've heard, at least anecdotally, how EMRs make it so much easier for physicians to report on compliance with quality measures, so this news was probably inevitable: those with EMRs are more likely to report adverse drug events. That is the finding of an Ipsos survey of 300 primary-care physicians, commissioned by pharmaceutical giant Pfizer.



December 10, 2009 7:48 AM PST

Microsoft to buy Sentillion for health care software

by Lance Whitney

Microsoft is adding another player to its portfolio of health care offerings.

The software powerhouse said Thursday that it plans to buy Sentillion, a privately held company that supplies software to health care professionals. Microsoft hopes to combine Sentillion's technologies with its own Amalga Unified Intelligence System (UIS). The goal is to offer integrated technology that can help health care providers more easily access patient data from across multiple sources.



Thursday, December 10, 2009

Plan Launched To Bring Health IT Academics to Ground Level

by George Lauer, iHealthBeat Features Editor

Until now, the academic emphasis in health IT and medical informatics has been largely at the post-graduate and research level. A new plan fueled by stimulus funding hopes to quickly take it to the community college level to train a new work force for the country's evolution toward a digital health system.

Put very simply, this is a tightly choreographed, high-speed effort to extend health IT academics beyond the theoretical realm to the everyday, hands-on realm.



Electronic Medical Records: The Good, the Bad, and the Ugly [Expert Insight]

Earlier this year, President Barack Obama signed the American Recovery and Reinvestment Act of 2009 (the stimulus bill), which provided payment incentives to encourage all hospitals and physicians to adopt electronic medical records (EMRs) by 2015. As a practicing internist who "grew up" using EMRs, this goal excites me. I cannot imagine practicing medicine without an EMR. In my career, I have been fortunate enough to use 3 different systems: Epic (EpicCare Inpatient and Ambulatory), Cerner (PowerChart), and VistA (the Department of Veterans Affairs Computerized Patient Record System, or CPRS). Having experienced similar issues with each of them, I want to focus here on EMR use in general and discuss both the benefits (the good) and the pitfalls (the bad and ugly) from a physician's standpoint.



iSoft signs first PACS deal in Germany

10 Dec 2009

ISoft has announced that it has taken the first order for its new Picture Archiving and Communications System in Germany.

The Diagnostische Zentrum am Vincentinum in Southern Germany has signed a €130,000 agreement to implement the system at its specialist diagnostic centre in Augsburg.

The deal is worth €70,000 in licence and implementation fees and €60,000 for services over five years, and for the first time provides the application as a service



Report: Health strategy could save W.Va. $1B


The Associated Press

Monday, December 7, 2009 6:57 PM

CHARLESTON, W.Va. -- West Virginia's health care system could save over $1.1 billion by going digital and centralizing patient care, according to a first-of-its-kind report presented to lawmakers Monday.

Those savings would be seen not just by government agencies, but by private insurers and policyholders, who could benefit directly in the form of lower premiums.

The report should lend urgency to some initiatives that have already begun, like electronic medical records and prescriptions, according to the groups behind its creation.



Loma Linda opens health ‘geoinformatics' laboratory

By Joseph Conn / HITS staff writer

Posted: December 9, 2009 - 11:00 am EDT

Students interested in public health and wanting to learn how computerized mapmaking and data analysis software can be used to improve the health of populations around the world will be able to take training at the newly opened Health Geoinformatics Laboratory at Loma Linda (Calif.) University.



Problems exist in keeping health data secure: experts

By Joseph Conn / HITS staff writer

Posted: December 9, 2009 - 11:00 am EDT

A new federal privacy breach law has revealed flaws in the healthcare industry's ability to keep healthcare data private.

The American Recovery and Reinvestment Act of 2009, which is expected to allocate $34 billion in health information technology spending, requires the government to create a national IT plan that includes security protections for health information exchange and “specifying technologies or methodologies for rendering health information unusable, unreadable or indecipherable.”



EHR Standard Goes International

HDM Breaking News, December 9, 2009

The International Organization for Standardization has published as an international standard the Electronic Health Record System Functional Model, Release 1.1. The standard was developed by Health Level Seven, a standards development organization in Ann Arbor, Mich.

The functional model is designed to provide guidance to EHR software developers and purchasers about the features any such product should have. The model contains about 1,000 criteria covering more than 150 functions in such areas as medication history, problem lists, orders, clinical decision support, and privacy and security.



Military to test lifetime EHR in six local communities

By Peter Buxbaum

Tuesday, December 08, 2009

The Department of Veteran Affairs is seeking community coordinators to head up as many as six localized health information exchange projects designed to advance the VA and Department of Defense joint virtual lifetime electronic record project (VLER).

"The Virtual Lifetime Electronic Record Health Communities Initiative is the first necessary step for the implementation and refinement of VLER," said an online business notice posted yesterday by VA.



IT helps drive $232B personalized medicine market

December 08, 2009 | Bernie Monegain, Editor

NEW YORK – Information technology and telemedicine are helping to boost the market for personalized medicine in the United States and also benefiting from it.

The $232 billion market is projected to grow 11 percent annually, according to a report published Tuesday by PricewaterhouseCoopers.

PricewaterhouseCoopers projects that the market for a more personalized approach to health and wellness will grow to as much as $452 billion by 2015. Its estimates are based on a broad view of the market opportunity beyond drugs and devices, including demand for high-tech storage and data-sharing as well as low-tech products and services aimed at consumers' heightened awareness of their own health risks.



McKesson Unveils Pharmacy Automation System

The system is designed to improve dosage accuracy and patient safety while saving pharmacists' time.

By Mitch Wagner InformationWeek

cKesson introduced a system to allow hospitals to automate dispensing tablets, capsules, and other oral solid medications that come pre-packaged from drug manufacturers.

By retaining original manufacturer packaging, PROmanager-Rx helps hospital pharmacies increase accuracy and improve safety. The system also frees pharmacists from packaging and dispensing, so they can play more integral roles on the clinical care team, McKesson said. The system dispenses medications in unit-dose barcoded form.



The Tipping Point for ePrescriptions

The use of ePrescribing is on the rise, but more must be done to encourage adoption of the technology.

By Sumit Dutta, MD

Electronic prescribing will soon become a standard medical practice in the United States. Initiatives promoting clinicians' use of ePrescribing are achieving remarkable results. Starting this year, Medicare is increasing reimbursements to doctors using ePrescribing. By 2012, physicians not using this technology will be penalized with lower Medicare reimbursements.

Key medical organizations have endorsed a timely transition to ePrescribing, and a growing number of health plan sponsors are supporting ePrescribing programs that put the technology into physicians' offices. Finally, the merger between major networks SureScripts and RxHub is setting the foundation for uniform ePrescribing standards. As a result of these and other efforts, an estimated 100 million ePrescriptions were "written" in 2008, a 300 percent increase from 2007.



e-Health initiative generates first published research

9 December 2009

The Wellcome Trust and Research Councils Joint Initiative in Electronic Patient Records and Databases in Research, supporting the use of electronic resources in health research, has generated its first published research.

The papers provide insight into the use of antibiotics to treat respiratory tract infections and the methodology of stroke research. They illustrate the potential of electronic patient databases to deliver key analyses that can help improve health care and public health, as well as analysing methodological questions facing researchers using large datasets from electronic records.



Tuesday, December 08, 2009

Celebrating the Small Wins: Respite From a Feast of Grand Visions

by Thomas H. Lee M.D.

As the turkey makes its way into sandwiches, casseroles and tetrazzini, and as the family slowly revives itself from food coma, it's perhaps a good time to digest and reflect upon the year.

And what a year it has been. Economic crisis. Multi-billion dollar stimulus for health IT. The contentious battle over health care reform. And the persistent rhetoric proclaiming that health IT will save the day.

Lost among the grand and hopeful visions for health care reform and health IT subsidies, however, have also been the small victories that occur daily on the ground. Accomplishments unheralded. Challenges overcome.



Technology 'could save HSE millions'


THE HSE could save €79 million a year by introducing electronic patient records and €195 million a year by treating chronic illness in the home, according to a report prepared by a coalition of 17 telecoms and technology firms.

The report, presented to Minister for Health Mary Harney, also found there would be 106,000 fewer prescription errors in the primary care sector and 292 fewer diabetic deaths per year if Ireland “radically improved” the use of and investment in technology in the health sector.



AT&T sets its sights on the 'telehealth' industry

By Venuri Siriwardane/The Star-Ledger

December 06, 2009, 6:00AM

A laser micro projector adjunct.The device works with a smartphone to illustrate diagrams, x-rays and MRIs on any surface.

The doctor will see you now. Or at least in the few seconds it takes AT&T to relay your vital signs over its broadband network.

The telecommunications giant has big plans to establish a foothold in the "telehealth" industry, an emerging field that links patients and physicians across the country via video and medical-information technology.



10 Most Hazardous Technologies in Healthcare

Cheryl Clark, for HealthLeaders Media, December 3, 2009

The ECRI Institute, an independent nonprofit company that evaluates medical devices and processes, has published its list of the 10 most dangerous technological hazards in healthcare.

The organization made its choice and prioritized the order "based on the likelihood and severity of the reports we've received over the past year, the recalls and other actions we've reviewed, and our continuing examination of the published literature," ECRI authors wrote in their introduction.

These 10 are "problems that we believe are the most crucial right now, and that hospitals should consider putting at the top of their to-do lists for keeping patients safe from technology-related risks."



DH mandates incident reporting

08 Dec 2009

The Department of Health has confirmed that it will end the voluntary system for reporting patient safety incidents to the National Patient Safety Agency.

Instead, it will make it mandatory for all NHS trusts in England, including hospitals, primary care trusts, mental health services and ambulance services to report instances of harm or death to the NPSA.



IT can improve health care and streamline health processes

Decision makers need to think about how digital data can help improve processes, Microsoft executive says

12/7/2009 4:32:00 PM By: Rafael Ruffolo

The best way to prevent wasteful spending and actually improve health care, according to Microsoft Corp.'s (NASDAQ: MSFT) global e-health czar, is to think about technology as a way to streamline health processes.

“Health care organizations are getting so caught up, and in many ways distracted, by the (electronic health records) discussion and are not thinking about the ways in which technologies can be used to transform medical practice,” said Bill Crounse, a medical doctor who is Microsoft's worldwide health senior director.



Turmoil grips NHS IT programme

07 Dec 2009

The future of the National Programme for IT in the NHS has been plunged into doubt after the Chancellor of the Exchequer singled it out as a suitable candidate for cuts.

Speaking ahead of the Pre-Budget Report, Alistair Darling made it clear that he believed there were savings to be made, and bluntly stated that he viewed the programme as expensive and unnecessary. NPfIT “isn't essential to the frontline”, the Chancellor told the Andrew Marr show.



Nurses group to open quality database to researchers

By Joe Carlson / HITS staff writer

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

The American Nurses Association is opening up its database of nursing and quality measures to scientific inquiries in the hopes that the large data set will enable researchers to draw more parallels between nursing and patient outcomes.

The proprietary National Database of Nursing Quality Indicators, or NDNQI, was established 11 years ago and today includes data submitted quarterly by more than 1,500 hospitals. ANA officials said the data are broken down into more than 12,000 individual nursing units, which enables researchers to find specific patterns that would otherwise be obscured by hospital-specific data.



Gov't won't always rule HIT, Blumenthal says

By Jennifer Lubell

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

Private industry, not the federal government, will eventually drive health information technology initiatives, said David Blumenthal, national coordinator for health information technology at HHS, at a policy conference sponsored by the National Committee for Quality Assurance in Washington.



New center at Duke University to focus on healthcare IT

December 04, 2009 | Kyle Hardy, Community Editor

DURHAM, NC – In response to the growing need for specialists in healthcare information technology, Duke University has created the Duke Center for Health Informatics.

The new center will be dedicated to overseeing an interdisciplinary approach to education in healthcare informatics gearing up a new generation of nurses, physicians and healthcare administrators, said Duke officials.



UK group: Facebook flirting 'wholly inappropriate' for doctors

December 7, 2009 — 12:20pm ET | By Neil Versel

It's well known that many physicians are among the 350 million-strong Facebook community, and that more than a few doctors have "friended" patients. It's been documented that physicians can embarrass themselves in such online social forums. We've also heard of patients attempting to discuss clinical information with their doctors via Facebook. So it seems inevitable that some people would use the world's most popular networking site to flirt with their physicians.



Medical imaging moves to the cloud

December 7, 2009 — 2:10pm ET | By Neil Versel

Editor’s Corner

Call it coincidence, or perhaps confirmation of a trend. HealthLeaders Media published a story about web-based PACS just as the massive, annual Radiological Society of North America expo got underway in Chicago.



Monday 7 December 2009, 7:43 PM

NHS spend on IT - How would you make savings?

Posted by Fat Pop Do Wop

So chancellor Alistair Darling may cut back or even scrap the National Program for IT, NPfIT, saying that the expensive system isn't needed right now. A spokesperson for the BMA said that this system is already being used in frontline care, and their comments seemed to show a worrying possibility that removing the NPfIT system could impact on care of patients. The spokesperson went on to add that the Government ought to examine the use of private sector external management consultants before cutting IT systems. The BMA's statement said that it's crucial that clinicians have the tools they need for the job.