ArgusConnect Asks Some Hard Questions. Some Clear Answers as to Intent Would Help!

The following was released by ArgusConnect today – March, 31, 2010

Over 11,000 users and a new Division of General Practice

In March ArgusConnect passed the milestone of more than 11,000 healthcare practitioners using Argus for secure exchange of clinical information.

We were also happy to welcome the Central West Gippsland Division of General Practice (CWGDGP) as the 63rd Division of General Practice to join the Argus Affinity program to promote secure messaging connectivity between health providers.

73% of Argus users are GPs and the rest made up of Specialists, Allied Health practitioners and a range of other healthcare organisations.

Even though the first flush of the eHealth PIP-driven installations has now passed, registrations of practices requesting Argus installation has continued unabated. In 2010, we are still experiencing new site requests at the consistent rate of just under three practices per day with almost equal proportion of these being GPs, Specialists and Allied Health practices.

The high ratio of Specialist and Allied Health practitioners is very gratifying as it confirms our experience that the use of secure messaging is maturing whereby each sector of healthcare is realising increasing benefits and efficiencies from messaging. There is also maturing of user recognition that all users need to contribute towards the expenses incurred in development, installation and support of the messaging solutions that deliver those benefits and efficiencies.

The hard yards in getting GPs, Specialists and Allied Health practitioners to adopt secure messaging and use it for the first time is being put in by companies such as ArgusConnect, Medical Objects, AllTalk and others. In our case we have greatly valued the assistance and contribution made by many dedicated staff in Argus Affinity GP Divisions/Networks across Australia who have not only encouraged take-up by their GPs but also promoted secure clinical communications with Specialists, Allied Health practitioners and hospitals in their areas.

This has been achieved in spite of the fact that across Australia only a very tiny proportion of total Government eHealth expenditure has found its way, largely indirectly, to the messaging vendor industry or to Divisions of General Practice to facilitate implementation of this basic eHealth foundation.

We believe that this all debunks the myth within some parts of eHealth governance that the 'secure messaging industry' is the stumbling block to progress in eHealth. Credit should be given where credit is due and NeHTA, the State Health Departments and the Federal Department of Health and Aging should better recognise and support the contribution made by the messaging vendor industry, the early adopter healthcare practitioners and the sponsor Divisions to pave the way such that those who propose eHealth reform can work in a compliant and more mature environment.

Media contact: Mr Ross Davey, CEO ArgusConnect

ph: 03 6335 2220

em: ross.d@argusconnect.com.au

Obvious questions flow to mind, especially in the light of the apparent plan from NEHTA, recently made public on this blog, to aim to deliberately displace Argus everywhere.

See here:

http://aushealthit.blogspot.com/2010/02/major-trouble-seems-to-be-brewing-in-e.html

Questions include:

"Who is really the bogie man? The messaging industry that has done so much or NEHTA that has delivered so little – at least so far?"

"Why are the State Health Departments trying to harm the present messaging industry with NEHTA and Standards as the 'cover'?"

I know, from discussions with most of the major secure messaging providers, that the alarm expressed by Argus in the way they are being treated is by no means a unique view. It is pretty much a totally shared view.

Everyone in the e-Health sector should be alarmed by this sort of oppressive behaviour from a government funded entity like NEHTA.

David.

A Serial Commenter Who Has Something Important to Say I Believe.

I have seen the following comment, or similar – from someone identified as Louisa – in a couple of comments on various articles relating to e-Health recently .

Louisa writes:

"I think it's very important with any e-health system that it be completely voluntary, and that the patients have complete control over who can see what specific information. When you consider some of the more sensitive information people can have in their medical records, such as:

* incontinence problems;

* sexual dysfunction;

* sexually transmitted diseases;

* sex-change operations;

* plastic surgery;

* therapy notes for mental illness;

* trauma counselling notes after rape or child molestation;

* ambiguous genitalia;

* stigmatised conditions such as HIV or weight-related issues e.g. diabetes;

It's very important that patients can feel like they can trust their doctor enough to confide in them in the first place. They need to be able to tell one doctor about their problem and have that information restricted to just that doctor, and not have it be available to other specialists in completely unrelated fields.

 I would hope that any e-health system will be completely opt-out (or preferably opt-in), and will allow patients the ability to completely lock down certain information, so that it can't be accessed by anyone other than nominated doctors, even in emergency situations. Failure to allow this could lead to people simply not confiding in their doctor in the first place, which obviously could negate any of the health benefits provided by an e-health system.”

There are few others I would add including basically any recorded mental illness, childhood behavioural problems, Hepatitis B & C, a previous abortion and so the list goes on.

If you consider the proportion of the public who have some health information they want to make sure remains under their control you wind up with – over people’s lifetimes – a pretty large slab of the population (doesn’t some form of mental illness strike 30+% of us at some time in our lives?).

There seems to be a cynicism among some so-called ‘experts’ that this concern does not matter – but I would argue that if these issues are not comprehensively and credibly addressed e-Health will just go nowhere. The claims that it is ‘too hard’ or ‘too complicated’ or ‘too expensive’ to implement will see all sorts of initiatives just quietly fail to be adopted and used.

The complexity of a part of this – the demands by workers compensation insurers to access total rather than relevant parts of medical records - is just the tip of an murky and complex iceberg.

See this program from the ABC Law Report this morning (Tues 30 March, 2010).

Protecting privacy

listen now | download audio

Meet Sara (not her real name). She's seeking compensation for injuries sustained in a road accident. The insurer wants access to all her medical records, including those relating to an unconnected sexual assault.

Sara says let the doctors decide what's relevant to her compensation claim and keep irrelevant and intensely private material out of the hands of the insurers.

Her case raises fundamental issues about how we regulate our privacy rights and deal with complaints.

Show Transcript

The link is here:

http://www.abc.net.au/rn/lawreport/stories/2010/2857288.htm

I know the e-Health evangelists find all this frustrating but the lesson is clear as far as I am concerned. Do it properly or not at all!

Thanks Louisa!

David.

The Australian National Health and Hospitals Network - Where Does E-Health Fit? - Draft

The following is a Draft of a Short Paper for a Trade Journal – Comments and critique are welcome!

----- Begin Article

In the report published in early March on the Commonwealth Government’s National Health Reform Plan there were a major set of structural reforms announced.

In brief these are (taken from page 9) of the report the Commonwealth Government:

• becomes the majority funder of public hospitals;
• takes over all funding and policy responsibility for GP and primary health care services;
• dedicates around one third of annual Goods and Services Tax (GST) allocations currently directed to state and territory governments (referred to throughout this document as ‘states’) to fund this change in responsibilities for the health system;
• changes the way hospitals are run, taking control from central bureaucracies and handing it to Local Hospital Networks; and
• changes the way hospitals are funded, by paying Local Hospital Networks directly for each hospital service they provide, rather than by a block grant from the Commonwealth to the states.

As with many such large scale reform proposals the more detailed revelations as to what is actually planned seem not to come in the initial document release and in the case of e-Health the report specifically notes that there are more detailed announcements in this specific area to come.

That Information Technology is an area to be addressed is seen on page 19 where “improved integration of information technology across our health system” was a key element of feedback received from the consultations held following the release of the NHHRC Final Report. This is confirmed in the press release associated with the report’s release where we find the following.

“On the basis of these reforms, over the coming weeks and months, the Government will announce critical additional investments to:

• train more doctors and nurses;
• increase the availability of hospital beds;
• improve GP services; and
• introduce personally-controlled electronic health records.”

As I write this, in late March, 2010, we have seen the additional clinical training announcement but are still waiting for the other three.

The final plan to introduce “personally-controlled electronic health records” is apparently the major thrust of a relatively imminent announcement. Just what these actually are and the implications of this plan are totally unclear at this point.

Before commenting specifically on this proposal we need to flesh out the other aspects of the plan a little. The reform plan talks of small networks of public hospitals of 3-5 or so hospitals. (It is mute on how these will relate to primary care and the private service sector (hospitals, radiology, pathology etc). According to the AIHW there are 736 public hospitals so we can assume that there will be around 170 Local Networks formed.

On the basis that we do not as yet have an e-Health plan announced what needs to be included?

First, any new plan needs to closely review the directions which have been agreed by the States and Territories to date in the form of the National E-Health Strategy which was released late in 2008.

Second any new plan needs to recognise that there are significant ‘facts on the ground’ already in place and in process and these, where appropriate, need to continue on uninterrupted.

Third the plan needs to properly address coordination of care and information flows between all the various elements of the health sector. It needs to be genuinely inclusive of the public, private and community health sectors.

Forth there is a major issue in e-Health regarding just what should be addressed at a national level and what is appropriate for local decision making and governance. My preference here is for a high degree of local autonomy within a pragmatic, flexible and responsive national e-Health standards and governance framework. If this is not addressed the risks of all sorts of failures is very high. Careful decision making will be required to determine the correct scope of national versus local provisioning and infrastructure etc.

Fifth any concept of shared personal health records needs to be deferred until the automation of all public and public care providers, and clinical messaging is well advanced and consistently standardised. Once this is achieved is the time to take the next steps of clinical information sharing with very high levels of consumer consultation around areas such as security and privacy. This is very much a walk before you run, essentially bottom / middle up approach rather than top down in most aspects.

Even with this limited ambition there are a range of problems that will need to be addressed.

An obvious one is that even if the number of local networks is only half of what seems to be planned there are a range of infrastructural elements which will be too small to be efficient and practical. E-Health is very likely in that basket.

A possible solution to address what is needed may be to adapt the Health Information Exchange (HIE) Model which is seemingly being quite successful in the US. In this model primary care computing and care co-ordination is central – empowered by secure information flows, with patient consent, between health care providers.

Appropriate aspects of the information flows can also made available to consumers via clinical portals and a Personal Health Records (PHRs). Everyone needs to realise PHRs are still a very unproven technology and may not actually prove to be all that useful or valuable in the longer term.

Appropriately sized Health Information Exchanges – maybe covering four or five local networks are both feasible and demonstrably effective.

If we do not see a proposal similar to this emerge from the Government in response to the NHHRC report and the National E-Health Strategy I will be very disappointed.

References:

National E-Health Strategy – September, 2008

http://www.health.gov.au/internet/main/publishing.nsf/Content/e-health_strategy_toc

National Health And Hospitals Network Report – March, 2010

http://www.health.gov.au/internet/main/publishing.nsf/Content/nhhn-report/$FILE/NHHN%20-%20Full%20report.pdf

Ministerial Press Release – March 03, 2010

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr038.htm?OpenDocument&yr=2010&mth=3

Primary Care Based Health Information Exchange (see for example).

http://www.healthdatamanagement.com/issues/18_3/247-primary-care-39835-1.html?portal=information_exchange

----- End Article

Thanks in advance for any comments!

David.

Weekly Australian Health IT Links - 28-03-2010.

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. Note also that full access to some links may require site registration or payment.

General Comment:

Things appear to have settled down a little after the utter waste of time we saw with the ‘Great Health Debate’ on Tuesday.

I really think it is just a joke that with an election coming in the next 5-6 months that the Labor Party is playing duck and drakes with releasing the details of its plans for the Health Sector. I fully understand why the States are being a bit hesitant is signing up to the plan when the details are not yet properly out there.

I especially would like to understand just how the proposed Heath Hospital Networks will interact with the Primary Care Sector, Private Hospital Sector and so on.

Of course I would also like to understand how e-Health will fit with all these new plans.

The Labor spokespeople keep saying they have a detailed plan, but I really don’t see significant detail just yet.

Of course we also presently have a substantial vacuum with respect to what the Opposition is planning. I have to say given Tony Abbott has 5 years of experience as Health Minister, I would have expected some decent policy be announced by now, and it needs to come soon.

On another topic it is interesting to see various interest groups coming out with comments in e-Health. It is really important we have an informed debate of all the topics around e-Health before we see too much in the way of legislation enacted. The more discussion and debate the better in my view.

Sadly there do seem to be some commentators who are not all that deeply across the issues they are spruiking. An example is the comment here from the College of Pathologists.

“They cite errors in the labelling of pathology results that have been linked to an estimated 150,000 to 200,000 identification mistakes every year.”

See article below.

Sadly there is no comment I could find on just how many of these ‘labelling errors’ will be fixed with the HI Service. I really struggle to see the linkage and I have to say the level of error in labelling seems to suggest some other major systemic issues. That is really a huge number of mistakes!

------

http://www.smh.com.au/national/security-fears-may-delay-ehealth-patient-identifier-reforms-until-after-election-20100321-qo72.html

Security fears may delay e-health patient identifier reforms until after election

MARK METHERELL

March 22, 2010

A CENTREPIECE of the Rudd government's health reforms - the electronic patient identifier system - is at risk of delay until after the election amid concerns over security and privacy.

To shore up support for the e-health scheme, advocates have compiled dozens of examples of how the patient identifiers would save lives and end long delays in locating patient records for effective treatment.

They cite errors in the labelling of pathology results that have been linked to an estimated 150,000 to 200,000 identification mistakes every year.

The Royal College of Pathologists of Australasia has warned that such mistakes can endanger lives and have called for the urgent use of the identifiers.

-----

http://www.medicalobserver.com.au/index.php/news/hackers-try-to-capture-patient-bank-details

Hackers try to capture patient bank details

2nd Apr 2010

Andrew Bracey

GPs are being warned to remain vigilant in protecting patient files after one Melbourne practice encountered a computer virus that breached its security provisions and attempted to access patient bank details.

Melbourne GP Dr Graeme Baro said despite firewalls and antivirus software, his machines and servers contracted a virus, which had been designed to seek out patient bank details and send them back to a remote source. The virus, however, did not succeed in sending any patient information out of the practice.

“A couple of computers were having trouble with their functions… so our IT person checked and found a lot of viruses in them. We have firewalls to protect us but [viruses like this] can apparently still get in,” Dr Baro told MO. “[I’m told] one of the viruses was trying everything to get the information out – multiple times per second.”

-----

http://www.medicalobserver.com.au/index.php/news/new-standards-must-not-hurt-gps-hip-pockets

New standards must not hurt GPs’ hip pockets

22nd Mar 2010

Shannon McKenzie

NEW practice accreditation standards must not require GPs to invest in expensive new equipment or set tougher e-health criteria, doctors have told the RACGP.

As part of a review of the Standards for General Practice, the RACGP last week released the results of an online member survey, which asked GPs and practice managers how the standards could be improved, and what should or should not appear in the next edition.

-----

http://www.pharmacynews.com.au/article/pharmacy-urges-support-for-e-health-bill/514367.aspx

Pharmacy urges support for e-health Bill

25 March 2010 | by Simone Roberts

The Australian Pharmacy Liaison Forum has called on all sides of politics to support the Rudd Government's controversial Healthcare Identifiers Bill now before Federal Parliament.

The forum, representing the full range of pharmacy education and professional activity in Australia, met in Canberra this week and unanimously expressed support for the passage of the legislation. The legislation allows for unique 16 digit number to be assigned to all health care providers and consumers by the middle of this year.

"Individual healthcare identifiers within a strong privacy framework are vital building blocks to the introduction of national electronic health records," the forum said in a statement released yesterday.

-----

http://www.medicalnewstoday.com/articles/183144.php

College Of GPs Urges Politicians To Deal With Future Of Australia's Healthcare Now

23 Mar 2010

At a time of major health reform debate, the Royal Australian College of General Practitioners (RACGP) is urging Australia's politicians to make e-health and the implementation of a national Healthcare Identifiers Service a priority. Dr Chris Mitchell, RACGP President, said that individual healthcare identifiers and healthcare provider identifiers are the key that will unlock e-health for Australians.

"Without improvements in e-health and medical information management systems we will continue to expose patients to unnecessary risks, including adverse events and medication errors. Major cost saving can be achieved from a reduced number of tests and better management of chronic diseases supported by evidence-based guidelines," Dr Mitchell said.

"Every person in Australia should receive care that is informed by an electronic medical record. The passage of the Healthcare Identifiers Bill 2010 is an essential step to enable e-health innovation and efficiency.

-----

http://www.smh.com.au/technology/technology-news/facebook-linked-to-rise-in-syphilis-20100326-r17y.html

Facebook linked to rise in syphilis

ASHER MOSES

March 26, 2010 - 1:27PM

A British public health expert has blamed Facebook for a resurgence of the sexually-transmitted disease syphilis, but Australian STI researchers have called the claim "far fetched".

Data published by several British newspapers this week indicated that cases of syphilis had increased fourfold in Sunderland, Durham and Teesside - the areas of Britain where Facebook is most popular.

Professor Peter Kelly, director of public health in Teesside, told The Sun newspaper that "social networking sites are making it easier for people to meet up for casual sex".

-----

http://www.ehealthnews.eu/isoft/1985-isoft-wins-two-year-contract-renewal-with-nhs-body

iSOFT wins two-year contract renewal with NHS body worth $9.8 million

Sydney – Tuesday, 23 March 2010 – iSOFT Group Limited (ASX: ISF), Australia's largest listed health information technology company, today announced that NHS Shared Business Services (NHS SBS) has extended its contract for iSOFT Business Solutions to host its Oracle finance and purchasing applications by an additional two years.

This latest contract, worth £6 million ($9.8 million), extends the original $47.8 million agreement, signed in March 2008, to 2016. It expands the services offered and includes new HP hardware and infrastructure and a move to Oracle Release 12. The contract is for services only and excludes licenses.

NHS SBS provides services such as accounts payable, debt collection, bank account reconciliation, and account reporting for 30% of all NHS organisations. iSOFT has provided NHS SBS with a fully hosted managed service since 2002.

-----

http://www.theaustralian.com.au/australian-it/d-haptics-to-help-surgeons-feel-the-cutting-edge/story-e6frgakx-1225843983931

3D haptics to help surgeons feel the cutting edge

• Jennifer Foreshew
• From: The Australian
• March 23, 2010 12:00AM

AUSTRALIAN researchers are developing a universal simulator to bring a realistic sense of touch to simulations for medical procedures, defence and policing.

The simulator is based on force feedback technology, or haptics, which in its simplest form is used in arcade games to give players a sense of touch -- such as feeling the forces when going into a corner in a driving game.

Deakin University robotics engineer James Mullins has been developing the technology with the goal to make a simulation so close to the real thing that it can be used for training purposes.

-----

http://www.theaustralian.com.au/australian-it/hunter-region-trials-intel-home-care-unit/story-e6frgakx-1225843984761

Hunter region trials Intel home-care unit

Karen Dearne

From: The Australian

March 23, 2010 12:00AM

HEART patients in the NSW Hunter region are the first to trial an in-home monitoring system with potential to revolutionise medical care of people living with chronic illness.

Developed by Intel, the Health Guide home-care unit and online support system has been piloted by a private home-care service, Hunter Nursing, and 50 patients with congestive heart failure or chronic obstructive pulmonary disease.

Participants took a daily reading of their own blood pressure using a cuff attached to the device, and the data was automatically sent for review by medical professionals at Hunter Nursing, says director Margaret Scott.

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http://www.computerworld.com.au/slideshow/340728/pictures_intel_monitors_australia_e-health/?eid=-255

In pictures: Intel monitors Australia's e-health

By Georgina Swan

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http://www.theaustralian.com.au/australian-it/health-bill-papers-fall-off-government-websites/story-e6frgakx-1225843980761

Health bill papers `fall off' government websites

• Karen Dearne
• From: The Australian
• March 23, 2010 12:00AM

COMPUTER glitches on two government websites were blamed for key documents on the controversial Healthcare Identifiers Bill going walkabout last week.

Last Tuesday, following revelations in The Australian that Medicare Australia had provided the Senate inquiry on the HI bill with new details on suspected staff snooping, the document detailing data privacy breaches disappeared from the Senate Community Affairs committee website. Also missing were three National E-Health Transition Authority responses, posted the previous day, to questions on notice from the Senate inquiry.

The committee secretary said computer glitches had caused some documents to "fall off" the page for most of Tuesday.

-----

http://www.6minutes.com.au/articles/z1/view.asp?id=514136

Benzo use not affected by e-intervention

by Jared Reed

The move towards e-health is ramping up but when it comes to notifications about medicines and prescribing habits, it seems GPs might be suffering from alert fatigue, or they place a higher trust in their own clinical judgement.

Over a six-month period, Queensland researchers emailed GPs, nurses and pharmacists three fact sheets about benzodiazepines, with the aim of decreasing their use in aged care facilities towards “more appropriate” prescribing.

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http://www.theaustralian.com.au/business/rudd-roasts-conroy-over-the-national-broadband-report/story-e6frg8zx-1225843475077

Rudd roasts Conroy over the national broadband report

• Malcolm Colless
• From: The Australian
• March 22, 2010 12:00AM

KEVIN Rudd is believed to have told Communications Minister Stephen Conroy to come up with a strategy within two weeks to take the heat out of the political crisis building up around the government's $43 billion national broadband project.

Canberra sources said the directive followed a "difficult" meeting between Rudd and Conroy after the Prime Minister was shown a copy of the controversial $25 million implementation study into the development of the national broadband network.

Conroy has dismissed Senate demands to table the 500-page report prepared by KPMG and McKinsey & Co, arguing that he intends to discuss its findings with cabinet colleagues first.

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http://www.smh.com.au/technology/technology-news/conroys-internet-censorship-agenda-slammed-by-tech-giants-20100323-qt83.html

Conroy's internet censorship agenda slammed by tech giants

ASHER MOSES

March 23, 2010 - 4:38PM

Australia's biggest technology companies, communications academics and many lobby groups have delivered a withering critique of the government's plans to censor the internet.

The government today published most of the 174 submissions it received relating to improving the transparency and accountability measures of its internet filtering policy.

Legislation to force ISPs to implement the policy is expected to be introduced within weeks. The filters will block a blacklist of "refused classification" websites for all Australians on a mandatory basis.

-----

Enjoy!

David.

A Bit of a Landmark Passed. 250,000 Page Views!

The following are the statistics for the blog so far – since March 2006.

Thanks to everyone who has made this happen!

Australian Health Information Technology

VISITS

Total 147,354

Average Per Day 247

Average Visit Length 3:12 mins

Last Hour 12

Today 257

This Week 1,730

PAGE VIEWS

Total 250,099

Average Per Day 432

Average Per Visit 1.7

Last Hour 26

Today 578

This Week3,027

I reckon a quarter of a million page views is starting to be useful!

What is needed now is content that is richer than I can provide alone. Thus those who know what they are talking about (including NEHTA but excluding the PR Department) are encouraged to see if they want a guest slot to have their say. You will reach a reasonable audience if you do, and I want to foster open debate and discussion!

Think about it!

David.

The Blog Has A New Look

I have just been trying the experimental advanced blog template designer and have come up with a format I think is easier to read and so on.

Comments please as this is a work in progress.

David.

AusHealthIT Man Poll Number 13 – Results - 26 March, 2010

The question was:

How Happy Are You With the Senate Inquiry Recommendation To Just Pass the HI Service Bills?

Thrilled

- 14 (34%)

Happy

- 8 (19%)

Bit Concerned

- 6 (14%)

Wrong Thing to Do

- 13 (31%)

Votes 41.

Comment:

Well, that is pretty unclear. Almost a split vote (53% to 46%). This means there are more than a few that are not happy with what NEHTA and DoHA are trying to railroad through. They ignore this substantial body of concern at their peril!

Thanks again to all who voted.

David.

Weekly Overseas Health IT Links 23-03-2010.

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. Note also that full access to some links may require site registration or payment.

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http://www.fierceemr.com/story/study-e-prescribing-greatly-improves-accuracy-less-so-safety/2010-03-18?utm_medium=nl&utm_source=internal

Study: E-prescribing greatly improves accuracy, less so for safety

March 18, 2010 — 11:53am ET | By Neil Versel

It's a small study group, but the results are eye-opening nonetheless: Primary-care practices cut their prescription error rates from 42.5 percent to 6.6 percent in a one-year period by adopting e-prescribing technology.

That's the finding of researchers at Weill Cornell Medical College in New York City, as reported in the Journal of General Internal Medicine, who studied the prescribing accuracy of 12 primary-care practices in New York state. Six of the practices wrote prescriptions electronically, resulting in the major reduction in errors, while the half-dozen practices in the control group that stuck with paper prescription pads had a small uptick in their error rate, from 37 percent to 38 percent.

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http://www.modernhealthcare.com/article/20100319/NEWS/303199990

Broadband plan aims to improve HIT infrastructure

By Shawn Rhea / HITS staff writer

Posted: March 19, 2010 - 11:00 am ET

The Federal Communications Commission has laid out an ambitious 10-year plan for drastically improving broadband connectivity and usage that, among other goals, aims to improve healthcare delivery, patient outcomes and control medical costs nationwide.

In a chapter dedicated to healthcare information technology infrastructure and usage, the National Broadband Plan offered 11 recommendations for how the government could incentivize healthcare providers' use of e-care technology, which FCC officials estimated would save the country $700 billion over the next 20 years. The recommendations include reimbursement incentives that pay providers for adoption and use of e-care services, such as remote diabetes monitoring and mobile medical applications, that are proven to improve patient outcomes and save money. The agency also proposes setting up a dedicated healthcare broadband access fund that would help providers pay for broadband services in areas where connectivity is more expensive because of a dearth of available service providers.

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http://www.modernhealthcare.com/article/20100318/NEWS/303189990

Letter tells CMS to set more specific EHR goals

By Jennifer Lubell / HITS staff writer

Posted: March 18, 2010 - 11:00 am ET

To successfully implement the broad use of electronic health records, the CMS needs to make its health goals and targets more explicit, according to public comments submitted by healthcare leaders from 56 organizations on the agency's meaningful-use rule.

The Markle Foundation, the Center for American Progress and the Engelberg Center for Health Care Reform at Brookings were the three organizations that coordinated these comments and submitted them to the CMS in response to several rules governing meaningful use and certification of EHRs.

The rulemaking originated from the American Recovery and Reinvestment Act of 2009, also known as the stimulus law, which provided billions of dollars in federal subsidy payments to hospitals and office-based physicians for the purchase of EHR systems. HHS plans to administer the new subsidies beginning in 2011.

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http://www.computerweekly.com/blogs/tony_collins/2010/03/catering-staff-given-access-to.html

Catering staff given access to electronic health records

The Irish Independent says that catering staff were able to access confidential patient information held on a £54m health service record system which is being rolled out across Ireland.

The disclosure, under the Freedom of Information Act, has implications for the roll-out of Summary Care Records in England, as part of the NHS IT programme, NPfIT.

Smartcards for access to the Summary Card Records and other NPfIT systems are issued on the basis of "role-based" access. The idea is that only those staff with a legitimate professional relationship with the patient can use their smartcards to access that patient's records.

But local operational procedures may require that secretaries and reception staff who collect information on patients have smartcards.

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http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=217715

Getting Physicians and Patients Connected

The EHR rollout process has been a gradual - and successful - one for Kaiser Permanente.

By Mark McGraw

It's no secret that the concept of electronic health records (EHRs) hasn't been universally embraced throughout the physician community.

Despite the inevitable move to a digital health care environment, some doctors are holding on to the idea that EHRs will bog down their practices, limit the number of patients they see each day and depersonalize the doctor/patient relationship.

The findings of a recent Nuance Healthcare Solutions survey echo those concerns. The poll of nearly 1,000 physicians found that 96 percent of respondents expressed fear "about losing the unique patient story with the transition to point-and-click (template-driven) EHRs."

The survey also found that 93 percent of doctors "disagree" or "strongly disagree" that using an EHR has reduced time spent documenting care.

It's unlikely that many physicians at Kaiser Permanente share those sentiments, however, at least according to Jack Cochran, MD, executive director of The Permanente Federation, the national umbrella organization for the regional Permanente Medical Groups.

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http://www.healthleadersmedia.com/content/TEC-248084/AHA-Recommends-Changes-to-EHR-Standards-Implementation.html

AHA Recommends Changes to EHR Standards, Implementation

Andrea Kraynak, for HealthLeaders Media, March 16, 2010

Adding its voice to the EHR standards debate, the American Hospital Association asked for changes to proposed EHR standards, implementation, and certification.

The AHA sent its recommendations and comments regarding the interim final rule specifying the initial set of standards, implementation specifications, and certification criteria for EHR technology to the National Coordinator for Health IT in a March 15 letter.

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http://www.healthleadersmedia.com/content/MAG-247660/Hospitals-as-Software-Service-Providers.html

Hospitals as Software Service Providers

Health systems are stepping into a new role, offering software as a service to realize value from EMRs.

It's no secret that small physician groups and community hospitals are going to be hard-pressed to meet the meaningful use requirements in 2011. Not only do they lack resources—financial and workforce—to purchase, implement, maintain, and use these systems effectively, but their options for electronic medical record products are limited, as well. Many of the vendors that support smaller hospitals began by offering financial systems and now are adding the clinical components to those systems.

There are approximately 4,000 hospitals with fewer than 250 beds, and the products for those hospitals will take a lot of heavy lifting to get them certified for meaningful use, says Chuck Podesta, senior vice president and chief information officer at Fletcher Allen Health Care, a 562-licensed-bed academic medical center in Burlington, VT. "These smaller systems don't have a good clinical track record—especially with computerized physician order entry," he says.

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http://www.kaiserhealthnews.org/Daily-Reports/2010/March/17/Health-IT.aspx

Device Manages Care Online For Chronic Disease Patients

Mar 17, 2010

The Cleveland Plain Dealer: A pilot project at the Cleveland Clinic that monitored 250 patients with chronic diseases showed patients were able to increase the number of days between visits. The study used a medical device that shared daily patient data online with doctors and nurses and found that patients better managed their care using the system.

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http://www.sacbee.com/2010/03/16/2609490/sutter-hospitals-to-invest-in.html

Sutter hospitals to invest in electronic health records system

bcalvan@sacbee.com

Published Tuesday, Mar. 16, 2010

Sutter Health said Monday it will push forward with converting to electronic health records at its hospitals after delaying the project to save money during the recession.

The health system expects to spend $400 million over the next five years to expand its digital medical system, with Sutter Medical Center going online in 2013, when expansion of its 28th Street campus is complete.

While the economy is still very unpredictable, the hospital system will go forward with the project, said Pat Fry, the chief executive officer for Sutter Health.

"There's never going to be a great time, so let's give the value to our patients as quick as we can," Fry said.

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http://www.ehiprimarycare.com/news/5736/scots_gps_say_paper_should_guide_portals

Scots GPs say paper should guide portals

16 Mar 2010

GPs in Scotland have demanded that a series of security measures are introduced to protect patient confidentiality when their records are accessed electronically.

Last week’s Scottish Local Medical Committees’ conference heard that GPs are coming under increasing pressure to share information from their records with the introduction of clinical portals across Scotland.

However, GPs agreed that secondary care clinicians should not have access to the whole of the GP record. Instead, they agreed that only information that would normally be shared on paper should be available to them electronically.

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http://www.ehiprimarycare.com/news/5723/scots_mps_criticise_slow_progress_on_it

Scots MPs criticise slow progress on IT

11 Mar 2010

The Scottish Parliament's Health and Sport Committee has criticised the Scottish Government for the slow roll-out of its clinical portal and limited progress on telehealth.

In a two part report, ‘Clinical portal and telehealth development in NHS Scotland,’ the committee praises several Scottish health boards for developing clinical portal projects to enable greater access to patient information.

However, it says that: “The committee is disappointed that, given the differing states of readiness of various portal systems, clear timescales have yet to be established for the development of portal technology across Scotland.”

It also calls for the Clinical Change Leadership Group and the Clinical Portal Programme Board to work closely with the Scottish Academic and Research Community to design “a nationwide portal infrastructure.”

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http://www.telegraph.co.uk/health/healthnews/7408379/Patients-medical-records-go-online-without-consent.html

Patients' medical records go online without consent

Patients’ confidential medical records are being placed on a controversial NHS database without their knowledge, doctors’ leaders have warned.

By Kate Devlin, Medical Correspondent

Published: 10:20PM GMT 09 Mar 2010

At present 1.29 million people have had their details placed on the system. A further 8.9 million records are due to be added by June

Those who do not wish to have their details on the £11 billion computer system are supposed to be able to opt out by informing health authorities.

But doctors have accused the Government of rushing the project through, meaning that patients have had their details uploaded to the database before they have had a chance to object.

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http://www.guardian.co.uk/society/2010/mar/07/nhs-database-doctors-warning

NHS database raises privacy fears, say doctors

GPs say patients' rights are being overlooked

Doctors' leaders are warning government ministers that the NHS is jeopardising its relationship of trust with patients by creating a vast database of personal medical records. GPs say they fear patients' rights are being overlooked, that "scaremongering" is being used to get people's agreement for the database, and that hackers could illegally access the central computer.

The NHS wants more than 50 million people in England to agree to the creation of an individual summary care record (SCR). The idea is to improve the quality and safety of treatment provided by hospital staff and out-of-hours doctors by giving them access to information usually only held by a patient's doctor.

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http://www.modernhealthcare.com/article/20100316/NEWS/303169990

Doc, hospital groups press CMS on meaningful use

By Andis Robeznieks / HITS staff writer

Posted: March 16, 2010 - 11:00 am ET

To facilitate meaningful use of electronic health records, the CMS should abandon its all-or-nothing approach to awarding financial incentives, eliminate goals and measures that don't directly apply to EHR adoption, and widen the eligibility for certain hospital-based physicians, according to a letter sent to acting CMS Administrator Charlene Frizzera. The letter was signed by the American Medical Association and 95 other state and specialty medical societies.

The 37-page letter stated that “physicians are deeply supportive and committed to incorporating well-developed EHRs into their practices,” but the “aggressive” criteria included in the proposed requirements for federal EHR-investment subsidies will deter many physicians from participating in the incentive program, which was included in the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.
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http://www.healthleadersmedia.com/content/TEC-248027/ComputerControlled-Pancreas-Could-Close-the-Diabetes-Loop.html

Computer-Controlled Pancreas Could Close the Diabetes Loop

Gienna Shaw, for HealthLeaders Media, March 16, 2010

Aaron Kowalski is the vice president for glucose control research at the Juvenile Diabetes Research Foundation. He also has type 1 diabetes and, like many others who have the condition, he sometimes struggles to regulate his blood sugar levels.

"I'm a scientist and I work in the field and I don't achieve perfect glucose control," he says.

In that he is not alone: Some studies have found that even highly-managed diabetes—those who test their blood sugar more than eight times a day, still spend almost 70% of their day out of normal blood ranges—an average of more than eight hours with high blood sugar levels and two hours with low.

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http://ehealtheurope.net/news/5735/ehtel_calls_for_local_action

EHTEL calls for local action

16 Mar 2010

The European Health Telematics Association has called for more regional and local level approaches to eHealth across Europe.

Speaking to E-Health Europe at the World of Health IT conference and exhibition in Barcelona, a spokesperson for the non profit organisation, said that eHealth needs to be done from the bottom-up.

The spokesperson said: “We need to look at the level that we can start doing real things with eHealth and that is at regional level.

"It isn’t at member state because it’s too big. It can only be at regional or below because otherwise there are too many people and it’s too complex.”

The organisation’s comments come ahead of its board meeting and coincided with the signing of a declaration by European eHealth ministers.

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http://ehealtheurope.net/news/5734/eu_ministers_sign_ehealth_declaration

EU ministers sign ehealth declaration

15 Mar 2010

European Union health ministers have signed a declaration that recognises the strategic value of eHealth and commits to greater collaboration across Europe.

The declaration was signed at the high-level ministerial conference on eHealth in Barcelona, which is part of the World of Health IT conference being held this week.

It was driven the Spanish presidency of the EU, which wants eHeath to be an integrated part of European policies.

As part of the declaration, the ministers responsible for eHealth said that they recognised the “importance of fully integrating digital healthcare into the European policy portfolio and the development of the post 2010 European strategy.”

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http://ehealtheurope.net/news/5746/ec_urges_bigger_thinking_in_ehealth

EC urges bigger thinking in eHealth

17 Mar 2010

The European Commission has called for a change in the "mentality" that leads to thousands of small scale pilots being run in eHealth.

Speaking in Barcelona, at the World of Health IT conference and exhibition, Zoran Stančič, deputy director general of the European Commission’s DG INFSO, said that while the Commission is committed to support for eHealth in the future, smaller pilots need to be stopped.

Stančič said: “We need to think in terms of new mechanisms and instruments to foster innovation and deployment rather than just relying on small pilots. In order to do this, we need the strong political commitment, which has to be driven by deployment and a clear leader framework.

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http://www.govhealthit.com/newsitem.aspx?nid=73314

FCC broadband plan targets e-health expansion

By Brian Robinson

Tuesday, March 16, 2010

The Federal Communications Commission formally adopted and forwarded to Congress a plan to significantly upgrade U.S. broadband connections that could greatly boost the adoption rate of health IT.

The National Broadband Plan was mandated by the 2009 American Recovery and Reinvestment Plan, and is the result of an unprecedented level of public workshops, hearings and online interaction. The process to get to the plan generated some 75,000 pages of public comment.

The health care chapter of the plan (http://www.broadband.gov/plan/10-healthcare/) includes substantial changes to the FCC’s existing Rural Health Care Program, which already funds some broadband improvements. It has authorized funding of $400 million a year, but only a fraction of that is actually used.

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http://edition.cnn.com/2010/HEALTH/03/15/bronx.clinic.iris.scan/index.html?hpt=C1

At Bronx clinic, the eyes are windows to medical records

By Madison Park, CNN

STORY HIGHLIGHTS

• Bronx clinic uses iris scanners to identify patient to his/her medical records
• Clinic serves needy and had trouble with duplicative names
• Clinic has cut down on duplicating records and prevent medical frauds

(CNN) -- Rafael Fernandez walks into the Bronx, New York, medical clinic, with his eyes wide open.

Checking Fernandez in, a clinic employee scans his eyes using a handheld camera. Within seconds, the camera reads his iris patterns, and a computer locates his medical record.

Such iris identification technology is usually seen in international airports to allow registered passengers to fast-track through passport checks and immigration.

But far from the sleek European airports, the South Bronx clinic that receives federal funding and operates in one of the most impoverished U.S. areas uses the instruments to prevent medical record mishaps.

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http://www.modernhealthcare.com/article/20100315/NEWS/303159930

Patient safety must start in classroom: report

By Andis Robeznieks / HITS staff writer

Posted: March 15, 2010 - 11:00 am ET

Healthcare delivery continues to be unsafe and will probably remain that way for some time unless medical schools make substantial improvements in how they teach patient safety, according to Unmet Needs: Teaching Physicians to Provide Safe Patient Care, a new report issued by the National Patient Safety Foundation's Lucian Leape Institute.

The report charges that medical schools do an inadequate job of developing student understanding of concepts such as systems thinking, problem analysis and team collaboration that will help them become architects of patient-safety and quality improvement efforts.

Information technology does not get mentioned much in the report, but its importance is noted.

“They must realize the value of information technology in helping them deliver up-to-date, evidence-based care, and be able to use information technology tools to find pertinent literature, review guidelines, calculate patient risk factors, and apply clinical pathways,” the report states in a section that talks about doctors being life-long learners.
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http://www.modernhealthcare.com/article/20100315/NEWS/303159916

Group develops guidelines for CPOE standards

By Shawn Rhea

Posted: March 15, 2010 - 5:59 am ET

The Institute for Safe Medication Practices has developed a set of guidelines aimed at helping providers create drug-prescribing standards for their computerized physician order entry systems.

The guidelines, according to a news release, will address drug-safety problems that hospitals and other providers often encounter. They will allow providers to set well-defined prescribing standards for common patient conditions.

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http://govhealthit.com/newsitem.aspx?nid=73262

It’s official: Hampton Roads is next VLER community

By Peter Buxbaum

Tuesday, March 09, 2010

The Department of Veterans Affairs and the Department of Defense yesterday officially inaugurated Hampton Roads, Va., a nexus of veterans and active-duty military as well as government and purchased healthcare providers, as the next site of its Virtual Lifetime Electronic Record (VLER) community pilot project.

The Virginia project will bring together DoD, VA, and commercial healthcare providers Sentara Healthcare, Riverside Health System and Bon Secours Medical Group.

The new project, dubbed “Phase 1b” of VLER by its government sponsors, follows on Phase 1a, a San Diego, Calif.-based project began last year to test the exchange of electronic health records between the VA and the private Kaiser Permanente health network.

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http://www.healthimaging.com/index.php?option=com_articles&view=article&id=21190&division=hiit&division=hiit

HIMSS: HMS launches HMS Connex, showcase ambulatory EHR

Healthcare company Healthcare Management Systems (HMS) revealed its new interoperability product HMS Connex at the 2010 annual HIMSS conference in Atlanta. HMS Connex will enable the exchange of clinical data between third party systems, health information exchanges and public registries while assisting in qualifying for the American Recovery and Reinvestment Act (ARRA) of 2009 HITECH stimulus funds, according to the company.

Built around IT company Mirth’s open source technology platform and customized for the HMS product suite, HMS Connex is designed to help customers achieve Stage 1 meaningful use interoperability requirements; specifically reporting hospital quality measures to CMS, exchanging key clinical information among providers of care, submitting lab results to public health agencies and submitting data to immunization registries, according to HMS, of Nashville.

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http://govhealthit.com/newsitem.aspx?nid=73304

HHS group proposes national EHR safety database

By Mary Mosquera

Friday, March 12, 2010

A Health and Human Services advisory panel today proposed creating a national database into which clinicians could report patient data errors and unsafe conditions they encountered in their use of electronic health records.

Clinicians could use the system to report instances – noticeably inaccurate patient data or an EHR technical glitch, for instance – that they believed might compromise patient safety.

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http://www.healthcareitnews.com/news/five-features-missing-most-ehrs

Five features missing from most EHRs

March 12, 2010 | Nancy McCallum, Contributing Writer

While EHRs are increasingly essential for healthcare providers, their efficacy can be constricted by the nature of their design, their use and the interpretation of data.

Jerry Buchanan, Program Manager and Scrum Master at eMids Technologies, Inc., an IT and BPO consulting company, weighs in on some features that are missing from EHRs:

1. Information, not data

While EHRs hold data, that's not the same as holding information, Buchanan notes. Data needs to be converted into relevant information to be of practical use. However, there's also the possibility that EHRs can get overloaded with information. The goal, Buchanan says, is technology that organizes data in a way that assists healthcare providers most efficiently and effectively in making clinical decisions. This includes EHRs capable of providing alerts and alarms about patient conditions, given to caregivers in real time.

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http://www.ihealthbeat.org/features/2010/defining-moment-for-health-information-exchange-in-california.aspx

Monday, March 15, 2010

'Defining Moment' for Health Information Exchange in California

by George Lauer, iHealthBeat Features Editor

California achieved two major milestones last week on its march toward a digital future in health care.

On Monday, state officials unveiled a new private organization to fit the state's needs to manage California's health information exchange.

On Thursday, that new organization -- Cal eConnect -- had something of a coming-out party with stakeholders from all over the state and from all parts of the health care industry convening to discuss strategic and operational plans.

"This is a defining moment for California in many ways," said Jonah Frohlich, deputy secretary for health IT at California's Health and Human Services Agency and principal architect of the new not-for-profit.

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Enjoy!

David.