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."

Monday, May 31, 2010

Weekly Australian Health IT Links - 31-05-2010.

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:

The most fun we are going to have in the near future is coming up with Senate Estimates as mentioned in a blog a day or so ago. See here:


I am hoping that we will get some clarity from these sessions as to just what the Government is planning for the e-Health space.

Other than this anticipated future fun there is of course just the ongoing concern about just how well the implementation of the larger health reform agenda is going.

I note the drip feed of announcements is continuing with the announcement of another $58M to support so called clinical leadership groups.


PM flags leadership groups for hospitals


May 28, 2010 - 6:09PM


Prime Minister Kevin Rudd has pledged more funding for the federal government's health reform program, after fronting the nation's largest doctors group.

Speaking at the Australian Medical Association (AMA) annual conference on Friday, Mr Rudd promised an additional $58 million to create lead clinician groups to guide local hospital networks.

The move was welcomed by the AMA, with President Dr Andrew Pesce saying it meant doctors would have a stronger voice in the management of public hospitals.

----- End Extract.

Why wasn’t the need for this discovered during the policy development and consultation process?

Why is it we keep having this drip feed rather than a coherent and planned policy? One really wonders about the quality of the policy formation process in DoHA if this keeps happening – and who knows what the same problem might cause with e-Health?

Just another minor gripe. Why is it that we keep getting press releases saying a solution to some major problem has been found (e.g. the CSIRO / SNOMED releases below) when whatever is being promoted is only a small part of the solution? Overhyping such information does nothing for credibility and public understanding!



E-health reforms demand proper chief

Australia’s urgent need for a chief to drive e-health reforms was highlighted today, by the chief information officer of Singapore’s Ministry of Health Holdings who is driving a ten year investment strategy for the nation costed at up to S$1.5 billion.

Speaking about Singapore’s move toward an electronic health record Dr Sarah Muttitt told a packed session at CeBIT today that such reforms; “Clearly need someone at the helm to influence the decisions...and try to do master IT planning.”While Muttitt was speaking about progress in Singapore her remarks would resonate for many locals who are still wondering who is in charge of e-health here.

Many consider NEHTA – the national health transition authority – led by Peter Fleming and chaired by David Gonski as the natural candidate, but it would need its mandate expanded and more clout. At present the organisation has been focussed on developing health identifier numbers for the national e health record, and acting as a form of clearing house for discussions on e-health governance, standards and the like.

Comment: What a silly suggestion – where is the evidence of capable leadership from NEHTA?



CeBIT opens with Gonski innovation plea

IT Industry - Market

David Gonski, chairman of Investec and also the chairman of the National e-Health Transition Authority, gave the keynote at this morning’s opening of CeBIT in Sydney, with an impassioned plea for the nation to lift its game in terms of innovation.

CeBIT Australia 2010, which has brought together 500 companies to showcase their wares, and organisers hoping they can attract more than 35,000 attendees, was officially opened by NSW premier Kristina Keneally. While the focus of the exhibition is innovation in ICT and the way that is leveraged by business and government, Gonski lamented Australia’s relatively poor international innovation ranking.He called for continued investment in infrastructure in Australia – particularly in the area of the national broadband network and an e-health network. Although the Opposition has in recent days pledged to dismantle these and the Digital Education Revolution investment of the Rudd Government, Gonski said that “In my role as the chair of NEHTA I am acutely aware of the NBN and what an e-heath strategy could achieve.”

Comment: Pity David Gonski is not aware we already have one! Jinx even.



E-Health system raises privacy concerns

24 May 2010 No Comment

A recent boost in federal funding for a shared e-Health report system has re-opened the debate about the protection of patient medical records. Alberto De Angelis reports.

CeBit Australia, the annual global business conference begins today at the Sydney Convention and Exhibition Centre and will be running e-Health workshops and conference to discuss the potential for a nationalhealth record database.

The Federal Government’s $467 million push for the establishment and implementation of an e-Health system however, has raised questions over the protection and control patients will have over their medical records.

The database would allow the health details of voluntarily registered users to be viewed and added to, by registered healthcare providers.

However, while the sharing of healthcare records is voluntary, every person who is in the database will still be issued a healthcare identifier.

These identifiers are numbers that not only link an individual to their health records, if they have volunteered to do so, but also personal information such as name, gender and date of birth.

Dr Chris Mount, acting assistant secretary of the e-Health branch of the Department of Health and Ageing confirmed the automatic assignment of identifier numbers at a privacy forum last week.



Patient data under threat, say auditors

May 25, 2010

FEDERAL government auditors have overruled Medicare, calling on the agency to improve security of patient details held by pharmacists.

Patient information on the 2o0 million prescriptions pharmacists dispense each year are largely electronically held, which the Auditor-General, Ian McPhee, says ''continues to be an area of growing threats''.

In an audit report on the administration of the Pharmaceutical Benefits Scheme released yesterday, Mr McPhee revealed a long-running turf war among three health agencies over responsibility for the PBS.



Patients key to nurse national e-health

By Darren Pauli, Computerworld Australia

May 26, 2010 10:53 AM ET

Health experts have warned that Australia's national $466.7 million e-health records system is being rushed and lacks a consumer focus.

Industry pundits from Australian health services joined representatives from the UK National Health Service (NHS) and the Singapore Ministry of Health at the CeBIT 2010 conference in Sydney today in proposing the Federal Government should engage consumers before deploying its e-health initiative.

NHS "Connecting for Health" clinical architect, Dr Mike Bainbridge, said the government needs to engage consumers now about how e-health should be deployed.

"You have to move now to engage citizens," Dr Bainbridge said. "You don't have the luxury of 7 years of mistakes like we did."



CeBIT 2010: Barcodes pushed for national medicine recalls

National medicines body looks to implement national barcoding system to ensure recall compliance

The Therapeutic Goods Administration (TGA) may introduce a new barcode-based product recall notification system as early as June next year, according to the company that built it.

The new system will be based on a global product database created by not-for-profit organisation, GS1, which is also used in sectors ranging from grocery and retail to transport and defence supply chain management.

According to GS1 Australia's chief executive officer, Maria Palazzolo, the RecallNet system would ensure compliance among individual healthcare providers for pharmaceutical and medical goods.



Officials nervous over Morecambe Bay's planned go-live

By Tony Collins on May 27, 2010 10:58 AM

NHS staff and executives at University Hospitals of Morecambe Bay NHS Trust are planning for an important go-live of iSoft's Lorenzo system this Bank Holiday weekend.

A spokeswoman for the Trust said this morning (27 May 2010) that she was unaware that any definite decision for a go-live had yet been taken, but all the signs are that the Trust wants it to happen this weekend.

Not all officials at Richmond House, the headquarters of the Department of Health, share Morecambe Bay's conviction that a go-live this weekend is a good idea.



Mentally ill turn to e-therapy


May 30, 2010

MENTALLY ill Australians are increasingly being diagnosed and treated online in virtual psychiatric clinics, without ever seeing a doctor.

Patients suffering from depression, anxiety and post-traumatic stress disorder are being assessed by computer and given ''e-prescriptions'' for online counselling courses instead of medication or treatment sessions with a psychologist or psychiatrist. Doctors who provide e-therapy say it produces better results than face-to-face treatment but at a fraction of the cost.

Private appointments with mental health specialists cost an average of $100 an hour.

With e-therapy, patients are clinically diagnosed after completing psychiatric reviews by answering online questions. They then have the option to enrol in a free electronic self-help treatment program or receive assistance from an online therapist at limited cost.



Coalition claims commitment to e-health, despite plan to axe e-records

24th May 2010


THE federal Opposition says it believes in electronic health records - even though it's promised to reverse Labor's decision to introduce them by mid-2012 if elected to government.

Earlier this week, the Coalition announced it would "abolish individual electronic health records" as a way of saving $467 million over the next two years.

The announcement drew criticism from health experts, and from the Government, which took the opportunity to underline that in 2007, then Health Minister Tony Abbott said “failure to establish an electronic patient record system within five years... would be an indictment against everyone in the system”. (Abbott attracts criticism for plan to axe e-health program, MO 21 May)



Crisis meeting over Qld Health payroll software

Queensland nurses are to hold an urgent meeting with health authorities at the state's Industrial Relations Commission (QIRC) on Thursday.



QLD Health must stop system docking pay

By Josh Taylor, ZDNet.com.au on May 28th, 2010

The Queensland Industrial Relations Commission (QIRC) has ordered Queensland Health to stop making unauthorised deductions from employees' pay, as troubles with the roll-out of the agency's new payroll system continue.

The Queensland Nurses Union (QNU) summoned Queensland Health to a meeting at the QIRC yesterday to address member concerns that the SAP-based payroll system had been making deductions from employees it incorrectly deemed to have over-paid.

Employees who had been underpaid using the payroll had been given ad-hoc payments. The system had taken these ad-hoc payments as overpayments above the normal wage, and had deducted that amount from the employee's next pay cheque.



e-health experts fan hospital waiting list style rage

To properly engage Australians in the e-health debate, it has to become an issue as significant to voters as hospital waiting lists, according to experts in the field speaking at CeBIT today.

During a panel session bringing together international experts on e-health, Mary Foley the national health practice leader for PricewaterhouseCoopers, said that although its recent surveys had found that 36 per cent of Australians supported having an electronic file containing their health records in a doctor’s office or hospital , and 30 per cent would like web based access to those records, the e-health sector was guilty of largely speaking to itself rather than the broader community.

She suggested electronic health records had to become as important an issue to the community as were hospital waiting lists in order to really engage health care consumers or patients.



Opposition to address e-health privacy

  • Karen Dearne
  • From: Australian IT
  • May 25, 2010 5:19PM

THE federal Opposition plans to tighten up aspects of the controversial Healthcare Identifiers Bill before debate in the Senate next month.

Coalition spokesman for regional health services Andrew Southcott said while supporting the Bill's intent, a number of amendments aimed at greater parliamentary oversight would strengthen protections for patients.

"In particular, the Bill as it stands continues to raise concerns about privacy and the possibility of function creep," Mr Southcott said in a statement.



E-health the 'right thing' to do: expert

  • Andrew Colley
  • From: Australian IT
  • May 25, 2010 4:42PM

THE economic arguments for rolling out tele-health services in Australia maybe tough to prove, a US e-health expert has warned.

Robert Bosch Healthcare business development director Suneel Ratan today warned that the economics of rolling out tele-health were strongest in the US where healthcare costs were high relative to other markets.

Mr Ratan was commenting on RBH's experience providing healthcare services for the US Department of Veteran Affairs at the CeBIT technology conference in Sydney.



'E-health needs a lot of work to become reality'

NEW e-health initiatives to connect patients with doctors won't work because of a lack of infrastructure, experts say.

Health and IT experts at the CeBIT expo in Sydney yesterday met to discuss the need for tele-health initiatives such as video conferencing to take pressure off the current Australian health system.

Brendan Lovelock, health practice Head at Cisco Systems, said Australia’s current health system was not sustainable for the future.

"There are not, and will not be, sufficient resources to meet our expectations of care in Australia," Mr Lovelock said.



Australia not ready for e-Health

25 May 2010 One Comment

By Alice Downey | Health Editor

New E-Health initiatives to connect patients with doctors won’t work because of a lack of infrastructure, experts said at the CeBit Conference in Sydney yesterday.

One of these initiatives is the implementation of Tele-Health practices such as video conferencing to take pressure off the current Australian health system.

Brendan Lovelock, the Health Practice Head at Cisco Systems, says Australia’s current health system is not sustainable for the future.



Web portal Warrior Gateway helps digital-age vets


May 24, 2010

For young veterans returning from duty in Iraq or Afghanistan, the process of re-entering society can be daunting, especially if they have been injured or have struggled with mental health problems.

A new, free Web portal wants to help these warriors find the services they need in an environment they are comfortable in: the Internet.

Warrior Gateway is designed with Google Inc. and social media in mind to make its intended audience as comfortable as possible. Veterans returning from Iraq and Afghanistan, generally in their mid-20s, grew up with e-mail, keep in touch using Facebook and are familiar with online communities that stretch across time zones.



Opportunity to join the new NEHTA Australian Clinical Terminology User Group (ACT-UG).

The purpose of the group is to:

  • Harness the Australian Clinical Informatics Community’s interest and willingness to contribute to the development of clinical terminology components that support the national e-health agenda.
  • Support safe, effective and efficient implementation of clinical terminology in Australian healthcare.
  • Disseminate information and feedback between the IHTSDO, other relevant clinical terminology standards bodies and the Australian Clinical Informatics Community.
  • Through the above, help expand the pool of clinical terminology expertise available in Australia to support the national e-health agenda.

The first meeting of the ACT-UG will be held on 30 June 2010, via web and teleconference, with agenda items covering rationale for the group; terms of reference, meeting schedules and calls for Co-Chair nominations. We will also use this opportunity to brief participants on current NEHTA and IHTSDO structures and goals. For those who would prefer to attend in either Sydney, Brisbane or Canberra meetings rooms can be made available. Please advise if you do wish to use this facility.



NEHTA snaps up CSIRO technology for e-health records system upgrade

Software will help computers ‘talk the same language’

The federal government’s national e-health transition authority (NEHTA) is using CSIRO software in its SNOMED CT infrastructure.

SNOMED CT, or systematised nomenclature of medicine - clinical terms, provides a consistent framework from which healthcare providers can share health records.

Inaccurate or missing data from patient records in previous systems led to unnecessary hospitalisations and a waste of about 25 per cent of clinicians’ time, according to the CSIRO.



Relieving the electronic health records headache

Source: CSIRO, the Commonwealth Scientific and Industrial Research Organisation

May 21, 2010

Inaccurate or missing data in patient records has resulted in people being hospitalised unnecessarily and wastage of an estimated 25 per cent of clinicians' time spent collecting patient data.

As part of the Federal Government's e-health initiatives, the National E-Health Transition Authority (NEHTA) is implementing an internationally agreed standard for the dictionary of clinical terms used in electronic health records software, called SNOMED CT.

CSIRO E-Health Theme Leader, Dr David Hansen, said that while SNOMED CT has been customised for Australia, health practitioners are still encountering problems with the system.



Little scientific credibility behind health scare headlines


May 24, 2010

News reports about mobiles giving you cancer aim to entertain.

MOBILE phones give you brain cancer, and a bacon sandwich a day puts up heart disease by a half. It makes the choice pretty simple: bacon is tastier than ceaseless phone chat, and myocardial infarction a lot less painful than a brain tumour. That said, it would be foolish to rule out the possibility that you've eaten a bacon sandwich while on the phone - in which case it's not a choice but a double whammy.

Both of these appeared as headlines in the right-wing London tabloid The Daily Mail: on the mobiles and brain cancer risk, its report was a marked contrast to those of the broadsheets, who agreed that the study on which the story was based had found no statistically significant raised risk. The author of the study, Professor Anthony Swerdlow of Britain's Institute of Cancer Research, clarified the findings for me (as he had already, in a press conference - the misreporting here isn't accidental): there were 10 usage groups, ranging from very low to very high. In the very highest group - those reporting using their phone for 12 or more hours a day - there was a raised chance of both glioma and meningioma.



Filtering by computer fails on judgment


May 25, 2010

The plan to filter the internet for material refused classification under Australian law is legally flawed. Australia's classification law is not compatible with the Rudd government's proposal, and in fact has its own problems that make it unsuitable as a basis for any internet ''clean feed''.

Publications, movies and computer games ''refused classification'' cover a wide spectrum. They deal with child pornography, explicit sex and extreme violence, and controversial areas such as euthanasia and abortion which are outlawed in all or part of Australia.

Working out whether something should be refused classification cannot be undertaken in any mechanical or formulaic way, like using word recognition or other automated techniques. The decision requires a personal, individual judgment that is, by its nature, highly subjective.



Commercial filters on the side of web censorship

  • Karen Dearne
  • From: Australian IT
  • May 26, 2010 12:08PM

GOVERNMENT firewalls and censorship are not the only threat to online freedom, with commercial filters increasingly blocking user access to websites, Tor Project founder Roger Dingledine warns.

As companies and public-sector organisations adopt unified security products and web content security, many more employees may find legitimate websites are blocked, along with known nasties.

"The Tor Project website is often blocked by filters used by news organisations, for example," he said.

"Journalists in the US are being censored by commercial filters such as SmartFilter or Websense which prevent access to the internet as the rest of the world sees it.



Sunday, May 30, 2010

Why is It Taking So Long to Have a Useable and Complete Medicines Terminology? NEHTA is Just Dragging the Chain On This.

The following announcement appeared a day or so ago.

NEHTA announces the availability of Australian Medicines Terminology (AMT) Release 2.11

28 May 2010


AMT Statement of Purpose

The Australian Medicines Terminology (AMT) has been developed to be fit for the purpose of unambiguously identifying for clinicians and computer systems, all Therapeutic Goods Administration (TGA) identified 'Registrable' medicines marketed in Australia, and is therefore available to be represented in acute sector clinical information systems for the following activities:






Communication of the above in a Discharge Summary

While systems developers and end users might choose to deploy AMT or information generated from AMT enabled systems for purposes other than those described, no assessment with regards to fitness for purpose has been made by NEHTA.

NEHTA Announces the Availability of Australian Medicines Terminology Release 2.11

The latest update, Release 2.11 of Australian Medicines Terminology (AMT) has been published, and is available for download from NEHTA’s Secure Website. AMT is freely available for e-health software developers to use in their Australian products, under NEHTA’s licensing arrangements with the International Health Terminology Standards Development Organisation (IHTSDO®1).

AMT does not provide total coverage of all products used in the Australian health sector. As a result, it is continuously updated and releases are issued on a monthly basis. Updates include additional data items, and refinements as identified by stakeholders.

The 28 May 2010 release of AMT contains all the Australian marketed products that are included on the Schedule of Pharmaceutical Benefits, including the Repatriation Pharmaceutical Benefits Schedule (RPBS). This release includes products that become available as PBS products on 1 June 2010.

The full release notification can be found here:


This has all been going on for quite a long time.


Release Notes

19 December 2007

NEHTA publishes the Australian Medicines Terminology Release 1.0.0

Australian Medicines Terminology (AMT) Release 1.0.0 has been published. This comes after an extensive development phase incorporating feedback from our stakeholders. The scope of this release is limited as described below, and information on upcoming releases and their contents will be published as they become available.

Australian Medicines Terminology (AMT) Release 1.0.0 is an extension to SNOMED CT and access is limited to those holding license agreements managed by NEHTA.

The development of Australian Medicines Terminology has involved analysis and review by NEHTA, and has incorporated feedback from stakeholders.

The Australian Medicines Handbook (AMH) reviewed AMT and provided a report of recommendations. This is available on NEHTA’s website1. Key recommendations, as identified by NEHTA, have been incorporated into this release. A meeting held by NEHTA with stakeholders in December considered the remaining recommendations from the AMH report; the outcomes from this meeting will be posted on the NEHTA website and incorporated into subsequent AMT releases.

This release contains medicines from the Australian Register of Therapeutic Goods (ARTG) that are included in the Schedule of Pharmaceutical Benefits as published on the 1st December 2007, and includes over 3,500 products. More Pharmaceutical Benefits Scheme (PBS) items will routinely be added to the AMT through monthly updates to the Schedule of Pharmaceutical Benefits.

Inclusion of non-PBS items listed on the Australian Register of Therapeutic Goods will also be added to future releases of AMT. NEHTA will work closely with TGA and PBS to identify issues and ensure AMT is updated as new products become available.

----- End Extract.

Indeed it goes back much further:

In a NEHTA document dated 14 August, 2006 we have the following:

Document Title:


NEHTA’s Task

There are numerous systems that document drug information in Australia, all of which require slightly different information and perform slightly different functions. These include: TGA (ARTG) Register, PBS Schedule, state-wide and local hospital drug formularies and proprietary drug files such as those used by the medical software and knowledge resource industry.

NEHTA aims to ensure that terminology used for the naming and identification of all medicines registered and listed with the TGA is standardised across all e-health systems used in Australia. This will be done by developing a standard medicines terminology which is accessible to all.

NEHTA’s medicines terminology will deliver:

• A standard means of identifying branded and generically equivalent medicines; and

• Standard naming conventions and terminology, to accurately describe medications.

NEHTA will work with industry and international experts to develop the standards, specifications and infrastructure necessary for this task.

The Australian Catalogue of Medicines (ACOM) is an important contributor to this project and will be the central source of up-to-date trade product information to the medicines terminology. ACOM is available to the pharmaceutical industry to populate with current and standardised product data.

Additional Requirements

The Australian medicines terminology is also designed to:

• Be an extension to the nationally agreed terminology for all clinical terms used in Australian healthcare, SNOMED CT;

• Be used by e-health systems in both hospital and community settings;

• Be extended to include the identification of extemporaneous formulations as well as clinical trial drugs; and

• Have the ability to be extended to include medical devices.

----- End Extract.

The purposes for having a medicines terminology (among others) include:

  • Facilitating e-Prescribing and Medication Management.
  • Reduction of Medication Errors
  • Enabling Improved Accuracy of Medication Recording.
  • Improving Clinical Trials and Medication Research.
  • Assisting in Providing Quality Clinical Decision Support

For this to work properly and practically ALL prescribeable medications must be covered and covered in all their presentations (packaging etc). That is why this incomplete coverage is a major barrier to effective use.

They say:

“AMT does not provide total coverage of all products used in the Australian health sector. As a result, it is continuously updated and releases are issued on a monthly basis. Updates include additional data items, and refinements as identified by stakeholders.

The 28 May 2010 release of AMT contains all the Australian marketed products that are included on the Schedule of Pharmaceutical Benefits, including the Repatriation Pharmaceutical Benefits Schedule (RPBS). This release includes products that become available as PBS products on 1 June 2010.”

You simply can’t make effective use of a terminology that only covers a proportion of what is prescribed and used.

I am also told the present data formats in which the terminology is provided are less than ideal.

Just why is it – after so long - this is just not done and dusted so the only updates are for new and deleted medications - as it has been promised and should have been.

Some good questions on this in Senate Estimates would not hurt! It is just hopeless.


Saturday, May 29, 2010

Senate Estimates Alert - Wednesday June 2, 2010

I understand the e-Health Area will be addressed at Senate Estimates next Wednesday when the Community Affairs area is addressed.
The following link provides access to a .pdf which has the various ways of watching etc.
This page shows how you can watch the session live – which might just be fun given all the things happening in e-Health.

Live broadcasts:

Senate estimates hearings are broadcast live over the Internet. Details can be found at www.aph.gov.au/live
Expect some commentary once the transcripts become available!

Friday, May 28, 2010

Here is the Reason We Are Getting Nowhere with Ms Roxon!

The following appeared today.

Expert criticism won't help: minister


May 28, 2010

HEALTH Minister Nicola Roxon has signalled to a group of eminent mental health experts they would help their cause more if they toned down some of their public criticism.

The Health Minister met yesterday with her National Mental Health Advisory Council in Canberra. Sources say the one-hour closed-door meeting turned frosty when one of the council members, the former Australian Competition and Consumer Commission chief Allan Fels, queried the Rudd government's commitment to mental health. Ms Roxon is understood to have told the members present that she looked forward to the group's support for advancing the cause of mental health.


According to sources, Ms Roxon replied that public criticism was not a good way to get results - and did not advance the advocates' cause.

Full Article Here:


Sad this – seems like “speaking truth to power” is forbidden by those in power and that their approach is the paternalistic (maternalistic?) Joh like “don’t you worry about that!”. We will get round to e-Health (and mental and dental health) when we feel like it!

Looks like we all just meant to shut up and wait for goodness to be rained on us! She just does not want to be bothered by experts telling her she is not doing a great job.

No wonder the polls are now showing the next election will be a contest, an unthinkable thought just a few months ago, with attitudes like this. Another self-inflicted bullet to the foot I reckon.


Thursday, May 27, 2010

Weekly Overseas Health IT Links 27-05-2010.

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.



Harnessing (and Securing) Meaningful Data

John Halamka talks about the future of health data.

By Allison Proffitt

May 18, 2010 | “There isn’t going to be some massive database in the basement of the White House run by Sarah Palin,” promised John Halamka, the CIO of Harvard Medical School, in his keynote at the Bio-IT World Expo. But there will be a “federated mechanism that enables us to send data from place to place for a whole variety of purposes for care and research.”

Halamka serves as the Chair of the US Healthcare Information Technology Standards Panel. Of the $30 billion allotted to health care IT in the Obama Administration’s stimulus package, most of it will be distributed to hospitals and clinics after they’ve put health care IT infrastructure in place and are using it wisely. The remaining $2 billion is being distributed by the Office of the National Coordinator for health care IT advances.

“Here’s the strategy,” Halamka said. “Give $2 billion in grants to accelerate the industry. Give the industry a set of standards that are unambiguous for everything from medications, to labs, to quality measurements, to both clinical care and population health… Declare how hospitals and doctors have to use this wisely, and then certify products as being good enough to have the features and functions and capabilities to make this whole thing work.”

In the next five years as these standards are put into place, doctors and hospitals will be required to collect “meaningful” data and protect that data. “This is not using a word processor to record data!” Halamka clarified. “This is actually using codified mechanisms so that if you capture medications, problems, allergies, labs, etc. You could use them to inform drug discovery.”



Main Culprit In Large Patient Information Breaches: Unencrypted Laptops

Dom Nicastro, for HealthLeaders Media, May 17, 2010

Perhaps it's time to make laptops look unappealing to thieves to prevent them from being stolen.

"A tongue-in-cheek solution—ugly, cumbersome, low-appeal devices," says Nancy Davis, director of privacy and security officer for Ministry Health Care in Sturgeon Bay, WI. "We had a suggestion . . . to paint them all mustard yellow."

Naturally, Davis and fellow HIPAA privacy and security officers and consultants have more serious ideas about securing laptops. And most agree—encryption is the safest way to ensure your patients' protected health information (PHI) is secured before it flies out the door.



Hospitals criticized over offers to earn or save money by sharing electronic patient data

11:11 AM CDT on Tuesday, May 18, 2010

By JASON ROBERSON / The Dallas Morning News


The landscape for electronic health records in North Texas and across the nation has changed dramatically during the first half of this year.

Every major health system in the area has implemented, or has budgeted to implement, a system for sharing patient records electronically.

Electronic records are expected to allow doctors to coordinate care for the sickest patients, eliminate paper-transcribing errors that lead to inaccurate prescriptions, and avoid duplicate lab and imaging tests.

Medical errors alone cost the country $37.6 billion each year, according to the Institute of Medicine, a nonprofit, nonpartisan health research group based in Washington, D.C.



Health IT consultants in demand

May 18, 2010 | Bernie Monegain, Editor

OREM, UT – As healthcare organizations work to achieve meaningful use, demand for skilled consultants is high, but the jobs are more targeted and with smaller budgets than in the past, according to a new report from research firm KLAS.

The report, Shifting Demand for Consultants: Who's Hot, Who's Not, and Why, finds that nearly 70 percent of the 118 healthcare providers interviewed expect to hire a professional services firm to help with the demands of achieving meaningful use.

The study also notes that, in 2007, just five firms enjoyed significant provider mindshare, while today 13 do. Accenture, ACS, CTG, FCG (now CSC) and IBM now share mindshare with Vitalize, Dell Perot, maxIT and many others, as several key people left the top firms.



Google Flu Trends Good At Suggesting, Not Pinpointing, Flu Cases

Google Flu Trends, the website that aims to track the spread of the flu by how many people are searching for terms related to the virus, is a guide to, rather than a finely tuned indicator of, actual cases of the flu.

That’s the conclusion, at least, of a study being presented at a meeting today of the American Thoracic Society. Researchers found that Google Flu Trends is very good at pointing out where people are experiencing flu-like symptoms. But, the abstract of the as-yet-unpublished study says, the web tool “has a lower correlation” with confirmed cases of the virus.



20-plus hospitals now operating IPMS

Gary Culliton


More than 20 hospitals are now operating a single common patient administration system, HSE Hospital Network Manager John Hennessy has confirmed.

The €60 million Integrated Patient Management System (IPMS) is used to manage patient records and was originally intended to link up all HSE records nationwide to aid treatment of patients.



E-health and Web 2.0: The doctor will tweet you now

Patients can now meet their doctors in 'the cloud'

Lucas Mearian

May 20, 2010 (Computerworld)

When Janel Wood's 9-year-old son recently began experiencing migraines, the working mother decided to try a new company health care program that allowed her to communicate with a doctor through videoconferencing, voice over IP, and instant messaging.

While her son was home for lunch, Wood logged onto a local medical practice's Web site and connected via videoconferencing and IM with the doctor on duty, who then reviewed her son's electronic medical record (EMR) online. The doctor sent Wood links to migraine articles and podcasts and prescribed more hydration for her son, which worked over time.

"I ended up bringing [my son] back to school before missing any classes, which he was kind of bummed about. It was so quick and efficient," Wood said.

While telemedicine may seem a cold and impersonal approach to patient care, physicians say it's exactly the opposite. And they are quickly embracing it as a way to foster a more intimate relationship with patients and educate them about treatments prior to office visits.


Healthcare Data Risk Greatest From Human Error

Despite advances in security technology and regulations, human mistakes will likely continue to cause data security breaches that jeopardize patient privacy.

By Marianne Kolbasuk McGee, InformationWeek

May 20, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224900435

Human foibles will likely continue to cause data security breaches despite advances in the security technology until users fully understand the risks involved with their behavior, said healthcare CIOs at during an e-health panel at the MIT Sloan CIO Symposium in Cambridge, Mass. on Wednesdays.

While advancements in security technology better protects patient data, and regulations like HIPAA aim to set rules for information security and privacy, some breaches boil down to humans making mistakes.



Data storage of top concern to healthcare providers

May 19, 2010 | Kyle Hardy, Community Editor

SANTA CLARA, CA – With the introduction of electronic health records, health data storage is expected to be high on providers' to-do lists. However, storing this data will be challenging, said Bill Burns, senior director for Hitachi Data Systems.

"The problem is split into two parts," said Burns. "The first 50 percent of the problem is the IT issue – how do I manage, back up, secure it? The second is how to integrate the technology with other applications at the provider's facility."

Burns said that when it comes to data in healthcare, he is seeing a trend shift. The largest amount of data (Excel files, videos, clinical images) are what is called unstructured file data, said Burns. This kind of data is expected to grow with the digitization of medical records and will be hard to store and secure.



Federal policy workgroup to focus on state HIE

By Nancy Ferris
Wednesday, May 19, 2010

A Health IT Policy Committee workgroup will focus its attention on state-level health information exchange issues, after identifying those that need policy solutions.

Micky Tripathi, president and CEO of the Massachusetts eHealth Collaborative, told the federal Health IT Policy Committee Wednesday that the information exchange workgroup, which he co-chairs, will narrow its focus on state HIEs as early adopters begin to set them up.

In a brief report to the Policy Committee, Tripathi said many HIE issues may arise at the state level and at the intersections of state and federal HIT implementations.


Execs View Telehealth As Game Changer

Telehealth will transform healthcare, but reimbursement models, fear of technology are barriers to adoption, study shows.

By Nicole Lewis, InformationWeek

May 19, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224900404

Through the use of telehealth technology, the U.S. healthcare delivery systems will undergo a significant transformation that will improve healthcare outcomes and cut costs, a new study shows.

The study, conducted by research firm Penn Schoen Berland on behalf of Intel, interviewed 75 C-level executives at hospitals, home health organizations, and insurance companies. Among the findings, 89% of healthcare decision makers believe telehealth will transform healthcare in the next 10 years.

The study also revealed that telehealth solutions, which deliver health-related services and information via telecommunications and computing technologies, are currently being used by two-thirds of healthcare professionals with an 87% satisfaction rate.



P2P networks a treasure trove of leaked health care data, study finds

Eight months after passage of HITECH Act, data leaks still a problem in health care industry

Jaikumar Vijayan

May 17, 2010 (Computerworld)

Nearly eight months after new rules were enacted requiring stronger protection of health care information, organizations are still leaking such data on file-sharing networks, a study by Dartmouth College's Tuck School of Business has found.

In a research paper to be presented at an IEEE security symposium Tuesday, a Dartmouth College professor Eric Johnson will describe how university researchers discovered thousands of documents containing sensitive patient information on popular peer-to-peer (P2P) networks.



The Big Business of Electronic Health Records, Part 2

Proposed federal regulations for obtaining funding could actually stymie the adoption of EHR programs, say critics. "While the proposed rules would push the industry forward through a challenging set of requirements, we have concerns that the proposals do not accurately reflect the amount of time it will take providers of all sizes to efficiently prepare to demonstrate 'meaningful use,'" said the eHealth Initiative's Diane Jones.

Part 1 of this series discusses the growing trend toward adoption of electronic health records among healthcare providers, insurance companies, and government agencies.

The U.S. healthcare sector is about to embark on a multibillion dollar information technology investment program to provide electronic medical records for tens of millions of patients.



Decision day for Morecambe Bay

21 May 2010

D-Day has arrived for University Hospitals of Morecambe Bay NHS Trust on whether it is allowed to proceed with plans to bcome the first acute hospital to take the delayed Lorenzo hospital information system.

NHS chief information officer Christine Connelly is due to decide today whether to give University Hospitals of Morecambe Bay NHS Trust her approval to go-live with iSoft Lorenzo.

E-Health Insider under understands that Connelly will today again personally visit the hospital trust, the latest in a series of visits to the Northwest hospital trust.



A Paradigm Shift on Quality Reporting

CIOs grapple with challenges of moving quality reporting to electronic health record systems.

By David Raths

Hospital CIOs have identified quality reporting from electronic health record (EHR) systems as one of their greatest challenges related to meaningful use compliance under the federal American Reinvestment and Recovery Act/Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act. In March, David Muntz, senior vice president and CIO of the Baylor Health Care System in Dallas, told the federal Office of the National Coordinator Standards Implementation Workgroup that the most significant impact of meeting meaningful use on his health system’s existing plan has to do with the required quality reporting. Baylor eventually would like the activities of documentation and ordering to produce the data it currently collects manually through chart abstraction. But he added, “If we rush to meet the Stage 1 criteria before we have deployed our enterprise-wide designed EHR in our hospitals and ambulatory settings, we will have to sub-optimize our processes to gather some of the numerators and denominators required to compute the proposed metrics.”



Colorado Picks its HIE Partner

HDM Breaking News, May 20, 2010

The Colorado Regional Health Information Organization has selected Medicity Inc. as the core platform vendor for the state's health information exchange.

The RHIO will start implementation in the San Luis Valley region, which spans 8,000 square miles in southern Colorado and includes the towns of Del Norte, Monte Vista, Alamosa and San Luis. A second phase is expected this summer with letters of intent received from Boulder, Denver, Colorado Springs and the northern Colorado region.



Northern Illinois Gets an HIE

HDM Breaking News, May 18, 2010

Centegra Health System, serving northern Illinois with hospitals in McHenry and Woodstock, will create a health information exchange with community physicians.

The delivery system also will offer electronic health records software to physicians not yet using the technology. Centegra will implement the Elysium Exchange HIE platform software of Axolotl Corp., San Jose, Calif., which includes the CCHIT-certified Elysium 9 ambulatory EHR.



EHRs must support two distinct types of care, Partners CIO says

May 20, 2010 — 11:23am ET | By Neil Versel

Ever notice how so many examples of how EHRs can improve care focus on diabetes? That's because diabetes care has many clear protocols, copious amounts of scientific evidence that gets included in clinical decision support and clear quality measures.

But not all care is like diabetes care, as Partners HealthCare System CIO John Glaser notes in Hospitals & Health Networks. "The outcomes of a stroke are variable and difficult to measure. There are often no crisp guidelines for treating the fragile, elderly patients with multiple chronic diseases. And it would be a challenge to adequately structure the documentation of the clinician's thought process for a patient with a rare disease that is eluding diagnosis," Glaser writes in one of his regular columns for the magazine.

According to Glaser, healthcare can be broken down into iterative care--making diagnoses--and sequential care, which involves following widely accepted patterns of treatment. "The EHR must accommodate this diversity within an organization as well as for an individual clinician (a clinician may see this diversity daily) and for a patient (any patient may move from iterative care to sequential care and back again)," he writes.



Hospital CPOE collaborative to market order sets via Zynx

May 20, 2010 — 1:10pm ET | By Neil Versel

Three major health systems that have jointly developed more than 1,000 clinical order sets are joining with Zynx Health to market the order sets to other providers implementing computerized physician order entry.

"CPOE is hard," Dr. Loren Hauck, senior VP and CMO of Adventist Health System, Winter Park, Fla., tells FierceEMR. "We want to share our learning and best practices with others that may not be as far along" toward achieving meaningful use of EMRs.



HHS to survey Medicare patients on PHR use

By Joseph Conn / HITS staff writer

Posted: May 19, 2010 - 11:30 am ET

Seventeen months after launching a pilot project to test whether Medicare beneficiaries will use personal health records, HHS is going back to Utah and Arizona to ask PHR users what they think about the systems.

HHS last week published official notice in the Federal Register of its intent to conduct an evaluation this fall of the pilot program, including a survey of 500 Medicare beneficiaries to assess user satisfaction, as well as barriers or facilitators of PHR use.



Resisting the push to digitize

By: Sarah Kliff

May 18, 2010 05:06 AM EDT

Electronic health records are often discussed as a panacea in health policy, with the potential to streamline record keeping, reduce costs and improve quality of care in one fell swoop.

So it’s no surprise that the federal government has propped up the industry with $19 billion for health information technology from the American Recovery and Reinvestment Act, and bolstered that support with provisions in the health care reform law.

But as a particularly stringent and new regulation nears, numerous medical groups say that the aggressive government push to digitize is too much, too soon. Health information technology in the United States remains highly fragmented, so any large overhauls, experts warn, must work on a timeline that stretches years into the future.



PCTs look for GP agreement to SCR

18 May 2010

Primary care trusts are seeking agreement from GP practices to go ahead with the creation of Summary Care Records in areas where their roll-out had been suspended.

NHS East of England told EHI Primary Care that the process to create SCRs will go-ahead in areas where agreement has been reached on whether adequate information has been provided to patients and practices.

A spokesperson added: “The process to reach agreement that adequate information has been provided is ongoing.”

In a letter to PCT chief executives sent in April Dave Marsden, director of strategic IM&T, said the SHA's assurance of PCT communication plans would be strengthened following the BMA's concerns and no SCRs would be created for a practice until it was content that it had been "fully briefed" and patients informed of their choices.



GP labels SCR up-load a 'disaster'

18 May 2010

A GP whose practice has just uploaded Summary Care Records has heavily criticised the process, which she claims has been a "disaster."

Dr Linda Parker is a principal at one of four GP practices based at Roebuck House in Hastings, East Sussex, which have begun uploading records over the past two to three weeks.

Dr Parker told EHI Primary Care that the upload had been “a complete disaster for the practice” with large numbers of patients reporting no knowledge of the Public Information Programme.

She said: “I have had a lot of patients saying they haven’t received a letter when I have asked them about it and none of my own neighbours have received a letter.”



Poll finds e-communications are in demand

By Joseph Conn / HITS staff writer

Posted: May 18, 2010 - 11:30 am ET

About half of the parents of children ages 17 or younger in a recent national survey indicated that they'd like to communicate online with their child's physician's office for such clinical and administrative purposes as requesting records or refilling a prescription.



Online physician ratings mostly positive: study

By Andis Robeznieks / HITS staff writer

Posted: May 18, 2010 - 11:30 am ET

Few patients are posting online reviews of their physicians and, among those that do, most of the reviews they write are positive, according to a study published on the Journal of General Internal Medicine's website.

Tara Lagu, a Tufts University School of Medicine assistant professor, and colleagues at the Center for Quality of Care Research at Baystate Medical Center in Springfield, Mass., took a random sample of 300 Boston-area doctors and searched for reviews posted by their patients on 33 physician-rating websites. They found 190 reviews for 81 of the physicians in the sample with 88% of the reviews positive, 6% negative and 6% considered neutral.



Civil rights office steps up health privacy enforcement

By Mary Mosquera

Thursday, May 13, 2010

The HITECH Act significantly strengthened the available legal tools for enforcing health information privacy law, according federal health officials, who pledged to step up their pursuit of health security and privacy rule violators.

Last year’s health IT law tightened the Health Insurance Portability and Accountability Act’s (HIPAA) security and privacy rules, increased fines, and centralized oversight in HHS’ Office of Civil Rights. OCR, which issued an enforcement rule that took effect in November, can now impose penalties of up to $1.5 million per violation.

“OCR has significantly strengthened tools with which to obtain compliance,” said Marilou King, senior attorney and acting senior advisor for privacy compliance and enforcement in HHS’s Office of General Counsel Civil Rights Division.



Tackling Health Care’s Scheduling Problem

Greg Gillespie

Health Data Management Blogs, May 17, 2010

Sometimes someone really hits the nail on the head. And I think Roy Schoenberg, M.D., CEO of American Well, did when I recently spoke with him about consumer disconnect.

The timing was perfect because I had recently suffered that disconnect. I had a horrific sinus infection, the same one I get every spring, and called my primary care doctor. A nurse got back to me, listened to my litany of complaints and told me that I couldn’t get a prescription over the phone. By that time I saw a doctor three days later and got my diagnosis confirmed I already had an ear infection. And to add to my misery I was away from my job, this job I so dearly love, for a half-day.

The way Roy sees it, and I wholeheartedly agree, is that we don’t so much have a technology or expertise problem when it comes to providing care; we have a chronic scheduling problem. Proving the most timely and high-impact so often hinges on everyone--providers, technicians, patients, families--being in the right place at the right time. And, let’s be honest, that takes a miracle and the whole process is so often unnecessary. I as a consumer have a lot of technology at my fingertips, as do doctors and nurses. No reason it shouldn’t be put to good use when I have a sinus infection and no car, and a doc has an hour of free time to check in online.



Security: Strive for 'Defensive Depth'

HDM Breaking News, May 13, 2010

Good data security means having "defensive depth" embedded in information systems, says Alain Sheer, an attorney in the Federal Trade Commission's division of privacy and identity protection. "Relying on one defense is problematic."

Speaking at the Safeguarding Health Information Conference in Washington, Sheer gave examples of the need for multiple levels of defense. An organization, for instance, may encrypt data but have weak user authentication controls. This enables a hacker to access the encryption module and find the decryption key.

Sheer also gave several examples of major breaches of well-known retailers who were amazingly lax in protecting sensitive consumer information. Petco Animal Supply, for instance, on its Web site collected consumers' names, addresses, and payment card numbers with expiration dates. The Web site stated that data was encrypted, but it was not. The FTC charged the company with deception and in a settlement order mandated a comprehensive information security plan and independent assessments of Petco's security measures every three years for 20 years.



HHS to study patient perceptions of health IT

By Mary Mosquera

Friday, May 14, 2010

The Health and Human Services Department will conduct two surveys to find out more about patient perceptions and preferences for the use of health IT in the course of their healthcare.

HHS said it knows little about patient perceptions of practices that use electronic health records (EHRs) or about patient preferences about what functions they want from a personal health record (PHR).

HHS announced the two studies in the May 14 Federal Register.



Blumenthal offers meaningful-use approaches

By Joseph Conn / HITS staff writer

Posted: May 17, 2010 - 11:30 am ET

David Blumenthal, head of the Office of the National Coordinator for Health Information Technology at HHS, took to e-mail and the Web last week to get the word out about an alternative way for providers to communicate to meet federal meaningful-use requirements and qualify for billions of dollars in health IT payments.

The American Recovery and Reinvestment Act of 2009, also known as the stimulus law, requires that providers must meaningfully use an electronic health-record system to qualify for up to an estimated $27.3 billion in federal reimbursements.

Last December, the CMS, which will administer the EHR funding under the Medicare and Medicare Advantage programs, issued a proposed rule defining the meaning of meaningful use. Congress, however, mandated three meaningful-use criteria that providers must meet—electronic prescribing, reporting quality measures to HHS and exchanging information electronically to improve patient care.



Rep. Buyer: Why Isn't VA Data Encrypted?

HDM Breaking News, May 17, 2010

Rep. Steve Buyer (R-Ind.), ranking member of the U.S. House Committee on Veterans Affairs, has sent a letter to VA Secretary Eric Shinseki expressing his "deepest" concern over the recent theft of an unencrypted laptop from a VA contractor, and the department's information security procedures.

Information Week first reported on the laptop theft. It was stolen from a personal vehicle on April 22 and contained sensitive information, including Social Security numbers, on more than 600 veterans receiving pharmacy services.



Study: Health IT, care coordination key to meeting national cholesterol guidelines

May 14, 2010 | Molly Merrill, Associate Editor

DENVER – Kaiser Permanente is crediting healthcare information technology and care coordination as helping more than 40 percent of very high-risk patients reach national cholesterol guidelines – a feat that past studies indicate is difficult to achieve.

In 2004 the National Cholesterol Education Program issued revised cholesterol goals recommending people at very high-risk for heart disease move their target LDL or "bad" cholesterol from 100 mg/dL to 70 mg/dL to reduce the risk for another heart attack.

Many health experts have questioned the legitimacy of such an aggressive goal. Previous research has found only between 15 and 30 percent of patients were able to get their cholesterol to the recommended goal.



Monday, May 17, 2010

In Search of ... Health Information Exchange

Californians think big -- as the seventh largest economy in the world we have to. And as one might expect we boast some of the biggest health IT successes and failures.

Kaiser Permanente recently completed a $4 billion-plus electronic health record initiative -- considered the largest completed civilian health IT project in the country.

While I was at the California HealthCare Foundation, I witnessed firsthand the market failure that led to the closure of the $10 million Santa Barbara County Care Data Exchange. Its closure taught us that health information exchange was not exempt from the power of market forces.

While grants can be critical to initiate efforts, they are insufficient to sustain them. It is now painfully clear that we need to better understand and respect market forces and harness them to our advantage. In other words, we need to know our customers and provide valuable services worth paying for.



E-Health Laggards Need To Start Moving Now

Posted by Marianne Kolbasuk McGee, May 17, 2010 03:59 PM

Healthcare providers starting from scratch with projects to implement e-health record systems in hopes of cashing in on the government's $20 billion-plus meaningful use incentive programs had better get going.

It's going to take a while for healthcare providers to get those systems running and users trained on them, let along using their new digital records, e-prescribing, computerized order-entry and other applications in the "meaningful" ways the federal government will require before it sends out HITECH rewards to doctors and hospitals.

Certainly, healthcare providers are in a bit of a quandary: Even though the government's health IT financial incentives begin kicking in next year, the "meaningful use" compliance requirements for qualifying for those rewards aren't even settled yet, and it's already mid-2010. The Dept. of Health and Human Services expects the rules to be finalized and published by "end of spring."