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."

Tuesday, November 30, 2010

E-Health Summit - End Day 1.

After the Workshops we had 2 presentations.

First we had:

Dr Ivan Lund Pedersen

National Program Manager, Connected Digital Health, Denmark.

Dr Pedersen has been the National Program Manager at Connected Digital Health in Denmark, (SDSD) in Denmark since 2007.

SDSD is the Danish counterpart to NETHA in Australia and Infoway in Canada,

At SDSD Dr Pedersen has been the chairman of steering committees in several of the major programs, for example the Common Medicine Record (FMK), the National Patient Index (NPI) and the Infrastructure for videobased translation.

From 1 January 2011, Dr Pedersen will be working with innovation and clinical customer relations in the new government organisation called National e-health agency.

From 2002 to 2007, he was head of the development and implementation of Electronic Healthcare Record at the hospitals in Region Sjaelland. The biggest achievement in that period was the development and implementation of OPUS Medicine which is a web-based medication module. It took two years to develop and is now running on its 7th year, with two yearly updates. It is now ready to integrate with the patients shared medications record.


This presentation made it clear this is a very long term project - that has gone pretty well for 15 years and is still evolving - and that consultation and incentives are vital and that Denmark is still learning - despite the hype.

Second we had a summary of the two workshop sessions conducted earlier in the afternoon.

This session was led by Adam Powick who was the lead developer of the 2008 Deloittes National E-Health Strategy.

Lack of rigor and care at this point on our e-health evolution will be a disaster seems to be the message. A lot of good people have put sound views and they really need to be integrated into the overall picture. We need to think hard to make this a success!

Bottom line of all this was that we need to develop a major discussion document on what the outcomes were from these two days - that then this needs careful discussion and scrutiny.

My view this should have happened before the Summit but better late then never!

Enjoy your evening!


Minister Roxon Has a Few E-Health Announcements to Kick off the Summit.

We had two announcements besides the speech given to open proceedings. These were:

Next Step for Telehealth Services for Patients

The Australian Government’s investment in better connecting patients to specialist services through technology took a step forward on 30 November, with the release of a discussion paper seeking views on the most effective delivery for the scheme.

30 November 2010

The Gillard Government’s investment in better connecting patients to specialist services through technology took a step forward today, with the release of a discussion paper seeking views on the most effective delivery for the scheme.

Over $352 million will support online specialist consultations for Australians in rural, remote and outer metropolitan locations.

“Telehealth will cut down the tyranny of distance and bring specialist services to the patient’s doorstep through the use of online videolink technology,” said Ms Roxon.

“That will cut down patients’ travel time and is part of the Government’s investment in delivering specialist services closer to home.

“From 1st July 2011, this telehealth initiative will provide around 495,000 services over four years, as well as training and incentives for specialists, GPs and other health professionals to participate in delivering online services.

“For example a patient in a regional area who is being treated for high blood pressure and whose GP wants a specialist’s opinion may be forced to travel a long distance to see a cardiologist – now they would be able to get the service delivered locally.


A copy of the discussion paper can be found at www.mbsonline.gov.au and submissions close on 27 January 2010.

More here:


The paper is pretty short (5 pages) and really is just seeking suggestions as to what would work best. It is a fair bit of money so I hope they get some really good ideas!

And this one

Mobile Phone Applications Could Help Revolutionise Health Care in Australia

Accessing a patient’s record may be as easy as using a mobile phone application as the Government’s investment in e-Health revolutionises health care in Australia.

30 November 2010

Accessing a patient’s record may be as easy as using a mobile phone application as the Government’s investment in e-Health revolutionises health care in Australia.

A demonstration iPhone app has been developed to show how Doctors could access a patient’s record easily with e-Health records including x ray results and allergies, making diagnosis quicker and safer.

“The mobile application is an example of how we want to make it easier for patients so that wherever they are in the country, doctors and nurses can see their medical history.

“Allowing doctors instant access to a patient’s health record will mean that any conditions such as allergies can be quickly discovered and that can save lives.

“It will cut down on medication errors which account for 190,000 admissions to hospital each year.

“In years to come, the Government’s e-Health investment will be considered as one of the great technological advances in medicine and like the invention of the stethoscope, the x-ray and the vaccine will be part of routine healthcare.

“e-Health will have great benefits, take for example the case of a young mother whose two children suffer from asthma.

“She would have their medication history at her fingertips which means that if the children were to be hospitalised with an attack, the emergency department teams won’t be working blind – they will be able to know the history and current drug treatments.

“The iPhone app is in the concept stage, but is a good example of how we can harness technology to help health professionals deliver better patient outcomes.

More here:


It is good the team get that once you have a mobile browser and a portal all sorts of things are possible. Doh!

Keep up the visionary work!


An Apparent Conceptual Overview of the PCEHR. Lunch Report from E-Health Summit

The e-Health Conference has now heard from many speakers including the Federal Minister for Health. (See link below for program and list).

It is fair to say that most of what has been said would come as no surprise to readers here.

My key observations are:

1. Most speakers were not at all clear just what was being talked about in any precise sense - with most equating the PCEHR with a bit of a cross between a Shared Summary EHR and a Personal Health Record.

2. Both the AMA and the Consumer Health Forum really get how complex this will be.

3. Everyone recognised that Mid 2012 as a date with the PCEHR would be available to be signed up to was a pretty huge ask!

4. A lot of the early discussion felt like it was suggesting the PCEHR was basically an 'aide memoir' for patients!

5. The linkage between what was described and the intended benefits was tenuous at best to me.

As far as the Ministers / DoHA view is concerned the following seems to be what they are talking about with respect to the PCEHR - derived from a 5 minute animated conceptual model shown about 11am.

1. There will be a central infrastructure that will be have an indexing service (to locate relevant records using the Health Identifier Service)

2. There will also be a central authentication / permission service that will decide what information is to be accessed.

3. There seemed to be the core concept of a centrally held summary record that was to be augmented by information acquired from remote clinical systems (referrals, discharge summaries, results etc.). It is this central Summary that Professor Coiera pointed out was pretty problematic yesterday.

The Minister made it pretty clear that DoHA was into standards setting, governance and piloting and the delivery of ‘linkages’ not actual systems (however that is to play out)

4. It is not totally clear just what information flow are patient / consumer controlled and what flows are healthcare provider controlled.

5. There is an underpinning assumption that all providers will make information they hold available for indexing and access and use. This assumption strikes me as extremely problematic.

6. Overall what seems to be under discussion is a model very similar to the US Health Information Exchange Model - available commercially and view the US DHHS Connect program (and based on the IHE methodologies to some degree)

The Minister repeatedly referred to the PCEHR as a shared effort between private and public sector but it is not at all clear what incentives / rewards are available for involvement. There was a lot of discussion about governance but just how the private sector (which includes GPs) are to be involved is still being evolved it seems.

All in all an interesting morning where 1-2% more clarity may have emerged. The session on Denmark and its approach at around 4:30pm looks interesting as does the summary of the day which follows.

Go to the webcasts tab to watch from here:


It worked pretty well this morning.


Monday, November 29, 2010

It Seems Some Serious Thinkers Are Pretty Concerned about the Current NEHTA / DoHA Strategy and Direction.

The following Commentary appeared in the Medical Journal of Australia today.

For Debate

Do we need a national electronic summary care record?

Enrico Coiera

eMJA Rapid Online Publication


  • Electronic referrals and discharge summaries can improve the quality and timeliness of clinical communication.
  • The electronic summary care record (SCR) extends the concept of digital health summaries to create a perpetually updated and centrally stored summary of care, extracting key data from local systems after each encounter.
  • The only major SCR evaluation to date, in England, found that rates of usage were low, and any impact on care was difficult to quantify.
  • The SCR is seen by some as a first step to building a national distributed shared electronic health record (SEHR). However, the SCR may be a problematic diversion, creating a need for centralised databases, while the SEHR can function by sharing locally stored records, letters and discharge summaries.
  • Uncertainty about the quality and provenance of SCR data raises concerns about patient safety, as key data may be absent and old data may persist, partly because of a lack of ownership of the summary.
  • A national e-health strategy should emphasise the true stepping stones to a distributed and shared electronic record, including encouraging the uptake and meaningful use of electronic clinical records, clinical messaging, electronic discharge summaries and letters, and services such as decision support and e-prescribing, all of which have good evidence to support them.

The full article is available (free) here:


It is well worth a click through to read the full article.

There is also coverage here:

Electronic summary care record a waste of GP time: expert

29th Nov 2010

Andrew Bracey

A SENIOR e-health expert has questioned Australia’s push to develop an electronic summary care record (SCR), saying it lacks evidence and will create more work for GPs.

In an article published today in the MJA online, Professor Enrico Coiera, director of the Centre for Health Informatics at the University of NSW, called on authorities to instead focus on developing technology to better share existing health records nationally.

“Right now, we should keep our eye on the main game, which is to develop a way of sharing our existing health records nationally and connect up the different silos of clinical data,” Professor Coiera wrote.

“Making clinical data ‘liquid’ enough to move across the system is our primary challenge. We need to ensure that every clinical service has its own electronic records, and that these records are meaningfully used.”

Professor Coiera said there remained little evidence supporting the worth of an SCR, saying its purpose and impact on clinical care remained unknown.

Full article here:


Additional coverage is here:

E-health records "unjustified"

By Gemma Collins

Nicola Roxon’s plans for a $467 million personally-controlled e-health record (PCEHR) system are “simply unjustified” and could cause major problems for Australia’s healthcare, a health IT expert has warned.

Professor Enrico Coiera, Director of the Centre for Health Informatics at the University of NSW, makes the scathing attack in the MJA (online 29 Nov) as he says that the negative response to the UK’s summary care record (SCR) should make Australia “pause and think again” before rolling out a similar system.

The government’s PCEHR systems are due to be rolled out by July 2012 but Professor Coiera says the national record system in England has only been used in 4% of GP consultations in England and has generated additional workload for doctors.

More here:


What Professor Coiera is saying here overall is that the direction of the 2008 National E-Health Strategy is a far preferable way to proceed than the silliness and wooliness of the NEHTA IEHR / DoHA PCEHR proposals. Both these proposals lack the evidence base to justify the proposed investment and these funds would be conclusively better spent on the projects mentioned in point six of the abstract.

The issues raised by Prof. Coiera are very serious and have not been properly addressed to date. Until they are there are much better things to do with the e-Health dollar!

Nice to have some heavyweight support for what I have been saying for a good while now! Maybe the Summit tomorrow could give some thought as to whether the present plan from the Federal Government is actually the right one?


There is Sneakiness Afoot Here! Publications Swapped To Confuse Us All!

The following link is the correct one for the Peter Fleming presentation on Friday.


The earlier link in the previous blog was correct - until in their excitement to get down the presentation with blanks in the achievements area they mistyped the URL (note the petrer not peter)

Here is the earlier link (which now requires a log on).


This link gave you a presentation that was 4 pages longer!

Oh well I guess that is the way it goes.


Sunday, November 28, 2010

Weekly Australian Health IT Links – 28 November, 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 subscription payment.

General Comment:

The following article reports what is a real bit of stupidity and nonsense if true.


E-health privacy attracts concern, not complaints

Researcher highlights gap between perceptions and reality.

A CSIRO privacy researcher has blamed "leading questions" for the persistence of public e-health concerns despite there being few actual complaints about researchers' use of the data.

Researcher Christine O'Keefe studied Australian regulations and perceptions about using health data in medical research.

The study came as the Government developed a $62 million Population Health Research Network, expected to link scientists with e-health data sources around the country.

By 2012, the network would bring together various statewide "data linkage units", which each stored de-identified data from hospitals, government and academia.

----- End Extract.

It seems this researcher is a little ignorant of work done elsewhere which has identified a range of issues with a range of anonymisation techniques where personal information has been re-linked with clinical information using a variety of data-mining techniques.

In these areas perception is reality and in this country there is a real suspicion about large national databases unless the governance and transparency is handled very well indeed. Blaming researchers for public perceptions is just plain dumb in my view. Explaining what you are doing, why and what the safeguards are will work much better!

Here is an editorial from the US on the topic.


Privacy concerns could block road to public health goals

By Jeff Rowe, Editor

For HIT proponents, one of the many benefits of moving the healthcare sector to EHRs is that easily accessible patient data will enhance efforts to improve the overall health of American citizens.

But a recent survey on patient privacy concerns suggests that, at least when it comes to the sharing of health-related data, public health advocates will need to tread lightly.

According to reports, the survey, sponsored by Patient Privacy Rights, a health privacy advocacy group, shows that “ninety-seven per cent of Americans believe that doctors, hospitals, labs and health technology systems should not be allowed to share or sell their sensitive health information without consent.

“The poll also found strong opposition to insurance companies gaining access to electronic health records without permission. Ninety-eight per cent of respondents opposed payers sharing or selling health information without consent.”

I hope we all get a good education from the E-Health Summit on Tuesday and Wednesday!



E-health record to contain basic patient details

  • Karen Dearne
  • From: Australian IT
  • November 25, 2010 11:32AM

THE Gillard government's much-vaunted $467 million personally-controlled e-health record due by July 2012 will in the first instance be a modest patient health summary drawn from existing data sources.

There are no details about summary record information but basic health data includes current medications, allergies and any chronic health conditions.

Health Minister Nicola Roxon yesterday put $55m in grant funding on the table for healthcare organisations that want to develop PCEHR systems and become lead sites for the nation’s e-health rollout.

Grant application documents reveal the headline $467m over two years will “provide the capability to produce nationally consistent patient health summaries from compliant information sources” for patients who choose to participate.

But a fully developed e-health record is still some way off.



$55m set aside for new e-health sites

By Suzanne Tindal, ZDNet.com.au on November 25th, 2010

Federal Health Minister Nicola Roxon yesterday called for the next round of organisations wanting to be involved in the government's e-health record roll-out, holding out $55 million to kick start a second round of e-health sites.

Roxon said that applications were welcome from Divisions of General Practice, professional organisations, non-government organisations and the private sector, in addition to others involved in Australian healthcare.

Organisations wanting to be involved have to file an application with the Department of Health and Ageing's tender site by 23 December 2010. The new sites are expected to be chosen next year.



Top ten most influential of 2010: E-health

Was 2010 the year of e-health?


Coming in at number four for Computerworld Australia's Top Ten Most Influential list for 2010: E-health.


Amidst the clamour of the National Broadband Network (NBN) and telecommunications reform in the halls of Australian Parliament, few technological issues have been given priority in 2010 as e-health.

A bit like ‘the Cloud’, the meaning and placement of e-health differs depending on who you talk to. For some, it’s the ability to simply identify someone with a unique number; others demand fully fledged health records. Then there’s the whole kit and kaboodle - electronical tags monitoring the entire process from the patient’s entry to the hospital, to the bed to the small vials of medication administered. As robotic as it sounds, for all intents and purposes advocates hope e-health will streamline the health system and cut down on waste and, more importantly, errors.

For all the talk in 2010 among doctors, corporations, industry professionals and government, much of the talk surrounding e-health has been conjecture. In Australia, at least, e-health is progressing in small steps rather than leaps and bounds. The education around cultural change and awareness that must go on - as well as the debates around privacy and other implications - are an immense forewarning of just how large an undertaking e-health really is.


Lack of public engagement blamed for failure of online record

25th Nov 2010

Caroline Brettingham-Moore

A BRITISH study highlighting the failure of the National Health Service’s personal health record has led e-health experts to caution local policy-makers against failing to engage with health consumers.

The study revealed that while more than 2.4 million people received letters inviting them to open an account with HealthSpace, the UK version of a personal health record, just 173,000 had done so.

Researchers also surveyed patients who had opened an account, and found that the record was perceived as “neither useful nor easy to use”.



Autonomy looks for meaning in health data


Autonomy has announced a new set of clinical diagnosis and information governance technologies for the healthcare market.

The platform is designed to confront a constantly growing volume of unstructured and structured healthcare information, increasingly complex industry regulations, and heightened patient expectations and empowerment. Also, healthcare providers worldwide face an increasing pressure to move to Electronic Health Records (EHR).

Autonomy Auminence, al point-of-care analysis dashboard, is designed to help the provider make better quality, data-driven, evidence-based diagnosis decisions. Based on Autonomy's Bayesian inference technology, it allows a healthcare professional to combine their personal knowledge with the wealth of knowledge that exists on the patient and their symptoms, clinical features, and related diseases - contained in the vast volumes of "human-friendly" information that make up healthcare data.



Health appoints Paul Madden CIO

  • Karen Dearne
  • From: Australian IT
  • November 22, 2010 1:29PM

THE Health Department has appointed its first chief information officer, Paul Madden, who comes from the Tax Office where he oversaw the recently completed Standard Business Reporting program.

Health secretary Jane Halton said Mr Madden had "a wealth of highly developed IT and organisational experience, as well as strategic advisory and leadership experience''.

Mr Madden assumes responsibility for boosting departmental IT capabilities in support of the Gillard government's $467 million personal e-health record initiative, and will report directly to Ms Halton.



WA mandate Project Stop

25 November 2010 | by Nick O'Donoghue

Pharmacists in Western Australia (WA) will have to make real time electronic records of all of all pseudoephedrine products as the State Government adopts Project Stop.

By mandating the use of the Pharmacy Guild of Australia’s pseudoephedrine sales recording system the WA Government has followed in the governments of Queensland, Tasmania, the Northern Territory and the ACT in their fight against methamphetamine manufacturers.

A spokesperson for the Guild said Project Stop helped pharmacists to make decisions about whether or not to sell cold and flu medications containing the drug used in the production of methamphetamine.



Search is on for GP helpline service provider

  • Karen Dearne
  • From: Australian IT
  • November 23, 2010 11:37AM

THE federally-funded National Health Call Centre Network is hunting a service provider for the $400 million GP helpline promised in the May budget.

During the election campaign, Prime Minister Julia Gillard threw in an extra $50m for video-conferencing facilities, so the helpline can also offer medical services online.

The GP after-hours access program is to operate under the Medicare Locals umbrella, which will see the construction of 450 GP super-clinics.

However, discussions with the medical profession, consumers and industry over the shape of Medicare Locals are continuing.

Doctors groups have warned the withdrawal of $58m in funds for GP after-hours services when the hotline opens will end home visits and shut-down current arrangements.



Computer use in consults may have negative effects

23rd Nov 2010

Catherine Hanrahan

RESEARCH showing computer use during consultations is impacting doctor-patient relationships has prompted calls for GPs to undergo training in the best way to use computers while in consultations.

The Dutch study, in which researchers videotaped 1170 patient consultations with 35 GPs, was used along with a patient questionnaire to assess doctors’ computer use in the surgery. The data was collected in 2001 and 2008 with the same doctors.

While the study showed that GPs were using their computers less during consultations in 2008, it revealed that GPs gave significantly less information to their patients if they used computers while the patient was talking.



DoHA grants $55 million to second health record trial sites

The new sites will join the first three selected sites in Brisbane, the Hunter Valley and Melbourne

The Department of Health and Ageing (DoHA) has issued a further $55 million in grants to introduce further trial sites for the implementation of personal e-health records.

The new e-health sites will join the first three trial sites in Brisbane, the Hunter Valley and Melbourne’s eastern suburbs, and will be among the first to send hospital discharge summaries electronically to GPs and referrals using national specifications.

The funding forms part of the $466.7 million investment announced in the 2010/2011 Federal Budget to be spent over two years for the development of voluntary, personally controlled e-health records from 1 July 2012.



Medical Records Snapped Up

CONFIDENTIAL medical records of thousands of bayside patients have been sold as part of the liquidation of a collapsed national health group.

Personal files of more than 7000 people, containing privileged doctor-patient information, changed hands for an undisclosed sum this month when the The Doctors Company sold assets to the newly established Cleveland Family Practice.

The new practice bought records to stop them falling into the hands of drug companies or independent businesses.



Creepy. That's the secret files verdict

Royce Millar

November 24, 2010

''CREEPY'' but not surprising is how Flemington student Claire Watson responded when The Age described how the ALP had kept a secret electronic file on her.

''Inappropriate,'' she said, was the fact that her file, along with those on thousands of other Victorians in marginal electorates, had been made available to Labor campaign workers to tailor their canvassing ahead of Saturday's election.

After gaining unofficial access to the ALP's campaign data base for a string of such seats, The Age yesterday revealed how the party has recorded the sensitive personal details of tens of thousands of Victorians.

That information - including details about health and financial problems, political activity and voting intentions - has been made available to campaign workers.



Revealed: How the ALP keeps secret files on voters

Royce Millar and Nick McKenzie

November 23, 2010

THE ALP has secretly recorded the personal details of tens of thousands of Victorians - including sensitive health and financial information - in a database being accessed by campaign workers ahead of this Saturday's state election.

In a rare insight into personal profiling by the major parties, The Age has gained access to the database used by the ALP to tailor its telephoning and door-knocking of individual voters in key marginal electorates.

The Coalition has a database capable of similar profiling of voters, but has refused to comment or to divulge any details.



Baillieu vows to release secret voter dossiers, Labor refuses

Royce Millar

November 26, 2010

JOHN Brumby and Ted Baillieu have taken contrasting positions on constituent privacy, with the Labor leader effectively confirming he would deny access to files kept on voters and the Liberal chief vowing to release files wherever possible.

The Age this week revealed how the ALP has recorded sensitive personal details of tens of thousands of Victorians. That information - including details about health and financial problems, political activity and voting intentions - has been made available to campaign workers.

The Liberals have software capable of similar profiling. The Age has not had access to the Liberal database.

Note: These two articles are to remind readers how consumers hate secret databases holding their details. Obvious implications for e-Health.



Faulty payroll system won't be scrapped

Repairing Queensland Health payroll system cheaper than scrapping it

  • AAP (AAP)
  • 23 November, 2010 14:33

The government will spend $209 million to fix Queensland Health's faulty payroll system, state Health Minister Paul Lucas says.

See more on Queensland Health's IT

A new report has found that repairing the system, which cost $64.5 million to implement, rather than scrapping it is the cheapest and safest option.

Mr Lucas has been under fire over the problem-plagued system, which has seen thousands of Queensland Health workers wrongly paid since it was rolled out in March.

An independent report by Ernst and Young, tabled by Mr Lucas on Tuesday, recommends keeping the SAP/WorkBrain payroll and roster system.



E-health record to identify violent patients

26th Nov 2010

Caroline Brettingham-Moore

PATIENTS with a history of violence should be identified by a marker on their e-health record, according to the Northern Ireland branch of the British Medical Association (BMA).

BMA (NI) chair Dr Paul Darragh said information about violent patients should be shared between all healthcare organisations including primary, secondary and community care organisations, to enable staff to take appropriate precautions to ensure their own safety.

The calls come as Northern Ireland deals with an increase in attacks on health and social workers.



Michelle O'Byrne, MP

Minister for Health

Sunday, 21 November 2010

Radiology Leaps the Digital Divide

Health Minister Michelle O’Byrne today announced the go-ahead for a new high tech medical information system that’s set to transform vital aspects of patient care.

Ms O’Byrne said the $2.5 million Radiology Information System / Picture Archiving Communication System (RisPacs) would streamline the handling of patient information and enable doctors and specialists to access diagnostic images without the need to physically transport them around the State.

“This will be cheaper, quicker, much more helpful for doctors in diagnosing the cause of problems, and most importantly far better for patients,” Ms O’Byrne said.



Kings “half way there” on e-prescribing

22 Nov 2010

King’s College Hospital NHS Foundation Trust has reached the halfway mark for rolling out e-prescribing as part of its iSoft electronic patient record system.

Speaking at an electronic prescribing and medicines administration event in Manchester, Richard Yorke, health informatics consultant at Kings said that the project has been progressing well and the trust has reached its target of rolling out across two wards every month.

Yorke said: “The scope of the project was to get ePMA live and do it quickly and provide a single process for all drugs.

“We now have 22 wards live out of 40 including medicines, neuroscience including theatres and recovery, cardiac and renal, so we are just over halfway there.”



CWZ Nijmegen Renews Contract with iSOFT Group Limited (ASX:ISF)

Sydney, Nov 25, 2010 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) has won a EUR 3 million contract with CWZ hospital at Nijmegen, the Netherlands, for continued support of hospital information system and electronic patient record for a further three years.

The new deal includes an innovation budget of EUR100,000 a year to trial and implement cutting edge technologies to further optimize clinical processes and so improve efficiency and quality and reduce costs at the 650-bed hospital.

"Due to our long standing partnership with iSOFT and the superb experience we have made with the offered solutions we have decided to renew the existing contract", said Mr. Guido van de Logt, member of the board at CWZ. "Additionally the new contract gives us the possibility to leverage new developments and technologies which will make our organization more profitable. I believe that iSOFT offers a very promising concept of future hospital IT systems."



NHS trust numbers look wrong on CSC deal

25 Nov 2010

The Department of Health may be basing a revised £3 billion deal with CSC using inaccurate figures on how many NHS hospital trusts plan to take Lorenzo.

Officially reported figures, seen by EHI, strongly indicate that the vast majority of NHS trusts in the North Midlands and East of England plan to take either Lorenzo or SystmOne electronic patient record software from CSC under the NHS IT programme.

This apparently resolute commitment to Lorenzo remains despite of lengthy delays; significant reductions in functionality; and being offered the chance to take alternative electronic record systems, outside NPfIT.



False hope on 'revolutionary' mental illness diagnostic technique

  • AT THE COALFACE: Melissa Raven
  • From: The Australian
  • November 27, 2010 12:00AM

AUSTRALIANS are being misled by promotion of a "revolutionary" new diagnostic technique for mental illnesses.

Recently the trademarked EVestG system -- short for Electrovestibulography -- won the grand final of ABC1's The New Inventors.

Its designers claim it can diagnose schizophrenia, depression and bipolar disorder in 45 minutes by measuring brainwaves in the vestibular system.

But it's an unproven experimental procedure.



Crucial Telstra bill paving way for NBN is passed by the Senate

LEGISLATION to split Telstra has passed the Senate after days of intense negotiation and heated debate on a bill that paves the way for the National Broadband Network.

The legislation to separate the retail and wholesale arms of Telstra will now return to the House of Representatives, which has been recalled on Monday to deal with the legislation.

The crucial bill was given the stamp of approval by the Senate at 12:40pm, despite a last ditch effort by the Coalition to extend debate until 4pm this afternoon.


Senators reject 7-year NBN gag

CROSSBENCH MPs have been ordered to sign gag orders as a condition of gaining details of the secret business case for the NBN.

The "draconian" conditions from the government were originally to include a seven-year order of silence but were amended yesterday after the Greens and independent Nick Xenophon refused to sign the deed of confidentiality.

The Gillard government is continuing to defy orders by the Senate and a majority of MPs to publicly release the NBN Co business case, arguing it would be misleading to do so before the competition watchdog issues a key ruling about the National Broadband Network's service hubs on November 30.



Vic Labor to make NBN opt-out

By Josh Taylor, ZDNet.com.au on November 25th, 2010

Victorian residents will have to opt out of the National Broadband Network (NBN) roll-out if they don't want to be connected should Labor retain government at Victoria's state election this Saturday.

The move, similar to one announced by the Tasmanian Government earlier this year, was announced today by Victorian ICT Minister John Lenders, who said the opt-out approach would ensure a quicker roll-out of the project in his state.

Lenders said this mandate could either be achieved as part of "a national process in partnership" with the Federal Government to be rolled out across the states or via a change in legislation in Victorian parliament.



Privatisation deal shores up Greens support for NBN bill

  • Joe Kelly, James Massola
  • From: The Australian
  • November 22, 2010 9:53AM

THE GREENS have defended a deal with Labor to make it more difficult to privatise the $43 billion National Broadband Network.

The deal was struck to shore up Greens support in the Senate for a bill which will see the separation of Telstra's retail and wholesale arms.

The agreement will see the government forgo its plan for automatic privatisation of the NBN five years after it is built.

If opposed by the Coalition, the structural separation bill's fate will now rest on the votes of independent senator Nick Xenophon and Family First's Steve Fielding.



12 Ubuntu derivatives you should consider

Canonical’s flagship Linux distribution isn’t the only variation with advantages for business users.

It's no secret that Ubuntu 10.10, or Maverick Meerkat, is one of the most user-friendly Linux distributions of all time for business and home users.

What many people don't realize, however, is that there are several other Linux distributions out there that are also based on Ubuntu and offer many of the same advantages. Some are focused on a specific niche; others are simply variations on the same general theme.

If you're already a fan of Ubuntu or simply want to experience what the excitement is all about, consider the following alternatives for what just may be an even more perfect match with your business's needs.




AusHealthIT Poll Number 46 – Results – 28 November, 2010.

The question was:

What Do You Think of the Quality and Value of the Proposed Program for the E-Health Summit?

Just Fabulous

- 3 (9%)

Pretty Good

- 2 (6%)

Just Average

- 1 (3%)

Could Have Been Much Better

- 5 (15%)

Beyond Saving

- 22 (66%)

Votes: 33

I think it is fair to say those who read here are of the view that based on what we have been told this may not the e-Health finest moment!

Again, many thanks to those that voted!


Now We Know Where NEHTA Priorities Really Lie - Getting A New Brand!

Clearly the legions of Public Relations staff at NEHTA are not anywhere near busy enough!

Not content with being the spin meisters for a high spending under delivering organisation they decide that what is needed is a new Brand for heaven’s sake.

In a presentation entitled:

eHealth: Making it Happen

Australasian College of Health Service Management 26 NOVEMBER 2010

We are introduced to a cute little bunny cuddling itself in a riveting red and white.

Go here to get the presentation:


The presentation seems to have no new news except the new brand and seems to have a number of empty slides at the end. Ready for late breaking news I guess.

Haven’t they go better things to spend their money on? Will some on explain to us what the cost-benefit of a new brand for NEHTA is and why it was needed?

Yours in amazement!


Saturday, November 27, 2010

The Summit is in Three Days and Still No Serious Documentation or Clarity. What a Farce!

I had a bit of a browse late Saturday afternoon.

News Item 1.

Well it’s a sell out!

Read here:

“Registrations are now closed. There are no further positions available.

For further information about the National e-health Conference please contact Conference Management:

Email: events@eventplanet.com.au

Link here:


More browsing shows:

Under the workshops tab we now are given information about the workshops.

----- Begin Extract.

Workshop Sessions Day 1

Conference workshop sessions will provide an opportunity for stakeholder groups to share their perspectives about the design and implementation planning for the PCEHR system. These sessions are part of the ongoing dialogue critical to the successful development and introduction of e-health in Australia.

There will be five separate workshops. At each, the same key themes will be discussed by a cross-section of stakeholder representatives drawn from consumers, healthcare providers, industry and government representatives.

Audience participation will be sought in each workshop, which will run for 75 minutes.

Workshop 1 – Where are we? Opportunities afforded by the PCEHR system

Panel members will discuss what they understand from their stakeholder perspective to be the key questions that need discussion as part of the implementation planning for the PCEHR system. Additionally, participants will be invited to discuss themes including privacy, consent, governance, scope and sustainability.

Workshop 2 – Making the PCEHR system work: Opportunities and Actions

Building on the first workshop, panelists will present their views about what is needed to “get down to business” so that people can begin using the PCEHR system from July 2012. Participants will be invited to discuss practicalities such as possible systems that may be ready to connect, data sources that can be used, legislation questions and change management frameworks.

Innovation Project Breakout Sessions Day 2

Innovative projects showcase

These sessions will showcase what is already happening in e-health in pockets across Australia, With a focus on online technologies, these innovative projects will demonstrate how e-health is already delivering benefits across the health care sector. Demonstrations will include embedded video footage of live scenario case studies. Participants will be involved in discussions focusing implementation practicalities and lessons to be shared.

----- End Extract

The information is found here.


As an exercise in vagueness the workshop descriptions rise to amazingly high levels!

And interestingly at least we now know that there will be a webcast!

Just click on the Webcast Tab that appeared yesterday.

The key sessions to watch will be Tuesday Morning when the luminaries presenting will tell us what the PCEHR is so it can be workshopped for 3 hours in the afternoon.

You can imagine just how much progress will be made with that!

What an amazing bit of nonsense this seems to be turning into.

I was told recently that no real technical capabilities or insight are required at the conference as it is all ‘high level’ and that the attendees have been selected on that basis. I note also some serious specialist journalists have seemingly been overlooked.

The time is quickly coming for those with serious intent to make it clear to Government that things must change and fast or we will be even more of an international laughing stock that we presently are if that is possible!


Friday, November 26, 2010

Weekly Overseas Health IT Links - 26 November, 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 subscription payment.



Wireless health care


The convergence of mobile telephony and health care is under way

Nov 11th 2010 | WASHINGTON, DC | From The Economist print edition

BILL GATES seems to relish being the skunk at the garden party. The former boss of Microsoft, now a global-health philanthropist, was invited to address a big “m-health” conference in Washington, DC, this week. Some 2,400 proponents of delivering health services over wireless telecoms, from the private and public sectors, gathered to celebrate the dozens of pilot projects under way around the world.

Mr Gates, however, warned the participants not to celebrate too soon. Just because an m-health pilot scheme appears to work in some remote locale, he insisted, don’t “fool yourself” into thinking it really works unless it can be replicated at scale. Rafael Anta of the Inter-American Development Bank was even more cautious: “We know little about impact and nothing about business models.”

Happily, evidence of m-health’s usefulness is at last starting to trickle in. A study this week in the Lancet, a medical journal, shows that something as simple as sending text messages to remind Kenyan patients to take their HIV drugs properly improved adherence to the therapy by 12%. WellDoc, an American firm, found in a recent trial that an m-health scheme that relies on behavioural psychology to give diabetics advice on managing their ailment has more effect than putting them on the leading diabetes drug.


Verizon Offers Free Security Credentials To Healthcare Professionals

The credentials meet Level 3 authentication requirements and allow healthcare providers to receive digitized health data from other clinicians securely.

By Marianne Kolbasuk McGee, InformationWeek

Nov. 17, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228201106

Verizon Business is offering 2.3 million licensed healthcare professionals in the U.S. free medical identity credentials to make it easier for clinicians to securely share patient information via Verizon’s own Medical Data Exchange and other e-health platforms.

The credentials can allow healthcare providers to securely receive digitized health data from other clinicians via private inboxes accessed from a new Verizon Medical Data Exchange physician web portal.

Verizon’s multi-factored identity credentials meet Level 3 authentication requirements of the National Institute of Standards and Technology, said Steven Archer, head of Verizon Business Innovation Incubator Group. The security offering allows healthcare providers to comply with provisions of the HITECH Act that require "strong identity" credentials for accessing and sharing patient data starting in mid-2011.



Standard Debate

The need for standards to underpin interoperability was one of the big themes of eHealth Insider Live 2010. Daloni Carlisle reports.

Back in the day, the mantra was “education, education, education”. At eHealth Insider Live 2010, it might have been “standards, standards, standards”.

From an IT perspective, the government’s pledge to free the NHS from bureaucracy and devolve power to the frontline can only be achieved with the underpinning of universally accepted standards.

It is standards, most of those attending the two-day conference and exhibition in Birmingham agreed, that underpin interoperability.

And it is interoperability that underpins the ‘connect all’ rather than ‘replace all’ philosophy for IT systems that was launched 18 months ago, but which has been taken up by the new administration.

It is also interoperability that will enable the flow of information that the NHS will need to deliver the efficiency, productivity and innovation required of it. And, indeed, the new information driven services for patients outlined in the current consultation on an ‘information revolution.’



OIC: Alarming Rates of Preventable Adverse Events

HDM Breaking News, November 16, 2010

A startling number of adverse events affect Medicare beneficiaries in hospitals, according to a study from the Department of Health and Human Services' Office of Inspector General. Based on a random sample of 780 beneficiaries discharged during October 2008, the OIG estimates:

* 13.5 percent of beneficiaries experienced adverse events during their hospital stay--prorated to 134,000 beneficiaries experiencing at least one adverse event during that single month;

* Another 13.5 percent experienced other events not labeled as "adverse" that resulted in temporary harm. Many cases were minor, but others were classified as "temporary" only because the patients were in the hospital for a lengthy period for other reasons, which allowed the hospital enough time to address the "temporary harm" before discharge;



GAO: EHRs promote better care

By Christine LaFave Grace

Posted: November 17, 2010 - 12:00 pm ET

The use of electronic health records supports efforts to improve patient care within integrated healthcare delivery systems, according to a report from the Government Accountability Office.

The GAO report details the strategies that 15 public and private integrated delivery systems serving medically underserved populations have employed to provide better-coordinated and higher-quality care. In interviews with GAO researchers, officials from the surveyed ID systems said that EHRs serve to boost care quality by improving communication among physicians, staff members and patients and by increasing the availability of clinical information and patient population data.



GAO: EHRs improve care coordination, quality at large health systems

November 18, 2010 — 2:13pm ET | By Neil Versel

EHRs can, in fact, improve the quality of care, at least at large, integrated delivery systems, says a new report from the Government Accountability Office. But even major provider organizations continue to struggle to share EHR data outside of their own networks.

The GAO report, required by the Health Care Safety Net Act of 2008, says that EHRs support care coordination, disease management, computerized physician order entry, e-prescribing and adherence with care protocols at many of the 15 public and private delivery networks the federal agency studied. Operating a health plan and employing physicians also can help bolster care quality, the GAO says.



Healthcare sector among top adopters of iPad

November 15, 2010 | Molly Merrill, Associate Editor

REDWOOD CITY, CA – The healthcare sector is among the top three industries seeing the heaviest adoption of the iPad for business use, according to data from Good Technology, a Redwood City-based provider of multiplatform enterprise mobility.

The data comes from an analysis of Good Technology's user base, which includes more than 4,000 enterprise customers, whose iPad deployments range from one to more than 1,000 iPads.

"We took a close look at our customers who have deployed iPad devices so far," said John Herrema, senior vice president of corporate strategy at Good Technology. "We found that the financial services sector dominated, accounting for 36 percent of Good's iPad activations to date. The technology sector came in second at 11 percent, followed closely by healthcare at 10 percent. We believe these industries are embracing the iPad because its unique design makes it easier to perform time-sensitive, mission-critical tasks."



Sunday, November 14, 2010 3:22 AM EST

Health apps: the next big thing in smartphone wave

By IB Times Staff Reporter

Five hundred million of a total of 1.4 billion smartphone users will be using mobile health applications in 2015, a report said.

The report from Berlin-based research2guidance found that both healthcare providers and consumers are embracing smartphones as a means for improving healthcare.

"Our findings indicate that the long-expected mobile revolution in healthcare is set to happen," Ralf-Gordon Jahns of research2guidance said.



First NHS trust goes live with Alert

18 Nov 2010

Blackpool, Fylde and Wyre Hospitals NHS Foundation has become the first NHS trust to go live with an electronic patient record system from Alert Life Sciences, E-health Insider can exclusively reveal.

The trust signed a deal with Portuguese company, Alert last November and went live with its Emergency Department Information System across it A&E department on Tuesday.

The system is being used by 200 core staff that work in the department as well as 250 who need to access the information as part of their job. The system is said to provide a fully integrated clinical record, including the use of orders and results, eprescribing and clinical documentation functionality.



Blumenthal: Specialists may claim exceptions to certain MU measures

November 18, 2010 — 4:17pm ET | By Neil Versel

Remember the uproar from some specialty societies and makers of specialty EMRs over their perception that the CMS rules for "meaningful use" of health IT unfairly favored primary-care physicians? Now, no less a figure than national health IT coordinator Dr. David Blumenthal is offering some tips on how specialists can comply.

According to American Medical News, Blumenthal told last month's meeting of the American Academy of Ophthalmology that specialists can claim an "exception" to each rule that doesn't apply to their specialty and still get credit for meeting that specific objective. He was backed up by Dr. Derek Robinson, medical director for HHS Region V, covering Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin.



Broken-glass perils

I was talking with Catherine O'Neill recently about a federal rule called 42 CFR Part 2.

O'Neill is senior vice president and HIV/AIDs project director for the Legal Action Center, a not-for-profit law and policy organization based in New York with an office in Washington.

She is good at her job—so good that when I asked an official with HHS' Substance Abuse and Mental Health Services Administration about whether the unique consent requirements of 42 CFR Part 2 would mesh with a proposed health information network, he recommended I give O'Neill a call.

The 42 CFR Part 2 rule is intended to give drug- and alcohol-abuse patients and their caregivers some protection from law enforcement officers nosing around in medical records—the thought being that if drug users want to kick their habits, they should be encouraged to seek confidential treatment.



Designed for Efficiency, New Computer Software at Health Dept. Misfires


In July, the San Francisco Department of Public Health started using an $11.2 million electronic medical records system, Avatar, that was designed to streamline billing and improve care for tens of thousands of clients. Thus far, however, it has brought administrative chaos to the mental health and substance abuse services in the city.

Documents obtained by The Bay Citizen under a California Public Records Act request show that shortly after installing Avatar, providers struggled to use the new software, causing health officials to lose track of millions of dollars of services.

Officials are scrambling to fill in the missing data to meet deadlines to qualify for reimbursement from the state.

The department has a $310 million budget for mental health and substance abuse, and San Francisco General Hospital, city-run clinics, community organizations and private therapists provide the services. Medi-Cal reimburses the department for some of those costs.



AMIA issues new recommendations for health IT vendors, customers

Written by Editorial Staff

November 10, 2010

The American Medical Informatics Association (AMIA) has adopted recommendations for new practices targeting the reduction or elimination of tensions that mar relationships between health IT vendors and their customers, specifically with regard to indemnity and error management of health IT systems.

The recommendations, which resulted from deliberations by an AMIA board-appointed task force, seek to imbue the health IT vendor-customer relationship with transparency, veracity and accountability through collaborative education focused on the installation, configuration and use of health IT systems in combination with enterprise-wide ethics education to support patient safety, according to the Bethesda, Md.-based AMIA.



Heart patients not helped by phone monitoring as much as hoped

Heart failure patients who called daily to report their weight and symptoms were just as likely to be readmitted to a hospital or suffer another heart attack or die as those who received conventional care, a six-month trial shows.

By Thomas H. Maugh II, Los Angeles Times

November 17, 2010

It was a good, commonsense idea that simply didn't work out.

Researchers thought that having heart failure patients who were freshly released from the hospital call their doctors' offices daily to report their weight and symptoms might catch relapses earlier, allowing physicians to intervene quickly and save lives.

Unfortunately, that's not what happened. Patients who called in regularly were just as likely to be readmitted to the hospital or to suffer a heart attack or die as were those who received normal care, according to a six-month clinical trial of 1,653 patients by Yale University.

"We had a lot of faith and hope that providing increased information could improve outcomes," said Dr. Sarwat I. Chaudhry of Yale, who led the study reported at a Chicago meeting of the American Heart Assn. and online in the New England Journal of Medicine. "Obviously that wasn't enough."


Guerra On Healthcare: Don't Underestimate CPOE Challenge

Government program rushes implementation and may compromise patient safety, but are CIOs empowered to buck the system?

By Anthony Guerra, InformationWeek

Nov. 16, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228200985

We all know that a cornerstone of the government's Meaningful Use program is CPOE. Requiring that only 10 percent of in-patient orders are entered electronically (for Stage 1) would seem to indicate policy makers realize just how difficult implementation is. However, speaking to CIOs who've given it a shot but were quickly rebuffed by livid physicians tells me that even 10 percent is unattainable if the approach is not right.

Usually "the wrong way" means too fast, and too fast means cutting corners. Those corners often involve engaging both the users and vendor at a deeper level than may seem necessary at first blush. I recently interviewed one of those rare -- but likely growing in numbers -- CIOs who is also an MD.



e-Health Intelligence Report

November 16, 2010

Scientific Articles

:: Why Do Evaluations of eHealth Programs Fail? An Alternative Set of Guiding Principles

PLoS Med 2010;7(11)

We argue that the assumptions, methods, and study designs of experimental science, whilst useful in many contexts, may be ill-suited to the particular challenges of evaluating eHealth programs, especially in politicised situations where goals and success criteria are contested. We offer an alternative set of guiding principles for eHealth evaluation based on traditions that view evaluation as social practice rather than as scientific testing, and illustrate these with the example of England's controversial Summary Care Record program.

:: Open mHealth Architecture: An Engine for Health Care Innovation

Science 2010;330(6005):759-760

Mobile communication devices, in conjunction with Internet and social media, present opportunities to enhance disease prevention and management by extending health interventions beyond the reach of traditional care—an approach referred to as mHealth. However, mHealth is emerging as a patchwork of incompatible applications ("apps") serving narrow, albeit valuable, needs, and thus could benefit from more coordinated development.



A wealth of data … for vendors

With the proposed new health IT glitch-reporting system, developers will know immediately when a complaint has been lodged against their EHR, and vendors may even know the name of the person who filed the complaint. But the physicians, clinics or hospitals saddled with a buggy or hard-to-use system won't know if there have been multiple complaints filed against their vendor.

The EHR Safety Event Reporting System was announced Nov. 15 at the National Press Club in Washington.

David Blumenthal, the head of the Office of the National Coordinator for Health Information Technology at HHS, added federal heft and credibility to the project by being on hand at the launch party, calling the effort "a great example of the private sector providing leadership in a very important area."



HIMSS: Not 10% can meet meaningful use

By Joseph Conn

Posted: November 16, 2010 - 11:45 am ET

Fewer than 1 in 10 hospitals is prepared to meet most of the meaningful-use requirements to qualify for federal subsidy payments for electronic health-record systems under the American Recovery and Reinvestment Act, according to a survey by HIMSS Analytics, the market analysis arm of the Chicago-based Healthcare Information and Management Systems Society.

This data point was drawn from an ongoing survey by HIMSS Analytics that included 687 hospitals. The questioning was begun before the final rule on meaningful use was released in July, fixing the number of core and so-called "menu" requirements at 14 and 10 respectively.



5 Must-Haves for CMIO Success

Gienna Shaw, for HealthLeaders Media , November 16, 2010

Thinking of adding a chief medical information officer to your IT staff? You can't just pluck anyone from the doctor's lounge and consider the job filled. Here are five key attributes that should be part of the job description for any CMIO.

1. Must have leadership, communication skills

It might seem a little obvious, but CMIOs can't effectively champion electronic health record systems if their peers won't listen to them. "This physician has to be more than just a clinician, they have to be a leader," says Edward Marx, CIO at the 13-hospital Texas Health Resources in Arlington, TX. "That's what helps make an excellent CMIO."

Jon Morris, CMIO at WellStar Health System in Marietta, GA, agrees that the CMIO must be more than a spokesperson. "Don't misunderstand: I'm out there selling a lot of the time, but I also act as an interpreter [and] facilitate engagement of other providers."

Morris' communication skills and the fact that he has the respect of his peers is what makes it work, says Ron Strachan, senior vice president and CIO at WellStar. "Physicians need to be involved and they need to be involved from working with a peer, a respected peer, because I or any other CIO that's not a physician can stand up and essentially preach all day long about values of their involvement in various projects and process change, but I'll never have the credibility with the physicians at large when compared to one of their peers. There's no replacement for that," Strachan says.



Hospitals are bad for your health

November 16, 2010 — 11:45am ET | By Sandra Yin

Add this to the list of reasons a hospital might not be the best place for patients to seek care. Hospitals kill an estimated 180,000 patients a year due to adverse events, according to a report released Monday by the Department of Health and Human Services' Office of Inspector General.

The OIG report offers the first statistically valid national incidence rate for adverse events among hospitalized patients who are Medicare beneficiaries, officials said.



Welsh telehealth pilots save £2.2m

15 Nov 2010

Three demonstrator projects in Wales testing new ways of managing chronic conditions including use of predictive risk software and telehealth have reported NHS savings of at least £2.2 million in the last year.

The Chronic Conditions Management demonstrator sites in Carmarthenshire, Cardiff and Gwynedd have published a report on the second year of their three year project showing improving patient care, reduced emergency admissions and NHS savings.

All three sites are also using the Welsh predictive risk tool PRISM to identify high risk patients, improved joined up working and inform priorities for community based services.



With innovation, the concept is the easy part

- By Edward Meagher

- Monday, November 15, 2010

I couldn’t escape a sense of déjà vu at a recent industry conference. Jonah Czerwinski, director of VA’s internal innovation initiative (VAi2), delivered a glowing report. VA Secretary Eric Shinseki challenged VA’s more than 300,000 employees to provide “actionable ideas” that would increase access, lower costs, improve performance, or raise the quality of the services and benefits provided to our nation’s 25 million veterans. More than 50,000 VA employees responded with over 10,000 submissions.

Czerwinski praised this awesome display of care and commitment on the part of VA employees, and he described how the VAi2 program would manage this wealth of ideas. They would be evaluated, then selected ideas would proceed to piloting, and those proven most beneficial would be implemented.



A computer's advice to cut medical costs

Star Tribune (Minneapolis

MINNEAPOLIS — Do you really need an MRI for that aching back or sore shoulder? How about a CT scan?

For the last three years, thousands of doctors have been using a computer program to help answer those questions. They plug in information about an individual patient, and a computer using national guidelines tells them if a CT or MRI is a good choice — or if there's something better.

That simple step has helped save an estimated $28 million a year by eliminating thousands of unnecessary tests, according to the Institute for Clinical Systems Improvement, a health research group in Bloomington, Minn.

Starting next year, ICSI will make it available, free of charge, to doctors throughout Minnesota, in what some say could be a national model for curbing health costs.

"Doctors aren't infallible ... sometimes, they choose the wrong thing," said Cally Vinz, a vice president at ICSI, which sponsored the project with some of Minnesota's largest health plans and medical clinics.



Doctors: Web ratings flawed

Critics say Web scores based on few reviews are unfair, unreliable

By Julie Deardorff, Tribune reporter

November 15, 2010

Web-savvy consumers use online rating services to review restaurants, rant about hairdressers, praise carpenters and even assess their college professors. So why shouldn't patients rate their doctors?

While more than 30 different online services now grade doctors, assessing a doctor's skills has turned out to be much more complicated and controversial than ranking hotels or restaurants. Critics say that most sites have too few reviews per doctor to offer statistically significant information, and the medical establishment has vocally questioned the concept.

But the trend gets another chance at growth this month, with one of the best-known restaurant guidebooks, Zagat, joining the field of medical reviews in Illinois in a limited way.



Report Gives Brief, Clear MU Explanation

HDM Breaking News, November 15, 2010

A new report from consultancy Computer Sciences Corp. gives a brief, clear layout of the requirements and implications of the electronic health records meaningful use incentive program.

"The purpose of this paper is to take a closer look at the relationship between certification and meaningful use under the temporary certification program, and to outline what products need to be certified--and how they need to be used," according to the Falls Church, Va.-based company.



Privacy desires ignored

For psychiatrist Deborah Peel, maybe patient privacy and patient consent aren't identical twins, but they're sure close relatives.

Not surprisingly, a recent Zogby International poll commissioned by Peel's not-for-profit Patient Privacy Rights Foundation, Austin, Texas, focuses on patient consent and its relationship to privacy—a unity the federal government has chosen to either ignore or deny.

The 2,000 adult poll respondents reached by Zogby via the Internet put great store in their right to privacy. They cling to the quaint notion that they should be asked before their electronic health records are sent skittering off to unknown users for unknown purposes.



Mobile phones become tools of health promotion

By Steven Overly

Monday, November 15, 2010; 9

When District-based Voxiva released a free text message service in February sending prenatal health advice to expectant mothers, the technology firm hoped it would be a successful example of mobile health in the United States.

Nine months later, they say it has delivered.

The company and the other minds behind "text4baby" said at last week's mHealth Summit that more than 100,000 mothers-to-be have used the service. Johnson & Johnson also made a multimillion-dollar pledge over several years to help grow the program.



Coalition will collect data on EHR problems

By Joseph Conn

Posted: November 15, 2010 - 11:30 am ET

A coalition of medical societies and medical liability insurance carriers has announced the creation of a Web-based reporting system for physicians and other healthcare organizations to provide a centralized national repository of problems with electronic health-record system software.

According to a news release, in addition to collecting information, the Web service, called EHRevent, will "create reports that medical societies, professional liability carriers and government agencies such as the U.S. Food and Drug Administration will use to help educate providers on the potential challenges that EHR systems may bring."



NIH committed to advancing mHealth research, directors say

November 10, 2010 | Diana Manos, Senior Editor

WASHINGTON – Leaders at the National Institutes of Health and its nonprofit Foundation for the National Institutes of Health (FNIH) said they would stand behind the advancement of research for the use of mobile phones for healthcare.

At a national conference on mobile health, the mHealth Summit, held Nov. 8-10 in Washington, D.C., NIH Director Francis Collins, MD, called mHealth "a growing opportunity."

Collins, noted for his prior work in leading the Human Genome Project said, "it's time to take advantage of the marriage of mobile technology and research. That's why, in 2010, NIH will issue 150 grants for mHealth research. The research will include the use of mobile phones, telehealth and GPS.

Some studies already underway include one at Arizona State University using a wearable, real-time chemical sensor system to assess personal exposure to hydrocarbons. Another at UCLA involves the use of a microscope that doesn't need a lens to transmit data in resource-limited locations. A computer can interpret the images from the phone for infectious disease.



Laptop thefts top cause of health data breaches

By Mary Mosquera

Friday, November 12, 2010

Laptop theft is the most prevalent cause of the breach of health information affecting more than 500 people, according to the Health & Human Services Department, which last year began tracking data breaches by public and private healthcare organizations.

The fact that laptops are so easily stolen underscores the importance of physical security in the protection of health information, according to Adam Greene, senior health IT and privacy specialist in HHS’ Office for Civil Rights, which enforces the privacy and security rules under the Health Insurance Portability and Accountability Act (HIPAA).

Of the 189 records of data breaches affecting more than 500 individuals in the first year, 52 percent were from theft. About 20 percent were from unauthorized access and disclosure of protected information, while 16 percent were from loss, he said Nov. 10 at the mHealth Summit conference.



AMIA 2010: 'Five to 10 years away' always seems five to 10 years away

November 15, 2010 — 3:25pm ET | By Neil Versel

Health IT always seems to be five to 10 years away from radically transforming what passes for a healthcare system in this country. If you recall, Dr. David Brailer's national health IT strategy was based on President George W. Bush's 2004 goal of delivering interoperable EMRs to most Americans by 2014. President Barack Obama, upon taking office in 2009, reiterated the 2014 target date, but raised the goal to all Americans.

I'll have more tomorrow in FierceMobileHealthcare about some lofty prognostications from last week's mHealth Summit. Today, though, I'd like to draw your attention to some comments made Sunday by Dr. Don Detmer, immediate past president and CEO of the American Medical Informatics Association.



e-health entering era of ‘normality' says industry leader

e-health is now very much on the political agenda, recognised as a key enabler for delivering better healthcare and choice for patients. In this article Dr Harald Deutsch, Vice President CSC Healthcare EMEA, explains why he believes we are entering an era of the “normalisation” of e-health and how the convergence of technology standards will be a key driver for success. He also explores how healthcare – and e-health – could be a winner from the financial crisis.

Time after time, we hear from industry when something new comes along – like cloud computing, for example – that it’s a “new era” for health, that it’s a breakthrough, that it’s something revolutionary. Then, on the other hand, there are some groups that are saying that there is an e-health speculative bubble in Europe which is going to burst.

Normalisation of e-health

I would say that neither of these positions is correct. What we are currently observing is “normalisation” of e-health. By that I mean that e-health is becoming recognised as the way we do things – and as a means of doing them better – in the day-to-day decisions taken by politicians and managers of Healthcare IT.