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, May 31, 2011

NEHTA Turns Up at the Senate Estimates and Claims That All Their Projects are On Track!

The e-Health Component of the Senate Estimates happened late in the afternoon yesterday - from about 4:30 till about 5:45pm.

The obfuscation was just fabulous. Peter Fleming was asked about the 2009 year of delivery and could not say what had happened then and so just chatted about where things have got to some 1.5 years later. He seemed happy - indeed claimed all the NEHTA projects were tracking to their ‘critical paths’ and that all was totally in hand. I seem to recall some detail on this was requested, on notice, so it will be interesting to see what is produced.

Sadly no-one asked about adoption, benefits and delivery of actual clinical outcomes.

The main achievement was that NEHTA actually turned up - after years of being utterly unaccountable.

There will be a transcript of the details in a day or so and we will subject the comments to the usual forensic examination - but sadly I think they think it was OK. It wasn’t by any stretch!

I am sure the questions on notice - on vacancy rates, consultant spends and the like will be fun in due course.

One area of questioning I found really quite amusing was when Senator Sue Boyce asked about staff morale and recruitment in the presence of the current drop dead date of June 30, 2012 for both NEHTA and the PCEHR Program. One can only imagine someone, somewhere has some plans but it was by no means clear the Peter Fleming (the NEHTA CEO) has any visibility on just what they care given his response to the questions.

It is also interesting that NEHTA has paid Medicare $14M for the IHI service and IBM $8M for NASH. I hope we see some actual use for these systems quite soon.

The main feature to my mind was, however, that we actually have set a precedent and now have expectations of at least a little more transparency every six months or so! This can only be a good thing. Even better would be value for money and efficiency audits of both NEHTA and the e-Health section of DoHA - conducted by the Auditor General. All other parts of Government are periodically reviewed to why not this area as well?


Monday, May 30, 2011

Consultation NEHTA Style - Long Lists of Participants But Not Many Answers!

Last week, just a day or so before submissions on the PCEHR were due, we had two consultation reports released. These were sent to stakeholders and today CHIK has received permission to make them available.

Two documents were made available to those groups consulted last week - but were not made available publicly.

As mentioned they are now accessible and have been made available from CHIK servers.

1. The PCEHR Consultation Report January 2011 to April 2011


2. Questions and Responses - from the roundtables held during March.


I was lucky enough to be sent copies late last week, and have has some time to browse them.

Sadly, in usual NEHTA style, we have many issues raised but very, very few issues actually resolved.

Typical of the sort of responses is the following.


Q - How can we be confident that the information in a PCEHR is correct and accurate at the time?

A - This is a challenging issue. The accuracy and reliability of information in any health record must be taken into account, in the context of other sources of information, including directly from the patient. However, this is largely dependent on the quality of information provided by healthcare organisations. Experience with shared records in Australia and globally indicate that the quality may be not be high initially, but improves rapidly with the introduction of the system due to its exposure and “peer-review”. The concept of having a nominated provider to manage the information going into the Shared Health Summary will help to ensure that information is up to date and relevant and to highlight important information needed for the ongoing care of the patient.

All one can conclude is that the whole PCEHR idea is just a very early work in progress.

Working out how the quality of information held in a shared record can be fit for purpose is quite fundamental and to be this vague at this point, is really quite alarming!

Enjoy browsing, if only to the frustrated regarding just how little is actually sorted out!


AusHealthIT Poll Number 72 – Results – 30 May, 2011.

The question was:

Should There Be A Fundamental Review of The PCEHR Proposal Before It Goes Any Further?

The answers were as follows:

For Sure

- 48 (81%)


- 4 (6%)

Probably Not

- 2 (3%)

Not A Chance

- 5 (8%)

The clearest poll yet. There really has to be a review of this monster before it gets out of hand!

Votes : 59

Again, many thanks to those that voted!


Sunday, May 29, 2011

Weekly Australian Health IT Links – 29 May, 2011.

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

As far as I am concerned the main news this week is that Paul Madden, CIO of the Commonwealth Department of Health has recognised that e-Health (forget the nonsense PCEHR) is a decade long journey and not something that can be undertaken based on political deadlines.

Senate Estimates is on tomorrow (May 30). We shall see what flows - look forward to some commentary later in the week!



Evaluation of features to support safety and quality in general practice clinical software

Read the full text

PDF Evaluation of features to support safety and quality in general practice clinical software

24 May 2011 Electronic prescribing (e-prescribing) offers an opportunity to improve the quality, safety and efficiency of health care and is now the norm in many countries. There is evidence to show that e-prescribing (often with clinical decision support) is associated with a reduction in medication errors and incomplete or unclear orders, improved drug allergy detection and greater adherence with clinical practice guidelines. There are however also reports of unintended negative consequences of e-prescribing, for example unfavourable effects on workflow and the introduction of new types of errors.



A future where we carry our genomes on our smartphones

Steve Dow

May 29, 2011

IT COULD be a grief-saving app of the future, the day we carry our gene sequence in our phones.

When two people want to have children, they'll bump genomes and a database might reply: ''Think again, you both have faulty disease-causing copies of the same gene.''

That's the hope of the Australian geneticist Richard Cotton, who heads the international Human Variome Project, which aims to collect all variations of all genes that cause all disease from all countries.

It's a Herculean task, but Professor Cotton is spurred by a "vivid imagination" and the rallying of clinicians, geneticists and researchers from more than 30 countries.

The 70-year-old founder of the Genomic Disorders Research Centre at Melbourne University, who yesterday spoke at the TEDx ideas conference at CarriageWorks, Eveleigh, regularly taps his imagination to "feel the pain" of those families whose loved ones are stricken with commonly fatal diseases such as cystic fibrosis or Huntington's disease.



Experts gather for CSC clinical advisory council

CSC Australia has established a clinical advisory council, funding participation by key medical thought leaders, as it steps up its local health presence.

CSC's chief medical officer Robert Wah was keynote speaker at the "kick-off" meeting in Sydney last week.

Dr Wah said the intention was to "start getting clinical input" that would become a valuable source of expertise to be tapped by current e-health projects around the nation.



Health shortlists infrastructure tenders

Fujitsu, CSC and at least two consortia of smaller e-health providers are believed to be among those shortlisted for potential participation in the Federal Government’s $467 million personally controlled electronic health record (PCEHR) initiative.

The national infrastructure partner, one of four such partners sought by the Department of Health and Ageing for the e-health rollout, would deliver, integrate and provide continued maintenance for enabling systems including core system infrastructure; operations and call centres; reporting and template servicing; and separated portals for use by both consumers and healthcare providers.



Health Communication Network sale divides analysts

PRIMARY Health Care's potential $300 million sale of its general practitioner software business, Health Communication Network, has divided the market, with some analysts questioning the strategic rationale of selling the division.

Primary on Friday confirmed a report in The Australian that it was considering the sale of HCN, which provides software and IT services to doctors, and that it was mulling over an incomplete draft proposal, tipped to be from private equity, or global health firms.

In late trade, Primary was up 1.7 per cent at $3.56 in a weak market.

Indeed, analysts expect healthy bidding tension for the unit as governments worldwide increase spending on e-health, and amid HCN's likely role in implementing any national rollout of an electronic health record system, a longer-term ambition of the government.



Health Communication Network up for sale

  • Karen Dearne
  • From: Australian IT
  • May 24, 2011 11:55AM

LOCAL GP software leader Health Communication Network is poised for sale by owner Primary Health Care, which is considering whether to sacrifice the division to pay down debt.

Primary yesterday confirmed it was looking at a draft proposal for a sell-off of HCN.

"The terms of the proposal are incomplete, and the proposal itself remains subject to board consideration,'' it said in a statement to the ASX.

"Primary will provide full details to the market, should a decision be made to proceed. However, there can be no assurance that that will occur.''



Market shows interest in e-health company

Conspiracy theorists wondered if the government was plotting an e-health joint venture after an official was seen at the Primary Health Care office.

The recent sighting of the federal government's Health Department chief information officer Paul Madden at the Sydney headquarters of Primary Health Care's Health Communication Network sparked speculation of some sort of joint venture for its e-health strategy.

That is not thought to the be the case.

However, the good news for Primary shareholders is that the company's decision to test the market's appetite for that asset has been well received.



Healthcare Identifiers Licensed Material

On this page

Medicare Australia is the owner and distributor (by whatever means) of the official Healthcare Identifiers (HI) Licensed Material, unless we notify otherwise. The material is distributed through this website. Developers are bound by the terms and conditions of the Licence Agreement - Use of the Healthcare Identifiers Licensed Material for Notice of Connection when using the Material available for the HI Service. Medicare Australia will inform developers, and provide notice on this website, whether the HI Licensed Material contains any third party material which may require a separate licence.



Industry Brief Special Bulletin May 2011

NEHTA has released an information pack for industry members wishing to comment on the Federal Government’s draft Concept of Operations for the Personally Controlled Electronic Health Record (PCEHR) before submissions close on 31 May 2011.

The resources include:

Audio recording and slide pack (see attached) from the ICT Industry Roundtable – more than 100 participants took part in this high profile discussion in Sydney, on 23 March 2011.

Audio recording from the 'Four-Cornered Roundtable' which brought together 200 key stakeholders from industry, government, clinicians and consumers, on 30 March 2011.



Search is on for the perfect anatomy alternative

23rd May 2011

Byron Kaye

WHEN books are a distant memory, medical students will be carving up synthetic cadavers and undertaking electronic simulations for anatomical training, experts say.

With the cost of cadavers rising – currently about $6000 per body – and technological advances offering ever more realistic alternatives, experts say the use of human cadavers is set to slow as educators look to more innovative options.

“Where the real future probably lies is with electronic or digital simulations which will… give a much more real perspective to students without the need for cadavers,” said GPET chair Professor Simon Willcock.



Local GP group bags telehealth funding

  • Karen Dearne
  • From: Australian IT
  • May 26, 2011 8:30AM

THE peak GPs' body will be paid $567,000 to develop telehealth standards and training ahead of the launch of new Medicare rebates for online consultations slated to commence on July 1.

The Royal Australian College of General Practitioners practically wrote a job application for the role in its January response to the Health department's discussion paper, Connecting Health Services with the Future.

“There will need to be an appropriate set of clinical and technological standards that define at least the minimum requirements for establishing and operating telehealth facilities,” the GP college said.



Healthcare funding model jeopardises telehealth

Healthcare funding models which effectively penalise doctors for keeping patients out of hospital are acting as a brake on widespread adoption of teleheath services.

David Ryan, executive officer of the Grampians Rural Health Alliance (GRHA), has warned that although the introduction of a Medicare claim number for video-consults from July this year will unleash demand for videoconferencing from GPs and private specialists, hospital based doctors who are paid by the States will have no incentives to adopt other telehealth services.

GRHA has already deployed a $7.6 million videoconferencing network connecting hospitals and medical centres in 40 towns in the Grampians region. That network is currently racking up 4,500 hours of videoconferences a year – a figure Mr Ryan believes could leap to 6,000 thanks in part to the advent of the Medicare rebate.



RACGP gets telehealth standards funding

The Royal Australian College of General Practitioners (RACGP) has reportedly been granted $567,000 in funding to develop telehealth standards.

The news comes ahead of next week’s Rural and Remote Telehealth Conference, as well as the addition of new telehealth items to the MBS on July 1.

The RACGP was unable to confirm details of the funding at press time, however it is understood the funding is intended to develop standards around the new MBS items.



Duplication nation

The roll out of e-health records present unique opportunities, and challenges, for aged care providers. Beverley Head reports.

The Federal Government has released a draft concept of operations document regarding the use of personally controlled electronic health records (PCEHR) in Australia, which are being touted as a cornerstone of national e-health programs that could revolutionise the way aged care is provided.

The Minister for Health and Ageing, Nicola Roxon, has said that the PCEHR initiative means "patients will no longer have to remember every immunisation, every medical test, every prescription as they move from doctor to doctor".

This national blueprint, and the consultation and development that will follow, will help to develop e-health records for all Australians who want one from 1 July 2012, she said.



iSoft takeover hits new roadblock

By Josh Taylor, ZDNet.com.au on May 27th, 2011

The sale of troubled healthcare software company iSoft to Computer Sciences Corporation (CSC) has again come under threat, with shareholders raising concerns in the Federal Court yesterday over the purchases of convertible notes.

Oceania Capital Partners (OCP) is a 24.5 per cent shareholder of iSoft, as it has $39 million in convertible notes in the company. In a move to clear all company debts before CSC takes over, the company is seeking to buy up all of these convertible notes at face value.

This has concerned the other shareholders in the company, notably former chairman Gary Cohen's company RJL Investments, as CSC has offered just 17 cents per share to acquire the company.

At a Federal Court hearing yesterday, seeking court approval to send out the documents for the scheme of arrangement for the takeover ahead of the shareholder vote, Justice Arthur Emmett said that shareholders may be of the belief that as the convertible notes are being paid out in full, they may not be getting the full value for their shares.



Morecambe Bay says Lorenzo now stable

23 May 2011 Jon Hoeksma

University Hospitals of Morecambe Bay NHS Foundation Trust has told eHealth Insider it has stabilised Lorenzo and now has only a small number of outstanding issues with the software.

The position indicates a remarkable improvement from the position at the end of March, when EHI understands the trust had almost 600 fixes remaining for the iSoft electronic patient record, almost a year after going live with the latest version.

The trust told EHI that it has made steady progress since then, and that: “486 of the 537 issues at the end of March 2011 are fixed. This leaves 51 lower priority issues open awaiting retest on build 646.”

It went on to state that the software “has been stable since December 2010”. EHI further understands that the trust is about to stand down key project managers. The clinical leads in the project left at the end of March.



Former chief Gary Cohen fails to derail iSoft sale

THE sale of Australia's former e-health star iSoft to US-based IT services group CSC is back on track with the NSW Supreme Court dismissing an action by iSoft founder and former chief Gary Cohen.

Last month, CSC offered to buy the struggling software firm for about $188 million, an offer accepted by major shareholder Oceania Capital Partners.



NSW court dismisses iSoft founder

After hearing evidence and submissions, NSW Supreme Court found RJL’s propositions relating to Pre-emption Deed were without foundation

The NSW Supreme Court has dismissed litigation by RJL Investments against investor Oceania Healthcare Technology Investments (OHT) relating to a Pre-Emption Deed on shares held in iSoft.

RJL is owned by former executive chairman and CEO of iSoft, Gary Cohen, who commenced legal proceedings against OHT, which is a subsidiary of Oceania Capital Partners (OCP).

RJL claimed circumstances had arisen in the CSC proposal to purchase iSoft, which required OHT to provide a transfer notice of approximately 15 business days to acquire a portion of the shares in iSoft held by OHT.



Hurdle removed in CSC iSoft buy

By Suzanne Tindal, ZDNet.com.au on May 23rd, 2011

The NSW Supreme Court last week removed an obstacle to CSC's purchase of iSoft, according to iSoft investor Oceania Capital Partners.

Oceania Capital Partners said a month ago that RJL Investments, a company controlled by former iSoft executive chairman and founder Gary Cohen, had filed legal proceedings against Oceania subsidiary Oceania Healthcare Technology Investments (OHT). Cohen left iSoft in August last year.

Cohen's firm claimed that the circumstances of the CSC proposal forced OHT to serve a transfer notice to RJT, providing it with 15 business days to acquire 15 per cent of the shares. Oceania had control of 24.5 per cent of issued iSoft shares.



Tools for the future

One shortcoming of Productivity Commission's draft report was the omission of a detailed examination of the role technology will play in delivering better quality healthcare to ageing individuals, writes George Margelis.

The Productivity Commission should be commended for driving such a wide ranging review of Australia's ageing services framework. The intergenerational report showed us the issues we are facing with a large and rapid increase in the ageing population. As someone on the tail end of the baby boomer generation, I think it is important to recognise that this ageing tsunami is not a bad thing. The alternative to ageing is far less palatable for those of us entering that phase of our life. It demonstrates that the various health and social policies of the past decades have, to a large degree, had the desired effect of improving the health and wellbeing of the population. The consequence of that is a population that is getting older and, human physiology being what it is, requiring aid.



Fedora 15 released, first with GNOME 3

New service manager to speed up boot time

The Red Hat-backed Fedora project has released version 15 today and is the first major Linux distribution to include GNOME 3 as the default desktop environment.

GNOME 3 was released last month, however, Ubuntu 11.04 shipped with its own Unity interface, not the default, like Fedora 15.

GNOME 3 includes the new “GNOME Shell” user interface which requires 3D video acceleration, which Fedora provides with open source drivers for Nvidia, AMD (ATI) and Intel, including support for “Sandybridge” GPUs.

With Fedora 15, 3D support in Nouveau, the open source Nvidia driver, is now available by default, and the mesa-dri-drivers-experimental package does not need to be installed.

KDE users also get the latest version with KDE 4.6 available for installation. And, not to be outdone, the smaller Xfce desktop environment is bumped up to version 4.8.




NEHTA To Be Discussed At Senate Estimates on Monday Afternoon. First Time Ever and About Time!

Here is the relevant part program for Monday May 30, 2011.



Outcome 4 Aged Care and Population Ageing

Output 4.1 Aged care assessment

Output 4.2 Aged care workforce

Output 4.3 Ageing information and support

Output 4.4 Community care

Output 4.5 Culturally appropriate aged care

Output 4.6 Dementia

Output 4.7 Flexible aged care

Output 4.8 Residential care

Outcome 10 Health System Capacity and Quality

Output 10.1 Chronic disease – treatment

Output 10.2 e-Health implementation

Output 10.3 Health information

Output 10:4 International policy engagement

Output 10.5 Palliative care and community assistance

Output 10.6 Research capacity

Output 10.7 Health infrastructure

Organisation – National e-Health Transition Authority (NEHTA)

Outcome 10 Health System Capacity and Quality

Agency - Cancer Australia

Agency – National Breast and Ovarian Cancer Centre

6:45pm – 7:45pm Dinner

There is a live video and audio stream. This can be accessed via this link.


Enjoy Monday afternoon! It will be very interesting to see who turns up from NEHTA.


Saturday, May 28, 2011

Weekly Overseas Health IT Links - 28 May, 2011.

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.


Healthcare IT Spending To Reach $40 Billion

The U.S market for healthcare IT hardware, software, and services is expected to grow 24% annually for several years, driven in part by mandatory use of EHRs.

By Nicole Lewis, InformationWeek

May 16, 2011

URL: http://www.informationweek.com/news/healthcare/EMR/229500682

The U.S. health IT market is forecast to grow at a compound annual growth rate (CAGR) of around 24% during 2012 to 2014, according to a study from RNCOS, a global market research and information analysis company.

The report, U.S. Healthcare IT Market Analysis, which was published earlier this month, said the health IT industry is expected to surge to $40 billion by the end of 2011. The growth will be driven not only by healthcare reform and the implementation of e-health systems, but also by a population that will demand and increasingly be able to afford quality services.

Segmenting the market into IT hardware, IT software, and IT services, the report notes that IT hardware accounted for 65% of the total market at the end of 2010. It also said the mandatory use of electronic health records (EHRs) has boosted the market for software. As a result, the healthcare IT software market will increase in revenues from $6.8 billion in 2010 to $8.2 billion in 2011.



Growth of e-prescribing intriguing, but far from finished

May 16, 2011 — 10:49am ET | By Ken Terry

Surescripts, a company that connects physician offices to pharmacies online, has released electronic prescribing data for 2010 that show a rapid expansion of this key health IT capability. The number of office-based providers who prescribed electronically jumped 50 percent from 156,000 at the end of 2009 to 234,000 at the end of last year. During that same period, the number of electronically routed prescriptions leaped 72 percent, from 191 million to 326 million.

That's impressive growth, and it shows that the government incentive programs for e-prescribing and electronic health records are having an impact. But before we assume that e-prescribing has taken over the world, let's remember that 3.99 billion medications were dispensed in the U.S. last year.



Gutteridge calls for 50m SCRs

13 May 2011 Fiona Barr

The NHS must deliver Summary Care Records for all its patients and encourage widespread use of HealthSpace or an equivalent, the Department of Health’s clinical director for informatics has said.

Dr Charles Gutteridge gave unequivocal endorsement to the SCR programme at this week’s Primary Health Info conference, while setting out how he hoped informatics would develop in future.

Gutteridge is a former medical director of Barts and the London NHS Trust and has played a key role in the implementation of Cerner Millennium at the hospital.


Medical Data Mining Strengthens Drug Safety

By applying analytics to medical journal articles, Rand researchers were able to uncover dangerous side effects before regulators' existing systems could.

By Neil Versel, InformationWeek

May 16, 2011

URL: http://www.informationweek.com/news/healthcare/patient/229500635

Data mining of the medical literature could help uncover drug side effects before they cause serious harm to patients, a new study suggests.

Researchers from Santa Monica, Calif., think tank Rand surmised that a review of published studies could help regulators, like the U.S. Food and Drug Administration, spot dangerous uses of drugs earlier and prevent situations like the 2004 recall of rofecoxib--sold under the brand name Vioxx--following revelations that the arthritis drug could increase the risk of heart attack and stroke.



NPfIT contracts face further scrutiny

18 May 2011 Lyn Whitfield

Two inquiries will start next week into the future of the care records element of the National Programme for IT in the NHS, following today's damning report by the National Audit Office.

The Common’s public accounts committee will hold hearings on the report into the non-delivery of detailed care records systems, while the Cabinet Office’s Major Projects Authority will take a “cold hard look” at the programme from a wider government perspective.

Both will ask fundamental questions about the future of the attempt to deliver integrated care records to the NHS, even though this element of the programme was originally slated for completion by 2010.



Insider view: Jon Hoeksma

The NAO’s third report on NPfIT provides the government with plenty of ammunition to kill off the integrated care records service and its contracts. But will it load and fire, EHI’s editor asks.

18 May 2011

This week’s National Audit Office report on the National Programme for IT in the NHS can only be described as damning.

With its narrow focus on detailed care records systems, it leaves the Department of Health and the programme’s main contractors little space to hide.

It bluntly says NPfIT has failed to deliver, and will now never deliver, on its key objective; getting integrated records into health communities.



Education of next generation of nurses to include effective clinical use of information and communications technologies

May 19, 2011 (Toronto, ON) - A new initiative announced today by the Canadian Association of Schools of Nursing (CASN) and Canada Health Infoway (Infoway) aims to prepare nursing students for practice in modern, technology-enabled clinical environments. Canada's nursing faculties and students will be involved in a three-year effort to strengthen learning on effective uses of information and communications technologies (ICT), now essential tools in clinical practice.



Expanded Emr Use Could Make Big Difference In Infant Mortality

Expanded use of electronic medical records would substantially reduce infant mortality in the U.S., according to an upcoming study in the Journal of Political Economy.

A 10% increase in hospital use of basic electronic records would save 16 babies for every 100,000 live births, the study found. A complete national transition to electronic records would save an estimated 6,400 infants each year in the U.S.

Many health professionals have advocated for electronic records as a way to improve care and curb costs. For obstetricians, electronic records might make it easier to identify high-risk pregnancies and coordinate care.



May 15, 2011

UCSF launches automated pharmacy

By Fred Gebhart, Contributing Editor

Pharmacists at the University of California San Francisco (UCSF) are in the process of bringing online one of the world's largest and most advanced robotic pharmacies. An automated picking system opened in October, 2010, and a sterile preparation and fill operation comes online this fall.

The automated pharmacy is not expected to reduce pharmacy staffing needs, said Lynn Paulsen, PharmD, director of pharmaceutical services, UCSF Medical Center, but it is already creating a safer working environment for both patients and pharmacy personnel.

"We have already filled more than 400,000 oral-solid and sterile-injectable doses with zero order-fill errors," Paulsen told Drug Topics. "Technician picking would generate between 0.1% and 1% errors."



13 May 2011Last updated at 07:13 GMT

Twitter 'vital' link to patients, say doctors in Japan

In the aftermath of the earthquake in Japan, Twitter is proving "an excellent system" for communicating with chronically-ill patients, say doctors.

In letters written to The Lancet, Japanese doctors say social networking sites have been vital in notifying patients where to get medication.

Although telephone networks were disrupted after the earthquake, internet access remained reliable.

But Japan must now strengthen its primary care system, they said.



First physicians in the nation get MU check

May 19, 2011 | Healthcare IT News Staf

NORTH KANSAS CITY, MO – Four physicians have become the first in the country to receive their Medicaid EHR incentive payments for demonstrating meaningful use.

Juan Salazar, MD, an internal medicine physician from McAllen, Tex., and three physicians from multi-specialty West Broadway Clinic of Council Bluffs, IA, announced receipt of government incentive funding for successful use of electronic health records (EHR), with the support of Kansas City, Mo. based health company, Cerner Corporation. West Broadway Clinic and Salazar achieved the first stage of rigorous requirements certifying them 'meaningful users' of health information technology and are excited to announce that the meaningful use dollars have been received via electronic bank deposits.



Blumenthal: Building national health network could take decades

WORCESTER, Mass. -- When Dr. David Blumenthal was national health IT coordinator, he focused on 2015, the HITECH Act's original target date for meeting meaningful use criteria. Now that he's back in civilian life, he's taking a longer view of the initiative to create a national health network triggered by the HITECH Act's cash incentives to physicians and hospitals using electronic health record (EHR) systems.

Blumenthal, who keynoted the Massachusetts annual health IT conference last week, quoted President Barack Obama's line that the HITECH Act was a "down payment" on health reform. He likened the fusion of health IT and payment reform processes -- in the spirit of reducing health care costs while making quality gains -- to a series of mountains to climb, one peak after another.



Worcester hospital finds success with remote ICU

May 17, 2011|By Liz Kowalczyk, Globe Staff

Seriously ill patients at UMass Memorial Medical Center suffered fewer complications and were less likely to die when they were monitored by doctors working in a remote “eICU,’’ some of the first evidence that telemedicine can improve on care provided at the bedside.

Intensive care specialists who oversaw the hospital’s intensive care units from a low-rise office building 3 miles away improved care by essentially acting as a second set of eyes for the on-site doctors and nurses, according to a study published online yesterday by the Journal of the American Medical Association.



Final PHI Protection Rule Won't Mandate Encryption

HDM Breaking News, May 17, 2011

The omnibus federal final rule that will cover changes to the HIPAA privacy, security, breach notification and enforcement rules will not include a mandate for encryption of protected health information, confirms Susan McAndrew, deputy director for health information privacy in the Department of Health and Human Services' Office for Civil Rights.



Looking for Imaging's Missing Link

Gienna Shaw, for HealthLeaders Media , May 17, 2011

Research proves it: Patients and caregivers alike "universally hate" CDs as a method of transferring image files. That's according to Jeffrey Carr, MD, part of a research team at Wake Forest University in Winston-Salem, NC, that's investigating alternative image-sharing technologies.

To be fair, those are just initial survey results, Carr says. But it sure makes sense.

Usually patients themselves have to schlep CDs from one provider to another—often carrying them to their primary care provider after a trip to the ED. And when the discs arrive, there's no guarantee the receiving organization will be able to open or read them.



Computers can help patients make decisions about end-of-life care

By Karen Kaplan, Los Angeles Times / For the Booster Shots blog

3:37 PM PDT, May 16, 2011

End-of-life planning isn't exactly fun -- especially when you are very sick and your days are probably numbered.

But researchers at Pennsylvania State College of Medicine and Pennsylvania State University are trying to make it easier with a computer program that helps patients think through difficult questions, such as whether they want aggressive treatment to prolong their lives or whether they'd rather maximize their quality of life, even if it means they'd probably die sooner.



Info exchanges not reaching potential: Harvard researchers

By Joseph Conn

Posted: May 17, 2011 - 12:15 pm ET

A team of Harvard researchers took a comprehensive look at the state of regional health information exchanges across the country and found the numbers—from a health information technology policy perspective—to be disturbing.

Their findings "call into question whether RHIOs in their current form can be self-sustaining and effective in helping U.S. physicians and hospitals engage in robust HIE to improve the quality and efficiency of care," the researchers wrote in an article, "A survey of health information exchange organizations in the United States: Implications for meaningful use," appearing online in the Annals of Internal Medicine.

The federal government has promoted regional information exchanges as a tool to enable interoperability among electronic health-record systems since the early days of Dr. David Brailer's regime as the first head of the Office of the National Coordinator for Health Information Technology in 2004.



Only 13 RHIOs Meet Meaningful Use Criteria

Margaret Dick Tocknell, for HealthLeaders Media , May 17, 2011

There are 75 operational RHIOs (regional health information organizations) across the U.S. but only 13 of them meet the most basic criteria for meaningful use of health information technology, according to a 2009 study by a group of Harvard University researchers.

With grant support from the federal government, RHIOs provide hospitals and physicians with a single connection to swap clinical data with other participating providers such as labs and public health departments.



Advanced IT linked with hospital profitability, Fitch finds

By Melanie Evans

Posted: May 17, 2011 - 11:00 am ET

Profits and profit growth rates were higher among not-for-profit hospitals that had implemented advanced information technology, received quality awards or both as compared with other hospitals, according to a report (registration required) released today by Fitch Ratings.

An analysis of 291 tax-exempt hospitals and health systems with Fitch credit ratings found that those with advanced IT or quality awards were more likely to be rated A- or above. Slightly more than 80% of those considered high quality or high technology were rated at least A-. That's compared with 67% of the organizations in the overall portfolio that received an A- or higher ratings, according to the report.



Audit reports hit HHS on digital security

By Joseph Conn

Posted: May 17, 2011 - 12:01 am ET

Two new audit reports question HHS' commitment to digital security in health information technology.

The reports, issued today by HHS' inspector general's office, target both the Office of the National Coordinator for Health Information Technology and the Office for Civil Rights for failing to adequately protect patients' electronic information.

In a 36-page “rollup” report citing audits at seven unnamed hospitals, the inspector general's office assails the Office for Civil Rights for a lack of rigor in enforcing the security provisions of the Health Insurance Portability and Accountability Act of 1996. The report also calls out the CMS, which previously oversaw digital security.

In a separate 23-page report, auditors criticize the ONC for lack of leadership in promoting electronic health information security.



Tele-ICU interventions reduce mortality rates: study

By Joseph Conn

Posted: May 17, 2011 - 11:00 am ET

Massachusetts researchers have found an association between using telecommunication technology in a hospital's intensive-care units with improved patient outcomes and better adherence to clinical best practices, according to a report on their study published in the Journal of the American Medical Association.

The study, conducted under the auspices of the University of Massachusetts Medical School, covered the period from late April 2005 to September 2007 and looked at the experiences of 6,290 adult patients admitted to seven intensive-care units at an unnamed 834-bed academic medical center. The tele-ICU system was rolled out at the seven ICU care sites with staggered implementation dates over the period of a year, letting the researchers compare results for a "preintervention group" of patients admitted to intensive care before tele-ICU was provided to that unit and a group of patients admitted after telehealth services were being used.



How far has Google Health really fallen?

May 11, 2011 — 9:12am ET | By Ken Terry

John Moore of Chilmark Research, a respected health IT industry blogger, suggested this week that Google Health is "cryogenically" frozen in place after the disbanding of most of its development team. The most recent departure is that of Missy Krasner, who tells FierceHealthIT that she left Google Health after "five wonderful years."

Google officials did not respond to requests for comment on Moore's assertion, but there's little doubt that Google Health has fallen behind Microsoft HealthVault, its main rival as a web-based personal health record platform. Google has signed up far fewer industry partners than HealthVault; and, unlike HealthVault, it has not announced it will allow providers to upload clinical data using the new Direct Project messaging protocol.



Telemonitoring Success May Depend on Patients' Age, Literacy Level

Findings from study of heart failure patients might help improve monitoring systems

THURSDAY, May 12 (HealthDay News) -- Heart failure patients who are older than 65 and have a high level of health literacy are more likely to continue using telemonitoring technology that tracks their condition than younger people with low health literacy, a new study finds.

Health literacy refers to the ability to read, understand and use health care information. Telemonitoring systems, which help doctors monitor patients outside of office visits, are seen as a way to improve care for heart failure patients, but results so far have been mixed.

The new study shows that individual characteristics play a major role in patients' interest and success in using telemonitoring systems -- knowledge that could help improve the design of such systems and increase patient participation, the researchers said.



May 12, 2011

Doctors Can Now Diagnose and Treat Remotely, Even On Vacation

By Deborah Hirsch

TMCnet Contributor

Imagine you’re in San Francisco and your psoriasis is kicking up, but your doctor’s traveling through Europe. A new breed of robots deployed at hospitals around the country now allows physicians to virtually consult with patients, even if they are miles away.

Called robotic telepresence, a study by Johns Hopkins Hospital shows that 80 percent of patients surveyed feel that the use of it increases physician accessibility.

Telepresence requires that the users’ senses be provided with information giving them the feeling of being in another location. Users get access to the physician at his remote location through the use of a robot. The doctor gets to see the user’s position, movements, actions, and hear his voice, all of which are transmitted and duplicated to the remote location. The real value is that information can now travel in both directions.



Comment Sought on EHR Certification

HDM Breaking News, May 13, 2011

The HIT Standards Committee's implementation workgroup is seeking public comment on the temporary electronic health records certification program being used to support Stage 1 of the meaningful use program.



Kvedar: Telemedicine may be 'EHR v2.0'

WORCESTER, Mass.—Currently, the world of HIT is enshrouded in meaningful use, said Jospeh Kvedar, MD, from the Partners HealthCare System and director of the Center for Connected Health. “However, there are some challenges beyond the ‘simple’ implementation of an electronic medical record,” Kvedar told an audience at the Health IT: Improving Healthcare and the Economy” conference on May 10.

“It’s almost like EHR v 2.0, or moving care out of the EHR and into the patient environment, making it more continuous, more just-in-time,” and telemedicine makes this possible, he said.

“I’ve been at this since 1995, when it really was a crazy thing,” Kvedar said. “I was inspired by the idea that we might be able to extract value out of healthcare interaction if we were able to separate the provider and the patient.”



VA hospital will test 'point-of-care' clinical trial

By Andis Robeznieks

Posted: May 13, 2011 - 1:45 pm ET

A new method for medical research, the "point-of-care clinical trial," will be tested in a study looking to find a better way to control hypoglycemia in 3,000 diabetic, nonintensive-care patients at an undisclosed Veterans Affairs Healthcare System hospital.

In a report published in the journal Clinical Trials describing the study, researchers from Stanford University, Palo Alto, Calif., and the VA Boston Healthcare System describe how the VA's VistA electronic health-record system will be used to conduct a clinical trial in which the "apparatus" of the study—involving recruitment, randomization and attaining consent—is embedded into routine care.



Telecoms firms looking to mHealth

13 May 2011 Shanna Crispin

Almost half of all global telecoms firms are actively working to break into the mHealth market, according to a London analyst.

The results of the Informa Telecoms and Media’s Vertical Markets survey has shown that 45% of telecoms companies are looking to mHealth to increase revenue.

Senior analyst Sheridan Nye said healthcare is extremely attractive for companies that already provide mobile services, smart devices, and cloud-computing.

Nye told eHealth Insider she expects to see a rapid increase in companies tapping into the ‘self-care’ area of mobile health.



EHI Interview: Keith Nurcombe

O2 Health’s managing director doesn’t like the term mHealth. He just believes it could transform the NHS. Shanna Crispin talks to him.

13 May, 2011

He wants to focus on how mobile technologies can transform the NHS, and passionately believes this can happen. It’s just a pity the service is having trouble realising it.

Now we are two

A specialist business unit run within O2 UK, O2 Health is just two months shy of its first birthday. It’s just one of a number of telecoms companies that have decided to try and apply their expertise to the health sector.

It seems that business is booming for Nurcombe and his team of healthcare experts come telecoms professionals, as he says demand for “mobile solutions” is far in excess of what they can actually supply.

But despite the demand from individual NHS organisations, he believes the NHS as a whole is standing in the way of allowing mHealth to improve healthcare.



Canadian E-Health Records System Still Lacking, According to New Study

(Montreal, Canada - Insurance News and Markets) - According to a new study released on February 23 in the Canadian Medical Association Journal, by researchers at the McGill University Health Centre Research Institute, an electronic, virtual health records system should be the mainframe of Canadian healthcare reforms. Additionally, the implementation of such a system must be accelerated across Canada; in the study's opinion, the best way for this to be done effectively is for doctors, medical administrators, and front-line healthcare employees, such as nurses, to take more active positions in the creation and maintenance of this electronic system.



5 keys to making e-Health a reality

Author: John Bowis

15 May 2011 - Issue : 935

Today when we speak about healthcare in Europe, much of the discussion centres on the financial burdens currently faced by Member States. Regardless of the need to focus on providing better healthcare to the patient, the underlying considerations will always be at the behest of the Health Ministry’s budget. And so, for years now, discussions throughout the EU have focused on the potential for e-Health to reduce costs for healthcare systems while providing improved care for patients.

Often, e-Health is seen as the panacea to the problems that remain in healthcare systems throughout the EU. Yet, policymakers and stakeholders continue to struggle with how to implement and utilise current technologies to make e-Health solutions a reality for patients and healthcare professionals. Issues of patient awareness and access, compatibility, interoperability, reimbursement and investment continue to hinder the uptake of e-Health solutions preventing e-Health from becoming the cure to the budgetary ills of Member States.

In light of these difficulties, stakeholders throughout the EU have engaged with policymakers to shed light on the issues preventing patients and health Ministers from realising the benefits e-Health has to offer.