Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, September 30, 2013

Weekly Australian Health IT Links – 30th September, 2013.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. 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

A really, really quiet week.
What is interesting to note is just how quiet the new government is being so far.
A new website has appeared at www.health.gov.au. Was pleasing to see it seems to be reasonably organised - but it is not clear just where the archives are.
As of 29 September, 2013 there is not a single news related media release.
As far as what the health Department looks after you can find that on Page 23 of 45 of this document.
The Personally Controlled EHR Act (2012) is administered from here. Just which minister is responsible is not clear.

The PCEHR: Moving forward

I can confirm that the Government is not going to build a massive data repository. We don’t believe it would deliver any additional benefits to clinicians or patients – and it creates unnecessary risks (~Nicola Roxon)
I’ve studied the PCEHR but I’m still not sure what the government has built and for what purposes. I was always under the impression that the PCEHR was designed to assist clinicians to improve patient care through better data flow. But this may not be the case.
The recent resignation of NEHTA’s top National Clinical Leads is an ominous sign. If the Department of Health does not start sharing ownership of the PCEHR soon and improve governance of the system, the PCEHR will fail. Here’s a quick rundown of the issues and how to move forward.

Peter Dutton shifts into high gear for e-health overhaul

HEALTH Minister Peter Dutton has moved swiftly to initiate a review of the troubled $1 billion personally controlled e-health record system at the behest of Tony Abbott.
Mr Dutton has received initial briefings on the PCEHR from key stakeholders such as the Department of Health.
The Coalition will undertake a comprehensive assessment of the true status of the PCEHR implementation as outlined in its health policy released in the lead up to the election.

Guild supports PCEHR audit

24 September, 2013 Kirrilly Burton
The Pharmacy Guild of Australia has backed a review of the $1 billion Personally Controlled Electronic Health Record (PCEHR) system by Peter Dutton, the Minister for Health. 
In the Coalition’s health policy released in the lead up to the election, it said it will undertake a “comprehensive assessment of the true status of the PCEHR implementation.”  
“Unfortunately, the Labor Government has failed to deliver on its PCEHR. Despite the $1 billion price tag, only 4000 records are reported to be in existence,” the Coalition said.   
“In Government the Coalition implemented successful incentives to computerise general practice and will continue to provide strong in-principle support for a shared electronic health record for patients.”

Guild keen to discuss PCEHR with Coalition

The Pharmacy Guild of Australia supports the concept of an electronic health record and has invested significant time and financial resources to see such a system become a reality. 
The Federal Election has just concluded and one significant area of policy difference between the major parties is in the area of eHealth. We welcome and support the direction of the incoming Coalition Government where a focus will be on electronic prescriptions and medication management. However the Coalition has announced they will undertake an audit of the current Personally Controlled Electronic Health Record (PCEHR) System and we wait to see the outcomes of the new Government’s audit and the subsequent policy changes before we review our position. 

Aniello Iannuzzi: Time for change

Aniello Iannuzzi
Monday, 23 September, 2013
EVEN though voters consistently place health high on their list of important issues, both sides of the political divide somehow managed to dodge the issue in the recent election campaign.
“Voting for change” and “6-point plans” seemed to grab the media’s attention rather than health.
In the hope that new Prime Minister Tony Abbott and new Health Minister Peter Dutton read MJA InSight, here is my 6-point plan for health change:

Commonwealth agencies to be cut by Abbott Government

  • Steve Lewis
  • News Limited Network
  • September 22, 2013 10:00PM
AGENCIES responsible for tackling obesity, capital city planning and security advice on asylum seekers are to be slashed as Tony Abbott takes the axe to Labor's reform agenda.
Less than a week after taking office, the Coalition Government has scrapped plans to build a multimillion-dollar embassy in Africa, and will also wipe $100 million off research funding.
The Prime Minister has also pulled the pin on a key Kevin Rudd initiative - Community Cabinet - as he instructs his new ministry team to put the broom through the bureaucracy.

Call to introduce real-time prescription monitoring

25th Sep 2013
BLEAK figures on the increase in deaths due to acute prescription drug toxicity in Victoria in the first half of the year provide new impetus for introducing real-time prescription monitoring, an expert believes.
Figures released by the Coroners Court of Victoria show prescription pharmaceuticals contributed to 82.3% of the 176 deaths due to drug overdose from January to June.
Benzodiazepines overtook opioids as the most prevalent contributor (58%) to death, with diazepam contributing to more deaths (84) than heroin (67) for the second year.
Alcohol was contributor to 30% of the deaths compared to 21% for 2102, while codeine contributed to one in four deaths.

Ephedrine bust shows benefits of Project STOP

26 September, 2013 Nick O'Donoghue
A 274kg haul of illegally imported ephedrine seized by a Department of Agriculture and Food officer in Port Melbourne this week is leading to calls for Government to fund Project STOP.
The find was made when the officer was testing several thousand bags of basmati rice imported from India, and was the third biggest in Australian history.
Speaking on ABC Radio National’s The World Today, Kos Sclavos, Pharmacy Guild of Australia national president, said the bust indicated that Project STOP has been effective preventing illicit drug manufacturers from sourcing materials through pharmacy.
“Unfortunately, historically, as we know this product was being misused and diverted to make speed, and so we’ve put in a system in place,” he said.

Mind of amputee controls new leg

  • The Wall Street Journal
  • September 27, 2013 12:00AM
IN an advance that could eventually improve the mobility of thousands of people living with amputations, researchers say a 32-year-old man has successfully controlled movements of a motorised artificial leg using only his thoughts.
Aided by sensors receiving impulses from nerves and muscles that once carried signals to his missing knee and ankle, the patient was able to climb and descend stairs. Importantly, he was able to flex the device's ankle, enabling a near-normal gait, something not possible with prosthetics.
It was "night and day" between the experimental bionic leg and the mechanical prosthetic limb he used every day, said Zac Vawter, a software engineer from Washington State who lost his right leg in a motorcycle accident four years ago.

On the future of CDA

Posted on September 28, 2013 by Grahame Grieve
I’ve had several questions about my comments on the future of CDA in the Structured Documents working group (SDWG) this week, so I thought I’d clarify here.
The context of this work was a question from the CDA R3 team whether they should close down the existing CDA R3 work, and instead focus on FHIR as a vehicle for CDA R3.
I think there was some confusion about this – in no way should this idea be understood as “abandon CDA” or even “stop working on CDA R3″, which I heard it characterized as. It’s simply proposing that the underlying format for the next release of CDA will be based on the technical vehicle of FHIR rather than the technical vehicle of the RIM Based ITS(s). The same functional use cases get carried forward to the next version of CDA, and the same basic requirement applies: that there be a conversion process to go forward from CDA R2 to CDA R3, just as there was for CDA R1 to R2.

Medical apps face tougher scrutiny

24 September, 2013 David Brill
Diagnostic smartphone apps are set to face tougher regulatory scrutiny under long-awaited new guidance from the US Food and Drug Administration.
In a document released Monday, the FDA said most medical-related apps posed minimal risk to the public and should not be regulated as medical devices.
However, the FDA said it intended to focus on those apps that posed a possible safety risk if they malfunctioned, such as apps that transform a phone or tablet into an ECG, ultrasound or glucose meter.
Apps that display patient-specific information, such as for viewing X-rays or analysing and interpreting test results, will now also be subject to FDA oversight.
The guidelines, first released two years ago in draft form, represent a trade-off between protecting patient safety and encouraging innovation, Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, said.

Formulary for success

Tasmania’s new Electronic Medicines Formulary, launched in June, is a web-based database for use by clinical staff across Tasmania’s four main hospitals and 17 rural and regional hospitals, and the most comprehensive formulary in Australia.
“Previously doctors wanting to access information about what they could prescribe, had to access a variety of sources – and in fact, a lot of the information wasn't available at all,” says Tom Simpson who is the Executive Director, Statewide Hospital Pharmacy at Royal Hobart Hospital.
“We didn't publish within our hospitals what drugs we stocked in the pharmacy, what drugs were allowed to be used for what indications, all those sorts of things.”

Why clinicians don’t like national e-health

And what needs to be done to change their minds
If a recent survey by Australian Doctor is anything to go by, many general practitioners (GPs) across the country don’t want to participate in the challenged national e-health program.
There are two key reasons for this: time and money. In recent months, several prominent healthcare professionals have criticised the time it takes to prepare information that can be submitted to a patient's personally controlled electronic health record (PCEHR), particularly to ensure the accuracy of data recorded about a patient’s health.
They’re also concerned about information contributed to a PCEHR system being viewed by the wider health community and the time it takes to ensure the data is concise.

Sinapse Delivers Rapid Implementation of Athena Software's Case Management Software Solution to Large Australian Government Department

Waterloo, Ont. company Athena Software and Australia-based firm Sinapse successfully implemented Athena's Penelope case management software solution to the Australian Government's Department of Veterans' Affairs, Veterans and Veterans Families Counselling Service (VVCS)

Waterloo, ON (PRWEB) September 25, 2013
Earlier this year, Sinapse was contracted to implement and support the deployment of Athena Software's Penelope case management application with the Australian government's Department of Veterans' Affairs (DVA).
The project saw the web-based Penelope application replace the Veterans and Veterans Families Counselling Service Management Information System previously used by the DVA.

NSW Health Pathology seeks CIO to improve networks

IT boss will oversee five networks at the new state-wide clincial service
NSW Health Pathology is looking for a CIO to create and deliver a five-year strategic plan to improve the organisation’s networks.
This is a new role at NSW Health Pathology, which has only been established for about 10 months. The state-wide clincial organisation is part of the NSW public health system and provides public pathology, forensic and analytical science services across NSW.
The CIO will overlook five specialised networks, which include: Pathology North, Pathology West, South Eastern Area Laboratory Service, Sydney South West Pathology Service, and the Forensic and Analytical Science Service.

Health reporting at risk

Nicole MacKee
Monday, 23 September, 2013
THE loss of experienced journalists from some mainstream media outlets could lead to the “dumbing down” of health reporting, says a long-term observer of health in the media.
Professor David Henry, co-founder of the online health reporting watchdog Media Doctor, said the sudden exodus of experienced journalists from major media outlets last year due to the restructuring in two of Australia’s most influential media companies would have consequences for health literacy in the community.
“The existence of an independent media and in particular one that includes journalists that have the skills and the knowledge to report accurately on health care interventions, is really quite critical”, said Professor Henry, who is now a professor of clinical pharmacology at the University of Toronto, Canada.

AMLA CEO resigns after just six months

23rd Sep 2013
AUSTRALIAN Medicare Local Alliance CEO Claire Austin has left the organisation just six months into the job as the 61 MLs brace for a sweeping review under the newly elected Abbott government.
The alliance confirmed Ms Austin’s departure late on Friday but declined to give details, including whether it was Ms Austin’s choice to leave. 
In a statement, the alliance said its board appointed its general manager for national programs and member services, Sean Rooney, as acting CEO.

The NBN board has run away. Why?

23 September, 2013
The resignation of the entire board of NBN Co has brought into sharp focus my membership of the NBN Peanut Gallery. Perhaps it is time to move on, to acknowledge the Coalition’s mandate and Get A Life.
But, no – I have decided to stay on; my country needs me. Ziggy Switkowski, on the other hand, needs to think twice.
The current chair, Siobhan McKenna and her five colleagues, will no doubt be unable to get out of the place quick enough. Each will be hoping not to be the one whom the new minister and shareholder, Malcolm Turnbull, asks to stay on to assist with the transition.
Meanwhile it is persuasively suggested that the minister has prevailed upon the former chief executive of Telstra, chair of Opera Australia and examiner of the Essendon Football Club to be executive chairman of NBN Co, which is another term for CEO.

Control-alt-delete was a mistake, says Bill Gates

Date September 27, 2013 - 9:29AM

Will Oremus

Bill Gates has admitted the control-alt-delete command used to log on to PCs was a mistake.
Hundreds of millions of people around the world, including virtually everyone who has ever used a Windows device, have had to memorise the key command "control-alt-delete". In retrospect, that was probably unnecessary, Microsoft co-founded Bill Gates revealed in a talk at Harvard last week.
As Geekwire points out, the surprising – and, let's face it, seriously belated – admission came in response to a wonderfully blunt question from David Rubenstein, co-chair of a Harvard fundraising campaign. "Why, when I want to turn on my software and computer, do I need to have three fingers: control, alt, delete?" Rubenstein asked the living tech legend. "Whose idea was that?"

In pictures: The desktop lover's guide to supercharging Windows 8.1

Don't like the Metro interface? Here's the best way to banish it and boost your productivity.

Sunday, September 29, 2013

Senator Boyce Gets The Most Recent Collection Of Non-Answers From NEHTA at Senate Estimates From June This Year.

There were five interesting responses among about 30 provided.

Subject Outcome: E-Health 10.2

Agency: NEHTA
Issue: NEHTA – Standards/Functionality of the PCEHR
Name of Senator: Sue Boyce
Senator Boyce asked:
Given the safety implications did NEHTA issue any form of warning alert? If not why not?
The information provided within the AMT fully describes and accurately identifies medicines. The descriptions listed in the AMT are correct. These are based on current Editorial Rules and accurately describe the products. The major issue relates to the different representation of the order of ingredients within the AMT Medicinal Product and Medicinal Product Pack descriptions which do not match the order on the product packaging. These are generic concepts and are not intended to reflect actual product labeling. Examples exist where different brands of the same set of ingredients have product labels with ingredients in different orders.
The issue or ingredient order for all medicines has been considered on a number of occasions by the AMT Support Group and late in 2012 an alphabetical approach to ingredient order was proposed and agreed. This would then result in descriptions that were clear and consistent. The Support Group is made up of representatives from Pharmaceutical Benefits Division, the Therapeutic Goods Administration, various state health jurisdictions, clinicians, medical software vendors and relevant professional organisations.
Senator Boyce asked:
Is it true that all the stakeholders in Standards Australia - 44 of them - with the exception of DOHA and NEHTA have lost confidence in, or are concerned about, the standards now being applied to electronic prescriptions?
This matter should be referred to Standards Australia. NEHTA cannot comment on the Standards Australia’s stakeholder’s confidence levels.
Senator Boyce asked:
Given the importance of transparency in encouraging co-operation, clarity and trust why hasn’t NEHTA/DOHA released PCEHR safety Report Part B and the HI Service pre-commissioning safety report?
NEHTA’s Clinical Safety Unit (CSU) works very closely with the Department of Health and Ageing in its role as System Operator of the PCEHR. This includes participation by NEHTA CSU in key committee processes including review by the Clinical Safety Working Group and Clinical Governance Committees. These Committees provide a forum for the safety assessments presented in the PCEHR Clinical Safety Case Report so they can be thoroughly considered in the development, testing and operations of the PCEHR. The reports are released and shared between forum participants. The Australian Commission on Safety & Quality in Healthcare have undertaken two of four audits of the safety of the PCEHR and the methods and processes that determine its creation. The clinical safety case reports are a key input to these audits and include findings noting that partner organisations continue to ensure that clinical safety case reports are shared appropriately between agencies and form a basis for ongoing risk management of the PCEHR. This work will ensure that recommended mitigating controls are being acted against and that existing mitigating controls can be evaluated for ongoing effectiveness.
Senator Boyce asked:
Given the widespread concern expressed by stakeholders in regard to issues of safety and privacy surrounding the concept and construction of the PCEHR why has NEHTA shown continuing reluctance to release PCEHR safety and compliance reports?
The PCEHR Clinical Safety Case Report assessments and recommendations are a key input to processes underpinning the continuing development, testing and operations. The report is released in the context of key governance processes important to clinical safety including review by the Clinical Safety Working Group and Clinical Governance Committees. The Australian Commission for Safety & Quality in Healthcare are leading through the audit activities the evaluation of arrangements for sharing the outputs of the NEHTA CSU.
Senator Boyce asked:
It’s also alleged by certain vendors that AMT codes in the PBS distribution appear to be different from AMT codes for the same concept in the AMT distribution. Is this correct and if so what are the consequences if that is not rectified?
If the question being addressed is “Do all AMT codes contained in the PBS exactly match codes contained in the NCTIS AMT releases” the answer is no. PBS have on occasion the need to allocate their own ‘AMT-like code’ due to differences in how a product may need to be described for legislation/ reimbursement purposes and the corresponding AMT description contains either too much/too little detail (e.g. inclusion/exclusion of a container type or salt of a substance). In these cases, PBS create their own description and use their own namespace identifier (a 7 digit ID which appears within the full identifier string) to differentiate it from a true AMT code.
NEHTA and PBS will continue to work together to ensure quality mapping processes and alignment between the releases. NEHTA anticipated that there would be a number of questions from vendors around inclusion of AMT codes and descriptions in PBS files and has drafted an FAQ document outlining some of the most likely questions to assist and guide vendors.
You can download and read all the answers from this link:
What we have here, to me, is foot dragging, denial and refusal to be open to potential problems and to have a reasonable sense of urgency in fixing potential issues.
I wonder will the change in Government lead to an improvement in openness and transparency or will Mr Dutton simply get rid of NEHTA.
Place your bets in the comments section.

AusHealthIT Poll Number 185 – Results – 29th September, 2013.

The question was:

How Would You Rate The Overall Performance Of The Labor Government In The E-Health Space Over The Last Six Years?

Excellent 5% (3)

Not Too Bad 6% (4)

Neutral 5% (3)

Not At All Good 11% (7)

Just Awful 74% (48)

I Have No Idea 0% (0)

Total votes: 65

This is a pretty clear outcome. Put simply Labor is seen as having failed by those who read here.

Again, many thanks to those that voted! 


Saturday, September 28, 2013

Weekly Overseas Health IT Links - 28th September, 2013.

Note: Each link is followed by a title and few paragraphs. 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.

Google starts new health company to tackle aging

Alistair Barr, USA TODAY 6:21 p.m. EDT September 18, 2013

Calico, a new company backed by Google, may use powerful data crunching to tackle age-related illness and disease.

Story Highlights

  • Calico counts Google and Apple Chairman Levinson as investors
  • Calico may use powerful data-crunching to tackle age-related diseases
  • Calico is the latest project that takes Google far from Internet roots
  • Google chief Page says tech can improve lives in many different ways
SAN FRANCISCO — Google is not happy just organizing the world's information. The Internet search giant wants to help you live longer now too.
Google unveiled Calico Wednesday, a new health technology business focused on aging and related diseases.
It will be run as a separate company and operated independently, however, Google is an investor alongside Arthur Levinson, the chairman of Apple and biotech company Genentech, who will be Calico's CEO.

EHRs Are Not A 'Digital Menace'

Healthcare IT can compromise patient safety, but studies show that lack of it may present an even greater risk.
"The lottery is a tax on people who don't understand mathematics."
It's one of my favorite truisms because it aptly describes the magical thinking that so many people buy into about their chances of winning that $100 million jackpot, despite the fact that a person is more likely to get hit by lightning on his birthday.
This truism also applies to misconceptions about lots of other probabilities -- like the risk of developing a serious reaction to the measles vaccine versus the benefits of averting a life-threatening measles epidemic. Or the risk of getting the wrong medication due to an EHR glitch versus the benefits that come from replacing paper with digital files. Those benefits include better care coordination, zero risk of misreading physicians' illegible handwriting, and monitoring of drug/drug and drug/food interactions.
Probability is not one of our strong suits as a nation, and unfortunately that weakness plays into the mass media's tendency to run scary headlines that talk about the "digital menace."
A recent Bloomberg article, "Digital Health Records' Risks Emerge as Deaths Blamed on Systems", illustrates my point. The piece starts out describing the case of an 84-year-old woman who was rushed to the hospital for a suspected stroke and eventually died because, says her physician son Scot Silverstein, one of the drugs she needed had inadvertently dropped off the medication list in the hospital's EHR system.

Do Physicians Spend Too Much Time With Computers?

SEP 17, 2013 9:35am ET
A recent study of work hours of medical interns in the new era of duty hour regulations produced an interesting side finding, which is that modern medical interns spend about 40% of their time at a computer [1]. To some, this prompted concern that computers were drawing medical trainees away from patients and their care.
A finding like this certainly warrants attention. However, I wonder whether many expressing concern are asking the wrong question. The proper question is not whether this is too much time at a computer, but rather if this amount of time compromises the interns' care of their patients or of their learning experience.
Implicit among those who raise the question of too much time with computers is the assumption that computers are taking physicians away from patients. It is instructive, however, to consider historic data of how much time physicians spend in direct vs. indirect care of patients. It turns out that physicians have historically spent most of their working time in activities other than in the presence of their patients.

ONC: HIE governance framework puts emphasis on trust

September 18, 2013 | By Marla Durben Hirsch
The different business models for health information exchange governance are taking shape, and make "trust" a priority, according to the Office of the National Coordinator for Health IT's latest update on its continuing efforts to support HIE.
The update by ONC officials and others, conducted via a webinar hosted by the National eHealth Collaborative (NeHC) on Sept. 17, noted that ONC heard "loud and clear" from responses to its request for information (RFI) on the subject that stakeholders wanted the government to wait before taking a regulatory approach to HIE governance. ONC instead focused on creating a National HIE Governance Forum where stakeholders could partner with one another and with ONC to identify and share emerging and promising approaches and challenges in a collaborative environment.
The forum is the "heart of our response" to the RFI, said Jodi Daniel, director of ONC's office of policy and planning.

ONC is 'not going to retreat,' post MU

Posted on Sep 19, 2013
By Anthony Brino, Editor, HIEWatch
You'd be justified in wondering whether the Office of the National Coordinator might soon see its influence wane, what with EHR adoption having reached critical mass and meaningful use incentive funding dwindling toward the halfway point. But you'd be wrong, says Farzad Mostashari, MD.
Mostashari, the outgoing national coordinator, is adamant the agency’s policy and technical services will continue to be in high demand and continue to work to address the IT challenges and opportunities in healthcare.
The need for the ONC’s work on policy development and coordination with other agencies "is only going to grow, as there’s more and more health information in digital format, and as the flow of that information becomes more important for quality measurement, privacy and security," Mostashari said during an interview this week.

A better approach to clinical decision support?

September 19, 2013 | By Susan D. Hall
Differential diagnostic decision support tools generally are built to identify a single correct diagnosis, while focusing instead on the value of information they provide might better achieve the goals of shared-decision making to improve care and cut costs, according to a BMC Medical Informatics & Decision Making article.
In a scenario in which a 64-year-old man comes to the emergency department with acute chest pain, a tool would be most useful in paring the potentially hundreds of diagnoses to a subgroup with clear paths of action. These actions would aim to decrease morbidity and mortality, while lack of action would increase these. Such clear-cut paths, however, might include diagnostic errors of omission, according to the article.

5 elements to achieving health IT interoperability

September 19, 2013 | By Julie Bird
The Office of the National Coordinator for Health IT (ONC) has released what it calls a path to achieving interoperability among different electronic health record (EHR) systems.
In a blog post Wednesday, David Muntz (pictured), principal deputy and Nora Super, public affairs director, outline five elements critical to achieving health IT interoperability. They are:
1.       Adoption and optimization of EHRs and health information exchange (HIE) services
2.       Standards to support implementation and certification
3.       Financial and clinical incentives
4.       Privacy and security
5.       Rules of engagement or governance

Most hospitals have tools to meet Meaningful Use Stage 2 now

September 19, 2013 | By Dan Bowman
More than two-thirds of U.S. hospitals have bought technology from a vendor certified to the 2014 Edition certification criteria, according to a newly published report from HIMSS Analytics, meaning that many hospitals already have the tools they need to meet Meaningful Use Stage 2 at their disposal.
The report, which used data from 418 hospitals collected through the first six months of 2013, also found that 70 percent of respondents are "actively moving toward meeting Meaningful Use Stage 2" mandates, while 60 percent have met the requirements for at least nine core metrics in Stage 2.
"Despite low current readiness rates to achieve metrics such as providing patient electronic access, providing summary of care records for all transitions/referrals and the use of clinical decision support technology to improve performance on high-priority health conditions, there is substantial activity planned for the future," the report's authors wrote. "These results suggest that the industry is moving forward toward Stage 2 Meaningful Use and hospitals will be ready to begin attesting in 2014."

Abandoned NHS IT system has cost £10bn so far

Bill for abortive plan, described as 'the biggest IT failure ever seen', was originally estimated to be £6.4bn
An abandoned NHS patient record system has so far cost the taxpayer nearly £10bn, with the final bill for what would have been the world's largest civilian computer system likely to be several hundreds of millions of pounds higher, according a highly critical report from parliament's public spending watchdog.
MPs on the public accounts committee said final costs are expected to increase beyond the existing £9.8bn because new regional IT systems for the NHS, introduced to replace the National Programme for IT, are also being poorly managed and are riven with their own contractual wrangles.
When the original plan was abandoned the total bill was expected to be £6.4bn.

Report Ranks EHR Vendors’ Patient Portals

SEP 17, 2013 3:30pm ET
A new report from vendor research firm KLAS Enterprises assesses the patient portal capabilities of multiple electronic health records vendors to adequately support Stage 2 meaningful use criteria for patient engagement.
Information in the report comes from KLAS interviews with more than 200 providers with patient portals and focuses on nine vendors: Allscripts, athenahealth, Cerner, eClinicalWorks, Epic, Greenway, Intuit Health, NextGen and Vitera. In general, providers are finding portals from EHR vendors to be better equipped than those from third-party vendors.

EHI interview: Neil Jordan

Lyn Whitfield talks to the general manager of health for Microsoft worldwide public sector about the health service’s looming XP problem and the company’s evolving role in healthcare.
17 September 2013
It’s eight years since Neil Jordan left for the US after being promoted from UK head of healthcare to global head of healthcare by Microsoft. In that time, a lot has changed for both the healthcare IT market and the company.
Back in May 2005, in the week that Jordan’s promotion was announced, the National Programme for IT was able to reveal that it had met its target of establishing 6,000 live connections to the new national network, N3.
It still had all five of its local service providers in place, and had big plans for national programmes such as Choose and Book (which, it was suggesting, might be able to offer patients appointment reminders – by text!)
Microsoft had just extended is Enterprise-wide Agreement with the health service, covering server, desktop and Office software licences for around 900,000 staff.
And in return, NHS Connecting for Health had secured the company’s backing for projects such as the ‘common user interface’ that it hoped to see adopted by all clinical application vendors.

Eight in ten NHS desktops still on XP

18 September 2013   EHI staff
Microsoft’s decision to end support for Windows XP in April next year looks set to cause significant problems for the NHS, which still has 85% of its desktops running on the obsolete operating system.
The scale of the XP challenge is revealed today in a report from EHI’s research arm, EHI Intelligence, which calculates that there are 677,000 computers across the health service that work on the OS, which was launched in October 2001.
By contrast, just 14% of the computers covered by the research (or 110,000) are running the Windows 7 OS that Microsoft introduced in October 2009, and just 1% (10,600) are using the newer Windows 8.

5 ways to link health information technology, quality measurement

September 18, 2013 | By Susan D. Hall
A new report from the Agency for Healthcare Research and Quality (AHRQ) summarizes the comments it received on its July 2012 request for information and from focus groups on how to enhance quality measurement through health information technology.
The 111-page report breaks the input down into three types of findings: "Perspectives" notes that different stakeholders have different views, and their opinions might vary in different situations. The perspectives section focus on linking quality measurement with systemic improvement, maximizing the capabilities of health IT, and understanding the tradeoffs involved in incorporating measurement with workflow. "Pathways" outlines critical topic areas to be addressed. "Practical guidance" outlines more than 100 practical steps organizations can take.

Docs optimistic HIT can improve care, but doubt promised cost savings

September 18, 2013 | By Julie Bird
Most physicians think health IT will improve quality of care long-term, but just as many are skeptical that it will also reduce the cost of care, according to a new study by the Deloitte Center for Health Solutions.
Doctors who have practiced 10 years or fewer are more likely to think health IT will improve quality of care--81 percent, compared with 73 percent overall.
Optimism about improvements in quality of care also is higher among physicians in larger practices--80 percent for those in practices of 10 or more physicians, compared with 73 percent for those in smaller practices.
When it comes to cost reduction, 81 percent of solo practitioners think health IT will increase costs, compared with 71 percent among all physicians queried.

Under Pressure

SEP 1, 2013
For health care finance executives, the adage "no money, no mission," has never been more apropos, as they face both dwindling reimbursements and payments increasingly tied to outcomes.
But another adage, "If you've seen one hospital, you've seen one hospital," also applies.
Delivery organizations vary widely by payer mix, local demographics, physician relations and even local I.T. talent available.
What follows are snapshots of how CFOs and senior level finance executives are using I.T. to streamline their financial organizations-and the tools they're considering to meet their future needs.

Top 5 security threats to the HIX hub

By Yo Delmar, Vice president, GRC Solutions at MetricStream
The vast amount of consolidated sensitive information passing through health information exchanges is unprecedented, and will introduce privacy and technology risks that HIX stakeholders need to be vigilant in addressing.
Questions arise as to who will have access to this information, how secure will it be from cyberattacks, and what training and clearances will be required to access and protect the data from fraud and abuse.
In many ways, the HIX will form part of what we have come to consider “critical digital infrastructure.” Critical infrastructure, which houses and processes sensitive and potentially valuable information, attracts threat agents, and is vulnerable to a wide range of security threats. So, a sophisticated attack, which seriously disrupts the HIX for a prolonged period across a wide geographic area, could devastate the health services ecosystem.

EMIS buys Ascribe for £57.5m

13 September 2013   Jon Hoeksma
Primary care systems supplier EMIS has purchased clinical software supplier Ascribe for £57.5m.
The purchase of Ascribe, a pharmacy and e-prescribing software specialist, is by far the largest acquisition yet made by AIM–listed EMIS.
The deal will significantly strengthen the position of EMIS in the increasingly competitive NHS clinical software market for hospital, community and mental health systems.
Chris Spencer, chief executive officer of EMIS Group, said in a statement: “The acquisition of Ascribe represents a significant milestone in our stated strategy of providing clinically led, integrated cross-organisational healthcare systems.

HHS launches site to help providers engage patients

September 17, 2013 | By Dan Bowman
The U.S. Department of Health & Human Services this morning launched a new website aimed at aiding providers in their efforts to engage patients in determining the best way to share their electronic information.
The site, called the Meaningful Consent site, provides "strategies and tools" to providers, including background information and lessons learned by other providers. It is based on 2011 recommendations made by the Office of the National Coordinator for Health IT's HIT Policy Committee.
"As patients become more engaged in their healthcare, it's vitally important that they understand more about various aspects of their choices when it relates to sharing their health in the electronic health information exchange environment," Joy Pritts, chief privacy officer at ONC, said in a statement.

ONC launches eHealth resource site

Posted on Sep 18, 2013
By Erin McCann, Associate Editor
For healthcare providers and organizations looking to brush up on laws and policies surrounding electronic health information exchange, or wanting some tips on patient eConsent engagement, look no further.
The U.S. Department of Health and Human Services on Wednesday launched a meaningful consent online resource to help providers effectively engage patients in choosing how they want their electronic patient health information shared.  
The site addresses laws, policies and issues related to health information exchange, and includes strategies and tools that can be used to spur patient engagement and further educate patients, officials said. 
September 16, 2013, 9:45 p.m. ET

Patients Share DNA for Cures

Patients with rare and deadly diseases are getting a powerful new boost.
Cancer foundations and other nonprofit patient groups are investing tens of millions of dollars to build genetic databases in an effort to speed drug development and jumpstart clinical trials.
The databases are designed to collect DNA and other information from patients with hard-to-treat diseases. The material can be analyzed for certain genetic mutations and made available to scholars and pharmaceutical companies.
The databases could also help patients familiar with their own genetic mutations to find information about clinical trials.
On Tuesday, the Leukemia & Lymphoma Society is set to announce a three-year, $8.2 million project that combines the resources of the Oregon Health Sciences University, gene-sequencing company Illumina Inc., and Intel Corp. Funded by the society, the resulting database will contain DNA information and analysis gathered from 900 patients with acute myeloid leukemia.

Survey: 41% of Patients Would Switch Physicians to Gain Online Access to EMRs

Written by Helen Gregg (Twitter | Google+)  | September 16, 2013
More than 40 percent of Americans would be willing to switch physicians to be able to access their electronic medical records online, according to a recent survey by Accenture.
The survey, featuring the results of 1,000 respondents from across the country collected in July, also found 84 percent of consumers believe they should have full access to their medical records, though 63 percent currently have limited access.

ONC Names Blue Button Plus Contest Winners

September 16, 2013
The Office for the National Coordinator (ONC) has announced the winners of its Blue Button Co-Design Challenge this week at the Consumer Health IT Summit, which is a daylong event held during the annual Health IT Week.
The contest asked developers to create apps that implement and use Blue Button Plus functionality to address one of several patient problems. The winning team was GenieMD, an app that provides users with a variety of patient services including symptom checking, finding providers and pharmacies, and alerts for drug interactions through what ONC calls is an “intuitive, easy-to-use interface.”
It also combined data from multiple providers through Blue Button +, including patient-entered data, data from smart devices, and content provided by Harvard Health Publications.

Patients Define Evolving Expectations for HIT

Scott Mace, for HealthLeaders Media , September 17, 2013

If providers keep up with the tools available to patients, and turn yesterday's one-page brochure on a disease into tomorrow's Web site or mobile app, they will continue to be at the center of patient care.

What's the value of health information technology?
That's the question being asked during this week, National Health IT Week, organized by the Healthcare Information and Management Systems Society (HIMSS).
Certainly health IT has been very good to the members of HIMSS. The billions in Medicare incentive money paid out to providers in the past several years have enriched participating health IT vendors in a way that few portions of the IT industry have been able to enjoy, even considering the dot-com boom and the Y2K scare.
In Verona, WI this week, attendees of Epic's annual user conference are marveling at the company's brand new conference center, which holds 13,000 people. That's one big corporate conference center.

The Building Blocks of an HIT Strategy

A comprehensive strategy can help providers promote adoption of health information technology and capture the benefits.
The adoption of health information technology (HIT) in its many forms—including electronic health records (EHRs), tools that assist in decision-making and patient interactions, and mobile technology—remains a work in progress. A recent Deloitte survey found that while many physicians recognize that HIT can improve the quality of care, they also remain unconvinced that it will reduce costs. Many smaller practices and older physicians in particular aren’t transitioning to EHRs. What’s more, many physicians have yet to fully utilize support tools and mobile devices that are intended to enhance patient service.
The stakes are high for providers that can lead the way in promoting HIT adoption. HIT has the potential to improve safety and outcomes, increase accuracy in diagnosing medical problems, and reduce administrative costs. HIT can also be critical to reaping the benefits of performance-based incentives used by Medicare and private plans to encourage effective care coordination and technology-enabled patient interaction and paperwork reduction.

Wireless health market poised for growth

Posted on Sep 16, 2013
By Erin McCann, Associate Editor
The global wireless health market has hit growth mode, according to new report findings, which project the market will expand more than 20 percent within a five-year period. 
The report, conducted by Research and Markets, pegs the wireless health market currently at $23.8 billion, expected to reach $59.7 billion by 2018, the growth being attributed to the uptick in remote patient monitoring applications and diagnostics, aging populations and growing hospital deficits. 
Wireless network technologies represent the largest market segment and will continue to be the largest contributor over the next five years, researchers say. 
The mobile devices and mobile apps segment, however, is also growing rapidly and will continue to grow at a similar pace over the next few years due to its wide applications and increased adoption by various healthcare professionals, pharmaceutical companies and research laboratories.

Consumers get serious about their EMRs

Posted on Sep 16, 2013
By Bernie Monegain, Editor
As patient engagement grows, a new survey indicates that a growing number of U.S. consumers (41 percent) would be willing to switch doctors to gain online access to their own electronic medical records. Doctors, though, are not as eager to make the change.
The survey, of more than 9,000 people in nine countries, shows that only about a third of U.S. consumers (36 percent) currently have full access to their EMR, but more than half (57 percent) have taken ownership of their record by self-tracking their personal health information, including their health history (37 percent), physical activity (34 percent) and health indicators (33 percent), such as blood pressure and weight.

Mental-health help goes online

Mystrength.com is there to help those who can’t wait to see a therapist

Sep 13, 2013, 4:00am MDT
Reporter- Denver Business Journal
The digital revolution let people with physical ailments visit websites such as WebMD and diagnose their own conditions for the past 10 years. But Scott Cousino saw what it couldn’t do — help Americans with mental-health ailments aid themselves without a therapist.
In 2010, Cousino — an online-education professional who had overcome a bout of severe depression in his 20s — began working on myStrength.com. The website provides mental-health checks, affirmations and other supplemental help to people whose therapists aren’t available.
Three years later, eight community behavioral-health networks in Colorado use the website, it’s expanded to six other states and officials from the National Council for Community Behavioral Healthcare have created an exclusive relationship with the Denver company to advance the use of technology as a mental-health treatment extender.

Mostashari launches National Health IT Week with a question: Is the time now?

Posted on Sep 17, 2013
By Diana Manos, Senior Editor
Farzad Mostashari, National Coordinator for Health Information Technology, kicked off this year’s National Health IT Week at a meeting Monday focused on the patient’s role in health IT.
In a meeting that brought together a host of federal officials and stakeholders, Mostashari asked: “Is the time now?”
“There’s a glorious band of misfits here today who saw the world of health and healthcare and said, `we don’t fit. We need to change what’s happening here,’” said Mostashari. “Is it time for this movement to move beyond us misfits to the broader world of health? Do we have new tools and approaches? Do we have the oxygen for those new tools and information and data that will be available? Will providers be supportive, will patients even know to ask or to care?”
Dave deBronkart, often called “e-patient Dave,” co–founder and board member for the Society for Participatory Medicine -- what he called “a rag-tag band of activists” -- argued that the largest yet the most neglected resource in the world is the patient.

Mostashari Reflects on Tenure at ONC

by Kate Ackerman, iHealthBeat Editor in Chief
Monday, September 16, 2013
After four years at the Office of the National Coordinator for IT and two years serving as the country's health IT czar, Farzad Mostashari announced last month that he would step down from his post this fall.
As the country's fourth national coordinator for health IT, Mostashari became well known for his trademark bow tie and contagious enthusiasm for all things health IT.
Among other things, his legacy includes helping to spearhead the meaningful use incentive program, promoting the use of data to improve health care and stepping up federal efforts to boost patient engagement.
As his last day at ONC quickly approaches, iHealthBeat caught up with Mostashari to ask him to reflect on his work at ONC, discuss what qualities his successor should have and comment on his future plans.

Mostashari on Why He’s Leaving, What He’ll Remember

SEP 19, 2013 4:45pm ET
Being honored at a dinner that ended the 12th Annual HIMSS Policy Summit in Washington on Sept. 18, Dr. Farzad Mostashari finally explained why he is leaving as national coordinator for health information technology on October 5. Looking toward his wife, he said, “I listened to my heart and there she is standing in the front row.”
He’s also worried that his daughter, 11 years old now, will be 14 when the Obama Administration ends and won’t want to hang around her father. Asked what his next career step is, Mostashari said, “I honest-to-goodness do not know what I’m going to be doing in my career.” He figures taking a day or two off after Oct. 5 and then start beating the bushes and finding out what opportunities are available.

Has the cloud found its moment?

Posted on Sep 20, 2013
By Mike Miliard, Managing Editor
Long looked upon warily by healthcare security experts, cloud technology could soon find more favor as new rules bring clarity and assign responsibility for privacy protections.
That's one of the conclusions from a recent study conducted by Porter Research and sponsored by Covisint. The report, "Healthcare Industry Reaches Tipping Point: CIOs Now Demand the Cloud for Shared Savings and Interoperability," finds increasing confidence in the cloud among healthcare decision-makers, due in large part to the new specifications of the HIPAA Omnibus rule.
"For a long time, the cloud was untrusted on multiple levels -- people weren’t familiar with it, they were afraid of the security aspect and, simply stated, it just wasn’t the safe career choice -- in other words, nobody got fired for not choosing the cloud in the past," says Covisint's Chief Medical Information Officer John Haughton, MD.