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, March 31, 2014

Weekly Australian Health IT Links – 31st March, 2014.

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 quiet week with some interesting projects being announced (or re-announced) by a range of entities.
Additionally we have seen AHPRA decide to have a rethink on their expectations of practitioners and their use of social media and their interaction with their patients and consumers.
The commentary around NSW Health has been interesting - it is going to be important to see what the final Strategy Document arising from their recently announced Blueprint turns out to recommend and plan to implement.

Ministers’ bid to beat painkiller addiction

PAINKILLERS and tranquillisers would be sold in smaller packs and subject to online tracking under a plan to address the growing problem of pharmaceutical drug abuse.
A new framework endorsed by health ministers says greater availability of opioids and benzodiazepines in Australia in recent years has caused more addiction, overdoses, trafficking and crime. With the ageing population, there is concern the prevalence of painful conditions and anxiety disorders will only increase, raising the risk of a new older generation of drug addicts.
The experts who developed the framework believe doctors and pharmacists need support to ensure the correct use of medicine and, along with consumers, may need to be made aware of other options — including non-drug alternatives — for treatment of pain, mental health problems, sleep disorders and addiction.
A priority will be the launch of a national Electronic Recording and Reporting of Controlled Drugs System, providing real-time alerts about problem customers or dispensers, along with tougher regulations.

Double-purpose nub to university's new Health Hub

Date March 26, 2014

Tom McIlroy

Legislative Assembly reporter at The Canberra Times

Australia's leading medical and academic experts have praised the University of Canberra's new campus Health Hub as an opportunity for better integration of vital services and learning.
University chancellor Tom Calma officially opened the $15 million facility, a partnership with Ochre Health, the Department of Health and Ageing and Health Workforce Australia, on Tuesday.
The Health Hub has a GP super clinic, an e-health lab, public health services, medical imaging, a chemist, pathology and allied health services.

Telehealth to boost regional treatment options: CSIRO

Patients in remote parts of Australia will have access to diagnostic and treatment options closer to those in major urban centres, a new report predicts
Telehealth consultations will become far more common for people in regional Australia and help reduce the gap in health outcomes between people in Indigenous communities and the rest of Australia, a new CSIRO report predicts.
"Eventually, digitally-enabled remote health clinics, connected via superfast broadband, will provide for the most part, equivalent comprehensive diagnostic and treatment options to remote communities as experienced in major cities," the report, A Digitally-enabled Health System, states.
"Specialists and clinicians will assist remote health workers in treatment using increasingly intuitive telepresence robots, and unobtrusive wearable computer systems, allowing each clinic to meet the majority of health needs of their communities without putting pressure on relatively low numbers of staff."

NSW e-health vision underway

By Natasha Egan on March 27, 2014 in Industry, Technology
Connecting healthcare across hospitals, the home and the community underpins the vision of New South Wales’ federated approach to e-health, the state’s health minister told a digital health forum in Sydney yesterday.
Speaking at the Health-e-Nation Leadership Summit, NSW Minister for Health Jillian Skinner gave an update on the state’s $1.5 billion plan for e-health as outlined in a blueprint she launched in December last year.
Ms Skinner said one of the most important changes was the adoption of a federated approach where the framework and standards will be centralised but local health districts free to select and procure systems to suit local needs.
Health-e-Nation brings together leaders from health and aged care, government and IT to discuss the future of digital health in Australia.

NSW Health launch $120 million Integrated Care initiative

20th March 2014
NSW Government will spend $120 million over four years to provide integrated health care to people across the State, as part of Integrated Care in NSW strategy.
The strategy will integrate hospitals, general practice, community care and allied health services to meet the needs of the community. It represents a major shift in focus from the hospital as the centre of health care to a broader outlook that encompasses the whole of the health care system.
Health Minister Jillian Skinner said that the government’s new focus on integrated care was an important step for health care in NSW.

Digitally-enabled Health System Reports Looks At Costs And Delivery Of Care Aged Care

Design In Health, e-health & ethics,
Hospital & Healthcare News March 26, 2014
Robots on hospital wards, smart apps on mobile devices and home-monitoring systems will transform our health system according to the new report A Digitally-enabled Health System released by CSIRO.
A Digitally-enabled Health System looks at how the Australian health system can reduce costs and deliver quality care.
“We know Australia’s health system faces significant challenges including rising costs, an ageing population, a rise in chronic diseases and fewer rural health workers,” CSIRO Health Services research leader Dr Sarah Dods said. ”We need to look at new ways to make the health system work smarter.

Changing the course of diabetes

Professor Glen Maberly has set out to achieve a momentous goal: to change the course of diabetes in Western Sydney.
Western Sydney has been identified as a diabetes ‘hot-spot’, because rates of diabetes are higher than the NSW and national average. The region has a fast-growing population of over 830,000 people and incorporates the five NSW local government areas of Auburn, Blacktown, Hills Shire, Holroyd and Parramatta.
Maberly is an endocrinologist whose medical training began at Westmead Hospital, and who has been back on his home turf for the last few years after an international health career that included a stint chairing the Global Health Department at Emory University in Atlanta, Georgia and consulting on nutrition to the US Centers of Disease Control and Prevention.
He is now Director of the Centre for Health Innovation & Partnership for the Western Sydney Local Health District, focusing on multi-sector partnerships across all three levels of government, Local Health Districts, Medicare Locals and aged and community organisations, hospitals, specialists, pharmacists and allied health as well as educational institutions and private and non-government organisations.

Google Flu Trends predictions not reliable: researchers

Date March 28, 2014

Mahesh Sharma

Technology reporter

Google has failed in its attempts to formulate algorithms which accurately predict the prevalence of flu, according to Harvard researchers who accused the search engine giant of technology "hubris".
When Google announced the Flu Trends application to track flu outbreaks in real-time, right down to the street level of those suffering from it, the company promised a new era in health, where new technology would more efficiently and quickly disperse the information required to allow doctors and pharmacies to prepare for an outbreak in advance.
Google failed, according to Professor David Lazer and his team at Harvard Kennedy School in the US, who said Flu Trends, which uses search queries to compile its results, tends to overestimate the occurrence of flu when compared with data produced by decades-old organisations that manually collect influenza reports from labs.

Docs pressure AHPRA to act

24th Mar 2014
PEAK doctors’ groups will take the profession’s concerns about new social media and advertising guidelines directly to AHPRA as pressure builds on the regulator to revise the controversial new rules.
Both the RACGP and AMA told MO they will discuss the apparent contradiction between the wording of recently introduced Medical Board of Australia guidelines and public statements from the board and AHPRA about how they will be enforced.
The guidelines state that a failure by doctors to seek the removal of unsolicited patient comments relating to their clinical work would attract official warnings, fines and prosecution.

Doctors win: AHPRA backflips on web reviews

26th Mar 2014
THE Medical Board of Australia has yielded to pressure from doctors over confusing advertising and social media rules, promising to change the wording of guidelines relating to unsolicited online testimonials.
In a statement issued on Wednesday afternoon, the board said it had decided to change the advertising guidelines to be clearer about the use of testimonials. 
“The board has decided that the guidelines need to change to make it clearer that practitioners are not responsible for removing (or trying to have removed) unsolicited testimonials published on a website or in social media over which they do not have control,” it stated. 

Medical board to rewrite social media rules

27 March, 2014 Antonio Bradley
After weeks of fury from doctors, the Medical Board of Australia has finally conceded that its new social media rules are too confusing and need to be rewritten.
The regulator announced Wednesday afternoon that it would change its new advertising guidelines due to the widespread concern.
The guidelines have been interpreted as threatening $5000 fines if a doctor does not try to delete a patient's online comment about their clinical care, even if it is unsolicited.

Wrap-up: 3 things I have learned from AHPRA

And so the AHPRA Action came to an end this week. The Medical Board announced on Wednesday it would work with the other Boards to change the advertising guidelines.
The media statement“(…) practitioners are not responsible for removing (or trying to have removed) unsolicited testimonials published on a website or in social media over which they do NOT have control.”
Hats off to the Medical Board and AHPRA for listening to the feedback. I have learned three things:

Wireless medical device receives backing from Allianz

ViSafe device uses wireless biomechanical technology to measure a worker’s movement
The ViSafe medical device. Image credit: dorsaVi.
A medical device which measures worker’s movement and muscle activity using wireless biomechanical technology will be recommended for use in Australian workplaces by insurance company Allianz.
ViSafe was developed by medical device company dorsaVi (ASX: DVL). According to CEO Andrew Ronchi, it will offer insights into how a worker operates in high risk work areas such as construction sites.
“Once risks are identified, the captured data can be used to re-engineer work environments to reduce risks and at the same time increase productivity,” he said in a statement.

Question: #FHIR, complexity, and modeling

Posted on March 23, 2014 by Grahame Grieve
HL7 V3 is known for increasing complexity up to the point where people give up. The RIM seems not adequate enough for modeling the world of clinical information (see. Barry Smith: http://de.slideshare.net/BarrySmith3/hl7-january-2013).
Is FHIR meant to be a cure? I understand that FHIR it is about using a RESTful architectural style in communication of clinical resources, but the resources themselves need to be modeled appropriately. Complexity is not going to go away. Thus, FHIR appears to be another way to slice the elephant, the elephant being the world of clinical information and the need for semantic interoperability. Is there a promise for a better modeling of resources in FHIR?

#FHIR for Clinical Users

Posted on March 28, 2014 by Grahame Grieve
One of the outstanding issues for FHIR has been to make the specification more penetrable for clinical users – or, more precisely, for non-technical users. The framing of what FHIR is made in a technology setting, and if you aren’t familiar with the technologies, then it’s hard to know where to start. I committed to doing something about that, so here’s a short “FHIR for Clinical Users” introduction:

Gaming consoles double the weight loss for obese kids

Date March 24, 2014

Xavier Small

From the backyard to the big screen, consoles and computer games may be helping reduce obesity in children.
For years, nagging parents have been telling overweight children to get off the couch and go outside – but that may not be the best way to help them, it seems.
Parents are now being encouraged to consider gaming an option for the entire family.
Gone are the days when children would spend hours outside in the sun playing a game of backyard cricket, climbing trees and running amok.
Instead, they now spend much of their lives in air-conditioned comfort in the living room.

Metro North puts Brisbane on the Map

March 24, 2014, Brisbane, Queensland, Australia. Press Dispensary. Following the successful conclusion of a thirteen week Map of Medicine pilot programme Metro North Brisbane Medicare Local, and the Metro North Hospital and Health Service, have launched a suite of 13 healthcare pathways to the wider clinical community across North Brisbane and Moreton Bay.
Map of Medicine pathways are designed to represent the patient journey through healthcare services, and to improve patients’ access to evidence-based best practice care. Developed in line with national guidance, including expert opinion; the evidence-based pathways provide health professionals with instant access to comprehensive, clinically proven care pathways. Map of Medicine's customisable clinical content allows health authorities to 'localise' pathways to best reflect the needs of their region. By targeting specific patient demographic requirements, customised pathways aim to improve the care of patients through efficient management with respect to local service provision. Uniting national guidance with local practice allows health professionals to appropriately manage and refer patients while providing best practice at the point of care.

Want to be anonymous? Now you have a right to be

Date March 24, 2014 - 11:59AM

Ben Grubb

Australian citizens now have the right to remain anonymous or use a pseudonym when interacting with government agencies, private health service providers, and large organisations under new privacy laws.
The Australian Privacy Foundation says the laws, which came into effect on March 12, are a huge win for those who don't wish to use their real identity when interacting with organisations and companies that have a turnover of more than $3 million a year.
The law states individuals "must have the option of dealing anonymously or by pseudonym".

Portland Hospital First in South West Alliance of Rural Health to Implement Electronic Medication Management, Using InterSystems TrakCare

Portland Hospital’s Quality Unit reports an increase in productivity
SYDNEY, Aust. – March 25, 2014 – InterSystems, a global leader in software for connected healthcare, today announced that Portland Hospital has become the first in the South West Alliance of Rural Health (SWARH) in Victoria to implement electronic medication management across all wards, using the InterSystems TrakCare® unified healthcare information system.
One of 12 public hospitals in the region using TrakCare for clinical information, patient administration, and shared electronic health records (EHRs), Portland Hospital’s medication management data is now available across the regional EHR system.
21 March 2014, 10.41am AEST

It’s harder to fake a sickie if the doctor’s a machine

A computer system has been developed that can tell whether facial expressions of pain are real or fake – with possible implications…
Ara Sarafian
Editor at The Conversation
A computer system has been developed that can tell whether facial expressions of pain are real or fake – with possible implications for those of us who fake the occasional “sickie”.
A study, published in Current Biology today, found the computer system can “see” distinctive features of facial expressions that are not noticed by people.
Back in 2005, an Australian study found that 4% of medical or psychiatric cases were reported to involve symptom exaggeration or probable symptom exaggeration.
The new research found the accuracy with which humans discerned faked expressions was no greater than that of random chance. With training, their accuracy improved to 55%.

Cost-benefit panel consults on NBN Co restrictions

Vertigan panel seeks submissions on NBN regulatory framework, telecommunications access arrangements
The panel appointed by the federal government to conduct a cost-benefit analysis of the National Broadband Network has launched two-part public consultation that examines the regulatory framework in which NBN Co carries out its operations.
NBN Co was established to operate only as a wholesaler of NBN access. Part 2 of the National Broadband Network Companies Act 2011 restricts the NBN corporations to supplying services only to carriers and service providers on a wholesale basis, prevents it from providing content and other non-communications offerings, and allows it only to provide Layer 2 services.
However, the act includes a handful of exemptions which, for example, allow NBN Co to directly deal with transport authorities, and power and water utilities, as long as they do not resell NBN services.
The NBN Review Panel, headed by Michael Vertigan, has issued a call for public comment on the framework established by the NBN Companies Act, including the restrictions on NBN Co dealing with end users, the restriction to supply of Layer 2 services (with the exception of some satellite services) and the restrictions on NBN Co investments and supply of non-access services.

NBN panel split on ‘flawed review’

A PARLIAMENTARY committee probing the National Broadband Network has split sharply, with Coalition senators alleging an “abuse of process”, “self-serving distortions” and “financial illiteracy” over a report that calls for a return to Labor’s plan to deliver fibre to the home.
A report tabled by the Labor-Greens-dominated committee late yesterday calls the Coalition’s strategic review of the $41 billion project “deeply flawed”, with financial manipulations and overly pessimistic assumptions about the fibre-to-the-premises build.
The interim report makes five recommendations, including directing NBN Co to speed up the rollout of a fibre-to-the-premises project “free from political interference” while further analysis is done and until a revised strategic review is produced to correct “deficiencies and distortions”.

PCs to lose more ground to tablets: survey

Date March 28, 2014
Sales of traditional computers will lose more ground in 2014 to tablets and other mobile devices, a market tracker says.
The overall market for connected devices – PCs, smartphones and tablets – is likely to grow 6.9 per cent to nearly 2.5 billion devices in 2014, according to a report by research firm Gartner.
More people will dump their PCs for other devices, but the drop in PC sales will moderate to about 6.6 per cent this year, with unit sales of 276 million.

Security software just a Band-Aid for Windows XP machines

Date March 23, 2014 - 12:00AM

Elizabeth Weise

After April 8, running a computer with Windows XP will be like turning on your house's security system but leaving the doors and windows open.
That's the analogy Gerry Egan, senior director of product management for anti-virus company Symantec, uses.
"Imagine you're living in a house. Every night before you go to bed you go around to make sure the doors are locked and the windows are closed. And maybe you've got an alarm system for extra piece of mind," he said from the company's offices in Culver City, California.

Nine great sites to teach yourself how to code

Date March 24, 2014 - 12:15AM

Adam Arbolino

For most of us, coding is a foreign language that we’ll never understand, or at least that’s what we think. But there are some great tools out there that can help anyone learn how to write computer code, and it’s much easier than you may suspect.
In fact, learning at least a few programming languages is a great way to become more versatile and employable, as well as save money.
For example, if you know how to code a website yourself, there's no need to pay someone else to create a website for you.

Alert - A Major Healthcare Executive Symposium - Late June 2014 - Port Douglas.

I heard about this a day or so ago.

2014 Health Executives Symposium

Complexity and Transformation in Healthcare

Pullman Sea Temple Resort, Port Douglas – June 25-27 2014

Facilitating Partner: McKinsey & Company 

Here is the basic write-up.

About the Symposium

There is little doubt that you, the leaders of today’s healthcare organisations, face challenges which eclipse those encountered by executives a decade ago in their variety, complexity and scale. Challenges which defy categorisation, have more than one originator and are almost impossible to solve with existing tools and thinking.
These challenges have led to the development of this, the inaugural Health Executives Symposium. Developed by ACU Executive Education as an opportunity for health executives to learn new approaches for tackling emerging issues, the symposium includes tailored content from ACU faculty and framework from McKinsey & Company, as well as an unrivalled platform for peer-to-peer learning.
For over a century, ACU has enjoyed a strong tradition of engagement with the healthcare industry, and in recent years has emerged as one of the nation’s foremost insti¬tutes for education and research in the sector. We look forward to joining with you, the leaders in your field, to help shape the future of Healthcare in Australia.

Program framework

This symposium is designed to provide executives of the healthcare sector with fresh, stimulating discourse on organisational resilience and systemic thinking, in conjunction with tools, models and processes which will provide delegates with solutions to transform their organisations.
The program aims to be as customised to the particular challenges facing the sector as possible, with content which is highly relevant and a focus on peer-to-peer learning and the inclusion of real life issues which can be addressed in a group environment.
To facilitate this, we would like all delegates to contact us in the months prior to the event with a short explanation of the main challenges they face from an organisational perspective, and we will incorporate these into the program.
We will be using the Cynefin Framework to categorise the issues which are shared with us and to provide structure and unity to the program throughout the different sessions.
 You can find all the details regarding the program, faculty and costs here:
For those at senior levels in the health sector this looks to be a pretty interesting three day program.

Sunday, March 30, 2014

Minister Dutton Is Being Very Quiet On E-Health. Wonder What This Means.

Health Minister Peter Dutton has been talking a lot this week.
First we had this:

Australian Private Hospitals Association 33rd National Congress Keynote Address

The Minister for Health Peter Dutton delivered the keynote address at the Australian Private Hospitals Association National Congress in Brisbane on 24 March 2014.
Page last updated: 24 March 2014
24 March 2014
Ladies and Gentleman, good morning and thank you for the introduction.
Thank you very much to Chris Rex for your words earlier and thank you Michael Roff also. We have developed, I think, over the years an excellent working relationship and I look forward very much to that continuing.
Thank you for meeting in my home town of Brisbane.
It’s really great to be here and I acknowledge the people today who have been pioneers in creating a sector that has played a pivotal role in building the Australian health system and those that continue the legacy today in the pace of today’s global economy that work continues to grow in importance and private hospitals in this country are, as most Australians know, world leaders.
So it is a pleasure to be here to open the 33rd National Congress.
The sector makes a major contribution to health and wellbeing of this country – providing Australian’s with more choice in the type of health care they can access while at the same time taking pressure off the public system, particularly public hospitals and emergency care.
Our world-class health system is as good as it is because it relies on a combination of private and public services. And like business, government can no longer just rely on increased funding for increased patient outcomes.
We need to be stripping costs, regulatory burden and bureaucratic nonsense from the process. We want to ensure patient safety and government can do that by helping to reduce the red tape industry that has been created in your sector under the guise of workplace health and safety, duplicative reporting requirements and the like.
But it is incumbent on all of us as taxpayers, as managers of the health system, as users of the health system and most importantly as deliverers of the health system, to make sure we deliver services in the most efficient way possible.
This is particularly the case given the Australian Government spending on health care has more than doubled in the past decade alone.
The discussion now must be about sustainability.
The $62 billion the Government currently spends each year on health will blow out another $13 billion over the next four years.
As a nation, we are spending around $120 a week on health care for each man, woman and child.
Over the past decade, Commonwealth spending on public hospitals is up 83 per cent and is projected to go up another 50 per cent over the next four years.
That’s why we started the discussion about the type of health system our nation needs to go forward with an ageing population and with the advent of many expensive medical technologies and costs beyond that.
We need to make sure that all aspects of our healthcare system remain strong and yet flexible enough to deal with future challenges – some of which are not so far into the future.
In closing let me say a couple of words about the economic legacy or mess that we inherited. We are six months into Government so we’re very much in the opening days of this term of government and already we’ve been able to correct some of the difficulties that we inherited, particularly around chemotherapy, around training and some other areas, but there is a lot of work to do.
I believe the future for your sector, but also for the way we deliver health services in a sustainable way is very bright.
I look forward to continuing building the relationship with the sector. I believe the private sector in this country, in particular private hospitals are held near and dear to all Australians and the Australian Government believes very strongly we will continue to build those relationships for the betterment of all Australians.
The full speech is here:
Second we had this interview.

Interview on Sky News with Peter Van Onselen

Minister for Health Peter Dutton was interviewed on Sky News with Peter Van Onselen and spoke about Knights-Dames, Racial Discrimination Act, Medibank Private Sale and Health Reform.
Page last updated: 26 March 2014
26 March 2014
Topics: Knights-Dames, Racial Discrimination Act, Medibank Private Sale, Health reform.
Peter Van Onselen: Now let me ask you about Medibank Private. Mathias Cormann is announcing that it will be put up to public offering, that was a policy you took to the last election are you concerned about getting that through Upper House and are you also concerned about what that might do in terms of putting upward pressure on premiums perhaps, that’s what the Opposition claims is the case?
Peter Dutton: Well Peter I’ll answer the second part first. There are over 30 providers of private health insurance in Australia at the moment. Medibank Private has just under 30 per cent of the market share. So we’ve got a very mature marketplace.
They’ve now gone into businesses such as pet insurance, so for the Government to have some sort of financial interest in a pet insurance business, I just don’t think reaches the mark that most people would apply in the common-sense test in these instances.
I think the first point thought, in relation to the legislation. Of course the legislation was passed in 2006 and for all the years of the Rudd and Gillard and Rudd Governments, they never sought to abolish this particular proposal. So in actual fact Labor went to the last election with the legislation in place to allow the sale of Medibank Private. I think particularly given the level of debt we’ve inherited from the previous Labor Government – approaching an accumulated debt of $667 billion dollars, people realise that we have to make tough decisions.
The fact is there is a great maturity to the private health insurance market, 11 million Australians have health insurance and I want to make sure we can continue to keep downward pressure on prices so that we can have good coverage across the population. Nobody’s been able to mount the argument that the sale of Medibank Private in a mature marketplace with 30 odd providers of health insurance would dampen competition or provide anything by way of upward pressure on premiums.
Peter Van Onselen: And just finally Mr Dutton, can I just ask you about general reform in the health sector space.
There’s been a lot of speculation since Tony Abbott became Prime Minister about this; we haven’t yet seen the meat on the bones if you like of what is coming. Is there a lot to come in this space, by the time we look back on the first term of the Abbott Government will we be able to say that you were one of the serious reforming Ministers do you think?
Peter Dutton: Well Peter, I want to make sure we can strengthen and modernise Medicare. It’s a system that was devised in the 1970s and 1980s.
We know that this year we’ll spend about $62 billion – just the Commonwealth Government - as part of the $140 billion dollars per year that we spend in this country on health. We know that public hospital funding over the next four years will go up by 50 per cent having gone up by 83 per cent over the last 10 years.
We’ve had a 170 per cent increase in the number of Alzheimer’s sufferers. Two in three Australians are overweight or obese.
So there are enormous pressures coming down the line including the ageing of our population over the course of the next 10 or 20 years, so any changes that the Government makes will be to strengthen Medicare, to make sure that we can have a world class health system going into the future and I think that most Australians would accept that.
I want to make sure that we can provide all of those world class medicines, cancer medicines, the personalised medicines and genomic testing that we haven’t factored into the forward estimates costs yet, they are very important and people will expect us to pay for those and they will run into the billions of dollars in years to come; so we’ve got to have a sustainable system going forward. If we make changes in this space that’s what it will be about.
----- Ends
The full interview is here:
To me there are a few things that come from all this.
First the government is very worried about the rate of growth of health expenditure.
Second the government is very aware that in all developed countries the level of health cost inflation is a good deal higher that overall inflation.
Third just saying that Medicare has been around for 30+ years is hardly a reason for wholesale change if there is not evidence to support the change.
More importantly it is clear that after six months in Government there is no articulated strategy for health and health reform. This has to be a major worry in my view.
Additionally it is pretty apparent that e-Health is not seen by the Minister as any significant part of the solution to the rising health costs. Not any form of mention in both discussions or elsewhere recently.
The budget in six short weeks will be very interesting indeed!

AusHealthIT Poll Number 211 – Results – 29th March, 2014.

Here are the results of the poll.

Was The Clinical Input To The Overall Design And Implementation Of The PCEHR Adequate?

For Sure 2% (1)

Probably 2% (1)

Neutral 4% (2)

Possibly 11% (6)

No Way 76% (42)

I Have No Idea 5% (3)

Total votes: 55

A very clear outcome with more than 75% thinking the clinical input was really inadequate.

Again, many thanks to all those that voted!


Saturday, March 29, 2014

Weekly Overseas Health IT Links - 29th March, 2014.

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.

Open, free popHealth at work on quality

Posted on Mar 21, 2014
By Anthony Brino, Editor, HIEWatch
An open source software program created with the help of the Office of the National Coordinator is now federally certified and ready to be used as a population health tool.
First developed in 2010, the program, called popHealth, imports data, then calculates, displays, and exports it as electronic clinical quality measures using Cypress, the same open source engine the ONC uses to certify eCQM functionality in EHRS.
Developed and certified in partnership with Northwestern University, popHealth “is in some ways a simple piece of software,” as ONC public health analyst John Rancourt wrote in a blog announcing its certification for meaningful use. "However, it is highly sophisticated and versatile because it is standards driven and it leverages the same quality measure engine as Cypress." 

How hospitals can make big data pay big

Posted on Mar 21, 2014
By Donna S. Charles, principal consultant, Oron Healthcare Group
Hospital executives are faced with numerous challenges related to healthcare reform in general and the Affordable Care Act  in particular. Strategic decisions about how to address these challenges will significantly impact not only the financial and clinical performance of hospitals, but the perception of executive leadership itself.
Even though optimizing workflows and other processes are the main avenues available to executives to address these issues, it’s critical to understand the role that advanced information technology has in bringing these efforts to fruition.
Reduced payments to hospitals for avoidable readmissions began in 2012 under the ACA’s Hospital Readmissions Reductions Program, and the program is expanding in future years by increasing the level of payment reductions and expanding the scope of illnesses covered.

FDA issues recall of McKesson Anesthesia Care Record

Author Name Kyle Murphy, PhD   |   Date March 20, 2014   |
Nearly a year after McKesson notified its customers about flaw in one of its health IT systems, the Food and Drug Administration (FDA) has moved to applying a Class I recall. The product in question is McKesson’s Anesthesia Care Record (ACR), a clinical decision support system aimed at helping anesthesiologists identify potential adverse drug events.
“The system is generally indicated in the anesthetizing environment when the anesthesia provider decides to perform a patient assessment, to generate a paper and/or electronic record of the administration of anesthesia to a patient, and to document care,” the FDA notes.

ONC Launches Program to Foster Health IT Use by EMTs

Written by Helen Gregg (Twitter | Google+)  | March 20, 2014
The ONC has partnered with the Office of the Assistant Secretary for Preparedness and Response on a campaign to increase the use of heath IT by emergency medical technicians and other first responders.

FDA Again Issues Recall Notice for McKesson Anesthesia Care Software

MAR 19, 2014
The Food and Drug Administration on March 14 issued a Class 1 recall notice to healthcare professionals for the Anesthesia Care software of McKesson Corp. The software collects, processes, and records data both through manual entry and from monitors which are attached to patients, such as in an operating room environment. San Francisco-based McKesson had initiated a voluntary Class II recall of the product last year.
The Class I recall is in the FDA’s highest risk category which is reserved for defects where “there is a reasonable probability that the use of or exposure” to the product “will cause serious adverse health consequences or death.” It is not often that the regulatory agency issues this kind of recall notice for standalone software that does not play a role in operating a medical device. However, the software “provides clinical decision support by communicating potential adverse drug event alerts proactively during the pre-anesthesia evaluation and at the point-of-care,” the FDA said in the notice.

FDA Surveillance System Leverages Databases to Monitor Medical Products for Adverse Events

MAR 19, 2014
The Food and Drug Administration is actively searching more than 100 million health insurance records to uncover possible adverse events, rather than relying on doctors and patients to report them, according to Michael Nguyen, M.D., Acting Director of the Division of Epidemiology in FDA’s Center for Biologics Evaluation and Research.
The surveillance system, called Sentinel, is the result of a partnership between FDA and the Harvard Pilgrim Healthcare Institute, who are using the system to determine whether a certain type of immune therapy is associated with heart attacks or strokes, and to better define the true rate of acute lung injury after transfusions of certain blood components. 

RAND: EHRs 'significantly worsened' doc satisfaction

March 18, 2014 | By Marla Durben Hirsch
Physicians' views of electronic health records are still mixed despite widespread adoption, seen as good in concept but that they "significantly worsened" their professional satisfaction, according to a new RAND Health report.
Conducted at the request of the American Medical Association, the report focused on determining the factors that lead to physician fulfillment. Its authors found that EHRs were a source of both promise and frustration. While they enabled doctors to improve quality of care and remotely access medical records, EHRs also:
  • Required time-consuming data entry that could be better accomplished by clerks and scribes;
  • Were difficult to use;
  • Interfered with patient face to face interaction;
  • Lacked interoperability; and
  • Degraded clinical documentation

David Blumenthal: Benefits of HIT programs will surface with time

March 20, 2014 | By Dan Bowman
An "asymmetry of benefits" for providers has kept the healthcare industry from ubiquitous adoption of health IT--and electronic health records, in particular--and thus realizing its full potential, according to David Blumenthal, former national coordinator for health IT and current president of The Commonwealth Fund.
"From the patient's perspective, this is a no-brainer. The benefits are substantial," Blumenthal told The Atlantic in a recent interview. "But from the provider's perspective, there are substantial costs in setting up and using the systems. Until now, providers haven't recovered those costs, either in payment or in increased satisfaction, or in any other way."
While to that end, Blumenthal said, the medical marketplace is broken, he added that there is still some hope. He pointed to systems like the U.S. Department of Veterans Affairs and Kaiser Permanente as examples where technology has thrived due to "internalized" benefits that have led to better and faster adoption.

When technology is a barrier to care

March 21, 2014 | By Ashley Gold
Are doctors suffering at the hands of the Herzberg principle--which says that the best way to discourage workers is to subject them to policies and procedures that don't make sense? 
An article in the Atlantic explores how changes in the healthcare payment model, health IT and the doctor-patient relationship are discouraging docs.
"It is easy for many healthcare leaders to forget that doctors go into medicine not because they enjoy entering data into complex electronic health records and ensuring that their employer gets paid for everything they do, but because they want to make good diagnoses, prescribe appropriate treatments and help patients," the article states.

5 Steps to Preventing Security Breaches

Lena J. Weiner, for HealthLeaders Media , March 20, 2014

Medical records are a high-value commodity, fetching up to $50 each. Medical data breaches are being reported ever more frequently. Risk assessments and basic IT and social media policies can help protect your organization.

Eight computers were stolen from medical billing contractor Sutherland Healthcare Solutions in Torrance, CA, on February 5, 2014. A month later, the week of March 6, many patients received letters on Sutherland letterhead alerting them that their personal data, including first and last names, social security numbers, and billing information—and possibly their dates of birth, addresses and even their personal medical information and diagnoses—had potentially been compromised. As many as 173,900 patients may be affected.
Medical records are a high-value commodity. While social security numbers go for about one dollar each on black market websites, medical records can fetch as much as $50 each, according to the Medical Identity Fraud Alliance.

IBM’s Watson finds a new challenge: personalised cancer treatment

March 19, 2014 8:33 pm by Richard Waters
For its most promising new technology, IBM has been searching for problems to solve that are both deep and broad enough. Now, with a clinical trial in the US aimed at personalising the treatment of cancers, it might just have found one.
The Watson question-and-answer system has felt like a solution waiting for the right problem. Winning the Jeopardy TV quiz show three years ago was a spectacular way to show off the new technology’s advances in pattern recognition and natural language. But how to make inroads into real business or social problems?
The big push CEO Ginni Rometty has given Watson this year suggests she’s impatient for some results. That has meant trying to apply the technology to broad issues in a way that can scale up quickly.
The announcement on Tuesday of a clinical trial to deliver more personalised care to brain cancer patients looks like a case in point.

IBM's Watson Takes Aim At Cancer

3/19/2014 03:26 PM
Collaboration between IBM and the New York Genome Center will use Watson to match cancer mutations to potential treatments, compressing process from months to minutes.
IBM Research and the New York Genome Center want to prove that IBM's Watson can dramatically reduce the time required to identify the most effective cancer treatments based on an analysis of a specific patient's genetic mutations.
In partnership with regional hospitals, the NYGC plans to evaluate Watson's ability to help oncologists develop more personalized care for patients with glioblastoma, an aggressive and malignant brain cancer that kills more than 13,000 people in the US each year. The NYGC is a nonprofit consortium of the state's academic, medical, and university leaders working to advance the applications of genomics, the branch of genetics that studies complete DNA sequences rather than individual genes.

3 tips to avoid BYOD breaches

Posted on Mar 19, 2014
By Diana Manos, Senior Editor
Without question, BYOD, or “bring your own device,” offers benefits to both healthcare employees and employers. It also presents security issues.
The benefits of BYOD are luring. To name a few, users are familiar and comfortable with their own devices, which increases productivity. No training is required. And employees provide the latest devices, saving hospitals the expense.
Yet, despite these benefits, security issues keep many hospitals from allowing BYOD, and with valid reasons. BYOD raises numerous red flags on the security and HIPAA compliance fronts and the bottom line is: No matter who owns the device, hospitals are responsible for any data breaches that occur.

Patient monitoring technology market to reach $5.1B by 2020

March 19, 2014 | By Susan D. Hall
The U.S. market for patient monitoring technology--increasingly moving outside the hospital--is expected to grow to more than $5.1 billion by 2020, according to a new report by iData Research.
The report points to the growth of multi-parameter vital sign monitors, electroencephalograms (EEG), electromyograms (EMG), cerebral oximeters and pulse oximetry devices in particular for fueling that growth. The pulse oximetry-monitoring market alone is expected to exceed $1 billion by 2020, it according to an announcement.

Health Information Exchanges May Reduce Hospital Admissions, Study Finds

Written by Ayla Ellison (Twitter | Google+)  | March 18, 2014
Weill Cornell Medical College in New York City has released the findings of a study that indicates health information exchange allows emergency departmentphysicians to treat patients more efficiently and effectively and could reduce unnecessaryhospital admissions.
 Using claims information collected from seven EDs in Rochester, N.Y., the researchers found that physicians and healthcare professionals who had access to patient data from other providers through the region's health information organization were better able to avoid hospitalizing patients who didn't need inpatient care.

ICD-10 Deadline: Ready or Not, Here It Comes

MAR 17, 2014 11:20am ET
Today is St. Patrick's Day, a sobering reminder that there are less than 200 days left until the October 1 ICD-10 implementation deadline. Either way, if you are a provider that is concerned about being prepared to make the code switchover, no one could blame you for having a good, strong drink (or two).
With only the spring and summer months separating providers from the ICD-10 go-live date, many are asking themselves how far along they should be at this point in implementation activities. Well, the truth is that significant numbers of providers have not even begun to prepare for ICD-10, as terrifying and as stressful as that may sound. A recent poll of 1,200 practices with more than 55,000 physicians found that less than 10 percent reported significant progress in overall ICD-10 readiness.

EHRs may help save lives from sepsis

Posted on Mar 18, 2014
By Erin McCann, Associate Editor
Here's another reason why those multi-million dollar electronic health record systems might be finally paying off, in terms of lives potentially saved. 
According to new research, EHRs can be used to predict the early stages of sepsis, one of the leading causes of death in the U.S., responsible for killing some 210,000 people each year. 
Researchers at UC Davis have found that routine health data – blood pressure, respiratory rate, temperature and white blood cell count – from the EHRs of hospitalized patients can detect the illness earlier in its infancy and help pinpoint what patients are at high risk of developing the disease. 
After analyzing the EHRs of some 741 sepsis patients, researchers were also able to determine that just three measures – lactate level, blood pressure and respiratory rate – can pinpoint the likelihood a patient will die from the disease.

EHR data can predict sepsis

Beth Walsh
Mar 17, 2014
EHRs can be used effectively to predict the onset of sepsis, according to researchers from the University of California at Davis. 
Researchers used routine information of hospitalized patients, including blood pressure, respiratory rate, temperature and white blood cell count. Analysis of the data from the EHRs of 741 patients with sepsis revealed that vital signs combined with serum white blood cell count can accurately predict sepsis, which is associated with increased blood levels of lactate. They found that lactate level, blood pressure and respiratory rate could determine a patient’s risk of death from sepsis. 
Sepsis is a leading cause of death and hospitalization in the U.S., occurring in more than 750,000 patients annually and killing nearly one-third of all people who develop the immune system response to infection that can damage organs and cause permanent physical and mental disabilities. Sepsis-related deaths and serious consequences, however, are preventable for up to 30 percent of patients. 

Evidence developed for IT investment

14 March 2014   Rebecca Todd
NHS England is working with McKinsey to develop an evidence base for the NHS to invest in technology.
The economic analysis will support the release of NHS England’s Transparency and Participation Call to Action, which is due out in the summer.
NHS England director of intelligence and strategy Christine Outram presented on the project with representatives from McKinsey at the Health and Care Innovation Expo in Manchester last week.
Outram said the Cabinet Office, Treasury and individual trusts “need persuading that it’s worth investing in empowering patients and the power of technology”.

3 ways to enhance patient engagement

March 18, 2014 | By Zack Budryk
Engaging patients in their own wellness and care--as well as their personal health data--is necessary to qualify for new payment models and incentives and to improve outcomes. 
Looking for some creative strategies to engage patients? Tech reporter Allison Diana compiled a whopping 16 of them in a slideshow for InformationWeek. Here are just three of the recommendations:
Electronic messages to patients: "Meaningful Use Stage 2 mandates that more than 5 percent of patients communicate with healthcare providers via secure electronic messages," Diana writes. "Increased messaging saves on phone costs and pleases patients with its convenience and immediacy." At Children's Medical Center in Dallas, for example, patients and families averaged 480 messages monthly over six months in 2013, a number that is expected to increase, according to the article. 

ICD-10 and EHR Fuel Clinical Documentation Improvements

Scott Mace, for HealthLeaders Media , March 18, 2014

The electronic health record is at the heart of efforts to improve clinical documentation. One effort strives to get disparate EHR software programs—and the physicians using them—to encode problem lists in a common way.

This article appears in the March 2014 issue of HealthLeaders magazine.
With the October 1 activation date for ICD-10-coded payments and the end-of-year move to meaningful use stage 2, this will be a watershed year for clinical documentation improvement.
Technology is playing a big role in both efforts. To an unprecedented degree, and with significant cost and effort, the electronic health record is becoming the heart of clinical documentation improvement—prompting doctors to enter more specific diagnoses, reducing the need for labor-intensive coding, and propagating a common vocabulary between disparate care coordinators to enhance decision support.

RECs Won't Finish Mission Without More Funding

Scott Mace, for HealthLeaders Media , March 18, 2014

For many small and rural providers, Regional Extension Centers have been a low-cost or no-cost lifeline through the process of acquiring EHR technology and participating in the meaningful use incentive payment program. What happens to the stragglers as the RECs wind down?

Consider the plight of the nation's Regional Extension Centers, which serve as serve as support and resource centers to assist providers in EHR implementation and Health IT needs around the country.
Until late last year, the RECs' funding was due to run out. Recently, unspent portions of that previously allocated funding was freed up through February 2015 through an ONC ruling known as a "no-cost extension."
For many small and rural providers, RECs have been a lifeline of low-cost or no-cost source of advice and support through the daunting process of acquiring EHR technology and participating in the meaningful use incentive payment program.

Online tool could be used to identify public figures' medical care, say critics

OmegaSolver's Patient Analyser tool has been taken offline after concerns over use of 'patient-level' data
An online tool that claimed to be able to use NHS patient hospital records to reveal treatment "right from initial diagnosis until the current day" has been pulled from the internet after privacy campaigners warned it could be used to identify the precise details of medical care for people in the public eye.
OmegaSolver, a company founded last year, had access to NHS hospital episode statistics and offered an "internal database [which] tracks actual patients within every hospital within England providing … up-to-date information for every disease area". The company said its clients included drugs firms.
However, the firm's website was closed down last week after press inquiries to the health authorities regarding the release of "patient-level" data to the company.
Satnews Daily
March 17th, 2014

ITU—Health Data Exchange Spec Enabled (Comms)

 [SatNews] Following calls for increased global coordination of standards enabling e-health, ITU has offered first stage approval to an important specification enabling an exchange of multimedia health data between a health provider, a controlling function and patient.
The new standard will enable different e-health systems to smoothly exchange patient health data in both low- and high-resource settings, making it ideal for applications in both developed and developing countries.
e-Health experts explain that a combination of a common data definition with connectivity across different systems—ranging from the personal health and point-of-care devices described in Recommendation ITU-T H.810 to a range of health management back-ends—will provide simple, secure and scalable interoperability.

Denmark tests new health IT systems

Posted on Feb 25, 2014
By Dillan Yogendra, Managing Editor, HIMSS Europe
Sixteen new hospitals are being constructed, including eight new super hospitals with a state-of-the-art health IT structure. US$7 billion will be spent over the next ten years. This means fewer, but more specialized hospitals and an expanded use of health IT, which will ultimately decrease the number of beds required by 20% and reduce the average duration of hospitalization from five to three days.
Keeping healthcare expenditure down with a growing aging population and an increase in chronic diseases is a challenge, but Denmark has managed just this. While US healthcare averages 17.9% of GDP, Denmark has kept its costs to 10.5% of GDP. This is in a large part due to expansion of health IT solutions throughout the sector.
The Danish Government Growth Plan leading up to 2020 has made available 12 billion DKK for core welfare services and is expected to bring substantial changes to the classical idea of healthcare provided primarily through hospitalization. Telehealth is seen as a tool to increase the quality of care for its populations while lowering public spending costs.

Identity crisis looms for US healthcare

Posted on Mar 17, 2014
By Anthony Brino, Editor, HIEWatch
While the U.S. continues digitizing its healthcare industry, a huge challenge is arising: not only securing those systems but verifying identities.
With a steady stream of HIPAA-covered data breaches continuing over the past few years, not to mention the debacle of Target’s recent customer financial information loss, some argue that current identity security approaches just aren’t adequate -- especially considering that criminal attacks on hospitals are increasing substantially.
“Protecting sensitive personal information with passwords is akin to building a massive stone fortress and then securing the front door with the kind of lock I use to keep my two-year-old out of my bathroom,” said Jeremy Grant, a senior advisor on identity management at the National Institute of Standards and Technology, heading up the National Strategy for Trusted Identities in Cyberspace.

Gamification comes to clinicians

Posted on Mar 17, 2014
By Mike Miliard, Managing Editor
There's been a lot of talk in the past few years – some would say too much, and way too excited – about gamification.
Using computer game design and mechanics to teach people, or encourage them to change their behavioral patterns, certainly seems to make some sense. Harnessing digital stimuli and score-keeping to make the most of a person's natural inclination toward fun and competition has some exciting potential benefits.
But it all depends on the game, and how it's put to use. As Gartner put it in a 2012 report on the phenomenon – which predicted that, by this year, as many as 80 percent of gamified apps would be doomed by poor design – "gamification is currently being driven by novelty and hype."

Docs, nurses learn to get along in simulation game

March 17, 2014 | By Ashley Gold
A new simulation game aims to teach doctors and nurses how to work more collaboratively and avoid conflicts in order to prevent dangerous or sometimes fatal miscommunications.
Researchers at the University of Texas at Arlington College of Nursing, Baylor Scott & White Health and University of Texas at Dallas have developed a video-game simulation that can teach doctors and nurses to work together--helping them avert tense situations in the real world by playing them out in the game.
"Our hope is that this project will enhance patient safety and, ultimately, improve patient outcomes," Beth Mancini, a UT Arlington nursing professor, said in an announcement.

Computer virus at Glenwood hospital may have jeopardized patient info

By Drew Munro
The Post Independent
Posted:   03/14/2014 12:39:00 PM MDT | Updated:   4 days ago
GLENWOOD SPRINGS —Personal information of more than 5,000 people who have been patients at Valley View Hospital may have been compromised by a computer virus that infected the hospital's computer system, according to officials there.
Hospital information technology (IT) officials discovered the virus in January, said Stacey Gavrell, Valley View Community Relations director, and steps were taken immediately to quarantine the virus and begin the process of determining what happened.
A forensic IT team was brought in to conduct the investigation, she said.