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"

or

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

Wednesday, December 15, 2010

FoxNews Talks About Wikileaks and E-Health - Do They Have a Point?

This popped up a few days ago.

http://www.foxnews.com/politics/2010/12/07/wikileaks-breach-raises-concern-privacy-electronic-medical-records/

WikiLeaks Breach Raises Concern About Privacy of Electronic Medical Records

The embarrassing leak of a quarter-million State Department documents by WikiLeaks has recharged the debate over electronic medical records, raising concern that the government may not be capable of safeguarding Americans' most intimate health care secrets when their records go digital.

Doctors and privacy advocates alike are pointing to the havoc wreaked by WikiLeaks founder Julian Assange and allegedly Bradley Manning, the low-level Army private accused of facilitating it, in arguing that the government needs to slow down its push for digital medical records.

The Obama administration is calling for all doctors and hospitals to go digital by 2014 or, if they're in the Medicare system, face penalties starting the following year. The 2009 stimulus bill pumped billions of dollars in incentives into this effort, while this year's health care law set up more programs to encourage the use and study of digital dossiers.

The goal is to reduce costs and medical errors by making this information accessible, presumably to the right people at the right time. But as the WikiLeaks fiasco showed, the bigger the network grows the more likely it is that the wrong people can take advantage of it.

"Even the most top-secret things can't be kept secret," said Dr. Alieta Eck, who with her husband runs a clinic near Edison, N.J., for the poor and uninsured. Eck said she keeps electronic records for her office only but does not plan on meeting the new federal standards, citing concerns about how that information will be shared and how it could erode the trust she has with her patients.

"If you think WikiLeaks is bad, this is gonna be WikiLeaks on steroids," said Deborah Peel, founder of Patient Privacy Rights.

Peel, who has long expressed concerns about the digitization of medical records, said "everything from prescription records to your DNA" will soon be floating around, susceptible to hackers from the outside and troublemakers from the inside.

She cited a study from health care security firm FairWarning, which estimated that health care providers have on average between 25 and 100 privacy breaches per month -- absent the kind of monitoring system that FairWarning sells.

The Department of Health and Human Services has stressed the importance of patient privacy as it encourages medical providers to go digital. The department this year has been formulating the rules to carry out a provision from the stimulus law known as the HITECH Act, under which Medicare doctors are eligible to receive up to $44,000 over five years to establish electronic health records. According to the department, the new rules would strengthen patient protections by giving them the right to restrict certain kinds of disclosures and prohibiting the sale of certain information without their say-so.

Full article here:

http://www.foxnews.com/politics/2010/12/07/wikileaks-breach-raises-concern-privacy-electronic-medical-records/

For those who don’t know Fox News is owned by an American Citizen late of these shores (Rupert Murdoch) and reflects a political position that it would be fair to say would make Alan Jones seem like a deep red leftie!

However they point they make has considerable validity and should just not be ignored - especially when faced with a sceptical and increasingly rather alienated population who seem to be losing faith in the overall political and government systems to deliver for them.

They make the point just how well will the Government do with private Health Information if they can’t protect national secrets!

Any planning for e-Health that involves large aggregated data sets needs to be very well managed - and shown to be both well governed and well managed for there to be the level of trust we will need for success!

David.

Tuesday, December 14, 2010

MyHospitals Web Site - Why Does Everything Wind Up Being So Contested?

Well we now have the media reaction to the Myhospitals web site. It seems the reviews are a bit mixed.

We have this:

Hospitals website hits early strife

  • Adam Cresswell, Health editor
  • From: The Australian
  • December 11, 2010 12:00AM

THE long-awaited MyHospitals website, allowing easier comparisons of waiting times against national benchmarks, is embroiled in controversy.

Within hours of it going live, there were claims its data was too old to be useful and the states had sought to hamstring the project.

The site, which allows public viewing of the waiting times for public and private hospitals in areas such as orthopedic surgery and emergency departments, partly delivers on Labor's 2007 election pledge to improve the reporting of hospital data.

But the figures relate to the financial year that ended in June, and permit only at-a-glance comparisons with the national average, not with other hospitals. And there are no figures on infection rates or other adverse events that Labor promised in 2008.

There are suggestions the government and bureaucracy disagree on the purpose of the new site, after federal Health Minister Nicola Roxon said yesterday it would be a "very valuable tool" that would assist patients to choose which hospital to visit.

Ms Roxon said the new site "helps the public if they're making a choice, if they've been waiting on a waiting list for elective surgery to be able to look at a hospital that might be near a carer who's going to look after them after their surgery".

However, when asked if the data would be too old to be useful, Penny Allbon, director of the Australian Institute of Health and Welfare, which runs the site, said that was not its purpose.

"The data is not intended to be real-time," Dr Allbon said.

and here:

MyHospitals website goes live despite data concerns

  • By staff writers
  • From: news.com.au
  • December 10, 2010 4:07PM
  • MyHospitals website goes live
  • Data on nearly 1000 hospitals available
  • Hospital-to-hospital comparison difficult

FEDERAL Opposition Health spokesman Peter Dutton has released an email that he claims shows the Federal Government's new MyHospitals website is unreliable and inaccurate.

The MyHospitals website contains data such as waiting lists, bed numbers and specialist services for more than 900 Australian hospitals.

Mr Dutton cited an email written by Australian Institute of Health and Welfare (AIHW) director Penny Allbon in which she pointed out flaws in the data and indicated it could not be relied upon.

He released the email from Dr Allbon to Government officials dated July 27.

It outlines the New South Wales Government's concerns that data would be out of date by the time it reached the website, and the state's view that staff numbers and outpatient numbers should not be included in the data.

"Queensland, Tasmania and Victoria all share this position," she writes, before signing off, "Ho hum".

Mr Dutton said in Brisbane today that Health Minister Nicola Roxon must guarantee the website's accuracy.

"She can't guarantee this data is relevant, that it's timely, and that it's accurate," he said.

"Ms Roxon needs to answer these serious allegations from what is an explosive email."

But Dr Allbon said the data issues mentioned in the leaked email have all been resolved on the website that went live.

…..

'MyHospitals data manipulated'

Victorian Health Minister David Davis also raised concerns about the site before its launch today, stating some information may have been manipulated by the state's previous Labor government.

"The Victorian auditor-general has pointed directly to data manipulation occurring in key public hospitals ... so the overall quality of the data is questionable," he told ABC Radio.

But Ms Roxon said the Commonwealth had checks and balances in place to ensure the website's data was reliable.

"The material has been provided by each state and territory but it has been checked and rechecked by the Institute of Health and Welfare, an independent and very credible body," she said.

Lots more here

http://www.theaustralian.com.au/national-affairs/hospitals-website-hits-early-strife/story-fn59niix-1225969194016

And here

Hospitals data site under fire

Julia Medew

December 11, 2010

THE Gillard government's MyHospitals website has been savaged on its first day, with allegations of old data that does not paint a true picture of hospitals' performance.

The site, launched by Health Minister Nicola Roxon yesterday, is meant to compare emergency department and elective surgery care in 769 public and 153 private hospitals across the country.

But within hours of going live, it was attacked by doctors, hospitals and Victoria's new Health Minister David Davis, who said it had inaccuracies.

While the site makes it difficult to compare states and territories, it showed Victorian hospitals performed well on emergency department care for the sickest patients against the national average.

However, in many cases, Victorians waited much longer than the national median times for elective surgery procedures, including heart, lung and brain operations.

Mr Davis said the data was unreliable because of ongoing allegations of fraudulent reporting in Victorian hospitals - a problem he has promised to crack down on. ''We know the data has been deficient [in Victoria] and that has formed the basis of what's gone on to the federal website,'' he said.

More here

http://www.theage.com.au/victoria/hospitals-data-site-under-fire-20101210-18svd.html

and last (there are many more)

Questions raised over My Hospital

Information on a new federal government website comparing hospital performance has been criticised as inaccurate, just hours before its launch on Friday.

  • AAP (Computerworld)
  • 10 December, 2010 10:30

Information on a new Federal Government website comparing hospital performance has been criticised as inaccurate, just hours before its launch on Friday.

My Hospital will compare hospital performance to national average waiting times for elective surgery and emergency department care, list the medical services provided, bed numbers and whether outpatient services are available.

The website - developed by the Australian Institute of Health and Welfare - will cover all public hospitals at first.

However, the Victorian Health Minister, David Davis, has raised concerns some information on My Hospital may have been manipulated by the state's previous Labor government.

"The Victorian auditor-general has pointed directly to data manipulation occurring in key public hospitals ... so the overall quality of the data is questionable," he told ABC Radio on Friday.

Federal Health Minister, Nicola Roxon, said the commonwealth had checks and balances in place to ensure the data was reliable.

"The material has been provided by each state and territory but it has been checked and rechecked by the Institute of Health and Welfare, an independent and very credible body," she said.

Roxon will launch My Hospital in Melbourne, with the website to go live from 11am (AEDT).

Consumer Health Forum of Australia chief executive, Carol Bennett, welcomed the initiative.

"Over time, transparency drives better performance and I think this is a fantastic step forward."

More here:

http://www.techworld.com.au/article/370885/questions_raised_over_my_hospital/

There is a bit to be said about all this.

First Mr Dutton just needs to relax. No minister can guarantee the accuracy of what they are given by State Governments - so his comments are just hollow rhetoric.

Second comments about looking up the site in an emergency are obviously rubbish. In an emergency you dial ‘000’ and wait for the ambulance to take you to hospital!

Third it is clear the basic idea is a good one. It is just that it has hardly been pushed to deliver yet!

If you want to get a feel for how it can be done a whole lot better and in more depth go here:

http://www.hospitalcompare.hhs.gov/

Just amazing richness of safety, and quality information including re-admission rates by disease and patient satisfaction survey results. A whole different world!

Equally in the UK a dramatically better effort. See here:

http://www.drfosterhealth.co.uk/hospital-guide/

As I said a day or so ago, just a start!

David.

Is This A Really Major Change For Health IT in the USA or Not? I Suspect It Might Be.

I think the answer is yes. And the flow on effects for Australia could be substantial indeed.

This announcement appeared a few days ago.

http://www.whitehouse.gov/administration/eop/ostp/pcast

President's Council of Advisors on Science and Technology

On December 8, PCAST released a report entitled “Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward.”

The press reaction has been quite positive. Examples include:

PCAST calls for universal exchange language

By Joseph Conn

Posted: December 8, 2010 - 11:30 am ET

The President’s Council of Advisors on Science and Technology issued a report calling on the federal government effectively to continue its work in facilitating the development of a nationwide capability to exchange health information, while specifically calling for it to promote the adoption of a common language to do so, including the use of data tagging for privacy and security protection.

In a letter to President Barack Obama accompanying the 108-page report, Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward (PDF), the council’s co-chairmen, John Holdren and Eric Lander, fully endorsed the potential benefits of health IT.

The widespread use of the technology and its attendant available data will help clinicians diagnose and treat patients, help patients take better control over their health, streamline public health monitoring, enhance the ability to conduct clinical trials, pare costs and create "new high-technology markets and jobs."

To achieve these objectives, the chairmen said, PCAST has concluded "it is crucial that the federal government facilitate the nationwide adoption of a universal exchange language for healthcare information and a digital infrastructure for locating patient records whole strictly ensuring patient privacy."

More here:

http://www.modernhealthcare.com/article/20101208/NEWS/312089965/

Here:

President's Advisors Tackle Health Data Exchange

HDM Breaking News, December 8, 2010

A report from an advisory body to President Obama recommends use of a "universal exchange language" to facilitate the exchange of health information while protecting privacy.

Use of such language could give patients more control over the dissemination and use of their medical information in an automated fashion.

Universal exchange languages for metadata descriptions, known as "extensible markup languages" are widely used, notes the President's Council of Advisors on Science and Technology. "The best way to manage and store data for advanced data-analytical techniques is to break them down into the smallest individual pieces that make sense to exchange or aggregate," according to the 108-page report. "These individual pieces are called 'tagged data elements' because each unit of data is accompanied by a mandatory 'metadata tag' that describes the attributes, provenance, and required security and privacy protections of the data."

This means that privacy rules, policies and applicable patient preferences "are innately bound to each separate tagged data element and are enforced both by technology and by law," the report continues. "For example, a patient with diabetes may decide that her blood sugar information should be available to any of her doctors and to emergency physicians requesting that information should she have a problem while traveling in another state--but that details of her past treatment for cancer should remain private and not be shared."

More here:

http://www.healthdatamanagement.com/news/President-Advisors-Tackle-Health-Data-Exchange-41491-1.html

and lastly here:

White House calls for standard language for health data exchange

By Mary Mosquera
Wednesday, December 08, 2010

The White House has called for a “universal exchange language” to enable healthcare providers to share health information in real time, in order to modernize and coordinate diagnosis and treatment while incorporating privacy and security of personal data.

To accomplish that, the Office of the National Coordinator for Health IT and the Centers for Medicare and Medicaid Services should develop the technical definitions and descriptions for the standard language and include them in requirements for meaningful use of electronic health records in 2013 and 2015, according to a White House report published Dec. 8.

In the report, the President’s Council of Advisors on Science and Technology (PCAST), a group of presidentially appointed experts from universities, industry and other organizations, urged the adoption of standards so healthcare providers can accelerate the exchange of patient records.

The federal government has made progress in laying the foundation for adoption of electronic health records (EHRs) through the incentive program under the HITECH Act, according to the PCAST report, “Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward.”

However, information for the most part is still held captive in proprietary systems, and providers cannot share and act upon the data to make better healthcare decisions, said Eric Lander, PCAST co-chair and president of the Broad Institute of Harvard and the Massachusetts Institute of Technology.

Among its recommendations, PCAST said that ONC should “move more boldly” to make sure that EHRs are able to exchange health information in a standard manner based on metadata-tagged data elements.

……

ONC is asking for public comments (http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__regulations_and_guidance/1496) about the report through Jan. 17.

More here:

http://govhealthit.com/newsitem.aspx?nid=75615

Now I understand fellow blogger Dr Eric Browne has more than a few reservations about the idea.

See here:

Recasting e-health in the USA

2010-December-11 | 11:35 By:

On December the 8th, 2010 the US President’s Council of Advisors on Science and Technology (PCAST) published an extraordinaryReport to the President realizing the full potential of health information technology to improve healthcare for Americans: the path forward“. This report is extraordinary for a number of reasons.

Firstly, PCAST is not comprised of government bureaucrats with little technical understanding, but by some of “the nation’s leading scientists and engineers”.

Secondly, PCAST concludes that “achievement of the President’s goals requires significantly accelerated progress toward the robust exchange of health information“. The report specifically denies a requirement for any national health record; it specifically denies any need for a national patient healthcare identifier; and specifically shuns the current shift towards exchanging documents in favour of exchanging structured atomic data tagged with context and privacy metadata.

Read the full blog here:

http://blog.healthbase.info/?p=198

Now I don’t have Eric’s deep understanding of the issues he is concerned about, the rather large bunch of government and industry experts involved in developing this document suggests that pretty much all the bases would have been covered - or do I have too much faith?

Whatever is true my suspicion is that this may be a game changer.

I strongly recommend a read and making up your own mind.

(I was also amused to read that PCAST does not believe SOA technologies, so much beloved of NEHTA are up to it in the long term for their needs for Health Information Exchange!).

I note there is also a period of public comment on the document - so you can be sure that if they have it wrong they will be told! Something we could use a bit more of I have to say.

ONC wants PCAST report feedback

By Joseph Conn

Posted: December 13, 2010 - 11:30 am ET

The Office of the National Coordinator for Health Information Technology is seeking public comment on a report released last week by the President's Council of Advisors on Science and Technology.

The formal request for information was published in the Federal Register (PDF). The comment period will be open through the end of the business day Jan. 17.

More here:

http://www.modernhealthcare.com/article/20101213/NEWS/101219987

David.

Monday, December 13, 2010

Will Someone Tell NEHTA and DoHA They Are Dreaming Please!

I think it is important we all grasp just how silly this PCEHR Project is looking in terms of any reality of a sensible delivery timetable.

As an example here is what is to be delivered by end June 2012.

It is the only stage 1 that a timeframe (for capability delivery) is stated to by DoHA / NEHTA so this is all we can judge the realist of the plans from. Here is what Release 1 is to deliver.

Release 1, End June 2012

PCEHR Core Infrastructure

- Consumer Portal

- Provider Portal

- Indexing and Search Service

Strengthen Consumer Participation

- Personal Health Diary approach agreed

- Portal for Consumers to access their own health information, manage who has visibility of their PCEHR and view an access audit trail

Better Assessment and Treatment Selection

- Pathology report summary information available via PCEHR indexed GP summaries

- Radiology report summary information available via PCEHR-indexed GP summaries

Safer Medication Management

- PBS information indexed by PCEHR

- Prescription exchange service provider information indexed by PCEHR

Improved Continuity of Care

- Discharge summaries electronically sent from hospital to GP

- Discharge Summary indexed by PCEHR

- PCEHR Referrals from GP to Specialists indexed by PCEHR

Enhanced Coordination of Care

- PCEHR populated with initial static health summary view using readily available information (e.g. MBS, Immunisation, GP Systems)

- PCEHR information is available for download to local GP system upon request

Just reading this list makes me tired! In this context it is worth noting that the “Clinical processes for maintenance of richer health summary records agreed” phase does not even happen until the next phase.

Now I know the people at NEHTA and DoHA are very smart cookies but the chances of getting the sort of standardised information flows implied here between hospitals, GPs, Specialists, pathology and radiology in 18 months - given we have wanted most of this to happen for a good part of a decade - is just fanciful. A properly planned and funded 4-5 year program maybe -but not 18 months.

Remember according to the BEACH survey we hardly even have GPs fully automated - let alone specialists. This is the current situation as reported in the Australian a few days ago.

“Eighty-five per cent are using desktop systems to print out prescriptions, while 72 per cent are receiving pathology test results online and 54 per cent are also ordering pathology tests online.

While the data -- from the Bettering the Evaluation and Care of Health (BEACH) survey of GPs -- confirms previously noted trends, the big shift to electronic medical record systems is a surprise.

Sixty-four per cent of GPs are now totally reliant on clinical record systems, with 30 per cent still hedging their bets via duplicate sets of electronic and paper records.”

See here for details

http://www.theaustralian.com.au/australian-it/government/gps-switching-to-electronic-records-survey-shows/story-fn4htb9o-1225968414063

If these clinical people are to be information providers ( and just what is in it for them is by no means clear right now - other than a lot of grief) there is a fair way to go with adoption etc!

If we are going to attempt this, and my lack of confidence in the whole approach is well known, then at least start with realistic and not utterly absurd expectations.

Unless more sensible expectations are set a lot of people are going to look pretty silly - and the fallacy of a delivering a live Health Identifier Service, that is still hardly used, will be repeated. One suspects this might be the case given the heading is that this is a ‘Capability Release Plan' and it may be that they will be able to mock all this up for demonstration in 18 months time - but that actual real world availability and delivery might happen years later.

We shall see!

David.

Sunday, December 12, 2010

AusHealthIT Poll Number 48 – Results – 12 December, 2010.

The question was:

Will The Recent E-Health Summit Have a Significant Positive Impact on E-Health in Australia?

Yes - It Was Fabulous

- 9 (21%)

Probably - It Was Pretty Good

- 5 (12%)

Probably Not - Did Not Involve The Right People

- 3 (7%)

No Way - It Was Just a Talkfest

- 24 (58%)

Votes : 41

I think it is fair to say those who read here are of the view that an opportunity was probably wasted with only 33% saying it will make a difference.

Again, many thanks to those that voted!

David.

Weekly Australian Health IT Links – 12 December, 2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment:

-----

Now here is an interesting join the dots exercise.

We had this appear a few days in an opinion piece.

www.rustreport.com.au

December 10, 2010

E-health on the agenda

Ian Birks*

The Australian Government's E-health conference last week wrapped up two days of focus on the national development of e-health initiatives and Personally Controlled Electronic Health Records (PCEHRs).

There has been a strong government investment in e-health, ranging from $A466 million over two years to deliver better patient records, to Senator Conroy's announcement at the conference of a $A4 million e-health trial in NSW. This investment is essential and welcomed by the ICT industry as the right way forward. However, a key requirement for the success of schemes such as the PCEHR will be consumer engagement. Basing the PCEHR initiative on an opt-in system is something that may ultimately hinder its success.

Many of those users who stand to benefit the most from a personally-controlled record may not understand the benefits on offer. To base the success of the system on the requirement for users to actively opt-in is a risk.

Australia must embrace the opportunities offered by a digital economy on a wide scale if we are to see the benefits. Any user should have the right to opt-out based on personal preferences or concerns, but without high levels of engagement the system will not deliver the potential benefits on offer.

---- End Quote

*Ian Birks is CEO of the AIIA

www.aiia.com.au

So what we have is the CEO of the Australian Information Industry Association (AIIA) telling us that the planned PCEHR should be ‘opt-out’ rather than ‘opt-in’ and being rather dismissive that any one might indeed actually opt out (preferences and concerns being cited rather than the obvious range of genuine issues such as discrimination and so on)

If you have a look at the AIIA board of directors it is clear this organisation is focussed on the ‘big end of town’ - IBM, HP, Telstra, Microsoft and so on and that their main interest is in growth of the ICT sector.

What a godsend then that the Government has decided to invest close to a $billion in e-health and related activities. Think what the money-making opportunities are!

It seems to me it might be a worry for the AIIA if the consent model keeps the whole effort going a little more slowly and so slows cashflows. That 'opt in', is unquestionably the right way to go initially, as we learn if the PCEHR is a good idea and if the benefits are real and sustainable, seems not to interest the AIIA - or am I just too cynical?

-----

www.6minutes.com.au

07/12/2010.

From the editor

Confused by the PCEHR? You're not alone

Michael Woodhead

In an article in the MJA last week, Professor Enrico Coiera, Director of the Centre for Health Informatics at the University of NSW made the case for a national shared record (PCEHR), but warned that building summary care records (SCR) was not the way to do it.

We reported this incorrectly as saying that Professor Coiera was not in favour of a PCEHR at all. In fact, Professor Coiera was saying that a centralised summary care record system is not justified for several reasons.

It would, for example, require centralised summary databases, the classic “top-down” approach to e-health. This is something Nicola Roxon appeared to have ruled out this week, when she told the national e-health summit 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.”

-----

http://www.theaustralian.com.au/australian-it/leak-of-draft-e-health-document-raises-privacy-concerns/story-e6frgakx-1225966635891

Leak of draft e-health document raises privacy concerns

PATIENTS will have limited control of their medical information, as a leaked document shows consumer access will be confined to a portal.

While Health Minister Nicola Roxon said consumers would "truly control" their personal electronic health records at her e-health forum last week, attendees did not see a draft concept of operations, showing a patient portal tacked on to a public/private providers' shared e-health record system (SEHR).

The confidential draft for the $467 million personally controlled e-health record (PCEHR) system was produced by the National E-Health Transition Authority, just before the forum.

The Australian has obtained a key system design diagram, which shows there is no mechanism for consumers to manage access by their doctors.

-----

http://www.theaustralian.com.au/australian-it/government/gps-switching-to-electronic-records-survey-shows/story-fn4htb9o-1225968414063

GPs switching to electronic records, survey shows

  • Karen Dearne
  • From: Australian IT
  • December 09, 2010 4:27PM

ALMOST two-thirds of GPs have switched to paperless medical records, with the others maintaining a hybrid mix of paper and electronic records.

The annual GP activity report by the Australian Institute of Health and Welfare shows 98 per cent of GPs are using computers for some clinical purposes.

Eighty-five per cent are using desktop systems to print out prescriptions, while 72 per cent are receiving pathology test results online and 54 per cent are also ordering pathology tests online.

While the data -- from the Bettering the Evaluation and Care of Health (BEACH) survey of GPs -- confirms previously noted trends, the big shift to electronic medical record systems is a surprise.

-----

http://www.theage.com.au/victoria/states-long-wait-for-surgeons-knife-20101209-18rez.html

State's long wait for surgeon's knife

Julia Medew and Kate Hagan

December 10, 2010

SCORES of Victorians waited longer than the national median waiting time for surgery last year, including for heart, lung and brain procedures, new figures show.

In many cases, Victorians also waited longer than a year to go under the knife during the past financial year, depending on where they lived and what type of surgery they were waiting for.

The hospital data, released by the state government, revealed that Victorians waited 21 times the national median time for vascular surgery.

-----

http://www.sciencedaily.com/releases/2010/12/101203091457.htm

Information Technology Could Improve Prevention, Treatment of Depression

ScienceDaily (Dec. 6, 2010) — Could information technology and data mining techniques be used to improve the diagnosis and treatment of depression? That's the question scientists in Australia hope to have answered in a forthcoming issue of the International Journal of Functional Informatics and Personalised Medicine.

Maja Hadzic, Fedja Hadzic and Tharam Dillon of the Digital Ecosystems and Business Intelligence Institute, at Curtin University of Technology, in Perth, explain how depression is rapidly emerging as one of the major health problems now facing society. They add that the World Health Organization has predicted that depression will be the world's leading cause of disability by 2020. "We are noticing a spread of a depression epidemic throughout the whole world," the team says. "Usually, an epidemic, such as a swine flu epidemic, has a pathogen associated with it. But, there is no pathogen involved with the depression epidemic." Indeed, the precise causes of depression have not yet been identified although it is clear that many different biological, psychological and social factors are at play in its development.

-----

http://www.arnnet.com.au/article/370259/ovum_mobile_devices_propel_consumer-based_healthcare/?fp=4&fpid=399285820

Ovum: Mobile devices to propel consumer-based healthcare

Smartphone and tablet applications to fuel the trend of consumers taking healthcare into their own hands, according to the analyst firm

Mobile devices such as smartphones and tablets will drive a market that allows consumers to take healthcare in their own hands, according to analyst firm, Ovum.

The comment comes off the back of the Government’s demonstration of an e-health record iPhone application last week. The app allows patients to control their health records and gives doctors expedited access to those records.

There are numerous health apps available on Apple’s iTunes App Store.

-----

http://www.zdnet.com.au/medicare-launches-online-health-directory-339307859.htm

Medicare launches online health directory

By Josh Taylor, ZDNet.com.au on December 9th, 2010

update Australian healthcare providers with health identifiers will now be able to gain information on other providers via an online directory, Medicare has announced today.

An individual health identifier is a 16-digit number that Medicare allocated to every resident of Australia following the passing of legislation in July this year. The government intends to use this number as the foundation for the construction of a personally controlled e-health record. Healthcare providers and institutions were also issued with a number.

-----

http://www.computerworld.com.au/article/370298/acquisition_drives_healthe_care_it_transformation/?eid=-255&uid=25465

Acquisition drives Healthe Care IT transformation

12 disparate patient management systems to be replaced

Acquisition has brought growth benefits but added an IT headache for Australian private health provider Healthe Care.

Faced with the challenge of trying to unite multiple facilities to create a more efficient business and provide improved customer service, the provider is now rolling out a common patient management system across 12 hospitals.

So far the system is in two of its hospitals with a view to completion in 2011. The move follows Definity Consulting conducting an IT architecture survey in 2009.

One of Definity's recommendations was to streamline the delivery of IT services by outsourcing IT support under a single managed services agreement.

-----

http://www.cio.com.au/article/370955/victoria_extends_rural_telehealth_trial/

Victoria extends rural telehealth trial

Live telemetrics, high definition video conferencing to be rolled out across all 16 hospitals in Loddon Mallee area

Telehealth video conferencing and live telemetrics equipment for trauma and critical will be extended to all 16 regional Victorian hospitals administered under the Loddon Mallee Rural Health Alliance following a successful, 20-month trial across four of the units.

The initial $5.2 million trial was funded under the Federal Government’s $118.6 million Clever Networks initiative and took place from June 2008 across hospitals in Mildura, Swan Hill, Machuka and Bendigo, connected to four metropolitan hospitals in Melbourne. The trial involved the deployment of eight mobile Virtual Trauma and Critical Care Units (ViTCCU) and seven fixed units across the regional hospitals, along with software and smart vitals devices from a consortium of companies including Telstra, Cerner, KPMG and Polycom.

The units were connected by a 100 megabits per second (Mbps) link provided by Telstra, running separately to the hospitals’ existing networks in order to avoid potential congestion.

Specialists at the Melbourne sites provided advice to primary treating doctors initially for critical care patients.

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http://www.computerworld.com.au/article/370782/bendigo_health_jumps_e-health_bandwagon/?eid=-255&uid=25465

Bendigo Health jumps on e-health bandwagon

The hospital has implemented a number of electronic systems to automate and improve hospital practices

Bendigo Health is jumping on the e-health bandwagon, announcing a $100,000 upgrade of its health systems, in an effort to automate hospital practices, increase operational efficiency and patient safety levels.

The hospital, located in Victoria, has deployed a number of systems from AeroScout, including the Real Time Location System (RTLS), patient and temperature monitoring system, and staff safety technology.

The hospital’s information and communications technology manager, Phil Coppin, told Computerworld Australia, the new systems help the facility provide better clinical care, meet regulatory compliance around medications and pathology and improve staff safety to comply with occupational health and safety legislation.

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http://www.theaustralian.com.au/australian-it/government/health-ibm-revisit-it-outsourcing-deal/story-fn4htb9o-1225967155174

Health, IBM revisit IT outsourcing deal

  • Karen Dearne
  • From: Australian IT
  • December 08, 2010 12:00AM

IBM Australia has kept its stranglehold on the federal Health Department, with a renegotiation of its service agreement over the next four years.

Briefing documents for the incoming Gillard government show former finance minister Lindsay Tanner gave the department approval to open discussions on a contract extension.

IBM has provided ICT services to Health since the department outsourced its IT infrastructure to the industry giant in 1999.

The current contract, estimated at $126.6 million, is due to expire in June 2011. The agreement has twice been renegotiated -- in December 2003 and again in December 2008.

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http://www.cdc.gov/eid/content/16/12/1960.htm

Volume 16, Number 12–December 2010

Dispatch

Online Flutracking Survey of Influenza-like Illness during Pandemic (H1N1) 2009, Australia

Sandra J. Carlson, Craig B. Dalton, David N. Durrheim, and John Fejsa
Author affiliations: Hunter Medical Research Institute, Wallsend, New South Wales, Australia (S.J. Carlson, C.B. Dalton, D.N. Durrheim); Hunter New England Population Health, Newcastle, New South Wales, Australia (S.J. Carlson, C.B. Dalton, D.N. Durrheim, J. Fejsa); and Newcastle University, Newcastle (C.B. Dalton, D.N. Durrheim)

Suggested citation for this article

Abstract
We compared the accuracy of online data obtained from the Flutracking surveillance system during pandemic (H1N1) 2009 in Australia with data from other influenza surveillance systems. Flutracking accurately identified peak influenza activity timing and community influenza-like illness activity and was significantly less biased by treatment-seeking behavior and laboratory testing protocols than other systems.

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http://rustreport.com.au/

Australian cure for Irish health

SA developer PowerHealth Solutions has been engaged to help the Irish Health Service Executive reform health services through the introduction of patient-level costing and activity-based funding. www.powerhealthsolutions.com

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http://www.racgp.org.au/ehealth/ecommunications

e-Communications in Practice

One of the steps in the process of developing the foundations to enable a national e-health system is to ensure the benefits of e-health can be realised as soon as possible. To achieve this, the National E-Health Transition Authority (NEHTA) is focusing their efforts on e-communications in practice by implementing and delivering early e-health services for the most commonly exchanged health information.1

NEHTA was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information.The College works with NEHTA, where our directions are aligned, and to ensure that general practice needs are reflected in NEHTA’s work.

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http://www.e-health-insider.com/news/6488/isoft_sale_%27one_of_the_options%27

ISoft sale 'one of the options'

08 Dec 2010

ISoft is planning to sell its iSoft Business Solutions subsidiary, according to the Sunday Times.

The newspaper claims that the software firm - which is in negotiations with its bankers over debts of AUS $240m (£152m) - is planning to offload the subsidiary, which designs finance systems for the NHS.

The paper reports that iSoft Business Solutions has offices in Dublin and Belfast and made a loss of £634,000 last year despite sales of £3.5m. It says iSoft has yet to find a buyer.

ISoft declined to comment on the sale. However, during its annual general meeting last week, chairman Robert Moran said: “We have previously announced that we are considering a limited number of asset sales or business closures in order to reduce debt and improve cash flow. This process continues.”

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http://www.theaustralian.com.au/business/industry-sectors/cabling-for-nbn-rollout-cut-back/story-e6frg97o-1225968560255

Cabling for NBN rollout cut back

  • Annabel Hepworth and Mitchell Bingemann
  • From: The Australian
  • December 10, 2010 12:00AM

A PROPOSAL for every new home built after January 1 to be connected with fibre cable for the National Broadband Network has been abandoned.

This came after the Gillard government admitted the magnitude of the task meant the plan would have to be phased in.

Federal Communications Minister Stephen Conroy said yesterday new houses in developments of fewer than 100 premises - common in cities and towns - would be connected to Telstra's copper network or wireless services with slower internet speeds, and only later would be hooked up to the NBN.

The government wants the NBN Co to prioritise the delivery of the super-fast fibre in larger property projects.

An estimated 1.9 million new premises will be constructed while the $36 billion NBN is being rolled out.

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New Zealand Spot - Seems Some Interesting Things Happening

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http://www.infonews.co.nz/news.cfm?id=61613

Auckland pharmacies and hospitals to "talk" via health intranet

By Pharmacy Guild of New Zealand

From today, all Auckland pharmacies will have access to important patient information through TestSafe. A metro Auckland DHB initiative, TestSafe is a data repository that enables community pharmacists to access only relevant and pre-defined patient information through a secure health intranet connection.

TestSafe is part of a regional initiative by the three Auckland DHBs (Auckland, Counties Manukau and Waitemata) to improve relevant information sharing among community and hospital health care providers. It brings together results from DHB facilities, community laboratories and now community pharmacies.

At this stage, community pharmacists will have access to selected laboratory results and dispensing information for their patients. It is anticipated TestSafe will eventually include relevant information from hospital discharge notes that will give the pharmacist a more complete picture of the patient’s condition and treatment plan.

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http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10692593

Pharmacists get access to health details of 1.1m

By Martin Johnston

5:30 AM Tuesday Dec 7, 2010

Sensitive medical records of hundreds of thousands of Aucklanders are in the hands of community pharmacists after they joined a computer network in a move expected to improve healthcare delivery.

By last year 1.1 million Auckland patients had diagnostic test results and drug dispensing reports stored on the TestSafe system run by the region's district health boards.

Set up in 2006 to improve healthcare safety and efficiency by sharing community laboratory test results among public hospital clinicians, TestSafe has been expanded by including some radiology and various other test results, plus drug dispensing reports.

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http://www.stuff.co.nz/technology/4425154/DHBs-start-electronic-patient-records

DHBs start electronic patient records

TOM PULLAR-STRECKER - The Dominion Post

Last updated 05:00 06/12/2010

Hospitals patients in the lower North Island should find doctors and nurses have better information on their prior care following a project that has been kicked off by the region's six district health boards to integrate health information technology systems.

Capital & Coast ICT director Stuart Wakefield is heading the project, which he said was a step on the way to creating a national system of online electronic health records by 2014.

Mr Wakefield said hospital staff would be able to get a single view of patient information that was stored on multiple software systems in the region through a portal they could access with one logon and password. "Most of this information is able to be shared today – it is just not particularly efficient the way that we do it."

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http://www.theaustralian.com.au/business/news/google-takes-pc-software-fight-to-mircrosofts-windows/story-e6frg90o-1225967473547

Google takes PC software fight to Mircrosoft's Windows

  • Murad Ahmed
  • From: The Times
  • December 08, 2010 10:17AM

GOOGLE has made its most direct challenge to Microsoft with the launch of its new operating system that aims to defeat Windows.

It is a battle for the future of personal computing.

Users of computers running Chrome OS will be able to get online much more quickly as the system will turn on instantly and automatically log on to the web within seconds.

In the first public demonstration of the software in San Francisco, Google showed that a user can be surfing the net within 60 seconds of switching on their computer.

Chrome also brings users a step closer to being able to store all photographs, music and emails online rather than on a hard drive. The files would be kept in the "cloud" on the internet and be accessed from any device with an internet connection.

Eric Schmidt, Google chief executive, said: "Cloud computing will define computing as we know it."

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Enjoy!

David.

Saturday, December 11, 2010

Weekly Overseas Health IT Links - 11 December, 2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

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http://www.prnewswire.com/news-releases/study-finds-medical-device-registries-enhance-patient-safety--quality-of-care-111130164.html

Study Finds Medical Device Registries Enhance Patient Safety & Quality of Care

Research Based on Nation's Largest Implant Registry

OAKLAND, Calif., Dec. 1, 2010 /PRNewswire/ -- A detailed and standardized national registry of commonly used joint replacement devices would improve patient outcomes and create clinical and financial efficiencies, according to a Kaiser Permanente research study of 85,000 joint surgeries published in the November issue of the Journal of Bone and Joint Surgery.

Information on the more than 600,000 total knee and hip replacements performed annually in the United States could enhance patient safety and quality of care and provide a foundation for more in-depth research projects that will contribute to better outcomes as increasing numbers of replacements are performed in the future, researchers found.

This prospective study of 80,000 total joint replacement and 5,000 anterior cruciate ligament reconstruction procedures within Kaiser Permanente's national implant registries – the nation's largest registry of implants -- looked at patient demographics, implants and surgical techniques in relationship to outcomes for these procedures. This is the largest community-based research study of outcomes with total knees and hips and ACL reconstruction procedures, and one of few studies conducted with a registry that includes a level of detail to assess outcomes in the United States.

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http://www.healthleadersmedia.com/content/LED-259668/Medical-Errors-Stubbornly-Common-Studies-Find

Medical Errors Stubbornly Common, Studies Find

John Commins, for HealthLeaders Media , December 2, 2010

It's been 11 years since the Institute of Medicine reported in December 1999 that medical errors caused more than 98,000 deaths and injured more than 1 million people each year. Unfortunately, the results from two recent studies indicate that—despite a lot of focus and effort—the nation's hospitals have not significantly reduced medical errors, which still lead to tens of thousands of deaths each year.

Hospital advocates don't dispute the findings, but they also don't believe the last 10 years were a lost decade. They believe that progress has been made, even if it is not immediately apparent.

"It was discouraging not to see more evidence that the hard work that has gone on in the past decade has had as substantial an impact as we believe it has. But the studies are what the studies are," says Nancy Foster, vice president for quality at the American Hospital Association.

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http://www.healthleadersmedia.com/content/TEC-259666/OCR-Data-Breaches-Double-Since-July

OCR: Data Breaches Double Since July

Dom Nicastro, for HealthLeaders Media , December 2, 2010

The number of entities reporting breaches of unsecured protected health information (PHI) affecting 500 or more individuals is close to reaching the 200 mark.

As of Tuesday, November 30, the number of entities reporting breaches to the government's HIPAA privacy and security enforcer hit 197. The number of entities—listed on the Office for Civil Rights (OCR) breach notification website--has almost doubled since July, when the number hit 107.

In the past five months, 90 new reports have surfaced, or an average of 18 per month, a higher pace than the 15-per-month the first five months after OCR launched the website.

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http://hitechwatch.com/blog/security-isn%E2%80%99t-always-technical-problem

Security isn’t always a technical problem

By Jeff Rowe, Editor

We’ve commented more than once about the government’s responsibility to help providers with HIT security measures.

But as reported security breaches continue to pile up, it’s clear that policymakers’ first order of business should be to determine how much of the healthcare sector’s overall security problem is due to the push to transition providers to new HIT, and how much is the result of avoidable human error.

According to this report, “As of Tuesday, November 30, the number of entities reporting breaches to the government's HIPAA privacy and security enforcer hit 197. The number of entities—listed on the Office for Civil Rights (OCR) breach notification website--has almost doubled since July, when the number hit 107.”

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http://www.modernhealthcare.com/article/20101202/NEWS/312029960/

HHS looking for a few good apps

By Christine LaFave Grace

Posted: December 2, 2010 - 11:45 am ET

In support of its new 10-year public health and illness prevention plan announced Thursday, HHS is calling on tech developers to create data-rich applications designed to promote community health.

The myHealthyPeople Application Developer challenge seeks "engaging and empowering" applications that pertain to the topics and objectives detailed in Healthy People 2020, the department's fourth 10-year health agenda. Submitted applications should target the professionals, advocates, funders and decisionmakers "who will be using Healthy People to improve the health of the nation," according to the Challenge.gov website.

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http://www.fierceemr.com/story/exceptionally-complex-cpoe-key-part-meaningful-use/2010-12-02

'Exceptionally complex' CPOE a key part of 'meaningful use'

December 2, 2010 — 12:59pm ET | By Neil Versel

Think EMR implementation is tough? Wait until you try computerized physician order entry--which just happens to be one of of the required measures of Stage 1 "meaningful use."

"Given the importance of provider order entry, it is not surprising that the federal government's promotion of health information technology--via the HITECH provision of the American Recovery & Reinvestment Act and related meaningful use rules for implementation of an electronic health record--places so much emphasis on using computerized physician order entry. However, considering the complexity of adopting CPOE and the challenges any organization faces when changing a core process, it's also not surprising that so few hospitals have taken on CPOE," write John Glaser and Dr. M. Kent Locklear in a Hospitals & Health Networks online exclusive.

"HITECH effectively has put CPOE in a prom dress, requiring those who wish to pursue stimulus dollars to get ready for the big dance."

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http://www.fierceemr.com/story/csc-right-people-processes-change-management-lead-ehr-success/2010-12-02

CSC: Right people, processes lead to EHR success

December 2, 2010 — 11:57am ET | By Neil Versel

As a principal with the Health Delivery Group of Computer Sciences Corp., and a critical care nurse with more than 35 years of experience in healthcare and health IT, Karen Fuller has seen more than a few successful EHR implementations. Now, on the CSC Meaningful Use Community blog and in an interview with Healthcare IT News, Fuller shares her top 10 internal factors to EHR implementation success.

As Healthcare IT News reports, Fuller puts the 10 factors into four "buckets": the right people, right processes, right change management and right technology. Without all four components, it's tough to make an EHR investment pay off.

Organizational leadership must show a clear commitment to the EHR and make sure clinical and operational executives are fully accountable for their actions and visible to rank-and-file staff. "They have to understand that is it is an organizational priority," Fuller says, and that the implementation represents a "transition for the entire organization."

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http://www.fierceemr.com/story/himss-analytics-few-medical-devices-connect-emrs/2010-12-02

IMSS Analytics: Few medical devices connect with EMRs

December 2, 2010 — 2:17pm ET | By Neil Versel

If you read FierceMobileHealthcare regularly, you'd know that many, if not most, mobile devices used in healthcare don't connect to much other than the Internet. According to a new white paper from HIMSS Analytics and communications IT firm Lantronix, the problem seems to extend to EMRs and in-hospital medical devices.

The paper, released Wednesday, says that just a third of the 825 U.S. hospitals queried report having active interfaces between devices such as defibrillators, physiologic monitors, vitals monitors and electrocardiographs and their EMRs. The results may be skewed by the finding that 71.7 percent of those with hubs for "intelligent medical devices" are interfaced with EMRs because just 11 percent of respondents reported using such hubs.

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http://www.ihealthbeat.org/data-points/2010/what-are-top-barriers-keeping-doctors-from-communicating-with-patients-through-email.aspx

Wednesday, December 01, 2010

What Are Top Barriers Keeping Doctors From Communicating With Patients Through E-Mail?

Sixty-four percent of health IT professionals surveyed said a lack of reimbursement is a key barrier keeping physicians from communicating with patients through e-mail, according to a Healthcare Information and Management Systems Society survey.

Fifty percent of respondents said they view an increase in workload as a key barrier, while 47% said data security and privacy issues were a barrier.

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VA Pilots Digital Medical Record Retrieval

A contractor will collect, scan, and transmit private healthcare records with the goal of speeding Veterans Affairs' claims decisions.

By Nicole Lewis, InformationWeek

Nov. 30, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228400215

The Department of Veterans Affairs (VA) has announced that it will work with a private contractor to speed claims decisions and significantly reduce the average time needed to obtain medical records from private physicians.

The department updated veterans on the progress of the VA Claims Transformation Plan on Monday, noting that one of the pilot projects it's conducting can significantly improve the efficiency of the claims processing system as well as help the department to meet its goal of processing all claims within 125 days and with 98% accuracy by 2015.

According to Eric Shinseki, secretary of Veterans Affairs, innovations that will speed, simplify, or improve VA's services are being rigorously tested.

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http://www.healthleadersmedia.com/content/TEC-259608/Top-10-Healthcare-Technology-Hazards-for-2011

Top 10 Healthcare Technology Hazards for 2011

Cheryl Clark, for HealthLeaders Media , December 1, 2010

The ECRI Institute, an independent group that evaluates medical devices and procedures, has issued its latest list of the 10 most perilous technologies in healthcare health providers should keep an eye out for in 2011.

This year's list reflects the group's judgment based on:

  • A review of recent recalls
  • Analysis of information found in the literature and in the medical device problem reporting databases of ECRI Institute, and other organizations
  • ECRI experience in investigating and consulting on device-related incidents

The goal "is to increase awareness of these hazards and to stimulate action within healthcare facilities to formulate programs" to minimize dangers, authors say.

1. Radiation Overdose and Other Dose Errors During Radiation Therapy.
This underreported problem makes the number one spot on the list for two reasons.

First, the consequences of a radiation overdose rarely manifest right away, "meaning that certain errors—such as those resulting from improper device setup or an inappropriate treatment plan—could lead to a patient being repeatedly exposed to an inappropriate dose before the error is noticed in clinical review. And by that time, the damage has already been done, and can't be undone."

And second, radiation treatment plans are more complex, "leaving very narrow margin for error," the report states.

Administering the wrong dose, or treating the wrong site or patient are all caused by human error, software problems, and provider or operator inexperience with the fast pace of technological change.

For example, the report says, in one year from July 2009 to July 2010, there have been over 40 reports of software errors, manufacturing-required software modifications or dose calculation errors for radiotherapy systems, linear accelerators and radiation treatment planning systems.

The report advises hospitals to make sure personnel have up-to-date and appropriate certifications and training and that staffing levels are adequate. Maintain systems to ensure that patient treatment procedures are documented and followed, with attention to providing oversight of incident reporting and safety alerts management.

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http://blogs.forbes.com/zinamoukheiber/2010/11/19/open-source-makes-debut-in-health-care/

Open Source Makes Debut in Health Care

Nov. 19 2010 - 4:22 pm

By ZINA MOUKHEIBER

The high-tech industry is littered with once-thriving companies that chose to cling to closed, proprietary software or hardware. Slow-footed to respond to customer demands, they’re now gone.

It is taking a surprisingly long time for companies that sell electronic health records (EHRs)—a backbone of hospitals and soon of doctors’ offices, to learn that lesson. A “closed” mentality still permeates the health care IT business. Among the big companies, Allscripts is finally taking a step toward open source. Next month, the Chicago-based vendor of EHRs will allow outside developers to write programs for its digital medical records. It is setting up an “Application Store & Exchange,” where customers can shop for applications, and also share their own. “It’s an Apple store for health care,” says Dan Michelson, Allscripts chief marketing officer.

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http://www.healthcareitnews.com/news/survey-finds-high-interest-home-medical-devices

Survey finds high interest in home medical devices

November 30, 2010 | Molly Merrill, Associate Editor

SAN FRANCISCO – Three in five Americans with chronic disease say using a home medical device would improve their health, according to a new survey.

The poll was conducted by GfK Roper on behalf of San Francisco-based EHR provider, Practice Fusion.

Almost half of Americans currently live with at least one chronic condition, and more than ninety percent of Americans age 65 or older are living with some form of chronic illness, according to the CDC.

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http://www.healthcareitnews.com/news/black-book-rankings-names-top-emr-vendors-2011?page=0,0

Black Book Rankings names top EMR vendors for 2011

November 29, 2010 | Molly Merrill, Associate Editor

NEW YORK – A survey by Black Book Rankings, a division of the market research firm Brown-Wilson Group, ranks the top EMR vendors for 2011 based on key performance indicators including meaningful use.

The rankings include the top 20 vendors in 10 categories including acute care/hospital, emergency and physician groups, which are broken down by size.

The rankings are a result of a four month poll, conducted by Black Book, that surveyed more than 30,000 healthcare records professionals, physician practice administrators and hospital leaders in the information technology arenas.

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http://www.e-health-insider.com/news/6471/nao_launches_npfit_investigation

NAO launches NPfIT investigation

01 Dec 2010

The National Audit Office has confirmed that it will launch an investigation into the value of the National Programme for IT in the NHS, focusing specifically on the £546m contract that was awarded to BT last year.

The decision to run an investigation follows a request made in September by Conservative MP and member of the Public Accounts Committee, Richard Bacon.

Bacon, who has followed NPfIT since its inception in 2002, wrote to Amyas Morse, the head of the government spending watchdog, asking him to examine the BT contract.

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http://www.technologyreview.com/biomedicine/26781/

Monday, November 29, 2010

Ultrasound Gets More Portable

A new handheld ultrasound device could be the first that can connect directly to cell-phone and Wi-Fi networks.

Two years ago, computer engineers at Washington University in St. Louis created a prototype that took ultrasound imaging to a new level of mobility and connectivity—they connected an ultrasound probe to a smart phone. Now a startup awaiting clearance from the U.S. Food and Drug Administration hopes to begin selling the device next year.

Such a device would be useful for emergency responders, who could scan an injured person to detect internal bleeding or other trauma, and then immediately send an image to the hospital so physicians could be better prepared for the patient's arrival. Or a nurse practitioner visiting a pregnant woman's home could ask a specialist stationed elsewhere to weigh in on anomalies in the scan.

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http://www.who.int/goe/ehir/2010/november_30_2010/en/index.html

eHealth Intelligence Report

November 30, 2010

Scientific Articles

:: A telemedicine service for HIV/AIDS physicians working in developing countries.

J Telemed Telecare. 2010 Nov 15. (Online ahead of print)

The user survey showed that telemedicine advice was valuable in the management of specific cases, and significantly influenced the way that clinicians managed other similar cases subsequently. Nonetheless, there was a declining trend in the rate of use of the service.

:: The empowerment and quality health value propositions of e-health.

Health Serv Manage Res. 2010 Nov;23(4):181-4.

In order to contribute towards an understanding and appreciation of e-health as a main stream concept, we propose the use of existing models, theories and principles in support of e-health. Specifically, the empowerment theory and the principles of quality health will be used to discuss the value proposition of e-health

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http://www.healthleadersmedia.com/content/TEC-259536/Meaningful-Use-Spurs-Leaders-to-Take-Action.html

Meaningful Use Spurs Leaders to Take Action

Gienna Shaw, for HealthLeaders Media , November 30, 2010

The headline for senior leadership editor Philip Betbeze's most recent column is dead on: Hoping for Repeal is Not a Strategy. As we gear up for our annual industry survey season here at HealthLeaders Media, he says he's noticing a disturbing trend: Some healthcare leaders are pinning their hopes for their organization's long-term well-being on repeal of the Patient Protection and Affordable Care Act.

In light of that news, healthcare CIOs and other leaders might want to give themselves a little pat on the back for their response to another federal program—the American Recovery and Reinvestment Act of 2009 and its meaningful use requirements.

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http://www.govhealthit.com/newsitem.aspx?nid=75194

VA provides tools to track hospital quality

By Mary Mosquera

Monday, November 29, 2010

The Veterans Affairs Department is “raising the bar” for its healthcare centers by providing online tools so veterans can compare how well the VA’s 153 hospitals perform, with the ultimate goal of spurring further improvements at those facilities.

Acute care, patient safety and intensive care are the principal areas targeted by the tools, which veterans and their families can access through the Linking Information Knowledge and Systems (Links) dashboard at VA’s Hospital Compare Web site (http://www.hospitalcompare.va.gov).

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http://www.govhealthit.com/newsitem.aspx?nid=75217

Direct Project completes first models of simple NHIN

By Mary Mosquera

Tuesday, November 30, 2010

The first version of the software that will allow simple information exchange between providers, a crucial enabler for the first stage of meaningful use of electronic health records, was announced by the Office of the National Coordinator for Health IT.

The open source reference model of the standards and services that enable connectivity, which will be available as both Java and .Net formats, will be deployed first in a series of pilots to test it for real-world use, according to Arien Malec, coordinator of the Direct Project, the new name for the old NHIN Direct, a project of the ONC.

The Direct Project is a streamlined version of the more robust nationwide health information network standards set (NHIN), and will offer physicians and small practices the ability to conduct basic health record exchanges. For example, a primary care physician who is referring a patient to a specialist can use the Direct Project to send a clinical summary of that patient to the specialist, and to receive a summary of the consultation.

“As we test out the specifications and learn more from the demonstrations, we’ll have more vendor support,” he said.

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http://www.cbc.ca/health/story/2010/11/30/ehealth-canada-health-infoway-budget.html

Funding delay slows e-health records project

Last Updated: Tuesday, November 30, 2010 | 1:15 PM ET

CBC News

The agency set up to digitize Canada's health-care system will fall just short of its target to see half of Canadians with electronic health records by the end of 2010, after the government delayed giving $500 million to the agency by one year.

Soon after the government announced the funding in the 2009 federal budget, officials wanted more information from Canada Health Infoway about where the money would be spent. Infoway complied and agreed to an audit that came back with no problems.

Then last September, finance officials emailed Health Canada to say the Prime Minister's Office had decided the money would be held back until 2010.

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http://healthcareitnews.com/news/top-10-factors-successful-ehr-implementation

Top 10 factors for successful EHR implementation

November 23, 2010 | Molly Merrill, Associate Editor

FALLS CHURCH, VA – Right people, right processes, right change management and right technology – these are the "four buckets" that one expert says her list of top 10 internal factors for implementing an EHR fall into. Without all the components, she says, it is very difficult for organizations to succeed.

Karen Fuller is a principal with Falls Church, Va.-based CSC's Health Delivery Group and is a critical care nurse with more than 35 years of experience in healthcare and information technology. She shared with Healthcare IT News her top 10 list, which she says has been generated from her own experiences and those of her clients:

1. Right Leadership

  • Top-level leadership unwaveringly committed to make this an organization priority.
  • Clinical and operational executives accountable for success are visible and present to demonstrate solid commitment.

Fuller says when an organization is considering a technology change, it should take a top-down approach. It should, for example, start with the hospital's board, but should include all the members of an organization. "They have to understand that is it is an organizational priority," she said, and that it is a "transition for the entire organization."

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http://www.fiercehealthit.com/story/health-it-still-far-its-potential/2010-11-29

Health IT still far from its potential

November 29, 2010 — 2:48pm ET | By Neil Versel

A couple of weeks ago, we referenced both the 1991 Institute of Medicine report, "The Computer-Based Patient Record: An Essential Technology for Health Care" and President George W. Bush's 2004 call for interoperable EMRs. Last week, Computerworld brought up these two pieces of history in benchmarking the slow progress in health IT.

"While there are many success stories, progress in using IT to improve patient care and cut costs has been slow. Research suggests that healthcare IT has a long way to go to match the hype," the magazine notes. "Not all healthcare providers have electronic records, many organizations can't share their records with other facilities unless they're affiliated with one another, and even those that can share with others outside their networks often have translation problems because there's no single data standard to facilitate the smooth transfer of information."

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http://www.e-health-insider.com/news/6460/royal_liverpool_signs_csc_portal_deal

Royal Liverpool signs CSC portal deal

29 Nov 2010

The Royal Liverpool and Broadgreen University Hospitals NHS Trust has confirmed that it has become the first trust to sign a deal for CSC’s clinical information portal.

The CSC clinical portal is an interoperability product, providing a single view of data from different systems, and forms part of the company’s new portfolio of NHS products launched earlier this year.

Following the signing of the contract last week, the trust told E-Health Insider that it is now defining the project scope and plans to begin rolling the system out in March in two separate phases.

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http://www.ihealthbeat.org/features/2010/physician-community-divided-over-social-media.aspx

Monday, November 29, 2010

Physician Community Divided Over Social Media

From Twitter to Facebook to blogs, millions of U.S. residents are tapping social media tools to communicate. Physicians are no exception. Many doctors see social media as a way to strengthen the patient-physician relationship, interact with their peers and publicize their opinions on key issues.

However, others argue that as physicians' use of social media increases, the line between personal and professional is beginning to blur. They also say that the growing trend raises new privacy and liability issues. Despite the concerns, experts say the number of physicians who are active social media users is growing.

Why Doctors Are Taking the Social Media Plunge

For a new report, titled "The Social Physician," Bunny Ellerin -- co-founder of NYC Health Business Leaders and president of Ellerin Health Media -- spoke with 10 active social media users.

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Enjoy!

David.