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."

Friday, March 12, 2010

Another 4pm Friday Information Release Leaves e-Health Experts Gasping.

This appeared an hour or two ago.

Roxon folds and releases draft health identifier rules

  • Karen Dearne
  • From: Australian IT
  • March 12, 2010 6:08PM

FEDERAL Health Minister Nicola Roxon has buckled and released proposed draft regulations for the Healthcare Identifiers service, after privacy and security experts told a Senate inquiry the HI Bill could not rationally be considered without the accompanying rules that underpin the legislation.

A consultation paper prepared by the Australian Health Ministers’ Advisory Council was also released late Friday afternoon.

But it may be a case of too little, too late, with the regulations providing little new detail, and failing to address problems with the bill including the compulsory nature of the scheme, under which every Australian will be issued a 16-digit unique healthcare identifier from July 1 for improved medical information-sharing across the health sector.

Liberty Victoria's spokesman Tim Warner described the release as another "stunning performance by those guiding the e-health initiatives".

"To release documents that give at least a skeletal outline of what is actually going to happen - 24 hours after the last testimony was given to the inquiry (into the governing bill) and one week after the close of public comment - is a bravura performance in the theatre of transparency," Mr Warner said.

"Yes, they have released the regulations before the Senate committee reports its findings (on Monday) and the Senate votes. But after all of the lodged submissions and testimony had to be made blind."

Law Professor Graham Greenleaf, co-director of the Cyberspace Law and Policy Centre, University of NSW, this week told the inquiry the bill "shares a surprisingly large number of elements with both the Australia Card scheme of a couple of decades ago, and the (previous government's) Access Card proposals of 2006-07".

"There has been inadequate consultation and inadequate time for all concerned to really deal with the real details," he said. "Even now, none of us are in a position to know what this is about, because we do not have the rest of the legislative scheme (the regulations)."

Professor Greenleaf said the healthcare identifiers database, to be initially operated by Medicare, would become "the key national information system for just about the most sensitive thing that there is in the community - medical information".

"There is always the potential (for the system to be hacked)," he said. "Given how many databases these health identifiers will be the key to, with many other systems based around this number as the primary access key, there may well be very attractive illegal uses from access to that set of numbers.

"So yes, it becomes a very attractive location for unauthorised access. That increases the dangers that are involved."

More here:

http://www.theaustralian.com.au/australian-it/roxon-folds-and-releases-draft-health-identifier-rules/story-e6frgakx-1225840170232

What to say? I have had a look and the regulations are pretty brief.

This material amazes me (Last page of Consultation Paper) which is available here (italics mine):

http://aushealthit.blogspot.com/2010/03/draft-regulations-to-support-health.html

----- Begin Extract

f. Information requested after disclosure of healthcare identifiers

In certain situations, the Service Operator may need to request information from a healthcare provider; for example, to assist in the investigation of a complaint or enquiry from an individual about access to the individual’s records held by the Service Operator.

Section 22 of the Bill allows regulations to require a healthcare provider to make available to the Service Operator certain information about the disclosure of a healthcare identifier to that provider.

Regulation 11 provides that, on request from the Service Operator, a healthcare provider must provide sufficient information to identify the person who accessed the Service, in relation to the disclosure of a healthcare identifier to that provider.

It is recognised that healthcare providers currently work with a wide range of IT and identity management systems that may not at present be able to record details of every individual who requests healthcare identifiers from the HI Service on the organisation’s behalf. However, to ensure sufficient certainty for consumers that access to information held about them by the Service Operator will be able to be subject to enquiry and investigation in the event of a suspected unauthorised access, it will be necessary for healthcare providers to make changes to systems and practices that will record all requests to the HI Service at the individual employee level.

In practice, many healthcare providers may be transitioning to an improved state of identity management and security over the next couple of years as uptake of e-health and electronic records systems becomes more widespread. During this period it is important that expectations around standards on rules for interaction with the Service Operator are clearly established from the outset. A penalty has been provided for in Regulation 11 to make clear that these standards will be enforceable.

Consideration is being given to allowing a period of transition for the enforcement of this penalty provision. During this period, the specified penalties would not be actively enforced, except in exceptional circumstances. The focus of this transition period (with a suggested period of 2 years) would be educative, helping providers to incorporate improved identity management standards in their systems. After this period penalties would be enforced.

If such a transition period were in place, this would not remove the requirement from a healthcare provider to make available to the Service Operator on request as much detail as they have on their records about a particular request for a healthcare identifier to assist in any enquiry or investigation. In addition, the transition period is only being proposed in relation to the requirements in Regulation 11. All other penalties provided for in the Bill and the regulations would be enforced from the commencement of the legislation.

Stakeholder feedback is sought on whether a transition period for enforcement of penalties in relation to Regulation 11 is an appropriate way to achieve a balance between ensuring appropriate security and identity management practices are in place to support a healthcare provider’s interaction with the HI Service, while at the same time allowing sufficient time for providers to transition IT systems and day to day procedures to reflect these standards.

----- End Extract.

Is this not a just a license to just not bother about identifying who is using the HI system and make the planned audit trails a joke? Or have I missed something?

David.

Draft Regulations To Support the Health Identifier Service Released.

The following e-mail has just been circulated by the Department of Health and Ageing.

Dear Subscriber,

As part of further consultation on the regulatory support for the Healthcare Identifiers Service, the Minister for Health and Ageing, the Hon. Nicola Roxon MP has released exposure draft regulations for comment. In addition, a consultation paper has been released by the Australian Health Ministers' Advisory Council to support interested stakeholders in making a submission.

Please find these documents attached below.

The e-Health consultation website will be updated to reflect this shortly.

Consultation will conclude on the 9 April 2010.

If you wish to request a hard copy of these two documents please contact the eHealth Strategy Branch by emailing ehealth@health.gov.au or call (02)

6289 3919.

Regards,

eHealth Strategy Branch

End e-mail

Everything you need is found on this page:

http://www.health.gov.au/internet/main/publishing.nsf/Content/pacd-ehealth-consultation

At least there is time to read slowly this time and the documents are not too long!

David.

Thursday, March 11, 2010

NEHTA Blasted by the Australian Medical Software Industry Association At Senate Enquiry.

The following appeared late yesterday.

NEHTA 'ignored' global standards, claims medical software expert

  • Karen Dearne
  • From: Australian IT
  • March 11, 2010 7:00PM

MEDICAL software-makers say the National E-Health Transition Authority has ignored international standards for implementation of the Healthcare Identifier service, under which Medicare will assign unique identifiers to all Australians for health record-keeping purposes.

Dr Vince McCauley, immediate past president of the Medical Software Industry Association, says NEHTA has "implemented basic web standards but the higher level application standards that are available internationally have not been implemented".

"There are particular standards applicable to healthcare identifiers both in terms of their structure and how they are allocated and accessed," he told a Senate inquiry into the federal government's Healthcare Identifiers Bill.

"NEHTA has, to a point, used the international standards for the structure of the identifiers, and where that is not entirely the case we (MSIA) have through negotiation been able to reach a point where they are compatible.

"However they have chosen to ignore the international standards for implementation of the service. They have basically made that up."

Dr McCauley said the industry was only provided with "a basic list of functions to be implemented" a week ago, and had not yet reviewed the list in any detail.

But non-compliance with international standards has enormous ramifications for software developers, locally and overseas.

Lots more here:

http://www.theaustralian.com.au/australian-it/nehta-ignored-global-standards-claims-medical-software-expert/story-e6frgakx-1225839683836

There is really only one question here. Just why does NEHTA think it is above the views of the rest of the world and want to impose additional costs on our struggling Health IT software industry.

Peter Fleming needs to fix this tomorrow or we will all know just how much NEHTA cares about the e-Health industry in Australia.

Of course that the MSIA members have so little information on the technical specifications for the HI Service is possibly, if that is possible, an even more stupid bit of nonsense. These guys are truly clueless about how the real world works

Over to you Peter! Just sort it out NOW!

David.

Weekly Overseas Health IT Links 11-03-2010.

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 payment.

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http://www.montrealgazette.com/health/File+sharing+programs+might+doctors+patient+records+risk+Study/2633764/story.html

File-sharing programs might put doctors' patient records at risk: Study

By Laura Stone, Canwest News ServiceMarch 2, 2010

OTTAWA — Doctors who trade music on file-sharing programs might also be accidentally swapping something else: their patients' health records.

In the first study to test the way personal health information is disclosed through file-sharing applications, researchers from the Children's Hospital of Eastern Ontario in Ottawa discovered that software installed on home computers can make health and financial documents vulnerable to fraud or theft.

For example, if a health-care professional uploads records onto his or her computer, and then uses file-sharing software to download music, patient information could be inadvertently released, said the study published last Friday in the Journal of the American Medical Informatics Association.

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http://healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=4CBF81C952E947DDBB885178A76B3AD7

Issue Date: March 2010

Improving Patient Care Through Data Availability in the ICU

At Children's Hospital of Pittsburgh, clinician and IT leaders together created an innovative dashboard for ICU intensivists and nurses

by Mark Hagland

For the physicians and nurses at Children's Hospital of Pittsburgh, a member of the 20-hospital University of Pittsburgh Medical Center health system, the logic behind going totally paperless as the clinicians and staff prepared to move into the hospital's new replacement facility in 2009 was inescapable. Already live for several years with its EMR and CPOE, the hospital's move to its brand-new facility was to be accompanied by the elimination of nearly all of its remaining paper-based processes.

And because the hospital's IT staff, led by vice president and CIO Jacqueline Dailey and CMIO James Levin, M.D., Ph.D., had long been collaborating closely with clinician leaders, the organization was well-positioned to reap all the benefits of automation in preparation for the move, which took place in June of 2009.

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http://www.modernhealthcare.com/article/20100305/NEWS/303059986

Meaningful use will slow docs down: MGMA survey

By Andis Robeznieks / HITS staff writer

Posted: March 5, 2010 - 11:00 am ET

Meeting the 25 meaningful-use criteria required to receive the financial incentives contained in the federal stimulus law will result in reduced physician productivity, according to 67.9% of those who responded to a Medical Group Management Association member survey released March 4.

With one being “very easy” and five being “very difficult,” the survey also asked on a one-to-five scale how easy or difficult certain proposed requirements would be to fulfill. According to the 353 respondents (out of 445) who answered the question, the most difficult requirement would be using a certified electronic health record to provide at least 10% of all patients with electronic access to their health information within 96 hours of the information being available. That requirement received a 3.72 difficulty rating with only 14 respondents saying meeting the requirement would be very easy, 90 saying it would be difficult and 99 saying it would be very difficult.

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http://www.ihealthbeat.org/perspectives/2010/investments-in-health-it-open-new-doors-for-hospitals.aspx

Friday, March 05, 2010

Investments in Health IT Present New Opportunities for Hospitals

It's been quite a year for health IT.

While a great proportion of the Advisory Board Company's research this year has focused on parsing out the implications of "meaningful use" requirements for hospitals and physicians, we've continued to emphasize that it's important not to lose sight of the longer-term imperative for these investments -- strengthening the health IT foundation that will allow hospitals to be successful under evolving health and payment reforms and finding a way to start accruing benefits from these significant capital outlays.

With health IT industry leaders caught up in the feeding frenzy around the stimulus dollars, many have ignored the implications of payment reform -- a market force that will place even greater demands on health IT than the meaningful use requirements. The stimulus package's incentives for health IT use are just one piece of the larger health care reform ambition that is working towards expanding coverage, promoting efficiency and ultimately reducing demand to inflect the total cost curve.

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http://sanfrancisco.bizjournals.com/sanfrancisco/stories/2010/03/01/daily56.html

RWJ Foundation gives $2.4M for patient observation studies, two in Bay Area

San Francisco Business Times - by Chris Rauber

The nationally known Robert Wood Johnson Foundation said Wednesday it’s awarded more than $2.4 million to five research teams to study how “patient-recorded observations of daily living” can be captured and integrated into clinical care.

Three of the five teams are based in California, including two in the Bay Area: one at San Francisco State University and a second team made up of researchers at UC Berkeley, UC San Francisco and The Healthy Communities Foundation.

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http://money.cnn.com/2010/03/05/smallbusiness/electronic_medical_records/

The next tech goldmine: Medical records

(CNNMoney.com) -- When Dr. Bradley Block, a family physician in Florida, began to investigate electronic medical record systems for his four-doctor practice, he discovered that many of the largest firms in the field were not particularly interested in his business.

One company refused to return numerous calls to set up a demonstration of its product. Another charged all practices -- no matter their size -- a six-figure setup fee that it refused to adjust.

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http://www.nextgov.com/nextgov/ng_20100304_9977.php?oref=mostemailed

Glitch prompts VA to shut e-health data exchange with Defense

By Bob Brewin

The Veterans Affairs Department closed off access to the Defense Department's huge electronic health record system on Monday because it found errors in some patients' medical data clinicians downloaded from the Defense network, according to a departmental patient safety alert, which Nextgov obtained.

Although no patient was injured, the errors shed light on how software glitches could affect the accuracy of electronic medical records and a planned national system that has been backed by the Bush and Obama administrations.

-----

http://topnews.us/content/212466-three-slapped-charges-e-health-project

Three Slapped with Charges in e-health Project

With the launch of British Columbia's $259-Million move to promote the e-health project, three people connected to the province's drive to adopt electronic health records have been alleged in the corruption criminal cases. The aim of the health system remains to create electronic health records to enable patients' information from lab tests to prescriptions which can be shared between health-care providers all across the country.

A special prosecutor John Waddell has directed that charges should be laid within a month against Ron Danderfer, a Former Assistant Deputy Minister of Health, who had helped in awarding Millions in contracts for the Government's high-profile electronic health initiative, Consultant Dr. Jonathan Alan Burns and Jim Taylor, a Manager with the Fraser Health Authority who administered an annual budget of $9 Million. They have been accused of fraud, breach of trust and influencing peddling.

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http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54502

How Patients Are Taking Charge of Their Own Health Records

The Power of the PHR and What It Means to You

By Steven Kraus, DC, DIBCN, CCSP, FASA

Ever have one of your patients enter your office with a binder of medical paperwork? They have old X-rays, MRIs, and reports, articles downloaded from the Internet, and copies of correspondence between their GP and four different specialists.

They've been through it all, and rather than just tell you their history, they're actually bringing along the data to prove it. Now imagine this same scenario not with one complex patient every once and awhile, but with every new patient, every single day. The day is coming with personal health records (PHRs). It could transform your practice, because PHRs are well on their way to transforming our patients.

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http://www.e-health-insider.com/news/5683/greenfield_four_becomes_three

Greenfield four becomes three

01 Mar 2010

The Department of Health is struggling to find four sites in the South of England willing to take the Cerner Millennium hospital system, bought by NHS Connecting for Health as part of a £540m deal with BT.

Despite offering the system at no cost, the DH has been unable to find four NHS trusts willing to commit. The reluctance appears to centre on the realisation that trusts will have to pick up ongoing revenue costs, payable to Cerner from 2015, after CfH contracts expire.

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http://www.ihealthbeat.org/features/2010/himss-10-blumenthal-outlines-health-it-progress-next-steps.aspx

Thursday, March 04, 2010

HIMSS '10: Blumenthal Outlines Health IT Progress, Next Steps

ATLANTA -- On Wednesday morning, the country's health IT chief admitted to a room full of health IT enthusiasts that when his employer -- Partners HealthCare System in Boston -- made the switch to electronic health records about 10 years ago, it wasn't "a match made in heaven."

While giving the keynote speech at the Healthcare Information and Management Systems Society's annual conference in Atlanta, National Coordinator for Health IT David Blumenthal said he was trained with paper records and a prescription pad and "didn't really see the need for change." However, he said, "Gradually, slowly, I found it was making me a better doctor" and "truly added value to my work."

The health IT convert, now tasked with bringing the U.S. health care system into the 21st century, said he is "optimistic" that we'll see widespread use of EHRs and other health IT tools in the near future.

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http://community.advanceweb.com/blogs/hx_4/archive/2010/02/23/e-mail-guidelines.aspx

Privacy for Health Information Executives

E-mail Guidelines

Published February 23, 2010 12:59 PM by Andrew Serwin

E-mail has gone from being an obscure form of communication for a Web-addicted generation to the predominant form of communication among business professionals.

The rules regulating e-mail communication in the workplace haven't necessarily followed suit. Even seasoned e-mail users don't always consider some basic e-mail communication guidelines. Here are a few things to keep in mind:

E-mail is permanent

Despite its relatively informal nature, e-mail is still a permanent form of communication. Whether it is stored on a server, by the recipient or by the business whose system is being used, in most cases, e-mail is forever. Even deleting an e-mail doesn't always ensure it's really gone.

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http://govhealthit.com/newsitem.aspx?nid=73216

NIST to study health IT exchange standards, test methods

By Mary Mosquera
Tuesday, March 02, 2010

The National Institute of Standards and Technology plans to test various health information exchange standards to see how well they meet the needs of clinical information exchange among providers and other health care organizations.

Standards are the foundation for health information exchange, according to Dr. David Blumenthal, the national health IT coordinator. The HITECH Act assigned NIST, an agency of the Commerce Department, a role to study and test technical standards.

As a part of its Health Information Technology Standards and Test Methods Project, NIST said it will examine high priority standards for “maturity, robustness, stability and suitability of a particular standard for use,” according to a Feb. 22 announcement seeking contractor support for the program.

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Meaningful Use Programs Spiking HIT Spending

About three-quarters of health IT executives plan to boost IT spending over the next two years, report shows.

By Marianne Kolbasuk McGee, InformationWeek

March 1, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=223101071

While the federal government hasn't yet hammered out all the criteria of its "meaningful use" health IT stimulus programs, the upcoming requirements already appear to be inciting an increase in IT spending among healthcare providers, according to a study released Monday.

Findings of the annual survey, conducted by the Healthcare Information Management Systems Society (HIMSS ) was revealed at the organization's conference in Atlanta Monday.

Seventy-two percent of respondents expect their IT operating budgets to increase over the next two years, according to the Web-based survey of nearly 400 healthcare CIOs and other senior IT executives.

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http://govhealthit.com/newsitem.aspx?nid=73239

ONC unveils plan for health IT certification

By Mary Mosquera

Tuesday, March 02, 2010

ATLANTA -- In a surprise announcement at the Health Information and Management Systems Society conference here today, national coordinator of health IT Dr. David Blumenthal and his staff unveiled the administration’s proposal for how electronic health record systems will be certified under the health IT incentive plan.

The notice of proposed rulemaking details a two-stage process that would enable health IT vendors initially to receive temporary certification for their products in time for providers to meet looming 2011 deadlines for qualifying for first stage meaningful use requirements.

To meet that time frame, certified electronic health records must be “available before fall 2010,” according to the proposed rule.

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http://www.modernhealthcare.com/article/20100303/NEWS/303039988

ONC to expedite EHR certification

By Joseph Conn / HITS staff writer

Posted: March 3, 2010 - 5:59 am ET

The Office of the National Coordinator for Health Information Technology at HHS will exercise the authority it was given by Congress and expedite the authorization of organizations for the certification of electronic health-records systems under the federal stimulus law.

The ONC action, which came in the form of a proposed new federal rule released Tuesday, could ease a major bottleneck to a multi-billion federal program to subsidize the purchase of electronic health-record systems by hospitals and office-based physicians under the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.
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http://www.ehealtheurope.net/news/5694/interoperable_emrs_still_top_us_priority

Interoperable EMRs still top US priority

02 Mar 2010

In the annual survey of chief information officers run by the Healthcare Information and Management Systems Society, achiving a fully interoperable electronic medical record has emerged as the top priority.

Top business objectives unveiled by the survey at the HIMSS10 conference in Atlanta were to improve the quality of care and patient safety, closely followed by the need to sustain financial viability.

These are the same top three concerns as in 2009, but financial concerns rank lower this year than 12 months ago.

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Microsoft HealthVault Extends Access To Hospital Data

HealthVault Community Connector gives patients and their dotors Web access to patients' hospitalization data upon discharge.

By Marianne Kolbasuk McGee, InformationWeek

March 3, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=223101316

Microsoft has unveiled HealthVault Community Connect, software aimed at helping the coordination of care between hospitals and referring-doctors while engaging patients.

HealthVault Community Connector allows hospitals of any size to to give post-discharge access to patient data to patients and their referring doctors. The application, unveiled at the Healthcare Information Management Systems Society (HIMSS )conference in Atlanta Tuesday, is the latest in Microsoft's family of HealthVault products.

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http://www.ehiprimarycare.com/news/5693/o%27brien_claims_govt_may_lock-in_npfit

O'Brien claims govt may lock-in NPfIT

02 Mar 2010

Conservative health spokesman Stephen O’Brien has accused the government of trying to tie the hands of an incoming Tory government over the future of the National Programme for IT in the NHS.

Speaking on BBC Radio 4’s Today programme this morning, O’Brien said he was “very concerned” that the current negotiations that are being held with suppliers could result in contracts that “potentially tie a future government’s hands more rigidly than would they may already be under the current contracts.”

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http://www.ehiprimarycare.com/news/5686/bma_says_scr_roll-out_%E2%80%98too_hasty%E2%80%99

BMA says SCR roll-out ‘too hasty’

01 Mar 2010

The BMA has criticised the roll-out of the Summary Care Record programme, claiming patients do not have enough information and that it is too hard for them to opt out if they want to.

The doctors’ union has publicised its concerns as the government steps up efforts to roll-out the SCR across five strategic health authorities over the next year.

Public Information Programmes (PIPs) for patients in the five SHAs are due to be completed by the end of March, so that the SHAs can take advantage of central funding.

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http://www.healthleadersmedia.com/content/TEC-247260/HIMSS-Survey-Meaningful-Use-is-Driver-of-Health-IT-Spending.html

HIMSS Survey: Meaningful Use is Driver of Health IT Spending

Cheryl Clark, for HealthLeaders Media, March 1, 2010

Although federal guidelines are not yet set for meaningful use, nearly three-fourths of hospitals and other healthcare organizations say they will increase information technology spending in anticipation of stimulus fund reimbursement. However, security issues remain a concern for hospitals.

Nearly half of the 72% of the 398 healthcare leaders who responded to this year's Healthcare Information and Management Systems Society (HIMSS) survey on meaningful use spending said they expected their IT budgets to increase, adding that meeting "meaningful use" criteria is a driver of that spending.

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http://www.prnewswire.com/news-releases/kaiser-permanente-honored-for-electronic-health-record-implementation-85948822.html

Kaiser Permanente Honored for Electronic Health Record Implementation

HIMSS Analytics Awards Another 12 Kaiser Permanente Hospitals Highest Recognition

OAKLAND, Calif., March 2 /PRNewswire/ -- Kaiser Permanente, the nation's leading health care provider and not-for-profit health plan, received 12 Stage 7 Awards from the Healthcare Information and Management Systems Society. The Stage 7 Award honors hospitals that have achieved the highest level electronic health record implementation. The 12 awards were presented at the HIMSS 2010 annual conference in Atlanta, Georgia.

Kaiser Permanente is known for leadership in the use of health information technology and its groundbreaking electronic health record, Kaiser Permanente HealthConnect®. Last year, Kaiser Permanente also received 12 Stage 7 Awards, meaning that two-thirds of the system's 36 hospitals have now received these premier awards. Only 39 American hospitals have achieved this status; 24 of those are Kaiser Permanente hospitals.

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http://www.modernhealthcare.com/article/20100302/NEWS/303029937

Annual survey shows stimulus law drives priorities

By Joseph Conn / HITS staff writer

Posted: March 2, 2010 - 5:59 am ET

Part two of a two-part series. To read part one, view the story Making IT work.

Findings of Modern Healthcare's annual information technology survey show how the federal stimulus law is driving project priorities.

John May, chief financial officer at 41-bed Wetzel County Hospital, New Martinsville, W.Va., may be typical of many survey respondents this year.

“Our biggest challenge is going to be to get compliant with the ARRA,” May says. For now, however, he says, “We're nowhere near that, and a lot of it is going to depend on our vendor being in compliance.”

“We'll make it over the total term of this thing, but whether or not we'll make it in year one, we're not sure,” May says. “We're not a critical-access hospital, but we're a small hospital, so I'm not sure how we're going to get this money at this point.”

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http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20100302/NEWS/303029988/1029#

Experts cautious about health IT money up for grabs

By Gregg Blesch and Joe Carlson

Posted: March 2, 2010 - 5:59 am ET

Part two of a two-part series. To read part one, view the story Zero tolerance.

With health information technology money up for grabs, many electronic health-record vendors are offering financing deals to attract business. But, just like shopping for a car, experts warn about reading the fine print before buying.

Nothing new

Some of these vendors have been offering financing to potential customers for years, either through partner lending institutions or their own financial arms.

“This is not anything new from that light,” said Dan Michelson, an executive vice president and chief marketing officer for Allscripts-Misys Healthcare Solutions. He wasn't sure exactly what remedies were in place should a customer fail to make payments to Allscripts' partner, U.S. Bank. “Whatever we've put in the contracts, people have gotten comfortable with at this point.”

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http://www.healthleadersmedia.com/content/TEC-247329/AccessPrivacy-Balance-Could-Prove-Elusive-for-Hospitals.html

Access-Privacy Balance Could Prove Elusive for Hospitals

Gienna Shaw, for HealthLeaders Media, March 2, 2010

Technology infrastructure can impact both the relative high cost and low quality of healthcare in the U.S., said Paul Tang, MD, vice president and CIO of Palo Alto (CA) Medical Foundation at a feisty "town hall" style discussion at the College of Healthcare Information Management Executives (CHIME) 2010 CIO forum held in Atlanta, GA, on Sunday.

"The government can't do it," said Tang, who is also the vice chair of the HIT Policy Committee and the chair of the Meaningful Use Work Group. "They don't have the expertise that's in this room and in the field."

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http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&objID=1799

Proposed Rule for the Establishment of Certification Programs for Health Information Technology

A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology

March 2, 2010

Today the Secretary of the Department of Health and Human Services (HHS) released a notice of proposed rulemaking (NPRM) outlining the proposed approach for establishing a certification program to test and certify electronic health records (EHRs). The HITECH Act mandates the development of a certification program which will give purchasers and users of EHR technology assurances that the technology and products have the necessary functionality and security to help meet meaningful use criteria. While we are making significant strides toward modernizing our health care system, these efforts will only succeed if providers and patients are confident that their health information systems are safe and functional.

The proposed rule incorporates two phases of development for the certification program to ensure that eligible professionals and eligible hospitals are able to adopt and implement Certified EHR Technology in time to qualify for meaningful use incentive payments. The rulemaking process will take time, so this phased approach provides a bridge to detailed guidelines to support an ongoing program of testing and certification of health IT.

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http://www.ihealthbeat.org/features/2010/himss-10-conference-highlights-possibilities-challenges-of-health-it.aspx

Monday, March 01, 2010

HIMSS ’10: Conference Highlights Possibilities, Challenges of Health IT

ATLANTA—Health care providers, vendors, policymakers and other health care stakeholders convened at the Georgia World Congress Center in Atlanta yesterday for the first official day of the annual Healthcare Information and Management Systems Society Conference.

At a media briefing, HIMSS CEO Stephen Lieber said that so far the conference has attracted 25,989 attendees and that more could register before the conference finishes on Thursday. He said that there are 1,100 fewer vendor representatives this year, noting that the decline likely was caused by the economic downturn. Still, the number of overall vendors exhibiting at the conference increased from the mid 800s last year to 924 this year, Lieber said.

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E-Health Record Certification Program Adds Specialties

Certification Commission for Health IT now tests and certifies oncology and women's health EHR products.

By Marianne Kolbasuk McGee, InformationWeek

March 2, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=223101101

The Certification Commission For Healthcare Information Technology--CCHIT--is expanding its certification programs for e-health record systems.

CCHIT officials unveiled new programs for EHR products catering to the needs of cancer and women's health specialists at the HIMSS health IT conference in Atlanta.

The Oncology and Women's Health EHR certification programs are the CCHIT's latest for products used in medical-specialty practices. Others include cardiovascular medicine, pediatrics, emergency departments, behavioral health, clinical research, dermatology, long-term care, and post acute care.

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Enjoy!

David.

Parliament (House of Representatives) is Debating the Health Identifiers Bill.

Go here to watch right now:

http://www.aph.gov.au/live

David.

Update 11:22am 11/03/2010.

The two bills have passed the House of Reps - Now for the Senate Debate which will be next week. The report on the Senate Enquiry is due March 15.

D.

Wednesday, March 10, 2010

First Reporting of Senate Enquiry on the NEHTA / Medicare HI Service.

The following has just been published.

NSW first for health identifiers

  • Karen Dearne
  • From: Australian IT
  • March 10, 2010 4:55PM

NSW public hospital patients will be guinea pigs for the countrywide rollout of healthcare identifiers, with an estimated 4.5 million people signed onto the new system by the state within 18 months.

National E-Health Transition Authority chief executive Peter Fleming told a Senate inquiry into the Healthcare Identifiers (HI) Bill that - once the legislation and as yet undisclosed regulatory controls are passed by Parliament - up to 6 million Australians could have Medicare-assigned unique patient numbers, intended to support clinician access to personal health information, within that timeframe.

NSW Health is spearheading NEHTA's work on linking some 20 separate hospital-issued health identifiers to the new unique personal identifiers, off the back of an upgrade of current radiology information and picture archiving and communications systems.

Existing medical imaging and radiology systems are considered to hold the cleanest data.

The department is presently seeking a supplier for a statewide central storage and retrieval facility to support these systems, together with a new patient registry and matching system, an enterprise service bus to solve interoperability issues, and a capacity to integrate messaging with patient administration systems.

Under the HI Bill, all Australians using private or public health services will be assigned an identifier by Medicare over time, but the speed of uptake by private practitioners and hospitals will depend on their IT systems having the capability to "populate" internal records with the national number.

Much more here:

http://www.theaustralian.com.au/australian-it/nsw-first-for-health-identifiers/story-e6frgakx-1225839264934

This is an evolving story. I will be reading the transcripts and seeing where this all goes over the next week till be hear the outcomes of the Senate Enquiry.

Enjoy.

David.

Weekly Australian Health IT Links - 10-03-2010.

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 payment.

General Comment:

There is little doubt the big news of the week is the release of the Rudd Plan for the Australian Health System.

Lots of information is found here:

http://aushealthit.blogspot.com/2010/03/brave-new-health-system-for-australia.html

and here:

http://aushealthit.blogspot.com/2010/03/at-quick-look-we-need-great-deal-more.html

Having now considered the coverage and the document it seems to me that while what is proposed is still unacceptably vague and incomplete and that substantial implementation risks exist at both the political level ( a few states are not seeming all that convinced at present) and actual practical issues that are not easily addressed.

I am concerned this may turn out to be a real mess, but will hold off on any formed view until we see all the details.

Second the Senate Enquiry on the HI Service has been great fun and the Senate Hansard make very interesting reading.

Go here to read the program and transcripts:

http://www.aph.gov.au/senate/committee/clac_ctte/healthcare_identifier/hearings/index.htm

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http://www.theaustralian.com.au/news/opinion/rudds-first-steps-to-a-healthier-network/story-e6frg6zo-1225837498979

Rudd's first steps to a healthier network

THE final report of the National Health and Hospitals Reform Commission last year was a blueprint for substantial reform of the health system that is long overdue and vital if we are to meet healthcare needs.

The government's response needs to be big, bold and far-reaching. It has to spark and re-energise. It has to call to action. Kevin Rudd's National Health and Hospitals Network announcement this week meets those expectations.

It reflects very strongly the NHHRC's recommendations for public hospitals funding. Our recommendations were a product of hundreds of consultations across the country with front-line health workers and people who use the health system. The policy is also a product of the concerns raised in the 100 or so consultations conducted by the government, several of which I attended.

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http://www.smh.com.au/nsw/thousands-receive-bank-statements-of-strangers-20100306-ppne.html

Thousands receive bank statements of strangers

RACHEL BROWNE

March 7, 2010

SYDNEY teacher Lisa Grando does not know the person whose St George Bank statement she received last week. However, she knows they have a taste for Nando's, KFC and McDonald's, and frequent the Blacktown Workers Club.

She knows who employs them and how much they earn. She can also see they are getting regular payments from Centrelink and she was privy to other details. Mrs Grando was one of 42,000 St George Bank customers who were inadvertently sent incorrect statements last week.

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http://www.smh.com.au/digital-life/computers/mindreading-computers-could-save-your-life-20100305-pmeq.html

Mind-reading computers could 'save your life'

March 5, 2010 - 9:41AM

Devices allowing people to write letters or play pinball using just the power of their brains have become a major draw at the world's biggest high-tech fair.

Huge crowds at the CeBIT fair gathered round a man sitting at a pinball table, wearing a cap covered in electrodes attached to his head, who controlled the flippers with great proficiency without using hands.

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http://www.nehta.gov.au/media-centre/nehta-news/612-software-test-facility-launched-for-hi-service

Software test facility launched for HI Service

1 March 2010. A new software testing environment for the national Healthcare Identifier Service was officially launched today.

The facility is managed by Medicare Australia, which has been contracted by NEHTA to operate the HI Service for an initial two year period.

It will assist early adopters in the commercial software market to build and test connection with the national HI Service ahead of legislation, currently before Federal Parliament, that will allow the service to operate.

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http://www.apo.org.au/research/review-health-technology-assessment-australia

Review of health technology assessment in Australia

Read the full text

HTML Review of health technology assessment in Australia

03 March 2010This report recommends improvements in the way new health technologies, procedures and services are assessed for public and private funding in Australia.

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http://www.abc.net.au/news/stories/2010/03/02/2834702.htm

Medicare privacy breaches 'only the beginning'

By Carly Laird for PM

Updated Tue Mar 2, 2010 9:56pm AEDT

Revelations that Medicare employees are being investigated for spying on customers' personal information have renewed fears from privacy advocates that healthcare staff cannot be trusted.

As the Federal Government works to bring in a national identity scheme for patients, around 400 cases have emerged of unauthorised snooping on people's private records over the past four years.

Medicare says it has implemented privacy controls and that the number of cases of snooping has been getting smaller, however it is not known who or how far the information was allowed to spread.

The agency has given few details of how the snooping was allowed to occur and no one from Medicare was available to speak to PM this afternoon.

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http://www.smh.com.au/technology/technology-news/many-germans-happy-to-shoulder-chips-20100302-pgcx.html

Many Germans happy to shoulder chips

March 3, 2010

HANOVER: It sounds like something from a science-fiction film, but one in four Germans would be happy to have a microchip implanted in their body if they derived benefits from it.

The survey, conducted by the German IT industry lobby group BITKOM, was intended to show how the division between real life and the virtual world is increasingly shrinking.

In all, 23 per cent of about 1000 respondents said they would be prepared to have a chip inserted under their skin ''for certain benefits''.

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http://www.theage.com.au/technology/states-computers-put-a-40m-byte-on-tax-dollar-20100302-pgff.html

State's computers put a $40m byte on tax dollar

RAFAEL EPSTEIN

March 3, 2010

THE Brumby government's poor management of the state's computers is wasting tens of millions of taxpayer dollars each year and causing greenhouse gases to be spewed out unnecessarily, according to its own technology experts.

A confidential report leaked to The Age warns that the many separate public service IT systems waste up to $40 million a year, producing ''high levels of unnecessary duplication, complexity and cost … and the true cost … is not understood or managed''.

The report reveals that the state's IT sector soaks up $1.65 billion a year, or 4-5 per cent of the state's entire budget, and says that for more than seven years the government has been unable to merge its poorly connected information systems.

Stamped ''Cabinet-in-confidence'', the report says $16 million could be saved by reducing the number of separate government computer banks.

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http://www.ehealtheurope.net/news/5685/dutch_hospital_deploys_lorenzo_r3.5

Dutch hospital deploys Lorenzo R3.5

01 Mar 2010

ISoft has completed the implementation of Lorenzo 3.5 across all surgical departments at St Jansdal Hospital in the Netherlands.

The hospital went live with the latest release of the system last week following an 19 month implementation project to become the first Lorenzo site in the Netherlands.

The system, which is referred to as “Lorenzo clinicals” is similar to the Lorenzo Regional Care system being implemented in the UK under the National Programme for IT but is not built to the specifications.

The release provides the hospital with the functionality for patient management, results reporting, requesting and advanced clinical data capture for 96 nurses and ten surgeons.

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http://www.computerweekly.com/blogs/tony_collins/2010/03/isoft-was-not-willing-to-give.html

iSoft was "not willing" to give up Lorenzo rights in CSC talks

Gary Cohen, CEO of iSoft, shines a light (below) on iSoft's negotiations with CSC in December 2009.

CSC has contracts worth about £3bn with NHS Connecting for Health and the Department of Health to deliver systems to the NHS as part of the NHS IT scheme, NPfIT.

CSC's main subcontractor is iSoft whose delayed NPfIT Lorenzo electronic patient record system is due to be installed at NHS trusts across England, outside of the London area and the south.

In December 2009, iSoft re-negotiated its contract with CSC.

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http://www.prnewswire.com/news-releases/lumetra-pso-joins-forces-with-isoft-solutions-85809542.html

Lumetra PSO Joins Forces With iSOFT Solutions

Delivering expertise with incident management software and healthcare quality and safety services to help reduce costs and risks.

SAN FRANCISCO, March 1 /PRNewswire-USNewswire/ -- The Lumetra Patient Safety Organization (LPSO), a federally listed component PSO, announced today a strategic partnership with Australia's iSOFT Group Limited (iSOFT), a world leader in health information technology, including incident management software. Under the agreement, Lumetra PSO will use, distribute and support iSOFT's AIMS incident management software to provide comprehensive solutions for healthcare providers and Patient Safety Organizations who want to reduce the complexity and cost of their patient safety and risk management programs.

In making the announcement, the CEO of Lumetra Healthcare Solutions, Linda M. Sawyer, Ph.D., RN, stated, "With our software and services approach to improving patient safety, Lumetra PSO offers reporting of data, analysis of issues and the formulation of corrective action plans that meet the needs of healthcare organizations and their providers in reducing costs incurred by adverse events. The combination of our world-class service with iSOFT's AIMS software will provide unparalleled solutions for organizations committed to improving their patient safety efforts."

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http://www.itwire.com/it-industry-news/market/37234-isoft-takes-on-us-market-following-acquisition

iSOFT takes on US market following acquisition

Healthcare solutions provider, iSOFT, is to enter the US market, announcing the move at this week’s HIMSS health IT conference in Atlanta and revealing what it says is a suite of “innovative solutions” which it will initially offer in the American market.

iSOFT, which is based in the UK, became part of the Australian-based IBA Health Group following a merger in October 2007, and the company now claims to be the largest healthcare information technology company outside the US.

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http://www.computerworld.com.au/article/337850/govt_refers_healthcare_identifiers_bill_senate_standing_committee/?eid=-255

Govt refers Healthcare Identifiers Bill to Senate Standing Committee

Greater input on individual healthcare indentifiers (IHI) sought

The Federal Government has referred its the Healthcare Identifiers Bill to the Senate Standing Committee on Community Affairs in an effort to gain greater input on the legislation from the Australian community.

The Bill allows for a unique 16 digit number to be created for every health care provider and every Australian resident enrolled in the Medicare Australia or Department of Veterans' Affairs programs.

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http://www.smh.com.au/business/telstra-very-concerned-about-nbn-legislation-20100302-pe5c.html

Telstra 'very concerned' about NBN legislation

March 2, 2010 - 10:04AM

Draft laws for the government’s national broadband network company NBN Co could create a retailer rather than a wholesale network provider, Telstra says.

The legislation states NBN Co is to be a wholesale-only company but it gives the communications minister significant powers of discretion to allow it to conduct retail services.

In a letter to shareholders today, Telstra said the draft legislation had for the first time raised the prospect of NBN Co becoming a government-funded retailer, not just a wholesale network provider.

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http://www.theaustralian.com.au/australian-it/medicare-privacy-breaches-shake-heathcare-identifier-legislation/story-e6frgakx-1225835812144

Medicare privacy breaches shake heathcare identifier legislation

REVELATIONS that Medicare Australia has investigated 1058 employees for possible unauthorised access to client records in the past three years may rock a Senate inquiry into the controversial Healthcare Identifiers Bill.

The bill has been dogged by concerns over patient privacy raised by consumer health, privacy and technology advocates.

Australian IT uncovered evidence that 948 staff out of a total 5887 employees were being tracked via an Unauthorised Access database as at June 30, 2009 for apparently snooping among client files without a valid reason.

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http://www.mja.com.au/public/issues/192_05_010310/mcn11157_fm.html

Clinical-quality registries: their role in quality improvement

John J McNeil, Sue M Evans, Niall P Johnson and Peter A Cameron

MJA 2010; 192 (5): 244-245

Registries can provide sound data needed by clinicians and organisations to improve patient safety and quality of care

In June 2009, the National Health and Hospitals Reform Commission released its report proposing an agenda to transform the Australian health system.1 A critical element of this agenda is improved monitoring of service delivery and outcomes of care.

Clinical-quality registries are an important development in monitoring and benchmarking quality of clinical care. Registries systematically and uniformly collect information from people who undergo a procedure, are diagnosed with a disease or use a health care resource. They are particularly appropriate for monitoring and benchmarking processes and outcomes of care where there is known variation and where poor performance results in high additional cost (eg, renal transplantation) or poor quality of life. Before outcomes are benchmarked, data must be statistically adjusted to isolate quality of care from prognostic factors that are beyond the influence of clinicians. Variables such as age and clinical comorbidities are typically included in risk-adjustment models.

Note: Access only on subscription etc.

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http://www.smh.com.au/opinion/society-and-culture/italy-risks-internet-stone-age-with-trial-of-google-executives-20100228-pb4u.html

Italy risks internet Stone Age with trial of Google executives

ANN WOOLNER

March 1, 2010

Distracted while thinking how to begin this column, I clicked on an email from a friend. She had sent me a YouTube video in which a tidy cylindrical shape on a shoulder strap unrolled to become a computer.

Almost every day, someone sends a YouTube clip or invites me to join them in Facebook or LinkedIn or something called Friendster.

When trying to find a way to contact a possible source last week, I Googled him and found he had Twitter but no listed phone number or email address. Maybe I should drop the curmudgeonly attitude and sign up myself.

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http://www.smh.com.au/opinion/society-and-culture/sorry-lara-we-have-no-right-to-privacy-20100305-posp.html

Sorry Lara, we have no right to privacy

JESSICA LAKE

March 6, 2010

SO LARA Bingle, famous for her appearance in the 2006 Tourism Australia campaign ''So where the bloody hell are you?'' plans to sue footballer Brendan Fevola for disseminating a nude photo of her taken in the shower several years ago. Public comment shows little sympathy for her plight and even less appreciation of the legal and ethical issues involved, which is not surprising as Australia lags behind the rest of the world in dealing with the multiple offences made possible by modern visual technology.

Max Markson, Bingle's manager, explained that her lawyers had decided to pursue Fevola for defamation, misuse of her image and breach of privacy. But only the first of these is recognised by Australian courts. Most people would, perhaps, be surprised to learn that there is no ''right to privacy'' in Australia, although the general idea of ''privacy'' is protected by a handful of other laws, including trespass, nuisance, breach of confidence, stalking, defamation and assault. We have a Privacy Commissioner, but as that office oversees only the compliance of organisations with specific regulatory regimes, it's not much help to Bingle.

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Enjoy!

David.