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."

Monday, January 05, 2009

The Australian Medical Journal Slips Into the Past and Irrelevance.

Today we have this announcement from the eMJA.

Access to eMJA: 2009

Martin B Van Der Weyden

MJA 2009; 190 (1): 5

The Medical Journal of Australia (MJA) is published by the Australasian Medical Publishing Company (AMPCo), a wholly owned subsidiary of the Australian Medical Association (AMA). The Journal is available on subscription and is included as part of the membership package of the AMA. Since 2001, AMPCo has published an Internet version of the MJA (eMJA) to which readers have enjoyed free open access since its inception.

The eMJA now contains 6350 pages of valuable information, which, while formidable, unfortunately comes with increasing production and maintenance costs. Because of these essential costs, the Board of AMPCo has decided that, commencing with the first MJA issue in 2009, access to certain content in the eMJA will require a subscription. In this move, the MJA will follow the steps taken by other prestigious medical journals, including the Journal of the American Medical Association (JAMA), the Annals of Internal Medicine (the journal of the American College of Physicians), the BMJ and The Lancet.

Much information, including all previously published articles, current editions of In This Issue, plus guidelines, position statements and supplements, will remain on open access. Research articles will be freely accessible online for 2 weeks following publication, after which a subscription will be required. Twelve months after publication, all articles will revert to open access. This policy will be continually reviewed. Naturally, open access will be provided for any articles we consider to be of urgent public health importance.

Importantly, all current AMA members will continue to enjoy free access to all content of the eMJA. Information about how to access the eMJA is available at

http://www.mja.com.au/access_policy.html.

The Medical Journal of Australia

Martin B Van Der Weyden, Editor.

----- End Announcement

A few points.

First if the MJA thinks it is of similar prestige to the Annals, JAMA, the BMJ or Lancet it is smoking a very strong brew of something which I suspect is not legal.

Second we now find Australia lacks an open professional platform for discussion of Health Policy – with the possible exception of the site run by John Menadue’s Centre for Policy Development (CPD).

This is the URL for this Centre.

http://cpd.org.au/

The ACHSE’s Journal has been member only for ages.

Third closing a professional health publications is a retrograde step in an era when we are working to improve information flows in health.

Last we will now find the Journal will become a journal for members, by members and its quality and relevance will inevitably decline I believe.

Given how rich and well funded the AMA is – a bit sad really.

I hope there will be an open professional journal emerge to fill the gap for Australia. In the mean time Health Affairs in the US - sadly by subscription - will be the most useful health policy journal.

It is ironic that in the first locked 'non-open' copy there is an article on the value of Telemedicine which looks quite interesting and would warrant wider dissemination.

See here:

http://www.mja.com.au/public/issues/190_01_050109/smi11086_fm.html

David.

Sunday, January 04, 2009

Useful and Interesting Health IT Links from the Last Week – 04/01/2009.

Again, in the last week, I have come across a few reports and news items which are worth passing on.

First – welcome back and Happy New Year!

These include first:

Why is Health IT so hard?

Every now and again someone decides that health IT is obviously doing something wrong and they are going to fix it. This is a familiar call, often made by well meaning bureaucracy and its part of the problem and not part of the solution.

Health IT is hard and its become much harder with the involvement of well meaning bureaucracy. They often regard (and even refer to!) health it people as a bunch of “nerds”. If only there were more nerds and less bureaucracy we may be further ahead. Yes it is possible for the banks to have ATM machines working in a global sense and interoperating but they are only adding and subtracting figures from a balance and tolerate a fair bit of fraud as part of the cost. I am sure it all we wanted to do was maintain long term records of patients blood pressure and have this interoperate, with low levels of security it could be done quite easily. If we did this for the same transaction fees as the banks charge for ATM transfers there would also be a funding model!

The full blog article is here:

http://blog.medical-objects.com.au/?p=37

This is well worth a read from a real expert and a clinician. He explains clearly just why even the basics are hard and why NEHTA has a way to go to achieve mastery of its domain.

Second we have:

UK doctors could be reviewed on the Net

December 31, 2008 - 2:06PM

British patients could soon rate their doctors by posting reviews on an official health service website, Health Minister Ben Bradshaw says.

By being able to read feedback from other patients, people would be better able to decide which doctor they wanted to consult, the junior minister told The Guardian newspaper.

The scheme would take its cue from the way people leave comments and ratings about books and music on internet retail sites, Bradshaw said.

Posters would be able to leave positive and negative feedback, though the site would be moderated.

However, doctors' representatives voiced concern that it would descend into a meaningless popularity contest rather than providing accurate information about medical skills.

Officials have been told to get the necessary software ready in 2009, The Guardian said.

More here:

http://news.smh.com.au/world/uk-doctors-could-be-reviewed-on-the-net-20081231-77ql.html

This is not a trend I think we should follow – but it will be interesting to see how a trial goes and if such feedback can make a difference.

Third we have:

Blog Stats for End 2008

I thought it was worth posting these for the end of December

VISITS

Total - 68,796

Average Per Day - 123

Average Visit Length - 2:49

PAGE VIEWS

Total - 110,406

Average Per Day - 212

Average Per Visit - 1.7

In December, 2008 there were 3,798 Site Visits with 6,561 Page Views

Despite the holidays, this was the busiest month ever with over 140 reader comments posted!

Fourth we have:

Snooping public servants sacked

Herald Sun

December 22, 2008 12:01am

HUNDREDS of federal public servants were sacked, demoted or fined in the past year for serious misconduct.

Investigations into more than 1000 bureaucrats uncovered bad behaviour such as theft, identity fraud, prying into private files, leaking secrets and being rude to clients in Victoria.

The most common breach was improper use of taxpayer-funded internet and email.

But investigators uncovered a wide array of offences, including two officials on overseas duty sanctioned for not behaving in a way that would uphold the good reputation of Australia.

Almost 80 public servants were sacked in 2007-08 for breaching their code of conduct, while 162 resigned while under investigation.

Fines were handed to 218 public servants, 111 were counselled, 93 took a pay cut, and 26 were shifted sideways.

About 50 were found to have made improper use of inside information or their power and authority for the benefit of themselves, family or friends.

Some of the offences were committed at social functions outside working hours.

More here:

http://www.news.com.au/story/0,27574,24832419-1243,00.html

Oh dear! Here we have the human nature of some being shown at its worst. Just how we can make people behave properly when handling easily accessible electronic health information remains a live issue. Certainly education, reminders, well managed surveillance and audit trails and appropriate sanctions will all play a part.

Fifth we have:

Fatal flaws in website censorship plan, says report

Asher Moses

December 23, 200

TRIALS of mandatory internet censorship will begin within days despite a secret high-level report to the Rudd Government that found the technology simply does not work, will significantly slow internet speeds and will block access to legitimate websites.

The report, commissioned by the Howard government and prepared by the Internet Industry Association, concluded that schemes to block inappropriate content such as child pornography are fundamentally flawed.

If the trials are deemed a success, the Government has earmarked $44 million to impose a compulsory "clean feed" on all internet subscribers in Australia as soon as late next year.

But the report says the filters would slow the internet - as much as 87 per cent by some measures - be easily bypassed and would not come close to capturing all of the nasty content available online. They would also struggle to distinguish between wanted and unwanted content, leading to legitimate sites being blocked. Entire user-generated content sites, such as YouTube and Wikipedia, could be censored over a single suspect posting.

This raises serious freedom of speech questions, such as who will be held accountable for blocked sites and whether the Government will be pressured to expand the blacklist to cover lawful content including pornography, gambling sites and euthanasia material.

The report, based on comprehensive interviews with many parties with a stake in the internet, was written by several independent technical experts including a University of Sydney associate professor, Bjorn Landfeldt. It was handed to the Government in February but has been kept secret.

More here:

http://www.smh.com.au/news/technology/web/fatal-flaws-in-web-censorship-plan/2008/12/22/1229794328860.html

More government secrecy because the government didn’t get the answer it wanted – and the report released just before Christmas – sound familiar?

Sixth we have

Windows 7: The Linux killer

Now Microsoft may fear Linux on the desktop as much as it does the Mac.

Preston Gralla (Computerworld (US)) 23/12/2008 08:46:00

Microsoft has long been worried about Linux competition in the server market. When it came to ordinary PCs and laptops, however, it knew it had little to fear.

But that was then. Now Microsoft may fear Linux on the desktop as much as it does the Mac. It's finally taking Linux seriously as a desktop operating system, and it has designed Windows 7 to kill it.

Let me explain.

The threat to Windows comes entirely from "netbooks" -- lightweight, inexpensive laptops that typically use Intel's low-powered Atom processor and don't come with substantial amounts of RAM or powerful graphics processors. They're designed mainly for browsing the Web, handling e-mail, writing memos, and taking care of simple word-processing or spreadsheet chores.

Netbooks will account for about a third of all PC growth this year, according to Citigroup. Shipments will rise at an annual average rate of 60% to reach 29 million netbooks in 2010, compared with 18% growth for standard notebooks, says a September BNP Paribas report.

Clearly, the future is in netbooks. And that has Microsoft worried. Netbooks can't handle Vista's hardware demands, so XP is the only Microsoft operating system that runs on them. But Linux is ideally suited for lower-powered netbooks.

More here:

http://www.computerworld.com.au/article/271645/windows_7_linux_killer?eid=-255

I found the idea Preston puts and the forecast penetration of Netbooks fascinating. Being old fashioned I still like having my data on my computer – but it seems times are changing!

Last we have the slightly more technical note.

15 events that changed technology history

The key milestones that shaped the industry

Neil McAllister (InfoWorld) 24/12/2008 09:00:00

There are certain key points that have shaped the way technology is today. We've rounded up the 15 most important milestones and explained why they changed the course of the industry.

Technology has become what it is today thanks to key milestones that changed the direction of the industry. For example it was only during a tour of Xerox PARC that Steve Jobs was struck with the idea of Macintosh after seeing the PARC's GUI in action, but would Apple be as popular today if he hadn’t made that pilgrimage?

We've charted the 15 most important points in tech history that have already influenced the direction the industry has taken and will continue to shape its future.

Much much more here:

http://www.computerworld.com.au/article/270452/15_events_changed_technology_history?eid=-255

This is a fun summary of some major turning points. I wonder do people agree with the choices made as to the key points?

More next week.

David.

Totally Unrelated Extra!

Rovin', rovin', rovin' - Mars explorers don't want to stop

Richard Macey

January 3, 2009

IT IS a common complaint these days: things are just not made to last any more.

But it is one gripe that does not hold water on the red planet. The warranty on NASA's two, six-wheeled Martian rovers - Spirit and Opportunity - guaranteed their survival for only 90 days on the planet's dusty surface, and promised that they would drive a mere 600 metres.

But this weekend Spirit celebrates its fifth birthday on Mars. Its identical twin, Opportunity, reaches the same milestone on January 24.

Since its landing Spirit has motored more than 7.5 kilometres, while Opportunity has clocked more than 13.6 kilometres. Together the rovers, which set down on opposite sides of Mars, have snapped about 250,000 pictures.

When Spirit opened its robotic eyes on January 4, 2004, after bouncing to a halt, it spotted a series of hills about one kilometre away. Engineers wondered whether the mechanical explorer, no bigger than a small ride-on mower, could be coaxed to reach them.

Spirit not only reached the hills, but climbed 110 metres to the summit of the highest peak, and then trundled down the other side.

The rovers have found Mars was awash with salty water 4 billion years ago but was drained bone dry by some environmental catastrophe. They have sent back movies of willy willies dancing across the Martian plains and pictures of eerie sunsets.

More here – with lots of pictures:

http://www.smh.com.au/news/world/rovin-rovin-rovin--mars-explorers-dont-want-to-stop/2009/01/02/1230681745988.html

I just think this is amazing and is a nice uplifting story to start 2009!

D.

Tuesday, December 30, 2008

News Flash – NEHTA Updates Web Site.

An informant has just let me know the NEHTA web site has had a major facelift.

Go to www.nehta.gov.au to experience the new site.

We also seem to have another new Director – here is what the site tells us.

Dr Peter Flett

Dr Peter Flett graduated in medicine in Adelaide, South Australia. After four years in the Royal Australian Air Force he undertook specialist chemical pathology training in Melbourne. He moved to Perth where he worked for 20 years in the private sector of pathology with a consultancy to the King Edward Memorial Hospital for Women. His current roles are Chief Executive of PathWest (the public pathology arm of the Department of Health of WA) and Area Chief Executive of the South Metropolitan Area Health Service, which oversees two major tertiary hospitals and several secondary hospitals.

Welcome and good luck Peter!

This means we now have 2 of 10 directors with a clinical background. My view is that that is still at least 2-3 too few!

The other distinct lack is that there is not a single Health IT expert on the Board – just how can that be justified?

Happy New Year to all!

David.

Wednesday, December 24, 2008

Happy Christmas - And Now Go Back to What You Were Doing to Celebrate Surviving 2008!

A partner in a major consulting firm recently described me as “sad” because of my enthusiasm for the e-Health cause...he was right – sadly!

So – have a great one – I plan to..and in case you need a tiny fix..here it is.

Hospital safety reports withheld

Sean Parnell, FOI editor | December 23, 2008

Article from: The Australian

REPORTS detailing the extent and economic impact of dangerous and sometimes fatal errors in hospitals are being withheld from the public.

The Rudd Government's hospital safety regulator, the Australian Commission on Safety and Quality in Health Care, earlier this year commissioned a series of reports from associate professor Terri Jackson.

But The Australian's bid to gain access to the reports using Freedom of Information laws has been blocked by the commission because it would damage relations between governments and potentially hinder reform efforts.

The commission's deputy chief executive Bill Lawrence yesterday said Professor Jackson obtained information from a state government "under the requirement that it would remain confidential unless and until the state approved its release".

While Professor Jackson -- who works at the Australian Centre for Economic Research on Health at the University of Queensland -- has used West Australian data in the past, it is understood for this project she is relying on Queensland and Victorian data.

The Australian understands Professor Jackson has found that, on average, about 12per cent of hospital procedures in those states encounter problems, the most costly being post-procedural and general maternity complications.

Mr Lawrence said while he considered the public interest in making the reports known to the broader community, he also needed to consider the need to preserve the efficient and proper function of government, its relationships and "the interest in promoting further research into the causes of patient safety risks and the economic effects of patient safety interventions".

"In my view, in relation to these documents, the factors against disclosure outweigh the factors in favour of disclosure, as the risk of damage to relations in regard to the safety and quality of healthcare is very high," Mr Lawrence said.

Full story here:

http://www.theaustralian.news.com.au/story/0,25197,24835779-23289,00.html

The arrogance of government and associated ratbags is just spectacular. The reason they can get away with not investing in Health IT is that they suppress and hide the information that shows just how bad the system is and how Health IT could actually help.

Just no excuse for this at all! Dissembling creeps the lot of them!

Back to Christmas Dinner. You too!

David.

Tuesday, December 23, 2008

And They Are Optimistic in the USA Too!

Sorry, I spotted this today and just could not resist spreading the joy!

It could be springtime for health IT

December 22, 2008 — 12:59pm ET | By Anne Zieger

Editor’s Corner

Don't say it too loudly or someone might take it back, but (shhhh) things may be turning around for the health IT business as a whole. While hospitals and clinics may be cutting back hard on building projects, or slowing down the IT projects they do have in force, it seems likely that the Obama administration will be inclined to give IT a boost.

Just look at the Congressional Budget Office report appearing in today's FierceHealthIT newsletter. As you'll see, the CBO has concluded that the only healthcare reform plans that are capable of offering reasonable savings relative to their cost are the health IT plans. The CBO came to that conclusion after examining 115 healthcare reform proposals, so that's not a "shoot from the hip" conclusion, either.

Of course, there's no question that a gusher of money will have to flow out of federal coffers to bring the whole healthcare industry up to the level that will meet the health IT standards assumed by the CBO's report. According to HIMSS, we're talking at least $25 billion just to kick up EMR adoption a notch. And that doesn't even cover a national health network, e-prescribing and other important efforts.

.....

Am I being too optimistic? Is there anything that can stop the changes that seem to be underway? Or is it springtime for health IT, for once? - Anne

Full article here:

http://www.fiercehealthit.com/story/it-could-be-springtime-health-it/2008-12-22?utm_medium=nl&utm_source=internal&cmp-id=EMC-NL-FHI&dest=FHI

Enjoy the optimism and the Christmas Spirit.

Have a great one!

David.

Monday, December 22, 2008

Welcome to 2009 – It May Be Very Much Better!

Well it has really be quite a year for e-Health in Australia in 2008.

In thinking about what has happened since Santa’s last visit (thanks to a reader for the term!) we have – ranked in importance in my mental map – the following:

1. Development of a National E-Health Strategy by Deloittes

2. Development of a Health IT Roadmap and Discussion paper for the NHHRC by Booz and Co.

3. A period of major change and transition and change at NEHTA (New CEO x 2 and major executive changes at least – but still a work in progress).

4. A COAG decision to continue NEHTA funding for another 3 years.

5. The emergence of IBA Health as a substantial (and Australian based) force in Health IT globally. (Usual share holding disclaimer applies)

6. Substantial change in the e-Health Leadership at DoHA very late in the day with continued silence from Ms Roxon on her position with respect to e-Health implementation.

7. Some really interesting scalable private initiatives in the e-Health domain with a few others I am very much less convinced about.

Despite some good things, however, we still have a long way to go. Hopefully 2009 can be the year of getting significant funding, improved governance and standards development and more implementation, better support of GPs, specialists and hospitals and a new era of improving message use and diversity.

There are some straws in the wind in the last week or two that lead me to see out 2008 with some hope and optimism.

First it is increasingly clear that the new NEHTA CEO (Peter Fleming) now has a clear view of much of what has gone wrong in the last 2-3 years and plans to set about fixing it. The loss of some senior management to date (CFO, CTO) may not be last as Mr Fleming reshapes the organisation to better deliver on its goals – with strong support from the Board. I am sure the NEHTA we have at the end of 2009 will be a much better one than we had in early 2008

Second there appears still to be a real chance of some funding to implement the Deloittes strategy coming either from the Health and Hospitals Fund or the May Budget.

See here for fund details.

http://aushealthit.blogspot.com/2008/12/health-and-hospitals-fund-announcement.html

As best I can tell the Act of Parliament – the Nation-building Funds Bill (2008) – which included the set up of the Health and Hospitals Fund - passed on the last day of Senate sitting (4 December, 2008) (amid some considerable chaos as I recall).

There also seems to be considerable recognition within government that the governance changes suggested by Deloittes are very important for future success.

Third there does seem to be an increasing political recognition that the performance of some bureaucrats in implementation of Health IT Policy and Plans may not have been as good as could have been expected.

Fourth there is a considerable change in the e-Health Branch at DoHA with Rob Cameron replacing Lisa McGlynn in the very recent past. The track record of this branch can only improve one might hope with less waste on silly one-off projects and more openness as to project outcomes.

Fifth I really think the NHHRC is recognising the need to make sure e-Health is a key ingredient of the reform agenda when it reports later in 2009.

Sixth I think the evidence of value in Health IT now found on the blog, the emergence of the Coalition for E-Health, the continuing growth of the Health Informatics Society of Australia (HISA) and the Health IT plans of President-elect Obama will contribute to significant forward momentum.

All in all I plan to go into 2009 on a positive and hopeful note.

Season’s compliments to all those who have put up with my rantings this year. (I am not promising any improvement – be warned ) .

To all those pollies and bureaucrats offended by what I write – remember you are free to comment - and that we will all be better off if truth and openness prevail.

The blog will be back – baring amazing vital news - in the week beginning January 5, 2009

Safe and Happy Holidays!

David.

International News Extras For the Week (23/12/2008).

Again there has been just a heap of stuff arrive this week.

First we have:

Obama pledges to pursue health IT, despite economic woes

President-elect Barack Obama vowed on Thursday to pursue the use of health information technology aggressively, while his pick to head the Health and Human Services Department said he viewed health IT as a key part of the new administration's stimulus package.

Obama, in remarks introducing Tom Daschle as his nominee for HHS secretary and as head of a new White House Office of Health Reform, said despite the economic crisis the nation needs to invest in a drastic overhaul of the U.S. health system.

While some people might question government investment in health care, Obama said, "How can we afford not to invest?" The nation's spiraling health care costs threaten the wellbeing of large and small businesses, he said, including the auto industry, which saw its request for a federal aid package founder in the Senate on Thursday.

Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, which will handle the economic stimulus bill Obama wants to pursue, told The Washington Post that he considered health IT a key part of a stimulus package. "It's very important that health IT be part of the economic recovery," Baucus said. "It represents the beginning of health care reform."

More here:

http://www.nextgov.com/nextgov/ng_20081212_8804.php

It is good to see some leadership on the Health IT front from Obama – given the economic situation the US finds itself in!

Interesting analysis of the corporate impact here:

Where the Obama Stimulus Plan Helps Tech

Much has been written about the infrastructure aspects of Obama's stimulus plan. Clearly, fixing roads, federal buildings and schools will provide much needed work for construction workers suffering through a crash in the housing market.

The Obama team has, however, been shrewd enough to understand that a stimulus package for the nation needs to help a broad swath of industries. As a result, they have added a bit of high tech to their plans.

There are four main areas where tech is involved:

  • improve efficiency of the health care industry
  • modernize schools
  • develop a green economy
  • ease congested traffic

Let's look at each in turn and see how it benefits tech.

Improve efficiency of the health care industry

This means software - software for creation and sharing of medical records between doctors, hospitals and insurance companies, software for managing prescriptions, software for tracking treatment regimens, etc.

At the heart of these systems there will be databases. That will favor companies like Oracle (ORCL), Microsoft (MSFT) and IBM (IBM). Software development could involve the same companies just listed as well a selection of companies more focused on the health care vertical such as Cerner (CERN), Eclisys (ECLP), McKesson (MCK), etc.

More here:

http://seekingalpha.com/article/110484-where-the-obama-stimulus-plan-helps-tech

Second we have:

NHS boss says IT programme at 'pivot point'

12 Dec 2008

NHS chief executive David Nicholson has said the National Programme for IT in the NHS is at a “pivot position” and that the DH would not tolerate continued delays, “we can’t go on and on like this.”

Answering questions from the House of Commons Health Select Committee yesterday Nicholson said: “If we don’t make progress relatively soon, we are really going to have to think it through again.”

He stressed that the programme could count many successes on areas such as PACS, QMAS and electronic transfer of prescriptions but said it continued to struggle on the core integrated shared electronic record systems – the Care Records Systems – meant to be provided by local service providers BT and Computer Sciences Corporation (CSC).

“The thing about the National programme for IT is that it has had some difficulties delivering part of it, but there have been significant improvements as well.”

In May, the National Audit Office said delivery of CRS systems was running at least four years late. Since then delays on CRS have further mounted across England, and Fujitsu fired as the LSP in the South. In London, there have been major problems at the first sites to receive the Cerner CRS system from BT.

Much more here:

http://www.e-health-insider.com/news/4405/nhs_boss_says_it_programme_at_pivot_point

This is an ominous article – I hope there is not a loss of political will to get the core parts of this plan done. The UK will be worse off if it fails I believe.

More here:

http://www.computing.co.uk/computing/news/2232570/npfit-pivot-point

Third we have:

Open Health Tools project to boost HIEs

By Molly Merrill, Associate Editor 12/12/08

The Open Health Tools (OHT) Foundation has approved a new project in principle for the development of server-based technology designed to create interoperability among disparate health information systems.

The project is expected to dramatically drive down the cost of interoperability components, which have contributed to significant cost barriers for the HIEs in their development of standards-based solutions.

Open Health Tools is a collaborative effort between national health agencies, major healthcare providers, researchers, academics, international standards bodies, and companies from Australia, Canada, the United States, the United Kingdom, and other parts of Europe. Its goal is to develop common healthcare IT products and services and provide software tools and components that accelerate the implementation of electronic health information interoperability platforms, thus improving patient quality of care, safety, and access to electronic health records.

The project will be led by Misys Open Source Solutions, a division of Misys plc, who will work within the open source community to build server-side components for the Integrating the Healthcare Enterprise (IHE) profiles.

More here:

http://www.healthcareitnews.com/story.cms?id=10588

This is an important step forward in the emergence of open health information systems.

More action in the same area also here:

http://www.govhealthit.com/online/news/350715-1.html

CDC takes its epidemiological software open source

By John Moore
Published on December 12, 2008

The Centers for Disease Control and Prevention has released an open-source version of its software for epidemiological analysis.

Fourth we have:

Statewide Center for Telehealth Established

Former DHCS director to lead California Center for Connected Health

December 15, 2008

The California HealthCare Foundation (CHCF) announced today the establishment of the California Center for Connected Health (CCCH), a strategy and planning body to lead and coordinate telehealth adoption throughout the state. The Sacramento-based organization will be led by Sandra Shewry, former director of the California Department of Health Care Services, who will become president and CEO, effective January 1, 2009.

Telehealth connects patients in remote or underserved areas of the state with medical providers and educators, overcoming barriers of time and distance and delivering health services and education in places that lack those resources. CHCF's support for telehealth is part of its broader mission to promote innovations in health care that can deliver affordable, high-quality care to more Californians. A recent influx of funds into the state for telehealth initiatives created the need for an organization to coordinate efforts.

Millions of dollars in new federal and state funds are available to support an expansion of California's telehealth infrastructure, including approximately a $30-million investment in broadband and connectivity through a pilot program with the Federal Communications Commission (FCC) -- the California Telehealth Network (CTN) -- and $200 million in Prop 1D infrastructure financing to expand telehealth and medical education through the University of California. The Prop 1D funding, approved by California voters in 2006, includes $10 million for a "community investment fund" to help equip community health care sites that partner with the University of California enhance access to medical services through telehealth.

More here:

http://www.chcf.org/press/view.cfm?itemid=133813

This is an important news release as it shows serious intent to leverage what will become much more important technologies in the decades ahead.

Fifth we have:

Secretary Leavitt Announces New Principles, Tools to Protect Privacy, Encourage More Effective Use of Patient Information to Improve Care

The growing computerization, exchange and analysis of patient data offer the potential to improve the quality of care and reduce costs and medical errors, but those benefits won’t be fully realized until privacy concerns are effectively addressed, HHS Secretary Mike Leavitt said today.

In a keynote address to the Nationwide Health Information Network Forum, Secretary Leavitt announced key privacy principles and a toolkit to guide efforts to harness the potential of new technology and more effective data analysis, while protecting privacy. Secretary Leavitt emphasized that appropriate privacy and security measures will be an essential sociological enabler of groundbreaking technology.

“Finding the balance between increased access to information and privacy is very important. If we don’t have it, we won’t succeed,” Secretary Leavitt said. “Consumers shouldn’t be in a position to have to accept privacy risks they don’t want. Each consumer should be able to choose products and services that best fit their health needs and privacy preferences.”

“Consumers need an easy-to-read, standard notice about how their personal health information is protected, confidence that those who misuse information will be held accountable, and the ability to choose the degree to which they want to participate in information sharing,” Secretary Leavitt said. “Over time, consumer confidence in the handling of health information is likely to grow just as consumer confidence in online banking has grown, but that won’t happen without similar protections and transparency about the use of their information.”

A full listing of the principles and other information is found here:

www.hhs.gov/healthit/privacy/

This is a useful guide to the issues we need to keep in mind here, while noting there are some in the US that even with these changes there are still major weaknesses in the US regime in this domain.

More commentary and reporting here:

http://www.nextgov.com/nextgov/ng_20081215_3876.php

HHS head calls for voluntary e-health privacy guidelines

Equipped for Efficiency: Improving Nursing Care Through Technology

Fran Turisco and Jared Rhoads, CSC

December 2008

Surveys show that nurses prefer to work in hospitals where safety, quality, and their own job satisfaction are top priorities. New technologies have the potential to improve the environment for nurses by helping them devote more of their time and expertise to caring for patients, rather than tracking down equipment, managing supplies, or locating clinicians and staff.

This report, a successor to the 2002 CHCF publication The Nursing Shortage: Can Technology Help?, examines hospitals’ experiences with eight types of devices and applications: wireless communications, real-time location systems, delivery robots, workflow management systems, wireless patient monitoring, electronic medication administration with bar coding, electronic clinical documentation with clinical decision support, and interactive patient systems. Two other technologies — alarm/event messaging and biomedical device integration — are also discussed.

.....

The complete report is available under Document Downloads below.

Equipped for Efficiency: Improving Nursing Care Through Technology (758K)

More here:

http://www.chcf.org/topics/view.cfm?itemID=133816

Another very important report – especially for those interested in helping nurses get through the work they need to – i.e. pretty much all of us!

Seventh we have:

HIMSS releases healthcare reform blueprint for Obama and lawmakers

By Diana Manos, Senior Editor 12/17/08

The Healthcare Information and Management Systems Society on Wednesday released a blueprint for harnessing the power of information technology to reform healthcare and stimulate the economy.

"A Call for Action: Enabling Healthcare Reform Using Information Technology" was developed by more than 100 HIMSS member volunteers and includes specific priorities and recommendations for reforming healthcare in 2009.

President-elect Obama and U.S. Health and Human Services Secretary-designate Daschle have clearly indicated their interest in finding ways to cost-effectively evolve our healthcare system to include 21st Century technology solutions that will help improve access, decrease costs and increase quality of healthcare for millions of Americans," said Charles Christian, chairman of the HIMSS board of directors and director of information systems and CIO at Good Samaritan Hospital.

"Our goal in releasing this report today is to share the expertise and recommendations of the health IT community with policymakers to help ensure health IT policy proposals achieve maximum impact for consumers and the healthcare community," he said.

More here:

The document is here:

http://www.himss.org/2009calltoaction/HIMSSCallToActionDec2008.pdf

Last for this week we have:

HL7 Publishes PHR Standard

Standards development organization Health Level Seven has published its Personal Health Record System Functional Model as a draft standard for trial use.

This means the standard is available for downloading from the Web site of Ann Arbor, Mich.-based HL7. The model defines a set of functions and security features that may be present in PHR systems. It also offers guidance to facilitate data exchange among PHRs or electronic health records systems. The model is designed to help consumers compare PHRs and select one appropriate for their needs.

.....

More information is available at hl7.org.

More here:

http://www.healthdatamanagement.com/news/HL7_PHR27445-1.html?ET=healthdatamanagement:e713:100325a:&st=email&channel=consumer_health

David.

Flash - New Leadership for E-Health at DoHA

It has been confirmed that Ms Lisa McGlynn is leaving the Commonwealth Department of Health and Ageing and is being replaced by Mr Rob Cameron.

The position Ms McGlynn is leaving is head of the e-Health Branch which is part of the Primary and Ambulatory Care Division of the Department. This Division is led by Ms Megan Morris and reports - as best one can tell - to the DoHA Executive led by the Secretary Ms Jane Halton.

Rob Cameron will be Acting Assistant Secretary until a new appointment is made. He can be contacted on the same office number (02) 62898458.

David.

Dramatic Evidence of the Impact and Value of Picture Archiving and Communication Systems (PACS) and Nursing Systems.

Canada Infoway released the following a few days ago.

Up to $1 billion in annual radiology cost savings and efficiencies uncovered across Canada

The findings are outlined in the Diagnostic Imaging Benefits Evaluation Report, an independent study commissioned by Canada Health Infoway (Infoway). The report highlights the various benefits Picture Archiving and Communications Systems (PACS) are providing to Canadians. It also uncovers the potential of electronic health record investments to help stimulate Canada’s challenging economy. Get the national perspective by reading the facts of the report. Learn more in the Diagnostic Imaging Benefits Evaluation Report Executive Summary .

“At a time when the global economy is prompting world leaders to focus on economic stimulus, electronic health record projects are emerging as viable investment opportunities,” said Richard Alvarez, president and CEO, Canada Health Infoway. “That’s because electronic health records have the unique ability to stimulate job creation, improve health outcomes and save money, as evidenced with today’s report on the benefits of Canada’s diagnostic imaging investments. It comes as no surprise that U.S. President-elect Barack Obama recently indicated such investments would be part of his planned economic stimulus package.”

PACS digitizes diagnostic exams such as x-rays, MRIs, ultrasounds and CT images. The technology provides clinicians with the ability to collect, store, manage and access images regardless of where they are located, or where the test was conducted. PACS improves productivity for doctors, technologists and radiologists and significantly improves remote reporting capabilities. Learn more about Infoway’s diagnostic imaging investment program and how it’s helping to offset Canada’s physician shortage.

Other benefits include:

  • 25 to 30 per cent increase in technologists’ productivity
  • Elimination of up to 17,000 patient transfers annually through remote access to images
  • Increased capacity of between 9 million and 11 million exams at current radiologist resource levels
  • Up to $1 billion a year in health system savings and efficiencies once PACS is fully implemented across the country

Infoway projects that by March 31, 2009, 79 per cent of Canadians will be in a position to benefit from $340 million in PACS investments.

“As physician consultants, radiologists are in great demand,” says Dr. David Vickar, president of the Canadian Association of Radiologists. “PACS is a technological tool which can significantly enhance the management of our increasing caseloads.”

“The benefits of government investment in health care infrastructure are accruing,” added Alvarez. “Equipping our radiologists with electronic tools to make their work more efficient is helping to offset the physician shortage through boosted clinical productivity, which is also addressing patient wait times. Cost savings are also being realized thanks to reduced patient transfers, fewer duplicate exams and the elimination of film. Once these systems are fully in place across Canada, the benefits to the health care system will reach up to $1 billion a year.”

Canada Health Infoway is an independent, not-for-profit organization funded by the federal government. Infoway jointly invests with every province and territory to accelerate the development and adoption of electronic health record projects in Canada. Fully respecting patient confidentiality, these secure systems will provide clinicians and patients with the information they need to better support safe care decisions and manage their own health. Accessing this vital information quickly will help foster a more modern and sustainable health care system for all Canadians.

For more information:

Dan Strasbourg

Director, Corporate Communications

Canada Health Infoway

(416) 595-3424

dstrasbourg@infoway-inforoute.ca

The full release is here:

http://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/375-jusqua-1-milliard-deconomies-de-cout-et-de-gains-de-rendement-annuels-en-radiologie-dans-lensemble-du-canada

Also this week we have:

OHSU study: nurse tracking of elderly patients saves lives

A nurse-managed, computerized system that can keep good track of seniors and their health problems can cut their death rate by as much as one-third, according to a new study from Oregon Health & Science University.

The patients, studied over three years by a team led by OHSU internist David Dorr, were actually enrolled at primary care clinics in Utah. Their average age was 76, and most had at least two chronic illnesses.

The study broke the 2,288 patients up into two groups – one group received standard health care and the second group received what the study calls Care Management Plus, which involved nurse managers using computerized records to carefully track patient conditions as well as needed tests and therapies such as medication changes.

The nurses and their computerized tracking appear to have extended the lives of patients in the second group, according to Dorr. The reason, he said, has to do with the fact that elderly people with chronic health conditions become complicated patients, and their care harder to coordinate.

More here:

http://www.portlandtribune.com/news/story.php?story_id=122939846339877200

Enough said..we just need to get on with all this as well!

David.

Sunday, December 21, 2008

Useful and Interesting Health IT Links from the Last Week –21/12/2008.

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

Household Access To Computers And The Internet

In 2007-08, 67% of Australian households had home Internet access and 75% of households had access to a computer. Between 1998 to 2007-08, household access to the Internet at home has more than quadrupled from 16% to 67%, while access to computers has increased by 31 percentage points to 75%.

In 2007-08, the number of households with a Broadband Internet connection increased by 22% from the previous year, to an estimated 4.3 million households. This represents over half (52%) of all households in Australia and 78% of households who have Internet access. A small proportion of respondents (1%) did not know the type of their internet connection at home.

The full report is here:

http://www.abs.gov.au/ausstats/abs@.nsf/mf/8146.0?OpenDocument

This is a useful summary of the present state of the use of the internet by ordinary Australians. Despite everything it seems adoption is really quite high and access to the Internet in some form near universal. This must help access to Personal Health Records and Health Information.

Second we have:

Hi-fi quest is music to the ears of the deaf

  • Nick Miller
  • December 18, 2008

WEEKS before his death last year, the world's first bionic ear recipient, Rod Saunders, told its inventor, Professor Graeme Clark, that the thing he missed most was music.

He used to sing in a choir. But while the cochlear implant restored his ability to understand speech, any music more complicated than a simple melody came through as a bewildering mess of noise.

More than 30 years on, Professor Clark believes a "hi-fi" bionic ear, allowing the deaf to hear music, is only a few years away. Such a prototype will also much better distinguish speech against a noisy background.

"Rod did miss music. He would have loved to be able to sing in the choir again," Professor Clark said yesterday. "But it's 'hearing in noise' that really kills deaf people with implants — and people with hearing aids. That's an ongoing challenge which we hope we can solve by giving high-fidelity hearing."

Yesterday he unveiled an early, animal-based prototype at La Trobe University, where he will lead the Graeme Clark Hearing and Neuroscience Unit in the university's School of Psychological Science.

More here:

http://www.theage.com.au/national/hifi-quest-is-music-to-the-ears-of-the-deaf-20081217-70tf.html

It is amazing it is now thirty years since the work to create the bionic ear was done at Melbourne University’s Biomedical Engineering Department. This computer based technology has been a major boon to many indeed to say nothing of the export dollars it has bought to Australia.

Third we have:

http://www.australianit.news.com.au/story/0,24897,24813123-15306,00.html

Microsoft releasing emergency patch for perilous IE flaw

Correspondents in San Francisco | December 17, 2008

MICROSOFT will release an emergency patch on Wednesday to fix a perilous software flaw allowing hackers to hijack Internet Explorer browsers and take over computers.

The US software giant said that in response to "the threat to customers" it immediately mobilised security engineering teams worldwide to deliver a software cure "in the unprecedented time of eight days."

According to researchers at software security firm Trend Micro, attacks based on the vulnerability in the world's most popular Web browser are spreading "like wildfire" with millions of computers already compromised.

Microsoft typically releases patches for its software on the second Tuesday of each month and rushing this fix to computer users out-of-cycle is testimony to the severe danger of the threat, according to Trend Micro.

"When the patch is released people should run, not walk, to get it installed," said Trend Micro advanced threat researcher Paul Ferguson.

More (including links to material) here:

The danger of a vulnerability such as this reminds us all of the importance of ensuring all internet exposed software is at current patch level and that regular backup are maintained.

Fourth we have:

New South Wales Department of Health Deploys Sterling Commerce e-Procurement Solution

Gentran Integration Suite will help standardise and simplify the department’s purchasing processes providing users with a platform for e-procurement

15 December, 2008 16:20:00

Melbourne – December 15, 2008 – Sterling Commerce, an AT&T Inc company, today announced it will supply a standards-based e-procurement hub solution to the New South Wales Department of Health (NSW Health).

Gentran Integration Suite (GIS), an integration platform for business-to-business (B2B) collaboration based on a service-oriented architecture (SOA) from Sterling Commerce, will help standardise and simplify the department’s purchasing processes providing users with a platform for e-procurement which will ultimately unlock greater quality, safety and efficiency benefits. It will replace a previous manual system, which was prone to human error, and provide the organisation with a single “source of truth” for all 30,000 internal items and potentially millions of vendor items purchased annually across the state.

GIS will provide effective business collaboration to enable NSW Health to extend secure, managed process visibility to suppliers and other government departments. Specifically, GIS will supply the department with the capability to maintain internal data for each product, while enabling receipt and management of vendor data via an on-line interface to the National Product Catalogue (NPC), an online datapool managed by GS1 Australia and administered to NSW Health by the National E-Health Transition Authority (NEHTA). The NPC allows institutions in all States and Territories to obtain essential information about the medicines, medical devices and healthcare products they use, from one electronic source. It also holds information about non-medical products, such as office supplies and food items.

Vendors not using the NPC will be able to add their term data directly into a web entry page. This form will enable one by one entry of term and pricing data or new items, changes to existing items and deletion of items. All new vendor data will be maintained in the vendor catalogue and updated automatically when additions or changes are submitted.

NSW Health users will be able to directly log-in to the catalogue, receive and manage contract data from NSW Commerce, and publish files to other systems, including the NSW Health Oracle ERP system and the Department of Commerce Smartbuy application.

More here:

http://www.cio.com.au/article/270943/new_south_wales_department_health_deploys_sterling_commerce_e-procurement_solution

This is real progress, once it is actually implemented, but has been a spectacularly long time in coming. I can remember discussions on such State-Wide procurement systems being held at least 20 years ago when I worked there. The slowness with which things happen is just amazing!

iSOFT appoints managing director for Australia and New Zealand

SYDNEY, AUSTRALIA - (HealthTech Wire / News) - iSOFT Health ANZ, a division of IBA Health Group (ASX:IBA) has appointed Denis Tebbutt as its managing director in its continued drive to build a solid management team to underpin its growth targets.

Denis was previously managing director of InterSystems Australia and New Zealand with responsibility for overseeing its expansion in the region including growth of its healthcare business. He joined InterSystems as managing director in 2002 and has 30 years sector experience gained in the UK, Europe, Asia and Australia.

More here:

http://www.healthtechwire.com/The-Industry-s-News-unb.146+M5f98c76b653.0.html

I almost missed this announcement – did not seem to be noted in Australia – but clearly this is an appointment that is important to the Australian Health IT Market Place. (Usual disclaimer re my few IBA shares).

Sixth we have:

Protests make clean-feed Internet a mess for govt

Big rallies take place around the country.

Darren Pauli 15/12/2008 09:41:00

Protests erupted across Australian capital cities on Saturday in opposition to the government's $70 million national clean feed Internet scheme, which will impose blanket content filtering for all Web connections.

The rallies, organised by members from activist groups including the Electronic Freedom Project and Digital Liberty Coalition (DLC), saw hundreds gather at Sydney's Town Hall, Brisbane Square, Melbourne's State Library, Adelaide Parliament House, Perth's Stirling Gardens and at Tasmania's Parliament Lawns to voice their opposition to the scheme.

Greens MP Scott Ludlam spoke at the Perth protests to a crowd of hundreds and questioned the need for national Internet content filtering scheme. Other speakers included members of Amnesty International, academics from state and national universities, the Electronic Frontiers Australia, and the Australia Sex Party.

More here:

http://www.computerworld.com.au/article/270902/protests_make_clean-feed_internet_mess_govt?eid=-255

I suspect the Government is going to have more of a fight on its hands about this issue. Clearly those who want a filtered Internet should be able to have it – and those who don’t should be able to access the Internet as it presently is. What I wonder about is the evidence base of the harm to the general public that has been caused by the unfiltered situation we have today that would actually be fixed by filtering, to be separated from the exited political huffing and puffing coming from Minister Conroy?

Last we have the slightly more technical note.

May the Force be with IT

Past and present: how 30 years of Star Wars imagination changed technology forever

Rodney Gedda (Techworld Australia) 18/12/2008 09:35:00

If you saw the first Star Wars film in 1978 you would have been dazzled by the awe inspiring technology the protagonists took for granted. Thirty years later and many of the film's forward-looking ideas – from videoconferencing and mobile communications to robotics and bionics – are being used in our daily lives.

During the next four months Sydney's Powerhouse Museum is playing host to one of the largest collection of Star Wars memorabilia combined with real-life examples of how such technology is being applied for business and social advancement.

The museum's computing and mathematics curator Matthew Connell helped develop the exhibition and, while not a self-confessed Star Wars aficionado, is very interested in comparing the science fiction to today's science fact.

Star Wars: Where Science Meets Imagination, took a year to set up in Australia and this is the first time it has travelled outside of the US. It was originally developed four years ago at the Museum of Science in Boston in conjunction with Lucasfilm.

“Unlike some of our staff and curators, I don't have a Storm Trooper outfit,” Connell said. “We had another Star Wars exhibition here some time ago and that was about the making of the film and that sort of thing. This is particularly different from that and while it has some artifacts in common, it is specifically about our shared understanding of this well-known movie and how this futuristic world can be used to stimulate thought about our future and how we might go and how science might get us there.”

Much more here:

http://www.computerworld.com.au/article/271235/may_force_it?fp=4194304&fpid=1

A huge slide show is also available:

Click on the following link to see the Star Wars: Where Science Meets Imagination slideshow

Just amazing to see how many ideas then are getting progressively closer..a nice optimistic way to end the news issues for the year!

More next week.

David.