Weekly Overseas Health IT Links 09-11-2009

Here are a few I have come across this week.

http://www.connectingforhealth.nhs.uk/newsroom/news-stories/eprcriteria

Department of Health publishes criteria for successful introduction of Electronic Patient Records

The Department of Health has published criteria for suppliers to successfully introduce information systems into hospitals which will enable electronic patient records.

An end of November deadline was set for suppliers to deliver significant progress in the acute sector. This was in the context of good progress having been made in delivering the infrastructure which can support electronic records, but greater pace needing to be injected into the programme for hospitals' electronic information systems.

-----

http://www.computing.co.uk/computing/news/2252354/criteria-patient-record

Guidelines published on what is a "successful" go-live of patient records

Milestones required by end of November published by Department of Health

Written by Tom Young

Computing, 02 Nov 2009

The Department of Health has released details of standards that suppliers must meet for an installation of the electronic patient records system Lorenzo to be considered successful.

-----

http://www.healthleadersmedia.com/content/241557/topic/WS_HLM2_TEC/Partnership-Tests-Value-of-EMRs.html

Partnership Tests Value of EMRs

Carrie Vaughan, for HealthLeaders Media, November 3, 2009

Many Americans are nervous about the security of their personal health information in a digital interoperable healthcare system—and for good reason. It seems like there is a new headline every week about a data breach involving personally identifiable patient information. Healthcare isn't exactly known for being the most advanced when it comes to data security. The industry still has a long way to go when it comes to securing electronic data. Unlike a paper-based health system, criminals don't need to break-in to a physical location to gain access to personal health information in a digital world.

-----

http://www.e-health-insider.com/news/5348/bury_goes_live_with_first_lorenzo_pas

Bury goes live with first Lorenzo PAS

03 Nov 2009

E-Health Insider has learned that NHS Bury has gone-live with Lorenzo Release 1.9, the first version of the software to include native patient administration functionality.

The trust went live with the new system, after switching off its old PAS, this morning.

-----

http://www.rand.org/news/press/2009/10/05/

Electronic Health Records Linked to Improved Quality in Primary Care Practices

Routine use of electronic health records may improve the quality of care provided in community-based primary care practices more than other common strategies intended to raise the quality of medical care, according to a new study by RAND Corporation researchers.

-----

http://www.ihealthbeat.org/features/2009/schoolbased-telehealth-may-be-in-line-for-doublebarreled-boost.aspx

Wednesday, November 04, 2009

School-Based Telehealth in Line for Double-Barreled Boost

by George Lauer, iHealthBeat Features Editor

Kids in public schools -- particularly those in low-income families and living in medically underserved areas -- could be getting more medical attention through school-based telehealth networks, according to a new report from a national children's advocacy group.

-----

http://govhealthit.com/newsitem.aspx?nid=72314

Connect software will embed ‘meaningful use’

By Mary Mosquera
Tuesday, November 03, 2009

Federally developed software that lets organizations exchange health information will incorporate features next year to help users become “meaningful” users of health IT, according to a Health and Human Services Department executive.

The updated version of the Connect software tool-set will make it easier for health care organizations to conduct transactions such as electronic prescribing and file sharing called for in the multi-billion-dollar health IT incentive plan, they said.

-----

http://www.modernhealthcare.com/article/20091104/REG/311049988

Justice Department move could affect EHRs

By Joseph Conn / HITS staff writer

Posted: November 4, 2009 - 5:59 am EDT

In a case that could have implications for the privacy of health records, the Obama administration has invoked secrecy privileges in a suit alleging massive domestic spying by the government.

-----

http://www.ehealtheurope.net/news/5343/jordan_unveils_integrated_health_system

Jordan unveils integrated health system

03 Nov 2009

The Hashemite Kingdom of Jordan has unveiled its integrated healthcare technology system for the first time in public.

The demonstration at the Prince Hamzah Hospital in Amman showcased the VistA open source clinical and healthcare information management system and the computerized patient record system due to be implemented over the next year.

-----

http://www.fierceemr.com/story/new-perspective-meaningful-use/2009-11-05?utm_medium=nl&utm_source=internal

A new perspective on meaningful use

November 5, 2009 — 2:09pm ET | By Neil Versel

The big EMR vendors have never been without their critics, but few drive their point home as well as SEEDIE, the Society for Exorbitantly Expensive and Difficult to Implement EHRs. It's got a professional-looking site with a picture of a happy child right at the top of the home page. ("What does this little girl have to do with selecting an EHR? ABSOLUTELY NOTHING! But it does register 10 on the warm and fuzzy meter!") Actually, it's a dig at the Epic Systems home page, which pictures a little girl writing in the sand on a beach.

-----

http://www.nextgov.com/nextgov/ng_20091028_2840.php

Health Hazard

By Andrew Noyes, CongressDaily 10/28/2009

Warning: Patient privacy could complicate the blueprint for an electronic medical records system.

Implementing a nationwide system of electronic medical records as prescribed by President Obama's economic stimulus package is a herculean task that will require a complex new matrix of policies and standards. Two Health and Human Services Department advisory committees are hard at work on blueprints for both, but some worry privacy safeguards will be an afterthought.

-----

http://www.fierceemr.com/story/vista-once-again-held-example-emr-success/2009-11-05?utm_medium=nl&utm_source=internal

VistA once again held up as an example of an EMR success

November 5, 2009 — 12:21pm ET | By Neil Versel

Lest anyone forget, there's a huge organization right here in the good old U.S. of A. that has been quite successful with an enterprise-wide EMR implementation for several years: the Department of Veterans Affairs. That EMR, the Veterans Health Information Systems and Technology Architecture--better known as VistA--is the subject of a major feature in the Wall Street Journal, intended as a lesson for the thousands of other hospitals that are moving to digitize their medical records.

-----

http://www.healthleadersmedia.com/content/241711/topic/WS_HLM2_LED/Commonwealth-Fund-US-Healthcare-is-Lagging-Behind-Other-Countries.html

Commonwealth Fund: U.S. Healthcare is Lagging Behind Other Countries

Janice Simmons, for HealthLeaders Media, November 5, 2009

When it comes to paying for healthcare, the United States—when compared with 10 other industrialized countries—tops the list as having the highest spending per capita ($7,290), while lagging behind those nations in access, quality, and use of health information technology, according to the Commonwealth Fund's 12th annual international health policy survey.

-----

http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=209879

A New Dawn for Computer-assisted Coding

Motivated by the upcoming ICD-10 transition, and incented by ARRA, hospitals should embrace CAC to drive clinical, financial and operational performance improvement.

By Mary Bessinger, MBA, RHIA, CCS, CPHQ

Although traditional coding processes may include the use of encoders or other computerized tools, they still require coders to read, or at least visually scan, all of the clinical documents from a treatment episode to identify health care provider-attested information. This information is used to justify the assignment of disease classification and medical procedure codes to the case for claim submission to a payer. Coders must then individually input a subset of the codes for which they have found justification to ensure completeness and accuracy of the claim. This repetitive, manual process not only absorbs much time and resources, but it also introduces the opportunity for human error and inconsistencies, resulting in rejected claims or underpayment from incomplete coding.

-----

http://www.healthcareitnews.com/news/physicians-still-worried-about-ehrs-disrupting-work

Physicians still worried about EHRs disrupting work

November 04, 2009 | Patty Enrado, Contributing Editor

EDEN PRAIRIE, MN – Physicians have limited knowledge of the American Recovery and Reinvestment provisions, according to a recent online survey of 1,001 physicians, and they are still reluctant to adopt information technology.

-----

http://news.yahoo.com/s/nm/20091104/hl_nm/us_philips

Philips betting on remote healthcare for future

By Harro ten Wolde Harro Ten Wolde Wed Nov 4, 2:03 am ET

AMSTERDAM (Reuters) – Dutch Philips Electronics is betting it can help doctors monitor patients remotely to keep an aging population healthier and battle rising medical costs.

-----

http://www.physorg.com/news176476261.html

Protecting your virtual privacy

November 3, 2009

The details of your personal life, such as grocery purchases and pizza topping preferences, are collected every day ― online and by club and discount cards from the gym, department store and supermarket. Though this data seems innocent enough, when it's put together it can tell a whole lot about your health, finances and behavior. That information, a Tel Aviv University researcher reminds us, could eventually be used against you.

-----

http://www.upmc-biosecurity.org/website/focus/2009_H1N1_updates/isssue_briefs/2009-11-02_IssBrf_Surveillance.html

Where Does H1N1 Influenza Information Come From?

An Overview of Influenza Surveillance in the United States

By Tara Kirk Sell, Jennifer Nuzzo, Eric Toner, November 2, 2009

The United States Centers for Disease Control and Prevention (CDC) tracks influenza illness in the U.S. through a combination of disease- and syndrome-based surveillance systems. Here we provide a brief summary of the main data sources for the CDC, explain what these sources can and cannot tell about an outbreak, and explain the differences in data collection during the spring wave of the 2009 H1N1 influenza A pandemic, the outbreaks during the summer months, and those now occurring.

-----

http://www.rwjf.org/newsroom/product.jsp?id=50308

Health Information Technology in the United States, 2009

On the Cusp of Change

October 26, 2009

Health information technology (HIT) has the potential to revolutionize the delivery of health care. In our two previous reports about HIT in the United States we detailed the challenges faced by policy-makers working toward the goal of increased adoption of electronic health records. Since that time the role of health information technology in promoting higher quality, more efficient health care has taken a central position in the current health care reform debate. There is broad bipartisan support to speed health information technology adoption, and the American Recovery and Reinvestment Act of 2009 (ARRA) has made promoting a national interoperable health information system a priority, authorizing significant resources to achieve this goal.

-----

http://www.modernhealthcare.com/article/20091102/REG/311029970

EHRs can help moderate use of antibiotics: research

By Jean DerGurahian / HITS staff writer

Posted: November 2, 2009 - 11:00 am EDT

Incorporating clinical-decision support into electronic health records can help mitigate the use of antibiotics, according to researchers presenting at the Infectious Diseases Society of America.

-----

http://www.healthdatamanagement.com/news/stimulus-39295-1.html

EHR Firms: Go With Existing Standards

HDM Breaking News, October 30, 2009

A coalition of electronic health records vendors is urging the HIT Standards Committee to focus its efforts on achieving implementation of data standards that the committee already has recommended to federal officials, rather than reopening decisions already made. The committee, authorized under the American Recovery and Reinvestment Act, advises federal officials on standards, implementation specifications and certification criteria for the electronic exchange of health information.
-----

http://www.govhealthit.com/newsitem.aspx?nid=72306

Feds urged to set simple, expandable HIE standards

By Mary Mosquera

Friday, October 30, 2009

Technology executives from across the business world told a federal health IT advisory group yesterday it should establish simple but expandable health information exchange standards or risk overwhelming healthcare practitioners.

The Health IT Standards Committee, which is helping establish the ground rules for the administration’s health IT incentive plan, has recommended a set of standards for delivering “meaningful use” of health IT by 2011.

-----

http://www.healthcareitnews.com/news/experts-give-five-tips-improving-medication-adherence

Experts give five tips for improving medication adherence

October 30, 2009 | Bernie Monegain, Editor

WASHINGTON – A group of healthcare and consumer organizations and companies has released five policy recommendations designed to promote better medication adherence, and one of them is use of information technology.

-----

http://www.fiercehealthit.com/story/texas-test-lab-says-it-may-compete-cchit/2009-11-02?utm_medium=nl&utm_source=internal

Texas test lab says it may compete with CCHIT

November 2, 2009 — 1:53pm ET | By Neil Versel

It's the news we've been waiting for since June, when the Healthcare IT Policy Committee recommended that there be multiple entities that certify EHRs for compliance with federal "meaningful use" standards: A group has come forward to say it may compete with the Certification Commission for Healthcare Information Technology.

-----

http://www.fiercehealthit.com/story/epics-faulkner-steals-show-chime/2009-11-02?utm_medium=nl&utm_source=internal

Epic's Faulkner steals the show at CHIME

November 2, 2009 — 3:50pm ET | By Neil Versel

Editor’s Corner

Dr. David Blumenthal may have been the featured speaker at last week's College of Healthcare Information Management Executives Fall CIO Forum, but he wasn't the most sought-after attendee at the meeting in Indian Wells, Calif. No, that honor would have to go to Judy Faulkner, founder and CEO of Epic Systems, the Verona, Wis.-based EMR vendor that's celebrating its 30th anniversary this year.

-----

http://www.healthdatamanagement.com/news/HIPAA-39292-1.html

HHS Issues HIPAA Enforcement Rule

HDM Breaking News, October 30, 2009

The Department of Health and Human Services has published an interim final rule that strengthens enforcement of the HIPAA privacy and security rules. The actions were mandated under the HITECH Act within the American Recovery and Reinvestment Act.

The interim final rule is effective on Nov. 30, 2009, and HHS will accept comments through Dec. 29.

-----

http://www.informationweek.com/blog/main/archives/2009/11/ehealth_privacy.html;jsessionid=YR5CMWPHHHNK5QE1GHPSKHWATMY32JVN

E-Health Privacy Regulations Draw Congressional Fire

Posted by Mitch Wagner on November 2, 2009 02:13 PM

The U.S. Department of Health and Human Services issued an interim final rule to beef up penalties for violations of the Health Insurance Portability and Accounting Act (HIPAA), as several Congressmen criticize the agency for leaving dangerous loopholes in the law.

-----

http://www.investmentnews.com/apps/pbcs.dll/article?AID=/20091101/REG/311019956/1035/TECHNOLOGY

Legislation causes boom in health care tech market

Companies leading the switch to digital medical records are poised to prosper

By Jeff Benjamin

November 1, 2009

In whatever way Congress and the Obama administration eventually change the national health care system, there is one segment of the health care market where reform has already begun and is gaining momentum.

The category, known as health care information technology, consists of companies dealing with the conversion of paper medical records to a digital format.

-----

http://govhealthit.com/newsitem.aspx?nid=72299

ONC launches blog for feedback on policy agenda

Friday, October 30, 2009

The Office of the National Coordinator for Health IT launched a blog this week to give the public a way to comment directly on the work being done by the two key advisory panels that are helping shape health IT policies.

The blog site is here.

-----

http://www.prnewswire.com/news-releases/nations-hip-fracture-rate-could-drop-by-25-percent-with-aggressive-osteoporosis-prevention-plan-kaiser-permanente-study-finds-68531377.html

Nation's Hip Fracture Rate Could Drop By 25 Percent With Aggressive Osteoporosis Prevention Plan, Kaiser Permanente Study Finds

Study of 650,000 Men & Women Over 50 Finds 38 percent Drop in Hip Fracture Rate

DOWNEY, Calif., Nov. 2 /PRNewswire/ -- Aggressively managing patients at risk for osteoporosis could reduce the hip fracture rate in the United States by 25 percent, according to a Kaiser Permanente study published in the November issue of The Journal of Bone & Joint Surgery. The first step must be a more active role by orthopedic surgeons in osteoporosis disease management, researchers say.

-----

Enjoy!

David.

This is Really Sad - Take a Careful Read of This Comment. Utterly Confirms Previous Post and It Really Needs More Prominence!

Anonymous has outdone him/her self!

Begin Quote -----

David,

I haven't worked within NEHTA but have participated in a number of their consultations and do have some friends that work there. It's very sad but I think your correspondent's reflections are true. I'm writing this blog posting anonymously because my employer is working with NEHTA, and I know that the kind of 'falling out of favour' that your writer describes doesn't just apply to employees, it also applies to the suppliers who are contracted to work with NEHTA.

One rule of working with NEHTA - frank and fearless advice is most certainly not welcome in NEHTA. Not from employees, not from consultants, not from vendors, not from anyone.

I saw a chain of small consultancies engaged to provide advice on the NASH program. I won't say their names. The amazing thing was as each consultancy was engaged, they gave very solid advice that the course of action that the NEHTA folks were taking with regard to NASH was impractical, unnecessary and grossly more expensive than estimated. Unfortunately, as each provided advice, their advice was rejected and then their consultancy was terminated. Step in the next consultancy to be asked the same question. The NASH program is now at the point of either collapse or rebirth - but don't hold your breath. My understanding is that it's about to be turned into a specification project, not a delivery project. That is, NEHTA will specify the contents of digital certificates, key management processes etc, not implement any national infrastructure. NASH has already spent a bucketload of money though so like I said don't hold your breath. Vendors participating in the secure messaging program (PIP) have been told not to expect NASH to be operational anytime in the future so the specs have instead assumed the use of the existing Medicare HESA certificates.

Which brings me to what I thing is the most damning change that has come about in NEHTA over the last six months. They don't care one bit anymore about the outcomes of eHealth, their focus out of fear is on the process. The mantra has become: "if we deliver a documented specification, ram it through an arbitrary consultation process, then get it legitimised by some group or standards body", then we're successful. It is irrelevant to the management of NEHTA that the specifications are not used or adopted in any way by the industry. Their job is done - they've produced the document.

Take one spec as an example:

NEHTA have a team of people working on the Australian Medicines Terminology. This is an important piece of work and we really do need a common medication vocabulary adopted in Australia. It would save lives and enable better quality care through medication management.

But look at the AMT specs. They've gone through 2 major and 20 minor revisions since 2007. But almost three years later who's using them: No one - not one single vendor, not one single healthcare provider. No one.

Now I would think NEHTA would take that as feedback to get engaged in actual adoption, stimulate and foster adoption, drive education, skill up other participants in eHealth, invest in industry partners who want to adopt AMT. Is NEHTA doing any of that? NO. They're succesful (by their definition) - the document has been produced.

We now have NEHTA publishing another raft of specifications on the electronic transfer of prescriptions. Excruciating detail on how an electronic prescription exchange must work! Is AMT mentioned - only as an eventual goal at some point in the future. The horse has already bolted - eRx and MediSecure are operational exchanges and NEHTA's writing a spec for how their web services should appear!!! But again, NEHTA are delivering a document.

NEHTA's also still talking about the Identifiers service (UHI, IHI) being operational by December. Remember Peter Fleming's remark : "2009 is The Year of Delivery"

Reality is a vague and abstract concept. Adoption is irrelevant.

David, I think you're right. It is well past time that this issue was critically reviewed by the Auditor General, and I think you are right to question the leadership provided by Peter Fleming and David Gonski.

I think it sad that 18 months ago, many of us were vaguely hopeful of progress - that some fresh blood and particularly someone with the previous stature of David Gonski.

( I just did a google search on David Gonski and found his wiki page: http://en.wikipedia.org/wiki/David_Gonski. Kind of curious that it makes reference to his chairmanship of CocaCola, Investec and others, but not a single reference to his chairmanship of NEHTA. Perhaps it's in his best interest to keep that one quiet)

I don't want to come across as entirely critical of NEHTA. There are some passionate, talented, dedicated people there who really believe in what they are doing. It's just very sad that:
(a) they are unsupported by effective management and attacked for voicing contrary opinions to the group consensus. Dissenting voices are removed, unqualified yesmen are promoted

(b) despite bringing in some good people, they've broken links with the people who are really delivering change in the health provider community. They're working in a vacuum, ignoring reality but somewhat mindlessly progressing to simply deliver document after document of tedium

(c) they're poorly governed. The Boston report said so three years ago. The DeLoitte strategy said so last year, but no substantive changes ever get made.

(d) they are surrounded by apologists. Jane Halton's remarks to the Senate estimates a few weeks ago were appalling and misleading. She has no idea of the true state of eHealth and made so many deceitful half-truths in that hearing that she should be reprimanded for contempt of the senate.

(e) they have taken a view that style is more significant than substance. Just once, I would love to hear that just one (only one) product of NEHTA's has been incorporated into a single working system in Australia, anywhere.

Come to think of it, can any of your readers point to an example. Just one, anywhere, any product (AMT, SNOMED, identifiers, secure messaging, NASH). After almost five years, surely there is one????? I'm sure Peter Fleming and Jane Halton would be happy to pay you a finder's fee, as they clearly don't know of any examples.

If it is the case that they haven't been deployed anywhere, then I'd like to ask for my $200million in taxpayers money back. If they have been, then that would give me such tremendous hope. Anyone know?

End Quote -----

Posted without comment. None is needed!

David.

What On Earth Are We Going to Do with the Hopelessly Dysfunctional NEHTA?

The following is the text of an e-mail I received yesterday (09/11/2009).

Begin Quote ----

As an ex-employee of NEHTA I have been extremely interested in the news of NEHTAs annual report. I was particularly interested that despite almost half the 2008-2009 budget being spent on consultants, the report included no description of what work was conducted by these consultants or why. So, I thought I would share a few insights into the subject.

Before I go on, it should be noted that there are a tremendous number of talented, dedicated people in NEHTA who are committed to creating an efficient, workable e-Health Record solution for Australia. Unfortunately, these efforts are being undermined by the sort of mismanagement, self-interest and, in some cases, incompetence in elements of NEHTAs leadership that are the hallmarks of a dysfunctional organization.

The sorts of things I saw resulting from this were:

- No project management processes

- No responses to issues and risks escalated to the project board

- Board decisions not being documented or communicated to the project team

When I questioned management on the lack of a project management system a consistent response was that NEHTA is a start-up, an answer I would find overly flippant in a company trading T-Shirts online but extremely worrying in a project of such national importance.

Obviously, someone had realized that something was wrong though and consultants were brought in to help fix the project by introducing basic project management processes. Were the consultants needed? Yes and no. They shouldn't have been needed but the environment is such that no internal staff could criticize (read: question) management without falling out of favour (and the culture of NEHTA is by no means mature enough for this to be a small thing) and yes, they were needed because no one was able to get anything done as they were being called to do reactionary, 'save the reputation of NEHTA' type of work regardless of pre-existing work they might be doing.

NEHTA is a broken organization. It appears that in the time since its inception no one has considered what must be done to build a functioning organization that is capable of meeting objectives. The public accountability and governance restructures will not occur simply because they would be far too embarrassing for everyone involved, particularly those who are committed to building their own fiefdoms in Australia's E-Health Solution infrastructure.

End Quote -----

What is being reported here is nothing short of a catastrophe and indeed the most serious of public scandals.

If true, and I have no reason to doubt the veracity of what is being said here as it accords with a lot of other things I am hearing, we can only conclude “Houston, We Have a Problem!”

We now understand why there is such a huge consulting bill. The 190 staff, as dedicated as they may be, are so badly led and so badly managed that they are in a loose, loose situation. NEHTA was never designed or resourced with the funds and skills to deliver a large scale IT project like the IHI (or UHI or whatever). That gap has now become apparent it would seem and NEHTA has been panicked into grasping at a huge consulting straw.

The likelihood of substantial delivery of what was intended now seems to be very much at risk and one wonders just what NEHTA plans to do when, come mid next year, this fact, seems very likely to become increasingly obvious.

Other sources keep telling me of the NEHTA approach being one very much of public relations rather than delivery. This approach is, of course, inevitably a disaster. Witness such other examples as Firepower and its fuel additive that saved 30% of your petrol bill and was clearly bunkum!

Why is it the most NEHTA presentations remind me of the foil ware and smoke and mirrors that was beloved of major computer companies in the 1980’s? The answer was that the seriously lacked any real substance.

What to do. It is pretty simple and involves two steps to avoid continued wastage of public money.

First the management and control of NEHTA should be returned to the public sector and second the Commonwealth Auditor General should be asked, by the Commonwealth Health Minister, to undertake a full review of NEHTA’s activities and deliverables (using external expertise if needed) so the public can be assured steps will be taken promptly to keep what is good and valuable from NEHTA and swiftly facilitate it getting back on the track to delivering what is needed.

Can I say if I were the present Chairman of the NEHTA Board I would be pretty worried about how my illustrious reputation may be damaged by this all ending in tears and taking independent steps to assure myself what is needed to be done is being done. It now becomes clear why the NEHTA Board needs an independent management adviser – there is no one internally with the organisational management skills to get this fixed.

I am told that NEHTA presently has a staff turnover approaching 30% annually and given the number of ‘former NEHTA staffers’ who have been in touch that is by no means a surprise. Of itself it is a key symptom of major organisational distress and dysfunction.

Time has come for the public to be assured that all this will be fixed, and soon. E-Health is meant to be about putting in place systems that improve heath and save lives. We need to get back there quickly! NEHTA has now been operational for going on five years and the practical outcomes have been pretty much zero. Time for a reboot!

David.

Can Medicare Australia Help Dig Australian E-Health Out of A Hole?

The following appeared a couple of days ago

Medicare turns into online services factory

Karen Dearne | November 03, 2009

MEDICARE Australia has become a key supplier of information and payment services for other government agencies as it continues to position itself as a national platform for broader electronic health programs.

Chief executive Lynelle Briggs said the nature of the services Medicare provided was "shifting as the government leverages our relationship with the community", such as its delivery of ceiling insulation stimulus programs on behalf of the Department of the Environment.

"Almost all residents, doctors, pharmacists and other health professionals have some connection with Medicare," Ms Briggs said. "We continue to focus on information and communication technology as a key business enabler."

Other initiatives included the Defence Force Family Healthcare and Teenage Dental programs, and a purpose-built combined Medicare and Centrelink office at Narooma on the NSW south coast.

Medicare's technology capabilities are based on its high-availability business processing systems, secure messaging over the internet using public key infrastructure and transaction connections with the health sector, banks and government agencies.

According to its 2008-09 annual report, more than 80 per cent of Medicare's business is conducted electronically.

Ms Briggs said online claiming of Medicare benefits had become widespread.

"Our focus is to increase the level of patient claiming (from the doctor's office), as this is where the benefits to both the community and government lie," she said.

About 9500 out of some 22,500 general and specialist medical practices offer Easyclaim facilities, and nearly 21 per cent of patient claims were made over the system at June 30.

More here:

http://www.australianit.news.com.au/story/0,24897,26295109-15306,00.html

This got me thinking that there might be a few important roles for Medicare Australia (MA) that could actually advance things at the cost of a very small proportion of the MA budget.

Among the most obvious are:

First to see whether it would be possible to contract Microsoft, Google or whoever to work with them to create a National PHR system – as they mention later in the article, they have at least some of the basic information already available and to provide a refined, more polished and richer offering might just be worthwhile and of use to all concerned.

Second, with the work already apparently close to complete in Individual Health Identifiers – or so NEHTA says – this may be the time to being some other useful work. An good place to start might be to consider setting (or contracting for provision of) up a standards based e-prescribing hub as NEHTA are proposing – which could then link all prescribers and dispensers in a NEHTA certified and standardised way using current messaging providers etc. (Appropriate inclusive governance and management are assumed) The cost would be relatively trivial and once established – and operating on an audited cost recovery basis – it would be the sponsor of competition at the GP, Specialist and Dispensing System level while ensuring appropriate regulation security and so on. It is a no brainer and just requires a little get up and go on the part of MA.

Third MA could procure and deliver a national health information portal as recommended in the National E-Health Strategy to offer services for both providers and consumers – perhaps integrating the present DoHA and State based initiatives. A really good and quite inexpensive idea that could also make a difference.

The only caveat in all this is that there is a really difficult history of MA initiatives, at least initially, being somewhat clumsy and lacking user focus. It would be good for MA management to work out what they could do to avoid repetition of this sort of outcome (you need to carefully listen to all those affected and respond sensibly etc in the design and pilot phases).

It seems to me with DoHA and the Minister of Health having vacated the field and NEHTA having constrained funds outside its mandate that the only other possible source of a little forward momentum might be MA. They should at least give it some careful thought. An yes I know there will be many reasons why not! Comments pro and con welcome!

David.

Professor Patrick Releases a New Version of His Review of the Implementation of Cerner FirstNet.

About two weeks ago I published a comment on a blog posted in the US expressing concern that this report had been censored.

The original post can be found here:

http://aushealthit.blogspot.com/2009/10/australian-censorship-of-adverse.html

There we many comments and discussion on the topic both on the blog and elsewhere.

Today Prof. Patrick has released a new upgraded and expanded version.

In part his announcing e-mail reads as follows:

"Dear Colleagues

I wish to advise you that I have released Version 5 of my essay on the use of Firstnet in NSW hospitals. It can be found at my Laboratory's web page in the section on Essays. It is item number 6.

See:

http://www.it.usyd.edu.au/~hitru/index.php?option=com_content&task=view&id=91&Itemid=146

....

cheers

jon"

The document has been much expanded and contains much more discussion. It is well worth a read. Other details of the saga are also found at his website.

David.

NSW and Victoria Health Should Read This Very Closely. Indeed as Should All Other States!

The following has just appeared in the UK from e-Health Insider.

SCR may have London roll out

09 Nov 2009

The head of the London Programme for IT has admitted that the ‘one size fits all’ approach to deploying Cerner Millennium was a “mistake”.

Speaking at E-Health Insider Live ’09, Kevin Jarrold said a “significantly different” approach was being taken at Kingston Hospital and St George’s Hospital NHS trusts, which are due to go live “this month” and “in the weeks after that” respectively.

“We have learned that one size fits all, big bang is not the solution,” he said. “We have moved to an incremental approach that lets us tailor the solution to fit particular requirements and a modular approach to deployment.”

Speaking alongside Jarrold, Don Trigg, managing director of Cerner UK, contended that the 60 products that fitted within the Millennium architecture were well fitted to this approach.

He said customers internationally had often taken one product for one department and then rolled it out more widely. He said Cerner had 17 NHS trusts using one or more Millennium product, and that it had 29,000 unique users across those 17 organisations.

More here:

http://www.e-health-insider.com/news/5374/scr_may_have_london_roll_out

The third paragraph is the vital one:

“We have learned that one size fits all, big bang is not the solution,” he said. “We have moved to an incremental approach that lets us tailor the solution to fit particular requirements and a modular approach to deployment.”

“Nota bene” is all that needs to be said. I would note I have been saying virtually forever that this sort of top-down solution delivery is a recipe for failure!

David.

It Seems The Secret Documents are To Remain Secret! What is Going On?

This appeared on the Australian IT Web Site on the 3^rd of November, 2009.

Secret e-health reports to be released

• Karen Dearne
• From: Australian IT
• November 03, 2009 4:00PM

AS the Rudd government prepares legislation to support the introduction of a national healthcare identity scheme linked to Medicare numbers, three separate investigations on privacy concerns conducted over the past three years are finally to be made public.

The privacy impact assessments -- by Galexia, in 2006; Clayton Utz, in March 2008, and Mallesons Stephen Jaques in August this year -- will be posted by the National E-Health Transition Authority, together with its response to each.

According to a NEHTA spokeswoman, the documents will be online "as soon as possible".

Consumer groups have been calling for the release of the documents as part of a protest against secrecy and lack of consultation over plans for a nationwide system for electronic sharing of patients' medical records.

Juanita Fernando, convenor of the Consumer-Centred E-Health Coalition formed in August, said she hoped the move "signalled government intentions to take consumer feedback on board and kickstart a rational debate about e-health implementations''.

The Mallesons study, provided to The Australian, warns there is "a very significant risk" that the community will view individual healthcare identifiers as "a rebranded welfare Access Card or a new Australia Card''.

It recommends "a transparent and public process for considering privacy and other impacts'', including the government "erring on the side of greater restrictions on uses'' of the number, rather than "greater flexibility in adding new uses''.

"Consideration should be given to imposing explicit restrictions on the use of the identifier and other data for non-healthcare-related purposes,'' it says.

Mallesons also recommends that consideration be given to establishing a separate, statutory, healthcare identifier authority, "which could subcontract the issuing of individual identifiers and operation of the service to Medicare, under the authority's supervision".

More here:

http://www.theaustralian.com.au/australian-it/secret-e-health-reports-to-be-released/story-e6frgakx-1225793984983

It is clear the Australian has the documents and have provided a useful summary of the key points so one has to wonder why the public release is taking so long?

From what the Australian says there is going to need to be a good deal of work and policy thought given to this to get this even close to right.

It has always amazed me why drafts of each of these three documents were not released for public discussion before finalisation. The process of getting things done right would then have been shorter I believe.

David.

IHE Workshop Announcements - Care Co-Ordination Profile Development – December 2009

Posted on behalf of Jon Hilton for Information of Readers.

Introductory Note.

IHE Australia is taking the lead in proposing a new international standard profile focusing on Patient Care Coordination for Chronic Disease, and Electronic Referral. This builds on work done to date by HISA and IHE Australia members, HL-7 Australia and others and is establishing Australia as an international leader in this field.

You are cordially invited to participate in a workshop to further develop the profile. This is your opportunity to contribute to this exciting development, to learn more about the IHE process, and to learn more about the IHE XDS. I look forward to seeing you there,

regards,

Jon Hilton

HISA Board Member,

HISA Representative, IHE Australia Executive

Announcement

Care Coordination and e-Referral - workshop

(December 9th – Sydney)

Sharing health records, images and communication – international case studies using

IHE Cross Enterprise Document Share (XDS) - seminar

(December 10th – Sydney)

Date: 9th & 10th December 2009

Time: 9am-5pm (East Australia Summer Time - Sydney)

Venue: NICTA

Address: Level 5, 13 Garden St, Eveleigh (near Redfern Station)

Cost: December 9th & 10^th - $200

December 9th one day only - $50

Book Online: (via MSIA) http://www.msia.com.au/?pid=44

(Please note: enter your company name and address for invoice, and names and email addresses of those attending so we can provide meeting updates)

Workshop website:

http://ihe-australia.wikispaces.com/event_12%2613_december_2009

Meeting background:

1. Care Coordination and e-Referral

These are common processes in healthcare, yet involve many different groups of health providers, across different sectors (public/private), and have different but overlapping needs for health record sharing and process management.

IHE Australia has proposed an extension to the international Cross Enterprise Document Sharing (XDS) interoperability profile to support care coordination processes. Further details are at the IHE Australia wiki.

(http://ihe-australia.wikispaces.com/Care+Coordination+and+eReferra)

This workshop will review the use-cases proposed and discuss technical solutions based on extending existing IHE profiles, while bringing in Australian experience with Hl7 referral messages and pioneering methods of managing care coordination in the community health sector.

Who should attend: Those involved in eHealth with focus on care co-ordination, healthcare communication and e-referrals, policy makers, standards developers and vendors.

Workshop resources: Jon Hilton, Chris Lindop

2. Sharing records and communication – international case studies using Cross Enterprise Document Share seminar

Since 2004 IHE has been progressively developing an architecture for standardised sharing of health records and diagnostic images using a non-proprietary decentralised federated architecture, known as Cross Enterprise Document Sharing (XDS for documents and XDS-I for images). This architecture is based on local document repositories, indexed in a regional registry, and retrieved by users, in response to a notification or as needed for patient care at a later time. In the case of images the document points to the location that images can be retrieved which may be the original PACS or a secondary repository. XDS uses both traditional messaging (e.g. HL7), and a standard set of “services” to manage patient and provider identities, locations, security, and record location and is now ‘web-service enabled”. All of this has been specified in detail in a series of implementation profiles and tested both in industry collaborative sessions (known as Connectathons) and also in the real world. This seminar will focus on how XDS has been used in international implementations

The majority of international vendors of eHealth and EHR systems have implemented and endorsed this model of health record sharing within their products. The concept of being able to manage health record sharing, starting at the regional level and building to achieve a state or national system in time by linking these standardised local approaches, is potentially very appealing both from a technical as well as from a policy perspective.

A recent interview with the Health Minister touched on shared EHR directions concluding that central models are unlikely to gather the funding and political support, and suggested that this problem be dealt with by relying on patient managed personal health records. While there are undoubted benefits of personal health records, this rather seems like throwing the baby out with the bathwater. IHE XDS provides a way of linking both models in a way which is currently technically feasible, delivers a scalable and flexible platform and can provide the information “glue” that will support the Australian patient centric model of shared public and private healthcare. This workshop will examine a series of real world implementations of the alternative approach to health record and image sharing based on IHE’s XDS profile. This workshop will look at the outcomes achieved, rather than a focus on the technical components, however from this perspective the technical factors that are influencing the success of this approach in a range of countries and regions will be highlighted.

Who should attend: Vendors, IT professionals, service providers, policy makers and health professional organisations, standards developers

For further information: see www.ihe.net.au or contact admin@ihe.net.au

Book to attend at http://www.msia.com.au/?pid=44

IHE Australia recognises the support of many organisations and individuals for this event including:

GE Healthcare

NICTA

MSIA.

Weekly Australian Health IT Links - 07-11-2009

Here are a few I have come across this week.

http://www.australianit.news.com.au/story/0,24897,26303442-15306,00.html

Health misses key goals

Karen Dearne | November 04, 2009

THE federal Health Department did not meet its e-health implementation targets for 2008-09, failing to progress the electronic sharing of clinical information to improve patient safety as well as increased use of secure messaging by GPs.

-----

http://www.australiandoctor.com.au/articles/5a/0c06505a.asp

E-health a ‘superhighway to nowhere’

4-Nov-2009

By Sarah Colyer

Millions of dollars spent on e-health will be wasted unless governments fund computer systems in public hospitals, the nation’s top clinical advisor on e- health warns.

-----

http://www.zdnet.com.au/news/communications/soa/Professor-issues-proprietary-e-health-warning/0,130061791,339299347,00.htm

Professor issues proprietary e-health warning

By Liam Tung, ZDNet.com.au

03 November 2009 04:59 PM

A health informatics professor from Sydney University today said Australia's e-health systems should be strictly open source rather than using proprietary software.

-----

http://colacherald.com/2009/11/04/hospital-ceo-launching-new-dispensing-system/

Hospital CEO launching new dispensing system

By The Colac Herald • Nov 4th, 2009 • Category: News

Colac Area Health chief executive officer Mr Geoff Iles will officially launch a robotic dispensing system at a Colac pharmacy today at 11am.

The Gollmann Robotic Dispensary System, installed in Colac Healthwise Pharmacy at a cost of $300,000, has Pharmacy Guild endorsement as the best robotic dispensing system available in Australia.

-----

http://www.theaustralian.com.au/australian-it/google-tries-to-allay-privacy-fears/story-e6frgakx-1225794910369

Google tries to allay privacy fears

• Karen Dearne
• From: Australian IT
• November 06, 2009 8:44AM

GOOGLE hopes to stem rising public concern over privacy and data protection issues with the release of a dashboard that puts visibility and control over personal information associated with various services firmly into the user's hands.

Just launched globally, the Google Dashboard provides an easy interface with a range of existing privacy controls intended to help users manage their interactions with the search giant's burgeoning range of email, social networking and voice products.

-----

http://www.news.com.au/story/0,27574,26313241-29277,00.html

Aussies doctors among world's least satisfied

AAP

November 06, 2009 03:12pm

OVER half of Australian doctors are dissatisfied with their jobs, a new survey showed.

The US-based Commonwealth Fund survey, based on a poll of more than 10,000 doctors from 11 countries, found the level of satisfaction among Australian physicians was the second lowest of all countries surveyed.

-----

http://www.medicalobserver.com.au/News/0,1734,5557,02200911.aspx

Jury out on definition of Internet addiction

Kirrilly Burton - Monday, 2 November 2009

THE launch of a new Internet addict recovery program, set up by US mental health counsellors, has not been welcomed by all experts in the addiction field.

-----

http://www.zdnet.com.au/news/software/soa/NEHTA-cuts-contractor-spend/0,130061733,339299280,00.htm

NEHTA cuts contractor spend

By Suzanne Tindal, ZDNet.com.au

29 October 2009 12:48 PM

The National E-Health Transition Authority (NEHTA) has dropped the amount it is shelling out for contractors while stepping up its in-house employee spend, according to its annual report released yesterday.

-----

http://www.news.com.au/story/0,27574,26312354-23109,00.html

Nanotechnology safety query after DNA damage done

From correspondents in London

Reuters

November 06, 2009 07:59am

NANOPARTICLES can damage the DNA of cells from a distance, even without crossing the cellular barriers that protect certain parts of the body, British researchers said.

-----

http://www.medicalobserver.com.au/News/0,1734,5556,02200911.aspx

Queensland passes national registration Bill

Elizabeth McIntosh - Monday, 2 November 2009

CONTROVERSIAL legislation that gives governments greater control over medical training standards has begun its national roll-out.

The Health Practitioner Regulation National Law Bill 2009 passed through the Queensland Parliament last week, and will now be used as a template by all other states and territories. Medical groups claim it will hand politicians the ability to manipulate medical education.

-----

http://www.computerworld.com.au/article/324790/minchin_uses_nz_broadband_study_call_nbn_cost_benefit_analysis_again?eid=-255

Minchin uses NZ broadband study to call for NBN cost benefit analysis, again

NZ study of 6000 businesses finds that "Broadband adoption is found to boost productivity but we find no productivity differences across broadband type"

Tim Lohman 03 November, 2009 13:51

Shadow Minister for Broadband, Communications and the Digital Economy Senator Nick Minchin has used the publication of a new report into the productivity of high speed broadband to reiterate his call for a full-cost benefit analysis of the NBN.

Enjoy!

David.

A Request for a Little Help.

As part of reducing the time spent on the blog and having a go at doing some more useful work in the time freed up I am planning to try and put together a history of e-Health in Australia going back hopefully to the 1980’s or earlier.

What I am hoping is that some who read will have some interesting tit-bits to share. I am especially interested in the goings on in States other than NSW and in Commonwealth material that was created before 2000.

The aim is to try and understand what has gone right and wrong and hopefully create some suggestions as to how we might successfully move forward.

My e-mail contact is available by clicking on the ugly picture at the top left of the blog!

If you only have paper the postal address is found on my Company web page just below the e-mail address.

Thanks in advance for any docs, links or whatever. Whatever I come up with will see the light of day as drafts here.

A parallel project is going to be trying to assimilate the lessons learnt from overseas that might be relevant.

David.

Electronic Prescription Transfer and E-Prescribing - What Happens Elsewhere?

I came upon this slide the other day from NEHTA.

eMM National Development Roadmap

• Progressive releases from 2008 – 2013

– Release 1: Electronic Transfer of Prescription

– Release 2: Adherence Monitoring

– Release 3: Current Medication List

– Release 4: Community Medication Review

– Release 5: Decision Support and Secondary uses

Source: Andy Bond Presentation – June 2009.

From this we can be sure we are all going to be waiting a good while for eMM (Electronic Medication Management) to become a reality in Australia.

What is happening elsewhere? Just for reference let’s look at the US and UK.

United States of America

I think this provides the flavour:

ALEXANDRIA, Va. and ST. PAUL, Minn. – April 22, 2009 – Surescripts®, which operates the country’s largest national electronic prescribing network, today announced that more than 100,000 prescribers are now routing prescriptions electronically in the U.S. What’s more, the use of three critical components of e-prescribing – electronic prescription benefit, history and routing – jumped 61 percent in the first quarter of 2009, resulting in more than 134 million e-prescribing messages being exchanged among prescribers, payers and pharmacies.

“In the past two years, the U.S. has gone from 19,000 to 103,000 prescribers routing prescriptions electronically – punctuated by 39 percent sequential growth in prescriber adoption in the first quarter of this year,” said Harry Totonis, president and CEO of Surescripts. “The past two years have also witnessed a sevenfold increase in the use of e-prescribing. And while this growth shows clear evidence that the steps taken by policymakers, prescribers, payers, pharmacies and others are having a positive impact, swift and specific action is required for the U.S. to achieve mainstream adoption and use of e-prescribing.”

Today’s announcement features the release of the annual National Progress Report on EPrescribing. Based on the operations of the Surescripts network, the Report features statistics and graphics detailing the status of e-prescribing adoption and use in the U.S. from 2006 through 2008. For a downloadable copy of the National Progress Report on E-Prescribing, go to www.surescripts.com/report.

Source:

http://www.surescripts.com/downloads/NPR_Announcement_Final.pdf

The network is standardised as can be seen from this report:

Surescripts Preparing for New Rx Standard

HDM Breaking News, October 20, 2009

Electronic prescribing network vendor Surescripts anticipates in May enabling software vendors, pharmacies, pharmacy management benefit plans, and insurers to begin the process of certifying their systems to support version 10.6 of the NCPDP SCRIPT standard electronic prescription.

The Centers for Medicare and Medicaid Services is expected soon to issue an interim final rule adopting the new version, mandated under the Medicare Modernization Act. Capabilities within the new version also are included in recommended meaningful use criteria the HIT Policy Committee has sent to federal officials.

More here:

http://www.healthdatamanagement.com/news/electronic_prescribing-39224-1.html

The standards are also mature and usable for the US:

See this from John Halamka a few days ago.(CIO Mass General)

“ePrescribing - we have a mature standard (NCPDP Script 8.x) that is being enhanced to support new features (NCPDP Script 10.x) on a reasonable timeframe with minimal burden. We have test harnesses, middleware and clearinghouses that will accelerate adoption. We have an ecosystem of application developers. There is work to do to encourage more transactions to flow, but we're in generally good shape.”

http://geekdoctor.blogspot.com/2009/10/implementation-workgroup-testimony.html

So full adoption is now really the issue and the specific US payment incentives for e-prescribing (from the Obama stimulus package)are likely to have that happening really quickly in the next 2 years.

United Kingdom

Seems some has got it organised in Scotland!

Scotland delivers e-prescription service

14 Jul 2009

Scotland has announced that it has become the first country in the UK to deliver an electronic prescription service, with more than 90% of prescriptions now submitted electronically.

Scottish health secretary Nicola Sturgeon said the electronic Acute Medication Service (eAMS) was the first national system of its kind to go live anywhere in the UK and was now enabled in 99% of Scottish GP practices and pharmacies.

The eAMS prints a barcode on prescriptions at a GP surgery and sends a message to Scotland’s ePharmacy Message Store.

When a patient presents at a pharmacy with their barcoded prescription, the pharmacist can scan the barcode to pull down the prescription and dispense the medicine.

Dispensing a prescription triggers the creation of an electronic claim message to NHS National Services Scotland (NSS).

The Scottish government said eAMS cuts the risk of errors between GPs and pharmacists, delivers improvements such as the use of universal codes for virtually all medicines, and boosts efficiency.

Sturgeon added: “With eAMS we are now seeing more than 90% of prescriptions submitted electronically. This shows the demand among GPs and pharmacists to work together to make the best use of the latest technology to improve services for patients.”

More here:

http://www.e-health-insider.com/news/5022/scotland_delivers_e-prescription_service

Note Scotland does have a population of over 5 million so this is not a tiny effort. It is an already working and coded implementation!

It seems England is being a bit slower – but are planning real SNOMED CT based decision support as part of their UK NHS implementation.

Lots about what they are up to:

http://www.connectingforhealth.nhs.uk/systemsandservices/eprescribing

The bottom line to me is that NEHTA has – as I said previously – seems to have been happy to go with a less than developed proposal and to really compromise more than I would like just because of still embryonic commercial offerings. A roadmap going onto 2013 hardly fills anyone with confidence.

The issue for me with all this is the total lack of coherent governance with DoHA seemingly having just vacated the field and everyone else pursing agendas which do not convince me have the national interest at heart.

Maybe someone should get all the players and stakeholders in a room and have them agree a single appropriate national approach that everyone can support and then we can get on with this. This festinatory Brownian Motion is just not good enough and no good will come of it I believe.

David.

Weekly Overseas Health IT Links 02-11-2009

Here are a few I have come across this week.

http://fcw.com/articles/2009/10/23/government-agencies-to-spend-15-billion-on-health-it-by-2014.aspx

Government agencies to spend $15 billion on health IT by 2014

Federal agency spending on health IT systems could rise to $5.6 billion

• By Alice Lipowicz
• Oct 23, 2009

Federal, state and local governments will spend $15 billion on information technology systems to support their public health and health insurance programs in 2014, a $3 billion increase from 2009 levels, according to a new report from the Input research firm of Reston, Va.

-----

http://www.washingtonpost.com/wp-dyn/content/article/2009/10/24/AR2009102400967.html

Electronic medical records not seen as a cure-all

As White House pushes expansion, critics cite errors, drop-off in care

By Alexi Mostrous
Washington Post Staff Writer
Sunday, October 25, 2009

In a health-care debate characterized by partisan bickering, most lawmakers agree on one thing: American medicine needs to go digital.

-----

http://www.fiercehealthit.com/story/critics-question-ethics-stepped-pharma-data-mining/2009-10-26?utm_medium=nl&utm_source=internal

Critics question ethics of stepped-up pharma data mining

October 26, 2009 — 2:28pm ET | By Neil Versel

With the crackdown on gifts to physicians, and a slowing in direct-to-consumer advertising, the pharmaceutical industry is turning to data mining of physician prescribing habits to fuel the marketing machine. And, as with so many other pharma marketing techniques, controversy is brewing.

-----

http://www.healthcareitnews.com/news/states-play-important-role-healthcare-reform

States to play important role in healthcare reform

October 23, 2009 | Kyle Hardy, Community Editor

WASHINGTON – The federal Office of the National Coordinator for Health Information Technology has released “requests for proposals” to all 50 states to apply for federal grants worth $1.2 billion.

-----

http://www.publictechnology.net/modules.php?op=modload&name=News&file=article&sid=21690

Health records transfer system lands interoperability award

The GP2GP software has won a national award for 'Innovation in Health Interoperability'. The honour came at the E-Health Insider Awards 2009, held at London's Hilton on Park Lane.

-----

http://www.npr.org/blogs/health/2009/10/stimulus_funds_could_widen_dig.html

Stimulus Funds Could Widen Digital Health Divide

12:25 pm

October 26, 2009

By Christopher Weaver

Federal stimulus spending meant to bolster the uptake of electronic medical records could wind up shortchanging hospitals that treat more poor patients, deepening a "digital divide" between the rich and the impoverished.

-----

http://www.modernhealthcare.com/article/20091026/REG/310269943

Hospitals serving indigent have less robust IT: study

By Joseph Conn / HITS staff writer

Posted: October 26, 2009 - 11:00 am EDT

As might have been suspected, there is a digital divide between hospitals disproportionately serving the poor and those hospitals serving the rest of the population, according to the findings of a team of federally supported researchers looking into adoption rates of health information technology.

-----

http://govhealthit.com/newsitem.aspx?nid=72242

Consumer technology may improve health outcomes

By Mary Mosquera
Friday, October 23, 2009

Consumer health information technology tools hold “significant” promise for improving outcomes across a variety of diseases and health conditions, according to research conducted for the Agency for Healthcare Research and Quality.

-----

http://govhealthit.com/newsitem.aspx?nid=72240

ONC taps information exchange software for NHIN Connect

By John Moore
Friday, October 23, 2009

The Office of the National Coordinator has tapped an Arlington, Va.company’s health information exchange software as part of the federally developed Connect Gateway.

ONC selected Vangent’s Health Information Exchange Open Source (HIEOS) software as a document sharing component of Connect Gateway v. 2.2, which was released late last month. Connect lets agencies and healthcare organizations share health data, employing nationwide health information network (NHIN) protocols, agreements and services.

-----

http://www.healthcareitnews.com/news/war-talent-about-begin-healthcare-it

War on talent about to begin in healthcare IT

October 23, 2009 | Bernie Monegain, Editor

John Glaser

BOSTON – The government's piece of the stimulus package aimed at boosting the adoption and use of healthcare information technology is expected to create 50,000 new jobs – maybe more.

-----

http://www.itweb.co.za/index.php?option=com_content&view=article&id=27486:end-of-health-smart-card&catid=69:business&Itemid=58

End of health smart card?

The R609 million smart card project will remain on hold indefinitely, pending a review of all department projects and major contracts.

By Audra Mahlong, Journalist
Johannesburg, 27 Oct 2009

Major IT projects may take a back seat as the Department of Health reprioritises its spending, following a damning report by the auditor-general.

-----

E-Health Records Option Extended To Families

Dossia, whose consortium members include Wal-Mart and Intel, is making it easier for employees' dependents to sign up for electronic health records.

By Marianne Kolbasuk McGee, InformationWeek

Oct. 27, 2009

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=220900733

During open-enrollment season for employee health insurance plans, employer consortium Dossia has added new functionality to the electronic personal health record that's offered to millions of workers.

-----

http://www.ihealthbeat.org/features/2009/health-care-might-be-ripe-for-cloud-computing.aspx

Tuesday, October 27, 2009

Health Care Might Be Ripe for Cloud Computing

by George Lauer, iHealthBeat Features Editor

Widely acknowledged as a laggard in adopting IT, the health care industry seems an unlikely breeding ground for one of the hottest trends in IT -- cloud computing.

But some cloud proponents contend health care's relatively late embrace of the benefits of IT might in fact produce excellent conditions for cloud formations.

-----

http://www.healthdatamanagement.com/news/H1N1-39248-1.html

State Uses Script Data to Track Flu

HDM Breaking News, October 26, 2009

The State of Rhode Island is receiving weekly, de-identified prescribing data from pharmacies across the state enabling epidemiologists to track cases of HINI influenza.

-----

http://www.ehiprimarycare.com/news/5326/cqc_criticises_discharge_summaries

CQC criticises discharge summaries

27 Oct 2009

The Care Quality Commission has warned that the NHS may be failing to prevent harm to patients by failing to share information when they move between services.

The findings come in a report by the watchdog called ‘Managing patients’ medicines after discharge from hospital’, based on a national study that visited 12 primary care trusts and surveyed 280 of their GP practices.

Eight out of ten (81%) of the practices surveyed said that when hospitals sent them discharge summaries details of medicines were incomplete or inaccurate “all of the time” or “most of the time.”

-----

http://www.isria.com/pages/28_October_2009_153.php

Jordan - King launches e-health plan

His Majesty King Abdullah on Tuesday launched the National e-Health Programme, Hakeem, which will create a database of medical histories of patients across the Kingdom over the long-term.

-----

http://govhealthit.com/newsitem.aspx?nid=72259

ONC panel wrestles with meaningful use by specialists

By Mary Mosquera
Tuesday, October 27, 2009

The Health IT Policy Committee today confronted the problem of how to craft a manageable set of requirements for the “meaningful use” of health IT across an industry where specialties and new practice variations are common – and where one policy may not fit all.

-----

http://www.healthcareitnews.com/news/diabetic-patients-report-better-care-use-web-based-phrs

Diabetic patients report better care with use of Web-based PHRs

October 27, 2009 | Bernie Monegain, Editor

WASHINGTON – Hundreds of diabetic patients in the Washington, D.C. area have adopted an online personal health record to communicate with their doctors and manage their disease, according to Howard University Hospital.

-----

http://www.sbsun.com/news/ci_13656809

Kaiser Permanente has a long history in computerized patient records

Jim Steinberg, Staff Writer

Posted: 10/27/2009 09:23:24 PM PDT

Dr. S. James Ku writes a prescription for a patient on a computer.

When he hits "enter," red letters at the top of the screen note the patient has an allergy to that medicine.

Quick, accurate, thorough are hallmarks of the HealthConnect electronic record system, said Ku, a family medical practice doctor who also teaches other Kaiser Permanente doctors from Chino to Redlands and Victorville the finer points of the world's largest civilian electronic health record system.

-----

http://www.modernhealthcare.com/article/20091028/REG/310289940

NHIN, privacy front and center at HIT policy meeting

By Joseph Conn

Posted: October 28, 2009 - 11:00 am EDT

The head of federal efforts to boost the use of health information technology told members of an IT advisory panel Tuesday that they need to step back and take a second look at the proposed national health information network, and also come up with some advice on a national policy framework for IT privacy and security that makes sense.

-----

http://www.ehealtheurope.net/news/5316/europe_launch_for_cisco_data_exchange

Europe launch for Cisco data exchange

23 Oct 2009

Cisco and Austrian software company Tiani Spirit have announced the availability of their new Medical Data Exchange Solution (MDES) in Europe.

The MDES enables healthcare providers to securely access patient information regardless of the provider’s location or IT system.

-----

http://www.modernhealthcare.com/article/20091029/REG/310299985

Cost containment not achieved with EHRs: survey

By Joseph Conn / HITS staff writer

Posted: October 29, 2009 - 11:00 am EDT

If anyone in Congress, the Obama administration or the public thinks that adoption of health information technology will quickly yield improved care or reduce costs, they'd be wrong, according to the results of a recent survey of medical group practices, including many with considerable experience using electronic health-record systems.

-----

http://www.healthdatamanagement.com/news/standards-39285-1.html

Doc to Feds: Tighten Standards

HDM Breaking News, October 29, 2009

National standards for health data exchange permit too much variability and must be tightened, a family practitioner told a federal advisory board on Oct. 29. The implementation workgroup of the HIT Standards Committee is taking testimony from providers, vendors, quality measures experts and others on the challenges of implementing health information systems and exchanging data.

-----

http://www.e-health-insider.com/news/5335/toolkit_to_nail_interoperability_-_jones

Toolkit to nail interoperability - Jones

29 Oct 2009

The new NHS interoperability toolkit has the potential to drive down the cost of interoperability and innovation, according to the Department of Health’s chief technology officer.

-----

http://www.rwjf.org/newsroom/product.jsp?id=50308

Health Information Technology in the United States, 2009

On the Cusp of Change

October 26, 2009

Health information technology (HIT) has the potential to revolutionize the delivery of health care. In our two previous reports about HIT in the United States we detailed the challenges faced by policy-makers working toward the goal of increased adoption of electronic health records. Since that time the role of health information technology in promoting higher quality, more efficient health care has taken a central position in the current health care reform debate. There is broad bipartisan support to speed health information technology adoption, and the American Recovery and Reinvestment Act of 2009 (ARRA) has made promoting a national interoperable health information system a priority, authorizing significant resources to achieve this goal.

-----

http://bits.blogs.nytimes.com/2009/10/29/ges-bid-to-connect-computerized-health-records/?partner=rss&emc=rss

October 29, 2009, 9:57 am

G.E.’s Bid to Connect Computerized Health Records

By Steve Lohr

There are all sorts of obstacles to moving the nation’s health care system, choking on paper records, into the computer age. The cost and complexity of making the transition are daunting, though the government’s $19 billion in incentives for doctors and hospitals to adopt electronic health records should help.

----

http://www.zdnetasia.com/news/business/0,39044229,62058989,00.htm

S'pore e-health records roadmap 'pragmatic'

By Vivian Yeo, ZDNet Asia

Friday, October 30, 2009 05:14 PM

Singapore and some of its Asian peers stand in good stead for the successful implementation of e-healthcare initiatives such as electronic health records (EHR), according to executives from GE Healthcare.

-----

http://www.healthdatamanagement.com/news/vendor_news-39242-1.html

EHR Vendor: Don't Pay Until Happy

HDM Breaking News, October 23, 2009

When it introduces the next generation of its software next year, AXEO Systems LLC will offer physician group practices an unusual pricing policy tied to reaping value from an EHR and practice management system.

-----

http://www.who.int/goe/ehir/2009/27_october_2009/en/index.html

eHealth Worldwide

27 October 2009

:: Australia: Following the Aussie lead on telemedicine (2 October 2009 - Tandberg)

Australia and the United States are similar in many ways when it comes to expanding broadband and improving the delivery of healthcare. The population is ageing, the countries are large with geographically dispersed populations, and there are particular challenges getting the best care to rural areas. TANDBERG is a major sponsor of the National Rural Healthcare Association (NRHA) and has supported the improved delivery of rural healthcare for many years

-----

http://www.computerweekly.com/blogs/tony_collins/2009/10/npfit-lorenzo-trusts-have-174.html

NPfIT Lorenzo - £57,500 per user so far

The NPfIT minister Mike O'Brien revealed in a Parliamentary reply yesterday that there are 174 regular users of the Lorenzo 1 system at five NHS trusts.

-----

Enjoy!

David.