Weekly Overseas Health IT Links 08-12-2009

Here are a few I have come across this week.

http://www.govhealthit.com/GuestColumnist.aspx?id=72673

Leverage today’s standards for meaningful use

· By Dr. Charles Jaffe

· Friday, December 04, 2009

By Dr. Charles Jaffe and John Quinn

Dr. David Blumenthal, director of the Office of the National Coordinator (ONC) for Health Information Technology, recently urged the healthcare industry to break down barriers to electronic exchange of healthcare information in order to improve the quality of care and better serve patients.

To reach that goal, we must develop a greater degree of interoperability among healthcare IT applications than we have today. To discard the existing data interchange standards and to replace them with something new and “simpler,” as some are proposing, would be counterproductive.

http://online.wsj.com/article/SB125944755514168145.html

Patient ID Theft Rises

By JILIAN MINCER

Medical identity theft is on the rise and expected to worsen.

The problem has grown during the recession as more uninsured people use the coverage of a friend, relative or even a stranger to get care. Of particular concern is the fact that most of the fraud is committed by people who pay medical workers for patients' information.

In one case, a front-desk clerk at a medical clinic in Weston, Fla., downloaded the personal information of more than 1,100 Medicare patients and gave it to a cousin, who made $2.8 million in false Medicare claims.

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http://www.forbes.com/2009/11/24/security-hackers-data-technology-cio-network-breaches.html

The Year Of The Mega Data Breach

Andy Greenberg, 11.24.09, 7:00 PM ET

Glance at 2009's data breach statistics, and you might think the IT world had scored a rare win in the endless struggle against cybercrime.

According to the Identity Theft Resource Center, government agencies and businesses reported 435 breaches as of Nov. 17, on track to show a 50% drop from the number of breaches reported in 2008. That would make 2009 the first year that the number of reported data breaches has dropped since 2005, when the ITRC started counting.

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http://www.modernhealthcare.com/article/20091204/REG/312049984

Ore. launches statewide emergency-care registry

By Associated Press

Posted: December 4, 2009 - 11:00 am EDT

Oregon has launched a computerized statewide registry to help make sure people's end-of-life medical wishes are easily available to doctors and paramedics.

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http://www.healthdatamanagement.com/news/CIOs_stimulus_meaningful_use-39462-1.html?ET=healthdatamanagement:e1103:100325a:&st=email

CIOs Worry About Stimulus Deadlines

HDM Breaking News, December 3, 2009

A survey of CIOs and other top information technology leaders at provider organizations finds most respondents worry to some degree about being able to implement standards recommended by the HIT Standards Committee to meet current deadlines for the meaningful use of electronic health records.

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http://govhealthit.com/newsitem.aspx?nid=72527

Blumenthal: Diverse HIE methods will emerge

By Mary Mosquera

Thursday, December 03, 2009

Health information exchange will spring from a variety of sources and methods beyond the federal government’s work to set-up a nationwide health information network (NHIN), Dr. David Blumenthal, national coordinator for health IT, said yesterday.

“We want to continue to make [NHIN] an option for the exchange of information and for aggregating enhanced uses of data, but we expect others to evolve,” he said at a panel discussion Dec. 2 sponsored by the Brookings Institution.

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http://blogs.wsj.com/health/2009/12/01/safety-guru-health-it-is-harder-than-it-looks/

December 1, 2009, 1:46 PM ET

Safety Guru: ‘Health IT Is Harder Than It Looks’

Yes, health IT systems done right can help improve patient safety. But health IT systems done wrong can actually create new safety risks, a doctor and patient-safety expert says in a new article published by the journal Health Affairs.

We heard something similar a few weeks back, when we chatted with a senior Kaiser doc who warned of “magical thinking” on health IT. Today’s commentary comes from Bob Wachter, a UC San Francisco hospitalist, who writes:

“recent experience has confirmed that health IT is harder than it looks … Several major installations of vendor-produced systems have failed, and many safety hazards caused by faulty health IT systems have been reported.”

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http://www.fiercehealthcare.com/press-releases/leapfrog-group-announces-its-2009-top-hospitals?utm_medium=nl&utm_source=internal

Leapfrog Goup announces its 2009 top hospitals

December 4, 2009

WASHINGTON, December 3, 2009 - While Congress debates whether health care reform would control health care costs, today employer purchasers point to 45 hospitals that lead through example-delivering the best quality care in the nation while attaining the highest levels of efficiency. Thirty-four urban, eight children's and three rural hospitals have been named 2009 Leapfrog Top Hospitals, based on results from The Leapfrog Hospital Survey. The survey (found at www.leapfroggroup.org) is the only national, public comparison of hospitals on key issues including mortality rates for certain common procedures, infection rates, safety practices, and measures of efficiency.

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http://www.e-health-insider.com/news/5442/one_in_10_prescriptions_have_errors

One in 10 prescriptions have errors

03 Dec 2009

One in 10 written hospital prescriptions contain mistakes, most are minor and spotted but some are potentially lethal.

In many cases the errors result from poor or illegible handwriting, transcribing errors, ambiguous prescriptions or other communication breakdowns.

This is the finding of major new research commissioned by the General Medical Council, which says despite the prevalence of errors most are spotted and few lead to serious harm to patients. Unlike some previous studies the focuses just on prescribing rather than covering prescribing through to medicines administration.

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http://www.e-health-insider.com/news/5430/dr_foster_names_safety_underperformers

Dr Foster names safety underperformers

30 Nov 2009

The Dr Foster Hospital Guide 2009 names 12 NHS trusts which it says significantly underperformed on its new measure of patient safety.

The guide, published over the weekend, identifies patient safety as the single most important element of hospital care. For the first time the guide has introduced a Patient Safety Score which bands trusts with similar scores awarding scores of one to the poorest performers and five to the best.

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http://www.modernhealthcare.com/article/20091203/REG/312039985

Patient Privacy Rights unveils PHR report card

By Joseph Conn / HITS staff writer

Posted: December 3, 2009 - 11:00 am EDT

Are personal health records privacy risks? Most people are at a loss trying to figure that out, according to the Patient Privacy Rights Foundation, which is the premise behind its new report card on selected PHRs.

“They're pretty much an unregulated new product,” said Ashley Katz, executive director of the Austin, Texas-based not-for-profit.

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http://www.healthdatamanagement.com/news/HIEs_Internet_stimulus_EHRs-39457-1.html?ET=healthdatamanagement:e1102:100325a:&st=email

What's the Future of HIEs?

HDM Breaking News, December 3, 2009

The numbers are daunting. Nearly two decades after the advent of community health information networks and more than five years after the Bush Administration starting pushing for electronic health records and health information exchanges, only 28 states have one or more operational HIEs. And operational doesn't mean everyone in a region, much less a state, is active in the HIE.

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http://www.fierceemr.com/story/hit-progress-stunningly-slow-10-years-iom-report/2009-12-03?utm_medium=nl&utm_source=internal

HIT progress 'stunningly slow' in 10 years since IOM report

December 3, 2009 — 1:54pm ET | By Neil Versel

Tuesday marked the 10th anniversary of the publication of To Err Is Human, the eye-opening Institute of Medicine report with the now-familiar assertion that preventable medical errors in U.S. hospitals kill 44,000 to 98,000 people every year. The landmark tome, plus a follow-up report, Crossing the Quality Chasm (2001), and other subsequent IOM publications called for greater use of health information technology to help reduce the number of mistakes and assure greater care coordination.

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http://www.itworldcanada.com/news/canada-faces-widespread-e-health-skills-shortage/139502

Canada faces widespread e-health skills shortage

By: Shane Schick On: 03 Dec 2009 For: CIO Canada

The Information & Communications Technology Council releases a report that indicates the country could require thousands of IT professionals with health-specific skill sets. What we need to do to prepare

While the Ontario government is dealing with the political fallout of the eHealth Ontario scandal and Ottawa reviews its funding commitments to Canada Health Infoway, a new research report suggests Canada may need to fill approximately 12,000 IT-related health-care jobs within the next five years.

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http://www.ehealtheurope.net/news/5428/moray_helps_public_get_health-e

Moray helps public get Health-e

01 Dec 2009

A new website that provides a platform to enable people to take more responsibility for their health has been launched in Moray, Scotland.

The new Health-e-Space website, which went live earlier this month, provides local health information, links to recommended websites and suggestions on how to live with health conditions.

Community Health-e-Space, the websites sister site supplies a social networking platform for people to share their health concerns and experiences with others in the Moray area.

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http://www.modernhealthcare.com/article/20091202/REG/312029987

Blumenthal to review NCVHS' past recommendations

By Joseph Conn / HITS staff writer

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

Part two of a two-part series (Access part one):

If the nation's top health information technology official makes good on a pledge he made recently to resurrect two key privacy policy papers, he will find that their recommendations are still relevant, according to a Kentucky lawyer who helped produce both documents.

David Blumenthal, head of HHS' Office of the National Coordinator for Health Information Technology, said last month he would be looking into the papers produced by the National Committee on Vital and Health Statistics.

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http://www.modernhealthcare.com/article/20091202/FREE/312029948

Sebelius announces $235 million for HIT advancement

By Joseph Conn / HITS staff writer

Posted: December 2, 2009 - 11:30 am EDT

HHS Secretary Kathleen Sebelius announced a three-year, $235 million Beacon Community Cooperative Agreement Program, including $220 million to contract with up to 15 not-for-profit and government organizations that are leaders in health information technology to "generate and disseminate valuable lessons learned that will be applicable to the rest of the nation's communities."

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http://www.healthdatamanagement.com/news/stimulus_ARRA_EHR-39454-1.html?ET=healthdatamanagement:e1101:100325a:&st=email

Vendor Exec to Feds: Change Course

HDM Breaking News, December 2, 2009

Convinced the government is moving in the wrong direction to encourage adoption of electronic health records, Evan Steele, CEO of software vendor SRSsoft in Montvale, N.J., recently cautioned Aneesh Chopra, chief technology officer in the Obama Administration, that the federal approach won't work.

SRSsoft sells what it calls a "hybrid EMR" that includes extensive use of document imaging and management software. In a letter to Chopra, Steele speaks of the volume of skeptical physicians posting to the "FACA blog," which is the blog for the HIT Policy and HIT Standards federal advisory committees.

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http://govhealthit.com/newsitem.aspx?nid=72522

ONC reorganizes for push on EHR, HITECH goals

By Mary Mosquera
Tuesday, December 01, 2009

The Office of the National Coordinator for Health IT (ONC) announced it would reorganize the office to better reflect its role as a leading force in the adoption of electronic health records and other health IT, including closer oversight of privacy issues.

Appointing a chief privacy officer is one of the main moves detailed in a notice published in the Federal Register. The notice is dated Nov. 20, but the changes are effective as of Dec. 1.

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http://motorcycleguy.blogspot.com/2009/12/canadian-perspective-on-standards.html

Wednesday, December 2, 2009

A Canadian Perspective on Standards Harmonization

Today I have a special guest post from Mike Nusbaum. Mike's a great guy and knows quite a bit about participating in multiple standards organizations. He has been in leadership positions to my knowledge in ISO TC-215, HL7 and IHE, and also facilitates and writes for ANSI/HITSP here in the US. Mike helped establish the Canadian framework for standards harmonization, and I asked him to write a guest post on the topic. Here's Mike:

Guest contribution by: Michael Nusbaum, BASc, MHSA, FHIMSS

(a Canadian healthcare IT consultant who also works with HITSP in the US)

A Canadian Perspective on Standards Harmonization

As the US health reform freight train continues to roar down the tracks, the IT standards imperative becomes increasingly critical. The government's well-funded priority to stimulate reform through the establishment of an interoperable nationwide health information network (NHIN) has put incredible pressure on standards harmonization activities over the past 6 months. Clearly, interoperability is achieved through the implementation and use of standards, and funding directed towards state and regional health information exchange (HIE) initiatives is contingent upon the adoption of those standards within all stakeholder communities.

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http://www.ehiprimarycare.com/news/5426/fracture_risk_tool_built_using_qresearch

Fracture risk tool built using QResearch

30 Nov 2009

A score to predict the risk of patients suffering fractures due to osteoporosis has been developed using the QResearch database.

The fracture risk algorithm, QFractureScores, can be used by clinicians and patients to calculate an individual’s percentage risk of an osteoporotic fracture over the next ten years, allowing early interventions to take place according to researchers.

The tool is available as open source software www.qfracture.org and users are asked to enter details including age, sex, weight, height and illnesses to determine the risk of a fracture.

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http://www.ehiprimarycare.com/news/5431/time_savings_reported_on_gp2gp

Time savings reported on GP2GP

01 Dec 2009

GP practices report that receiving records via GP2GP saves time on the first consultation and time spent summarising records, according to GP2GP benefits survey developed as part of the national SHA benefits return.

CfH conducted two surveys earlier this year covering the clinical and administrative benefits of the GP2GP project which enables the almost instant transfer of patients’ electronic record between practices.

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http://www.govhealthit.com/Article.aspx?id=72297

Healthcare needs a security framework

By Lisa Gallagher

Today’s healthcare organizations are being urged to adopt electronic health records in the midst of complex legal and regulatory changes, especially in the areas of privacy and security. In this environment there is a clear need for a security framework specifically designed to help healthcare organizations build a security program that addresses all current data protection requirements.

For years, there has been considerable opinion in the healthcare industry that HIPAA does not adequately protect health data in today’s rapidly changing IT environment.

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http://www.healthdatamanagement.com/news/HIPAA_privacy_breach_hospital-39428-1.html?ET=healthdatamanagement:e1098:100325a:&st=email

Sixteen Fired for Records Snooping

HDM Breaking News, November 30, 2009

The Harris County Hospital District in Houston recently terminated 16 employees for violating the HIPAA privacy rule after improperly accessing patient information on a colleague who was shot during a robbery attempt, the Houston Chronicle reports.

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http://www.healthdatamanagement.com/news/home_health_acquisition_vendor_consumer-39448-1.html

GE Buy Expands Home Health Line

HDM Breaking News, December 1, 2009

GE Healthcare has acquired Living Independently Group Inc., which sells the QuietCare wireless, sensor-based passive patient monitoring system for use in assisted living facilities, senior communities and private homes. Terms of the acquisition were not disclosed.

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http://www.healthleadersmedia.com/content/242616/topic/WS_HLM2_TEC/HHS-Will-Spend-80M-to-Train-HIT-Support.html

HHS Will Spend $80M to Train HIT Support

John Commins, for HealthLeaders Media, November 24, 2009

Understanding that there is a lack of qualified technical workers, Health and Human Services said today it will make $80 million in grants available to develop the nation's healthcare information technology workforce. Community colleges will get $70 million of the grant money to develop training programs, and the remaining $10 million will be used to develop educational materials to support those programs, HHS said.

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Microsoft, Google Face Off On Healthcare

Microsoft HealthVault and Google Health want to be the repository of choice for millions of personal health records. Are they up to the task?

By Mitch Wagner, InformationWeek

Dec. 1, 2009

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=221901566

Microsoft and Google are taking their rivalry to the doctor's office, running competing services that allow people to store their medical records online for access by family members and healthcare providers.

Google Health and Microsoft HealthVault are similar approaches: They let patients input their own medical data either by typing it in or by giving permission for the vendor to get the information from a healthcare provider or insurer with which it's partnering. Google Health and Microsoft HealthVault then provide tools for those partners to give the patient personalized health advice and other services built around the person's records.

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Colorado Healthcare Providers Launch Information Exchange

"They've standardized the content so we can exchange and have interoperability with health records," explains the CIO of Children's Hospital.

By Mitch Wagner, InformationWeek

Dec. 1, 2009

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=221901513

Three Colorado hospitals have tied themselves in an information exchange, sharing medical records to improve patient care and reduce unnecessary redundant tests.

The program unites the Children's Hospital, Exempla Healthcare, and Kaiser Permanente Colorado, to share complete medical records, including medications, discharge results, lab results, radiology reports, and more. All three hospitals use EMR software from Epic Systems, which simplifies the process.

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http://www.ottawacitizen.com/health/Modern+medicine/2284323/story.html

Modern medicine

The Ottawa Citizen

November 30, 2009

It is good to see that the spending scandal at eHealth Ontario has not sabotaged plans to bring health records online in Eastern Ontario.

The eHealth scandal was about spending abuses and lack of oversight. Provincial auditor Jim McCarter concluded that Ontario taxpayers did not receive value for the $1 billion that had been invested in the project. The agency's mismanagement put Ontario behind most jurisdictions in the effort to set up a province-wide network of electronic health records.

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http://www.floridatoday.com/article/20091129/NEWS01/911290319/1006/news01/Hospitals+will+get+heart+data+via+Bluetooth

Hospitals will get heart data via Bluetooth

BY KAUSTUV BASU

FLORIDA TODAY

Trauma doctors in Brevard County will soon be armed with technology that makes life-saving care available to patients before they roll up to the emergency room door.

Brevard County Fire-Rescue is implementing Bluetooth technology to transmit electrocardiogram readings from cardiac patients in the field to hospitals so doctors are better prepared to treat them.

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http://www.modernhealthcare.com/article/20091130/REG/311309932

3-D diagnostic imaging cost issues hinder adoption

By Shawn Rhea / HITS staff writer

Posted: November 30, 2009 - 11:00 am EDT

In radiology, the availability of virtual technology has long been a reality. But questions over effectiveness and reimbursement have hindered widespread adoption of the cutting-edge technology.

It has been roughly three decades since doctors began using virtual imaging—CT, MRI or ultrasound scans converted into three-dimensional images—as a screening, diagnostic and surgical-assist tool, and a growing number of studies are finding the technology to be nearly as effective as more invasive surgical alternatives when it comes to detecting diseases and conditions.

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http://www.healthleadersmedia.com/content/242663/topic/WS_HLM2_TEC/BCBS-of-Tennessee-Notifying-Members-After-Patient-Information-Stolen.html

BCBS of Tennessee Notifying Members After Patient Information Stolen

John Commins, for HealthLeaders Media, November 25, 2009

BlueCross BlueShield of Tennessee is readying a Nov. 30 mass mailing to some of its 3.1 million customers in the Volunteer State who may have had their Social Security numbers and other private data compromised after an Oct. 2 hard drive theft at a remote training facility in Chattanooga.

"It's going to be a progression of mailings, with those who would be most at risk receiving the first mailings, depending upon how many people had a Social Security number compromised," says BCBST spokeswoman Mary Thompson.

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http://www.healthcareitnews.com/news/anesthesia-it-users-see-benefits-complain-about-functionality

Anesthesia IT users see benefits, complain about functionality

November 25, 2009 | Bernie Monegain, Editor

OREM, UT – The anesthesia information system (AIS) market is small and immature, but early adopters are seeing benefits, including better patient care, a reasonable return on investment and even decreased liability, according to KLAS.

In "The Growing Market for Anesthesia Software: Liability, Integration and the Benefits of Adoption," KLAS interviewed 100 organizations that use AIS, representing an estimated 75 percent of those doing anesthesia documentation in the United States.

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http://www.computerweekly.com/blogs/tony_collins/2009/11/claim-of-censorship-over-cerne.html

Claim of censorship over Cerner system

The Sydney Morning Herald and ZDNet in Australia report that the University of Sydney removed from its website - temporarily - a negative essay about a Cerner system which had been installed at hospitals in New South Wales.

The author of the essay is a medical IT professor, Jon Patrick, who is reported to have claimed that NSW Health, which is part of the government of New South Wales, put pressure on the university to take down the paper.

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http://www.ehiprimarycare.com/news/5433/kingston_hits_go-live_date_with_cerner

Kingston hits go-live date with Cerner

01 Dec 2009

Kingston Hospital NHS Trust has confirmed that it has gone live with its Cerner Millennium Care Records Service (CRS) programme.

E-Health Insider can exclusively reveal that the trust switched from its iSoft CliniCom Patient Administration System (PAS) to the new Cerner system at the weekend with “different areas coming up on stream” over Friday, Saturday and Sunday. The final functionality went live yesterday morning in the outpatients department.

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http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/11NOV2009/091123HHN_Online_Pelletier&domain=HHNMAG

What the Health Care Industry Really Needs

By Jeff Pelletier

The most crucial component of going digital is connectivity.

The economic stimulus package signed earlier this year earmarks $19 billion for health information technology (HIT) improvements that demonstrate "meaningful use" to improve patient safety and outcomes. While HIT covers a range of technological tools and advancements, much of the discussion has focused on electronic health records (EHRs) and computerized provider order entry.

Investment in these key systems will bode well for patient care, but it is only scratching the surface of the technological advances needed to make the U.S. health care system a seamless, error-free entity. Connecting EHRs to other medical technologies used in patient care and ensuring those technologies work together—for example, to automatically document medical procedures in patient records—is where health care systems will see the biggest return. It is also where the stimulus package goals (improvements in quality of care, care coordination, and reductions in medical errors and duplicative care) will be fully realized.

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http://www.businessweek.com/technology/content/apr2009/tc2009047_562738.htm?chan=top+news_top+news+index+-+temp_top+story

How Kaiser Permanente Went Paperless

Electronic medical recordkeeping may not cut the overall cost of care, but by eliminating redundant procedures and reducing errors, quality may be improved

By Rachael King

When physician Andrew Wiesenthal needs to work out a problem, he runs around Lake Merritt, across the street from his Oakland (Calif.) office at Kaiser Permanente. As one of the main drivers behind Kaiser's decades-long, multibillion-dollar effort to overhaul the way patient health records are kept, Wiesenthal has had a lot of laps to run.

Doctors and other medical professionals across the country will be working through similar challenges in the coming years. President Barack Obama plans to spend $17.2 billion to induce care providers to maintain patient records electronically, scrapping the current paper-based system. The Obama Administration wants electronic health records for every American by 2014.

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Enjoy!

David.

AusHealthIT Man Poll Number 2 - Results

The question was:

Have NEHTA and DoHA Lost Control of the Electronic Prescribing Agenda in OZ?

Results:

They Have It Totally In Hand

- 5 votes (10%)

They Seem to be Struggling

- 9 votes (19%)

It Looks to be Out of Control

- 8 votes (17%)

NEHTA and DoHA have been Bypassed Totally

- 24 votes (52%)

Total Votes: 46

Comment:

Obviously blog readers are trying to tell NEHTA something here! I think NEHTA needs to do a little more work in this area to regain any form of informatics community trust and support

We will see if anyone is listening.

Thanks to all who voted.

David.

e-Health News From DoHA - New Draft Health Identifiers (HI) Legislation Released.

The following has just appeared here:

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

Healthcare Identifiers Service

The Healthcare Identifiers Service (HI Service) is being developed as a foundation service for e-health initiatives in Australia.

What’s new

10/12/2009 – As part of further consultation on the legislative proposals for healthcare identifiers, the Minister for Health and Ageing, the Hon. Nicola Roxon MP has released an exposure draft of the Healthcare Identifiers Bill 2010 for comment.

A copy of the exposure draft bill and other supporting material is now available. Consultation will conclude on 7 January 2010.

20/11/2009 - On the 20 November 2009 the National E-Health Transition Authority (NEHTA) released the Health Identifier (HI) Service Concept of Operations and supporting documentation, which can be downloaded from the NEHTA website

19/11/2009 - Following the recent announcement by the Australian Health Ministers Conference, a publication Building the foundation for an e-health future: Update on legislative proposals for the Healthcare Identifiers Service (PDF 966 KB), is now available.

A html version of this document is being prepared. If you are having difficulty downloading the PDF document, please email EHInputs@health.gov.au and we will arrange for a copy to be sent to you.

16/11/2009 - The Australian Health Ministers Conference have announced further consultation on Legislative proposals for Healthcare Identifiers. A copy of the communique is available for download (PDF 140 KB)

A html version of this document is being prepared. If you are having difficulty downloading the PDF document, please email EHInputs@health.gov.au and we will arrange for a copy to be sent to you.

16/11/2009 - NEHTA has released three Privacy Impact Assessments on the Healthcare Identifiers Service. A copy of the Privacy Impact Assessments and NEHTA's response can be found on NEHTA's website.

7/10/2009 - Updated Frequently Asked Questions for consumers and providers.

7/10/2009 - Submissions to public consultation on healthcare identifiers and privacy now available.

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Get downloading, reading and commenting.

Just typical we have important stuff like this released just before Christmas and to be responded to very early in January. Reckon they are seriously wanting comments. I don’t.

David.

Give Me One Legitimate Reason Why The Commonwealth Government Can’t Follow For Australia?

A key recommendation of the Deloittes National E-Health Strategy was the establishment of a professional Health Information Portal for Clinicians and an expanded and improved consumer health information portal.

Here we have the AMA in the US (The American Medical Association) going ahead with such a portal (or similar)

The press release reads as follows.

New AMA Platform To Offer Isabel Healthcare’s Pro Clinical Decision Support System

Diagnosis Decision Support Checklist System to be Available to Physicians Nationwide

http://www.isabelhealthcare.com/pdf/AMAPressRelease.pdf

CHICAGO, December 7, 2009 - Isabel Healthcare, the leading provider of diagnosis decision support announced today it is working with the American Medical Association (AMA) to offer physicians nationwide the Isabel PRO diagnosis decision support system through the AMA's new online health information solutions platform. The platform is aimed at helping practicing physicians meet their clinical and practice-related needs. It will provide physicians access to information, products, services, and resources to help facilitate medical practice and ease adoption of health information technology. The platform is currently being beta tested in Michigan in collaboration with the Michigan State Medical Society.

"Being part of this new, innovative platform validates our mission and goals," said Isabel Healthcare CEO Joseph Britto M.D. "There has been a great deal of focus nationally on Electronic Medical Records and they are a necessary first step, but a diagnosis decision support system can enhance patient care and help improve outcomes. As knowledge workers we can improve the quality of the most fundamental upstream clinical event - the diagnosis decision with diagnosis decision support. Isabel PRO has been shown to leverage the exponential increase in knowledge and data to mitigate incorrect or delayed diagnosis and thereby improve patient safety and quality of care."

The Isabel system was conceived 10 years ago as a direct response to the near-fatal misdiagnosis of a patient named Isabel Maude who developed necrotizing fasciitis, a well-described complication of chicken pox. Isabel was seen by both the primary care physician and the local hospital's ED, and both failed to recognize the typical clinical features of necrotizing fasciitis and sent her home. Isabel not only assists in making the right diagnosis but also helps answer clinical questions with up-to-date knowledge. Isabel uses natural language processing software as opposed to standard key word searches. In more than 23 published studies and clinical trials, Isabel has proven that it is fast, easy to use, and improves patient safety and quality of care by augmenting providers' knowledge and cognitive skills in hospital and primary care settings.

"Isabel PRO is an award-winning diagnosis decision support system that can help physicians make faster, data-driven decisions at the point of care," said AMA Immediate-past Board Chair Joseph M. Heyman, M.D. "Adopting new health information technologies like Isabel PRO can help physicians enhance care quality and improve patient safety."

Isabel is an extensively tested and validated point-of-care diagnosis decision support system designed to enhance the quality of diagnosis decision making. Isabel PRO's unique feature is a diagnosis reminder checklist system. It can be used as a stand-alone system or connected to an electronic medical record and instantly provides a checklist of likely diagnoses, including bio-terrorism conditions and causative drugs for a given set of clinical conditions. Isabel PRO has been shown to help improve the quality of diagnosis decision making at the point-of-care resulting in improved patient safety and enhanced practice efficiency.

The new AMA Web-based platform will provide tools and resources to improve patient care and reduce administrative burdens. AMA will partner with physicians and their practice staff from the initial selection of products and services through implementation to ensure meaningful results.

The AMA aims to launch its new platform in early 2010.

About Isabel Healthcare, Inc.

Reston, Virginia based Isabel Healthcare Inc, was founded in 2000 by Jason Maude and Dr. Joseph Britto, and is named after Maude's daughter who almost died after a potentially fatal illness was not recognized by family and emergency room physicians. The Isabel system, validated in clinical trials, is designed to improve patient safety and quality of care by minimizing diagnosis error. For more information, please visit http://www.isabelhealthcare.com

About the American Medical Association

The American Medical Association helps doctors help patients by uniting physicians nationwide to work on the most important professional and public health issues. Working together, the AMA's quarter of a million physician and medical student members are playing an active role in shaping the future of medicine. For more information on the AMA, please visit www.ama-assn.org

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So maybe we can’t find the billion or so for some of the other stuff just now – GFC and all – but this would be cheap and is proven to work to improve patient safety and save lives

I really wonder why it is so hard to seemingly get such simple stuff in place.

David.

Weekly Australian Health IT Links - 07-12-2009

Here are a few I have come across this week.

http://www.medicalobserver.com.au/News/0,1734,5714,04200912.aspx

GPs forced to provide Easyclaim the hard way as incentives end

Elizabeth McIntosh - Friday, 4 December 2009

PRACTICES will soon be stripped of thousands of dollars worth of incentives to provide the Medicare Easyclaim system and forced to bear the costs, prompting calls for an extension to the scheme.

The incentive scheme, due to end on 31 December, provided practices with a one-off payment of up to $1000 for installation of EFTPOS equipment plus an ongoing payment of 18 cents for every Easyclaim transaction made.

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http://www.coffscoastadvocate.com.au/story/2009/12/05/software-leads-to-hard-work-for-our-doctors/

Software hard work for doctors

Ute Schulenberg | 5th December 2009

• 

SOFTWARE being introduced to hospital emergency departments by NSW Health is being described by local doctors as ‘appalling’ and the consultation process with NSW Health IT staff as ‘insulting and dysfunctional’.

One clear voice on the issue is Dorrigo doctor Horst Herb, who worked with Electronic Medical Records in both Germany and Norway and was previously a professional software developer.

“I was keen to see eMR implemented in NSW...but after two weeks of conscious effort using Cerner FirstNet to record my patients’ information I came to the conclusion the system was not only unusable but outright dangerous.

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http://www.medicalobserver.com.au/News/0,1734,5737,04200912.aspx

It's official: Ads banned in practice software

Elizabeth McIntosh - Friday, 4 December 2009

THE Medicines Australia Code of Conduct was yesterday given the final stamp of approval from the Australian Competition and Consumer Commission (ACCC), spelling the official end of brand-name reminders and product advertisements in practice software.

The green light for the code comes as the Medicines Australia Code of Conduct Committee released its annual report, showing pharmaceutical companies were hit with a total of $1.42 million in fines in 2008-09. This was down from the $1.83 million recorded in 2007-08.

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http://www.smh.com.au/world/science/part-man-part-machine-amputee-gains-robotic-hand-20091203-k8r0.html

Part man, part machine: amputee gains robotic hand

ARIEL DAVID

December 4, 2009

ROME: An Italian man who lost his left forearm in a car crash has been successfully linked to a robotic hand, allowing him to feel sensations in the artificial limb and control it with his thoughts.

During a one-month experiment, 26-year-old Pierpaolo Petruzziello felt like his lost arm had grown back again, although he was only controlling a robotic hand that was not even attached to his body.

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http://www.news.com.au/adelaidenow/story/0,22606,26430850-5003680,00.html

Adelaide health technology firm PSI sold to iSOFT

Article from The Advertiser

VALERINA CHANGARATHIL

December 02, 2009 12:30pm

ADELAIDE-based Patient Safety International says becoming part of global healthcare company iSOFT has given it the "marketing springboard" it needed.

The company was recently acquired by iSOFT in a deal worth $5 million.

The major drawcard for the deal was PSI's renowned AIMS incident management software. The patient safety software enables healthcare organisations to record, monitor and take relevant management action to minimise future adverse medical events.

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http://www.theage.com.au/national/new-guidelines-on-hospital-waiting-times-20091202-k6kw.html

New guidelines on hospital waiting times

JULIA MEDEW

December 3, 2009 - 12:01AM

Victorian hospitals have been inconsistently measuring patient waiting times in emergency departments - a practice that has the potential to falsely enhance their performance data.

Victorian hospitals have been inconsistently measuring patient waiting times in emergency departments — a practice that has the potential to falsely enhance their performance data.

The State Government's director of data integrity, Tim Barta, told a parliamentary inquiry yesterday that new guidelines on how to calculate waiting times had been created for the departments because previous advice had been open to interpretation.

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http://www.anzhealthpolicy.com/content/6/1/24/abstract

Medication safety in acute care in Australia: where are we now? Part 2: a review of strategies and activities for improving medication safety 2002-2008

Susan J Semple and Elizabeth E Roughead

Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, University of South Australia, GPO Box 2471, Adelaide, 5001, Australia

Australia and New Zealand Health Policy 2009, 6:24doi:10.1186/1743-8462-6-24

Published: 22 September 2009

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http://www.theage.com.au/national/biometric-tests-for-asylum-seekers-20091204-kb34.html

Biometric tests for asylum seekers

ARI SHARP, CANBERRA

December 5, 2009

A SCHEME to gather biometric data from asylum seekers is being introduced in an effort to crack down on fraud and help identify those with overseas criminal records.

Starting this week asylum seekers in Melbourne and Sydney are being asked to provide an image of their face and a scan of their fingerprints as part of a six-month voluntary trial. The data will be checked against records in the United States, Britain, Canada and New Zealand in a search for multiple identities and criminal backgrounds.

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http://www.theaustralian.com.au/australian-it/the-hub/google-chrome-os-stakes-all-on-cloud-based-low-power-machines/story-fn4k6e9r-1225805697769

Google Chrome OS stakes all on cloud-based low-power machines

• David Frith
• From: The Australian
• December 01, 2009 12:01PM

TALK about vapourware. Google lifted the lid on its new operating system, Chrome OS, for an all-new range of small computers the other day. But if you want one, you'll have to be patient, as Chrome OS won't be available until the end of next year. Still, most things Google does are innovative, and sometimes controversial: think Google Earth, Google Docs, Google Scholar, Google Maps, Google Books . . .

At its most basic, Chrome OS is based on the Chrome web browser. Initially it will run on netbooks, the low-cost mini-portable PCs that have swept the worldwide computer market in the past year or so.

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http://www.theaustralian.com.au/australian-it/microsoft-unveils-cheaper-windows-7-family-pack/story-e6frgakx-1225805418344

Microsoft unveils 'cheaper' Windows 7

• Andrew Colley
• From: Australian IT
• November 30, 2009 3:27PM

MICROSOFT has bowed to pressure from customers and retailers and introduced a local version of the three licence Family Pack upgrade deal for the new Windows 7.

From December 1 Microsoft's Australian retail partners will sell the software under a Family Pack licensing scheme that had previously only been available to its US customers.

The Windows 7 Family Pack, which includes software licences to upgrade three computers from previous versions of the software, will carry a recommended retail price of $249.

-----

Enjoy!

David.

News Alert: Serious Differences Seem To be Emerging Between NEHTA and Some Clinical Messaging and Software Providers

I am hearing, from multiple sources, there are ructions emerging between those who are meant to be delivering the software for the DoHA Secure Messaging PIP program and NEHTA.

The differences seem to centre around some pretty fundamental technical issues and approaches. Specifically whether one secure messaging environment should be used for all secure messages versus different approaches for different message domains.

FWIW I reckon one should be enough! Feels like another example of NEHTA making things harder than they need to be.

How these differences are resolved will show just how consultative the “new” NEHTA has become!

David.

The Future of the UK National Program for Health IT Seems to Be Under a Cloud.

The following appeared in the Financial Times a day or so ago.

Turmoil over NHS records scheme

By Nicholas Timmins, Public Policy Editor

Published: December 6 2009 20:59 | Last updated: December 6 2009 20:59

The world’s biggest civilian IT project was thrown into turmoil on Sunday after Alistair Darling, the chancellor, implied that it was going to be scrapped.

The chancellor told the BBC’s Andrew Marr Show the £12.7bn NHS IT programme – already running years late – was “something that I think we don’t need to go ahead with just now”.

Treasury officials rushed to explain that the government was looking for “significant savings” of up to perhaps £600m over the medium term by cutting back some features that are less important for patients.

A senior health department official, meanwhile, said bluntly that “the chancellor mis-spoke” in saying the project to create an electronic medical record would be scrapped.

Much more here (subscription required):

http://www.ft.com/cms/s/0/71d29630-e2a5-11de-b028-00144feab49a.html

This has been also covered here:

Troubled £12bn NHS IT system to be scaled back

The government is to scale back its £12bn NHS IT system in what the Tories are calling a "massive U-turn".

Chancellor Alistair Darling said he would be delaying parts of the scheme in Wednesday's pre-Budget Report as it was "not essential to the front line".

The move may save hundreds of millions but Mr Darling admitted it was only a fraction of total spending cuts needed.

The Tories and Lib Dems have been calling for the IT system, which has been hit by costly delays, to be axed.

Mr Darling told BBC One's Andrew Marr show he was determined to halve Britain's budget deficit over the next four years and as a result public spending would be "a lot tighter than it was in the past".

He stressed that the pre-Budget report was not a spending review, but added: "I do think it is necessary for me to indicate areas where we are going to cut spending or where we're not going to spend as much as we were.

"For example, the NHS had a quite expensive IT system that, frankly, isn't essential to the front line.

Lots more from the BBC here:

http://news.bbc.co.uk/2/hi/uk_news/politics/8397854.stm

And some detailed commentary here:

NHS IT scheme to be scaled back

Tony Collins

Monday 07 December 2009 08:42

The chancellor Alistair Darling and the Treasury are to scale back spending on the NHS's National Programme for IT.

Although the BBC reports that the NPfIT "may be cancelled in Wednesday's pre-Budget report", the Treasury has said that only parts of the programme will be scaled back.

Alistair Darling told the BBC yesterday that the NPfIT "isn't essential to the frontline" . This contradicts the previous position of health ministers and officials: that the national programme will help avoid unnecessary deaths by giving doctors information on allergies, drugs that can cause adverse reactions, and other important information at the point of care.

The e-prescriptions part of the NPfIT is aimed at cutting the number of deaths caused by errors in medications.

Darling said: "I'm not doing a spending review just now. But I do think it is necessary for me on Wednesday to indicate areas where we are going to cut spending, or where we're not going to spend as much as we were.

"For example, the NHS had a quite expensive IT system that, frankly, isn't essential to the frontline. It's something that I think we don't need to go ahead with just now. But I will be setting out a clear direction of travel because it's important that we do that."

More here:

http://www.computerweekly.com/Articles/2009/12/07/239598/nhs-it-scheme-to-be-scaled-back.htm

It will be interesting to see what impact this has on the work being undertaken by iSoft and Cerner as key software providers for the program.

I note Gary Cohen of iSoft is reported by the Australian Financial Review saying that the changes could be a positive – although the share price today has not really reflected that view (-3.4% today vs Market down -0.19%) Usual disclaimer about having a few shares.

With so much progress having been made one hopes the UK will avoid the ‘baby and bathwater problem’. That outcome is always a risk as governments cast around to save money.

David.

Details of the New National Partnership on e-Health.

I have now had an opportunity to browse this document.

It is downloadable from this page:

http://www.coag.gov.au/coag_meeting_outcomes/2009-12-07/index.cfm

As best I can tell what we get is an Health Identifier (HI) service which for the next few years will be operated my Medicare Australia (MA) – and the MA CEO becomes the HI Service Operator.

The HI Service will be established under its own Federal Act of Parliament, which is yet to be finalised and will be issued in draft for more discussion and consultation.

The service is to commence July 1, 2010.

The governance mechanism is basically via the Australian Health Minister’s Council (AHMC) – assisted by the Australian Health Ministers Advisory Council (AHMAC).

Reports on how things are going to come to AHMC from MA and the Privacy Commissioner each September as I read it.

Just where the private sector fits in all this is simply not apparent at all!

The funding seems all to have been provided – via the grant to NEHTA - late last year.

If ever there is going to be a situation where the devil is in the detail of how all this will work it is this!

NEHTA needs to start a massive both consumer and professional education program real soon now!

I have also to say calling this whole thing a National Partnership for E-Health seems a little over the top to this observer!

David.

COAG Again Does Not Endorse the NEHTA IEHR Business Case – When Will They Give Up?

The outcomes of the Council of Australian Government Meeting today are here:

http://www.coag.gov.au/coag_meeting_outcomes/2009-12-07/index.cfm

As far as e-Health we have:

E-Health

Delivering a safe, patient-centred e-health system is one step closer today, with COAG affirming its commitment to the introduction in 2010 of national healthcare identifier numbers and agreeing to release for further consultation draft legislation for establishing the healthcare identifiers.

Healthcare identifiers are unique numbers that will be given to all healthcare providers, healthcare organisations and healthcare consumers. The healthcare identifier will enable a person’s health information to be linked uniquely to them, no matter how many different health care providers they see. This new system will provide a new level of confidence when communicating patient information between private and government healthcare providers and systems.

COAG also considered feedback from the first phase of public consultations held in July-August 2009. Following these consultations and feedback, further work has been done on the identifiers to clarify and strengthen patient privacy, including limiting the use of information, clearly outlining who has access to information and providing penalties for any misuse of information.

COAG also agreed a National Partnership on e-Health, setting out the objectives and scope for the Healthcare Identifier Service to be operated by Medicare Australia, as well as relevant governance, legislative, administrative and financial arrangements. The identifiers are an important building block for the future introduction of a patient-controlled Individual Electronic Health Record.

So:

Baby steps and no IEHR for now at least, and probably forever.

This comment is a bit of a worry:

"The identifiers are an important building block for the future introduction of a patient-controlled Individual Electronic Health Record."

They are still going on with the stuff that we know is of low priority and off the agenda!

Note there is also still more work to do on privacy etc for the IHI.

The IHI etc won’t happen at any scale next year I believe. I wonder what this framework that has been agreed actually looks like? It is not clear from the communiqué.

This is, of course, all a smokescreen by Ms Roxon and Mr Rudd for having no clear health reform agenda sorted out after 2+ years in office. The NEHTA CEO said ages ago that the concept of a national EHR system delivered by Government was probably dead.

See here:

http://www.theaustralian.com.au/news/governments-change-direction-on-health-e-records/story-e6frgal6-1225786043408

David.

NEHTA, Yet Again, Just Misses the Point With Approach for Conformance and Certification.

In the last few days we have had the following press release from NEHTA

Industry heavyweights unite on Australian e-health software standards

4 December 2009. Consensus reached on a new direction for product compliance and conformance assessment.

Four peak industry groups have joined with the National E-Health Transition Authority (NEHTA) to develop a standards assessment approach for medical software in Australia.

A joint statement released this week defines the principles on which compliance, conformance and certification of software products will be based and outlines a cost-effective pathway to standards development using existing industry mechanisms.

The consensus statement represents a landmark agreement between heavyweights in Australia’s medical software and standards compliance industry including the Medical Software Industry Association (MSIA), Australian Information Industry Association (AIIA), National Association of Testing Authorities (NATA) and Joint Accreditation System of Australia & New Zealand (JAS-ANZ).

It also addresses issues of concern for the commercial software industry, helping to clarify market confusion around roles and processes, and guiding NEHTA in the development of Australia’s premier e‑health conformity assessment scheme.

Conformity assessment will be based on existing national and international standards and will focus on the specific software functionality components that align with NEHTA requirements.

A tiered system, ranging from self-assessment through to accredited external assessment, will be introduced to minimise the time and cost of compliance in line with product risk.

Where appropriate, external third-party assessment will be undertaken by independent agencies accredited through internationally-recognised accreditation organisations, such as NATA and JAS-ANZ in Australia.

NEHTA Chief Executive Peter Fleming applauded the agreement as a milestone in private-public sector collaboration and a significant step in the development of a national e-health infrastructure for Australia.

“The development and adoption of national specifications, and a supporting standards framework, is critical for improving patient care and healthcare delivery for all Australians,” he said.

“When systems work better together, the efficiency and accuracy of transactions improve, which creates a positive flow-on effect for clinical safety and quality.”

Read the Consensus Statement here.

Release is here:

http://www.nehta.gov.au/media-centre/nehta-news/569-cca

And when you follow the link you arrive here:

http://www.nehta.gov.au/connecting-australia/cca

E-Health Compliance and Conformance

To achieve the promised benefits that e-health offers, it is important for healthcare providers and medical software vendors to comply with e-health specifications and standards.

Compliance with these standards has two requirements:

• conformance in the way medical software systems implement the relevant e-health specifications and standards
• compliance by organisations that operate an e-health system or supply an e-health service with the relevant laws, codes of conduct, industry standards and principles of good governance.

Conformance, which relates to how products and services implement e-health specifications, is generally conducted through self-assessment by the party implementing the software system or by an independent third party such as a test laboratory. Conformance may also be assessed by a second party, such as a healthcare provider that is evaluating a software system prior to purchase.

Compliance, which ensures consistency among e-health specifications, usually takes the form of self-assessment, but may also be performed by an independent inspection body.

Assessment scheme
NEHTA is creating an Assessment Scheme for each of its major e-health specifications. The documentation will describe the process for assessing compliance and conformance for NEHTA’s e-health specifications and the assistance that NEHTA provides to organisations performing the assessment.

The Assessment Scheme documentation will give the following information:

• who may perform assessment (e.g. the scope of self assessment and the role of independent test laboratories and inspection bodies)
• guidance concerning assessment methods, test specifications and test tools
• levels of conformance and the timeframes for achieving conformance
• guidance concerning conformance claims by implementers and the presentation of assessment results.

For most e-health specifications, NEHTA will also provide conformance test specifications and a comprehensive list of test cases to be used in conformance testing. NEHTA may also provide test software and assistance in understanding e-health specifications.

Assistance for procurers

NEHTA provides assistance to healthcare providers procuring an e-health system with regard to tender specifications and evaluation. In particular, NEHTA can help in correctly stating compliance and conformance requirements in tender specifications. NEHTA also makes available to procurers its conformance test specifications and test tools to assist in evaluating candidate e-health systems.

Contact

David Manfield, Manager: Compliance, Conformance and Accreditation –david.manfield@nehta.gov.au

A slightly different consensus statement – with signatures and all is found here:

http://www.nehta.gov.au/component/docman/doc_download/908-cca-consensus-statement

This reads:

Leaders in Medical Software and Compliance, Conformance and Accreditation working together for e-health

Leaders in the Australian health software industry and compliance, conformance and accreditation (CCA) community demonstrate their ongoing commitment to the development of e-health by a declaration of consensus to work towards compliant and conformant e-health systems in the industry.

This statement is a commitment to the collaborative development and adoption of national e-health standards and the supporting CCA framework to improve patient safety and the quality of healthcare delivery for all Australians.

The Medical Software Industry Association (MSIA), Australian Information Industry Association (AIIA), National Association of Testing Authorities (NATA), Joint Accreditation System of Australia & New Zealand (JAS-ANZ) and the National E-Health Transition Authority (NEHTA) have achieved consensus on the following:

1. The focus in e-health for Conformity Assessment will be on specific functional capabilities of software products.

2. International and Australian standards will be used as the basis for conformity assessment.

3. A tiered approach to conformity assessment will be undertaken when applying conformity assessment for quality, safety and risk-based measures.

- Contingent on the risk involved, conformity assessment may consist of options from self-assessment through to accredited external assessment.

- Conformity assessment will be commensurate with risk and geared to minimise resources and time.

4. Accredited conformity assessment bodies (CABs) will be responsible for accredited external testing and certification.

5. Accreditation of CABs will be carried out by internationally recognised accreditation organisations, such as NATA and JAS-ANZ.

6. It is not the intention of NEHTA to become or perform the function of a CAB.

7. Existing and future conformity assessment bodies, such as AHML, will be leveraged as the basis for e-health conformity assessment.

8. Successful completion of an appropriate CCA process will be publicly recognised.

9. Whilst the CCA Framework’s primary focus is safety and quality, it will guide and assist other processes such as procurement and healthcare practice improvement.

10. The CCA Framework will focus on the foundations for e-health underpinning innovative development.

Signatures

End document.

Presumably this is all done in response to this undertaking:

Month: July

Initiative

Conformance, compliance and accreditation

Explanation: (Ensuring that software complies with Australian Standards and NEHTA specifications)

Outcome

A document describing how a national certification authority for eHealth related software will function will be completed during July.

See here:

http://aushealthit.blogspot.com/2009/12/what-did-nehta-promise-senate-to.html

By way of contrast in the last few days we have also had the following from Canada

http://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/508-canada-health-infoway-expands-certification-services

Canada Health Infoway expands Certification Services

'Infoway Certified' mark shows products meet pan-Canadian standards

November 30, 2009 (Toronto, ON) – Canada Health Infoway (Infoway) has added four new offerings to its pre-implementation Certification Service. Health information technology vendors can now receive certification for consumer health applications, client registries, provider registries, and immunization registries.

Receiving the 'Infoway Certified' mark provides vendors of health information technology products a competitive advantage in the marketplace by signalling their commitment and leadership to pan-Canadian standards and best practices.

"The certification mark signals a level of quality to buyers," says Richard Alvarez, CEO of Canada Health Infoway. "It tells the buyer that a vendor’s solution meets pan-Canadian standards and will increase the recognition, acceptance and adoption of trusted, interoperable health information technology solutions in the Canadian marketplace."

Infoway is the only organization in Canada certifying health information technology systems against pan-Canadian electronic health record (EHR) standards. Having produced national interoperability standards and a technology framework for the sustainable development of an interoperable EHR system across Canada, Infoway is well positioned to ensure current and emerging products provide required privacy and security and can interoperate with the EHR systems being implemented across the country.

The four new offerings join the pre-implementation Certification Services for consumer health platforms, which was launched in February 2009.

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.

Backgrounder

Go to the e-Health Certification Section

Release here:

http://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/508-canada-health-infoway-expands-certification-services

and this from the CCHIT is the USA

Three EHR systems pass stimulus certification

By Joseph Conn / HITS staff writer

Posted: December 1, 2009 - 11:00 am EDT

Three electronic health-record systems are the first to pass muster with the Certification Commission for Health Information Technology under its new preliminary testing program for compliance with the "meaningful-use" criteria under the American Recovery and Reinvestment Act of 2009, the Chicago-based not-for-profit organization has announced.

The three products are eHealth Made Easy, Version 3, by eHealth Made Easy, supporting two of 27 applicable meaningful-use objectives for eligible providers and two of 24 applicable objectives for hospitals; KIS Track, Version 5.1, by Kaulkin Information Systems, supporting two of 27 applicable objectives for eligible providers; and Medios, Version 4.5, by IOS Health Systems, supporting 27 of 27 applicable objectives for eligible providers, according to CCHIT.

The new testing regime differs from previous CCHIT certification programs in that it does not require that a vendor pass all test criteria. Checklists of those criteria passed for each product are listed on the CCHIT Web site.

More here:

http://www.modernhealthcare.com/article/20091201/REG/312019985

Similar news is provided here:

CCHIT Certifies First EHR Programs Under Federal Standards

John Commins, for HealthLeaders Media, December 1, 2009

The Certification Commission for Health Information Technology today announced the first group of four electronic health records programs certified under its two programs—CCHIT Certified 2011 Comprehensive and Preliminary ARRA 2011.

Both programs inspect EHR technology for the first time against proposed federal standards to support providers in qualifying for 2011-2012 incentives under the $787 billion American Recovery and Reinvestment Act.

"These first four health IT companies, demonstrating their compliance with the proposed federal standards, are now able to offer certified products to providers who wish to purchase and implement EHR technology and achieve meaningful use in time for the 2011-2012 incentives," said commission Executive Director Alisa Ray. "We've had about 25 applications in our 2011 programs and inspections are continuing. Look for additional announcements from these early applicants in the upcoming days and weeks."

More here:

http://www.healthleadersmedia.com/content/242778/topic/WS_HLM2_TEC/CCHIT-Certifies-First-EHR-Programs-Under-Federal-Standards.html

What to say?

First, we still – months late - do not really have an explanatory document worthy of the name.

Second we learn we are to be certifying for compliance with “relevant laws, codes of conduct, industry standards and principles of good governance.”, and second that we are looking for conformance with NEHTA Standards once the assessment mechanisms are worked out.

Vendors are hardly going to push into illegality and defiance of codes of conduct etc!

Third – to the amazement of all – where is Standards Australia and IT-14 in all this? As I read it they seem to not be involved, did not sign off, and one can only ask why as the legal Commonwealth Standards setting entity, from which NEHTA claims to be a Standards taker from seems to out in the cold?

Fourth MSIA is hardly an organisation which has supported interoperability and data portability to date (think GP practice systems) and the other organisations do not – as far as I know have any specific e-Health expertise as far as standards etc are concerned.

Fifth, why are not clinical useability, functionality, contribution to patient safety of software and system etc at the top of the agenda. The answer is that compared with the Canadians and Americans the NEHTA technocrats are in a totally different and clinically detached space.

Sixth, what is all this about self assessment? That is hardly a way to ensure things are done right. As President Regan said “Trust but verify!”

So what we have is a silly announcement from a group that excludes the key player and which does not address the real issues around clinical software and its optimal use!

And people wonder why sometimes I am just a little bit grumpy.

David.

More Evidence Regarding the Silliness of the NHHRC and NEHTA Approach to EHRs.

The following press release appeared a few days ago

Fujitsu releases Research Report into Health Reform

Survey Highlights Key Health Reform Agenda – Prevention Is Better Than Cure

Sydney, 1 December 2009 — Fujitsu Australia and New Zealand, a leading provider of business, information technology and communications solutions, today released its latest research report into Electronic Health Records, revealing that alarmingly many Australians are not willing to take greater responsibility and control for their personal health outcomes and more Australians need to take ownership of their own health records.

The survey examined 5,600 Australians aged between 45 and 64 (Baby Boomers), which researched their attitudes towards their ownership of their own health outcomes and their awareness of Electronic Health Records. Over 40% of Baby Boomers identified they should take more responsibility of their health record but an additional 31% were unsure, because they did not really understand what this meant for them. About a quarter of respondents did not want to take any further responsibility for their own health, or health record.

Regarding taking control of personal health care records, over 60% of those surveyed did not want to take control of their record, as opposed to 38% who did want to take control. When we examined this further, less than 10% of Baby Boomers wanted to manage specific information into their health record. Results also identified that not many respondents understood what a health record was, and 26% had no idea who had access to their health record.

Highlights of the survey include:

Access to information on health - The first conclusion is that if people are going to take greater responsibility for their own health, there needs to be a different approach to providing quality information on health concerns. Today there is no single authoritative source to provide this information and the public’s thirst for knowledge on personal health topics is not being met.

Care from home – The second conclusion of the report identifies that if improvements in chronic illness management could be achieved in a home setting, this has the potential to improve well being and make a major positive impact in health budgets. Many care providers could invest in technologies to help people live at home longer.

Individual responsibility – The third conclusion highlights that while there is some acceptance amongst Baby Boomers that they should take more responsibility for their own health, this does not translate into a strong willingness to own or manage their own health record, because the concept is not widely understood and there are some concerns about the security of electronic information. This highlights both the gap and opportunity about building enthusiasm for and acceptance of electronic health records.

Over the next decade, Baby Boomers are likely to consume the bulk of Healthcare expenditure. If we are able, from a policy perspective, to encourage them to take more personal responsibility, focus on wellness, and proactive strategies for health then there is a chance the Health sector will be able to deliver an acceptable standard of care for all. If not, then the estimate 9% of GDP Australia spends on healthcare services will rise, whilst services will be degraded and standards of care compromised.

“Fujitsu believes that health reform must encompass the entire health eco-system,” states Martin North, Executive Director of Industry at Fujitsu Australia. “There is clearly demand to provide technology to enable smarter hospitals. There is opportunity for development of lean process change in for example, the management of an operating theatre. But it is also going to be essential to consider the community context – and Baby Boomers are right in the eye of the storm.”

Adoption of Electronic Health Record, if it requires Baby Boomers to step up, will require significant education and incentive. This suggests that strategies which are centred on the individual rather than the health professionals will take longer to gain momentum. However, extending the envelope of care into the community setting, shifting the agenda to prevention together with offering consumers access to information and the right monitoring environment offers a path to better health outcomes and a better use of resources.

It is feasible to provide a range of simple to use health monitoring equipment, wirelessly enabled to be able to pass data into the health system, to enable smart monitoring of individuals health status. If this is linked to information portals and peer benchmarking data, it is feasible to provide a supportive “wellness” environment together with tools and advice in the case of adverse indications. To work this must be simple to use, and become in essence part of a daily routine.

Sue Thomson, National Professional Development Manager, The Australian College of Health Service Executives (ACHSE) states “ACHSE has worked collaboratively with Fujitsu Australia and New Zealand for the past few years because we recognise the importance and the usefulness of this type of research in shaping future policy. It also plays an important role in informing the sector about how we can manage health services more effectively now and into the future. As the largest professional body representing health management in Australia, we commend Fujitsu for its commitment to this industry and in particular for its capacity to undertake this research role.”

To download a copy of the report, click here

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About Fujitsu

Fujitsu is a leading provider of IT-based business solutions for the global marketplace. With approximately 175,000 employees supporting customers in 70 countries, Fujitsu combines a worldwide corps of systems and services experts with highly reliable computing and communications products and advanced microelectronics to deliver added value to customers. Headquartered in Tokyo, Fujitsu Limited (TSE:6702) reported consolidated revenues of 4.6 trillion yen (US$47 billion) for the fiscal year ended March 31, 2009.

For more information, please see: fujitsu.com

About Fujitsu Australia and New Zealand

Fujitsu Australia and New Zealand is a leading service provider of business, information technology and communications solutions. As the third largest ICT Company in the Australian and New Zealand marketplace, we partner with our customers to consult, design, build, operate and support business solutions. From strategic consulting to application and infrastructure solutions and services, Fujitsu Australia and New Zealand have earned a reputation as the single supplier of choice for leading corporate and government organisations. Fujitsu Australia Limited and Fujitsu New Zealand Limited are wholly owned subsidiaries of Fujitsu Limited (TSE: 6702).

For more information, please see: fujitsu.com.au

About the Fujitsu Baby Boomers Surveys

In the first year we showed that many had not thought about how they would pay for their healthcare needs in later life. Last year we examined their savings strategies and concluded that many were unlikely to be able to support themselves into old age because they had not saved enough, a trend exacerbated by the Global Financial Crisis and consequent fall in asset prices.
We surveyed 5,600 Baby-boomers (in tranches from 40-64) to understand their views of health records and their use of online services. We discussed our preliminary findings from this research with a number of Senior Health Professionals during a working session at the Australian College of Health Service Executives Conference on the Gold Coast in August 2009. ACHSE is Australia's largest professional body representing health management and it aims to develop and foster excellence in health service management through education and ongoing professional development for existing and potential health service managers. As a result of this session, and a number of other discussions we have had across the sector including NEHTA – the National E-Health Transition Authority.

For more information, please see: http://www.nehta.gov.au

The release is found here:

http://www.fujitsu.com/au/news/pr/archives/2009/20091201-01.html

It is very much worthwhile to download the full report.

It really makes a total joke of the NEHTA and the NHHRC claims about all of us wanting a patient owned and controlled record. Most baby boomers (those who use 80% of health resources and are aged between 45 and 65) really don’t use the internet all that much compared with the younger cohorts, want the clinician to look after their record and are a long way from the wellness agenda just yet!

Many thanks to Fujitsu for debunking the silliness we have had from NEHTA and the NHHRC.

As I have been saying endlessly we need to focus on supporting care providers with quality systems – this is where the pay dirt is – and possibly at the same time commence the education and awareness program for the younger boomers and below about how PHRs can help. A 10 year project I suspect!

David.