It Seems Everything Old Has Become New Again.

For reasons I do not understand the following appeared as news a few days ago, but the reminder was useful!

NEHTA looks offshore to end e-health delays

Skills review to be completed by February 2008

• Sandra Rossi (Computerworld)
• 17 December, 2007 16:30

Struggling to recruit the necessary IT skills base required to push forward Australia's e-health reform agenda, the National E-Health Transition Authority (NEHTA) is looking to offshore outsourcing and other contractual measures to fill the resources gap.

Admitting the national IT skills shortage will result in serious "delays in delivery" for Australia's e-health framework, NEHTA is currently operating up to 50 per cent under budget due to recruiting delays.

The decision to look offshore for IT staff is necessary to ensure the implementation of electronic health records can begin in 2008 and follows an independent review of Australia's e-health framework by the Boston Consulting Group (BCG). The review examined NEHTA's progress since it was established in 2005 and found "labour capacity constraints" in the local market has forced timelines to be revised.

According to the BCG report e-health reforms are suffering from significant staffing shortfalls pointing out that: "ongoing shortfalls during the current financial year is likely to cause irreversible delivery delays. The biggest challenge has been recruiting staff and the increased resources required is extraordinary, roughly a doubling of personnel spend every year up until 2009."

This shortage has made it impossible to put standards in place for secure messaging with the report claiming NEHTA has been unable to "engage with users and standard bodies or build up accreditation or compliance."

To address the problem funding has increased to over $1.5 million in the 2007/8 financial year to try and overcome "under-resourcing issues" for the development of secure messaging standards.

A review is also underway to identify areas in urgent need of staffing and is expected to reach completion in February 2008.

.....

Responding to the skills crisis, NEHTA today released an action plan for the implementation of electronic medical records in 2008.

The Board of NEHTA has endorsed a business case for developing a national platform for personal electronic health records to be put to the Council of Australian Governments (COAG) early next year.

.....

The NEHTA action plan outlines key areas for the adoption of measures to improve the electronic communication of critical health information.

NEHTA has been tasked with Australia's e-health reforms since it was established in 2005, and the body's chair Dr Tony Sherbon, said it is now in a position to deliver some concrete applications. Sherbon said the government's emphasis on the provision and use of broadband communications will assist NEHTA in advancing e-health. "The recent independent review found NEHTA had made significant progress on our goals to date and made a number of recommendations about NEHTA's future. The action plan we are announcing today flows directly from our acceptance of all the recommendations in the review," he said.

The review also called for closer consultation with stakeholders. Health industry professionals and the IT industry described NEHTA's engagement style as "dogmatic" with the review recommending implementation programs with bodies such as the Australian Medical Association, Royal Australian College of General Practitioners, Australian Association of Pathology Practices, various Divisions of General Practice and the Rural Doctors Association of Australia

Dr Sherbon identified the action plan as also being an acknowledgement of where NEHTA now needs to go in order to expedite e-health reform in Australia. "We have come to a point where many of the foundations to enable e-health are in a position where we can now move towards implementation and adoption," he said.

NEHTA's Board of Directors is composed of the heads of all nine government health departments in Australia. NEHTA's Action Plan for Adoption Success and the independent review of NEHTA conducted by the Boston Consulting Group are available on the NEHTA website at www.nehta.gov.au.

The full article is found here:

http://www.computerworld.com.au/article/202851/nehta_looks_offshore_end_e-health_delays/?pp=1

Bold emphasis is mine.

Note the date carefully. This is over 2 years ago and it is fair to say that as far as Electronic Patient Records are concerned there has been no detectable progress at all. Practical outcomes with anything else are still rather hard to identify 2 years later. One really wonders just what the public is paying for with NEHTA?

It is absolutely obvious that Dr Sherbon clearly had no idea what he was talking about (many foundations now in position and so on!) and no clue about the issues that stand in the way of the progress he was hoping for. I hope the new chairman has a much better grasp of reality. However labelling 2009 as the “Year of Delivery” suggests not a great deal has been learnt.

I wonder what 2010 holds for all of this. It’s a new year so let us be optimistic at least until we are in the situation of the individual marrying for the third time where the realise they are the victim of ‘Hope triumphing over experience’.

Happy New Year!

David.

A Powerful Lesson on How to do e-Health Properly.

The following appeared in the New England Journal of Medicine over the holidays.

Launching HITECH

Posted by NEJM • December 30th, 2009 • Printer-friendly

David Blumenthal, M.D., M.P.P.

Information is the lifeblood of modern medicine. Health information technology (HIT) is destined to be its circulatory system. Without that system, neither individual physicians nor health care institutions can perform at their best or deliver the highest-quality care, any more than an Olympian could excel with a failing heart. Yet the proportion of U.S. health care professionals and hospitals that have begun the transition to electronic health information systems is remarkably small.^1,2

On December 30, the government took several critical steps toward a nationwide, interoperable, private, and secure electronic health information system. The Department of Health and Human Services (DHHS) released two proposed regulations affecting HIT (www.healthit.hhs.gov and http://www.federalregister.gov/inspection.aspx#special). The first, a notice of proposed rule-making (NPRM), describes how hospitals, physicians, and other health care professionals can qualify for billions of dollars of extra Medicare and Medicaid payments through the meaningful use of electronic health records (EHRs). The second, an interim final regulation, describes the standards and certification criteria that those EHRs must meet for their users to collect the payments. In addition, between August and December 2009, my office — the DHHS Office of the National Coordinator for Health Information Technology (ONC) — announced nearly $2 billion worth of new programs to help providers become meaningful users of EHRs and to lay the groundwork for an advanced electronic health information system. All these actions were authorized by the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of the American Recovery and Reinvestment Act of 2009, also known as the stimulus bill (see table).³

The provisions of the HITECH Act are best understood not as investments in technology per se but as efforts to improve the health of Americans and the performance of their health care system. The installation of EHRs is an important first step. But EHRs will accomplish little unless providers use them to their full potential; unless health data can flow freely, privately, and securely to the places where they are needed; and unless HIT becomes increasingly capable and easy to use.

Understanding this, Congress and the Obama administration structured the HITECH Act so as to reward the meaningful use of qualified, certified EHRs — an innovative and powerful concept. By focusing on the effective use of EHRs with certain capabilities, the HITECH Act makes clear that the adoption of records is not a sufficient purpose: it is the use of EHRs to achieve health and efficiency goals that matters.

The effort to achieve meaningful use provides the best lens through which to understand the government’s actions in implementing the HITECH Act. The administration is trying to do four basic things: define meaningful use, encourage and support the attainment of meaningful use through incentives and grant programs, bolster public trust in electronic information systems by ensuring their privacy and security, and foster continued HIT innovation.

The full and detailed article is available (freely) here:

http://healthcarereform.nejm.org/?p=2669&query=TOC

For e-Health in the US, and by some considerable trickle down to us I suspect, this is the biggest and most important policy statement I have seen!

If the turkeys who run Australian e-Health had anything like some brains they would be reading closely and working out how they can use similar Government policy levers to achieve similar results.

It is really pretty much all here in my view. Incentives, incremental improvement, clinician driven and the list goes on.

We have wasted a decade and it has taken the Obama administration a little less than a year to legislate funds and start serious work.

It would be real fun to be in US Health IT right now.

Go read the article closely to see just how much is being done in all the right area (training, standards etc).

This is the biggest thing in e-Health since the UK Government launched Information for Health a decade ago and kicked off the National Program for Health IT. This is genuine e-Health history in the making I believe.

David.

AusHealthIT Man Poll Number 4 - Results

The question was:

What Chance Do You Think We Have For a Major Funding Boost to e-Health in the Next Year?

Results:

100% Chance of Major Funding Boost

- 3 Votes (10%)

75% Chance of Major Funding Boost

- 2 Votes (6%)

50% Chance of Major Funding Boost

- 6 Votes (20%)

25% Chance of Major Funding Boost

- 11 Votes (36%)

0% Chance of Major Funding Boost

- 8 Votes (26%)

Total Votes 30.

Comment:

So 75% of voters thought we were at 50% chance or less and over 50% gave the odds of a boost as being less than 25%.

It is hard to know where this is going without more resources. Right now blog readers do not see much joy on the horizon.

Thanks again to all who voted.

David.

A Real Giggle To Start the Year - Serious Blogs Start Tomorrow!

While browsing I came upon this!

2009 NEHTA Grants Awarded!

Congratulations to the following recipients each awarded a $250.00 grant for expansion of HT programming:

The ARC of Blackstone Valley, Pawtucket, RI: Daggett Farm Greenhouse & Gift shop will expand its services to residents of Riverview Terrace apartments. Staff will offer classes at Riverview Terrace to elderly and disabled who have difficulty going into the community without assistance. Classes will be based on gardening in small spaces, such as indoor window boxes with interchangeable seasonal plants during the four seasons.

Winthrop University Hospital Child Life Program, Merrick, NY: For continuation of horticultural therapy services for hospitalized children at Hagedorn Pediatric Inpatient Center and for children with cancer and blood disorders who are being treated at Winthrop’s outpatient Cancer Center for Kids. Activities will be conducted for groups and bedside for children ages one and up through a “Nurture with Nature” approach.

See the wonderful logo here:

http://www.nehorticulturaltherapy.org/2009NEHTAGrantsAwarded.html

NEHTA is, of course, the North Eastern Horticultural Therapy Association (NEHTA).

I would never have guessed it. Maybe some grants from NEHTA in OZ could help some of their problems?

It sounds like the NEHTA of New England is doing kind, generous and caring things. One can only hope our version might, one day, follow suit!

Sorry this was too funny to let past, there is a message and I hope all readers have a really great 2010. It will be a big one, what with a Federal Election and all, - I wonder if Rudd and Roxon are up to it or will be sadly disappointed again?

David.

The Happy Christmas and Have a Great New Year Blog.

Just a short blog to wish all those who drop by the Season’s best.

It has been quite a year and much of the hope we stated it with has really yet to actually come to fruition, sadly.

The saddest things to me have been the consistent lack of leadership in the e-Health space and the persistent stupidity of the belief held by some really hopeless bureaucrats that something can happen without both quality leadership, some effective governance and some reasonable seeding investment.

The amount of time and effort that has been wasted because these three things were missing is terrible and the denial that is actually matters in terms of patient’s lives and limbs borders on the criminal in my view.

The good things this year have all been about the hardy souls in the commercial e-Health space who have been prepared to chance their arm and just go for it! They all know who they are so there is no point providing a list as I would be certain to leave some good guy or gal out!

I really hope 2010 can be a much better year for all concerned.

As a really amazing note, this is blog post number 1100. At least I hope I get a few points for effort!

Go well, be safe and have a great break.

I plan to be back typing away on January 4, 2010.

David

NSW Health Takes A Hit from the Australian Financial Review.

The following appeared today.

Fears for patients amid e-record troubles

The NSW government and senior health bureaucrats have been accused of putting the lives of patients at risk by ignoring the concerns of clinicians over the troubled deployment of the FirstNet electronic patient records and administration system.

The key points of the article are:

1. Some departments have reverted to using paper for patient records.

2. The concerns centre on the time it takes to enter and retrieve details.

More here (subscription required)

http://www.afr.com/p/business/technology/fears_for_patients_amid_record_troubles_Jt8sQPbgQ32PngTpFLFTmJ

Those who have been watching will know this issue was covered a while ago on the blog.

See:

http://aushealthit.blogspot.com/2009/11/nsw-health-cerner-and-professor-patrick.html

and here:

http://aushealthit.blogspot.com/2009/11/new-release-of-jon-patrick-essay-on.html

and here:

http://aushealthit.blogspot.com/2009/11/professor-patrick-releases-new-version.html

The opposition Health Spokesman in NSW (Ms Jillian Skinner) has apparently also been briefed on issues in the metro hospitals as well as the known issues at more regional hospitals.

As always the silence from NSW Health is deafening.

The mess just continues unfixed it seems.

Let me know if things are better anywhere so we can let people know.

David.

Weekly Overseas Health IT Links 23-12-2009

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

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http://www.news-medical.net/news/20091216/Physicians-support-EHR-use-but-privacy-breaches-remain-an-issue.aspx

Physicians support EHR use, but privacy breaches remain an issue

16. December 2009 03:19

Although physicians support the use of electronic health records, concerns about potential privacy breaches remain an issue, according to two research articles published in the January 2010 issue of the Journal of the American Informatics Association (JAMIA), in its premiere issue as one of 30 specialty titles published by the BMJ (British Medical Journal) Group, UK.

One published study is based on views of more than 1,000 family practice and specialist physicians in Massachusetts who were asked whether they thought electronic health information exchange (HIE) would drive down costs, improve patient care, free up their time and preserve patient confidentiality. They were also asked whether they would be willing to pay a monthly fee to use the system.

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http://govhealthit.com/newsitem.aspx?nid=72733

Decision on tougher lab data standards put off to January

By Mary Mosquera

Tuesday, December 15, 2009

If the Department of Health and Human Services publishes a rule defining the meaningful use of electronic records this month, as expected, health providers will still have to wait for a key policy decision on standards to use to exchange lab test results.

Dr. David Blumenthal, the national coordinator for health IT, yesterday asked the advisory Health IT Policy Committee to defer until January a decision on whether to allow temporary variations in those standards to be used.

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http://www.healthdatamanagement.com/news/HIE_viability_survey_research_RHIO-39535-1.html

What Makes HIEs Viable?

HDM Breaking News, December 17, 2009

Results from a national survey of regional health information organizations show simplicity and early funding commitments from participants improve viability of the initiatives.

Researchers from Harvard University, Brigham and Women's Hospital and Boston Veterans Affairs Hospital surveyed all known RHIOs in the United States in mid-2008. They examined two main outcome measures: whether the RHIO was operational and the percent of operating costs covered by revenue from participants.

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http://www.modernhealthcare.com/article/20091218/REG/312189986

New technology a 'push' toward EHR future

By Joseph Conn / HITS staff writer

Posted: December 18, 2009 - 5:59 am EDT

There is a push going on for push messaging, a likely first step in rolling out a proposed national health information network in time for healthcare organizations to use electronic health-record systems in a “meaningful manner” and qualify for federal EHR subsidy payments under the American Recovery and Reinvestment Act of 2009.

In late October, David Blumenthal, head of the Office of the National Coordinator for Health Information Technology at HHS called for pause in the planning of the NHIN.

Earlier this week, in testimony before a federal healthcare IT advisory panel, on blogs and postings to online discussions, what is beginning to emerge is the outline of what the healthcare IT world was put on hold to wait for, an outline of a “lighter” NHIN than has been the focus of much planning and development work in the past.

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http://www.e-health-insider.com/news/5480/ehrs_deliver_soft_benefits_for_hard_cash

EHRs deliver soft benefits for hard cash

16 Dec 2009

Electronic health record and e-prescribing systems deliver benefits such as safer and more convenient services, but only over long periods of time and with a net increase in spending, a major European study has concluded.

The final report of the European Commission EHR IMPACT study pulls together more than 700 indicators of cost and benefit derived from detailed case studies of 11 EHR and e-prescribing systems in use in Europe, the US and Israel.

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Keeping a SHARP Focus on Innovation

December 18, 2009

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

Today the Obama administration announced the availability of $60 million in Recovery Act funds to support the development of the Strategic Health IT Advanced Research Projects (SHARP) program. SHARP awards will fund research focused on identifying technology solutions to address well-documented problems impeding broad adoption of health information technology (health IT). By helping to overcome key challenges, the research will also accelerate progress towards achieving nationwide meaningful use of health IT.

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http://www.ehiprimarycare.com/news/5463/stalis_standalone_e-discharge_summary

Stalis standalone e-discharge summary

11 Dec 2009

Stalis has launched a clinical e-discharge solution to allow NHS trusts that do not have discharge summary functionality built into their patient administration system to produce immediate summaries for patients.

The company has made the CareXML/eDS product available after finding that many trusts are unlikely to hit the government’s April 2010 target for delivering discharge summaries to GPs within 24 hours.

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http://www.who.int/goe/ehir/2009/15_december_2009/en/index.html

15 December 2009

eHealth Worldwide

:: China - E-health in China, our practice and exploration. (8 December 2009 - IEEE Engineering in Medicine and Biology Society)
China started to pay more attention to regional and national health information network construction after the SARS epidemic outbreak in 2003. The Chinese government marks the public health system construction as the most urgent part of national medical reform, with information and computer tech-nology(ICT) being considered as the key of deploying regional collaborative medical service(RCMS), which is also known as e-Health. In this paper, we firstly analyze the difficulties of carrying out e-health projects in China and then present the active attempts, finally a case representing current progress is presented and studied.

Heaps more follows.

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http://www.information-management.com/news/health_information_exchange-10016678-1.html

Are HIEs the Answer?

Alternatives to regional health information exchanges are emerging

Information Management Online, December 9, 2009

Joseph Goedert

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.

In a nation of 300 million residents over 3.5 million square miles, there are 193 HIEs in various stages of development, according to eHealth Initiative, a Washington-based industry advocacy organization. By self-attestation, 57 of the HIEs are operational. Most HIEs don't have a sustainable business model, and getting a critical mass of regional stakeholders to cooperate in exchanging their data remains an extremely difficult proposition.

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http://www.healthleadersmedia.com/content/243427/topic/WS_HLM2_TEC/Top-10-Smartphone-App-Trends-for-2010.html

Top 10 Smartphone App Trends for 2010

Cynthia Johnson, December 11, 2009

Many chief information officers have smartphones on the top of their 2009 wish list. The compact mobile devices combine online access to information with PDA (personal digital assistant) functionality, making them perfect for on-the-go clinicians.

According to a report by market-research firm Manhattan Research, the number of physicians who own smartphones will increase from 64% to 81% by 2012. The October 2009 report states that the ability to complete tasks remotely will become even more indispensible to physicians in the future.

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http://www.healthleadersmedia.com/content/243567/topic/WS_HLM2_TEC/Facilities-Use-Cloud-Computing-to-Share-Radiology-Images.html

Facilities Use Cloud Computing to Share Radiology Images

Carrie Vaughan, for HealthLeaders Media, December 15, 2009

It started with a simple goal: to send radiology images to healthcare facilities throughout Montana in a manner that was cheaper and more efficient than using FedEx to mail CDs overnight. About 30 healthcare organizations in Montana joined the grassroots organization called the Image Movement of Montana.

The group needed a solution that would work not only for more tech savvy facilities with picture archiving and communications systems, but also for folks who don't have PACS and would need to access images on a PC, says Gayle Knudson, radiology manager at Great Falls Clinic and IMOM co-founder.

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http://www.ihealthbeat.org/features/2009/nurses-claim-their-seat-at-the-health-it-decisionmaking-table.aspx

Tuesday, December 15, 2009

Nurses Claim Their Seat at the Health IT Decision-Making Table

by Paula Fortner, iHealthBeat Senior Staff Writer

Many of the policy discussions about health IT appear to focus almost exclusively on how such systems might affect physicians and physician workflow. We're hearing a lot about computerized physician order entry systems, physician performance measurement and physician incentives for electronic health record adoption.

But what about nurses?

Although they might not get as much press time, nurses are actively taking a seat at the table and participating in federal discussions about best practices, standards and the meaningful use of EHRs.

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Patient consent and 'granular' privacy control ties

By Joseph Conn / HITS staff writer

Posted: December 14, 2009 - 11:00 am EDT

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

The online culture is changing, shifting toward affording individuals more control over their personal information, as evidenced by the rollout last week of revisions to the privacy and security policies and technological framework by Facebook, a popular personal media site.

Privacy and IT industry experts interviewed for this story say the fine-grained levels of personal control incorporated by Facebook demonstrate a "proof of concept" that a similar, so-called "granular" consent-management system could provide a template for personalized privacy protection in the healthcare industry.

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http://www.google.com/hostednews/ap/article/ALeqM5hHDt7MH7Tw3xYTQXK908rSk2zcNgD9CGNKJG0

Sens. move to block drugmakers from mining Rx data

By MATTHEW PERRONE (AP) – 4 days ago

WASHINGTON — Drug companies would no longer be able to mine pharmacy records to track which doctors are prescribing their medications, under a proposal unveiled Thursday by two Senate Democrats.

The amendment to the Senate health care bill would effectively ban pharmaceutical data mining, the drug company practice of buying prescription records to target sales pitches to doctors.

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http://www.healthcareitnews.com/news/missouri-hospital-saves-lives-virtual-icu-technology

Missouri hospital saves lives with virtual ICU technology

December 11, 2009 | Diana Manos, Senior Editor

JEFFERSON CITY, MO – St. Mary's Health Center, an SSM Health Care facility in Jefferson City, Mo., reports success with the use of a virtual ICU program, used in conjunction with its in-house program.

At the Institute for Healthcare Improvement National Forum, Dec. 9-12 in Orlando, Fla., executives from St. Mary's announced results of its virtual use of ICU technology to improve mortality rates, lengths of stay and quality measures. Since St. Mary's launched its use of virtual ICU technology in 2006, ICU mortality dropped by 24 percent after one year; cardiac arrests plunged by 69 percent; ICU patient total length of stay fell by 14 percent; and there were no cases of ventilator-associated pneumonia (VAP) since the program's inception.

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http://www.healthcareitnews.com/news/electronic-health-records-not-panacea-researchers-say

Electronic health records not a panacea, researchers say

December 14, 2009 | Diana Manos, Senior Editor

LONDON – Large-scale electronic health record projects promise much, but sometimes deliver little, according to a new study.

In a study published Monday in the U.S. journal Milbank Quarterly, researchers at the University College of London (UCL) said they identified fundamental and often overlooked tensions in the design and implementation of EHRs. The study was based on findings from hundreds of previous studies from all over the world.

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http://www.milbank.org/quarterly/8704feat.html

Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method

Trisha Greenhalgh, Henry W.W. Potts, Geoff Wong, Pippa Bark, and Deborah Swinglehurst

University College London

Context: The extensive research literature on electronic patient records (EPRs) presents challenges to systematic reviewers because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches.

Methods: Using the meta-narrative method and searching beyond the Medline-indexed literature, this review used “conflicting” findings to address higher-order questions about how researchers had differently conceptualized and studied the EPR and its implementation.

Findings: Twenty-four previous systematic reviews and ninety-four further primary studies were considered. Key tensions in the literature centered on (1) the EPR (“container” or “itinerary”); (2) the EPR user (“information-processer” or “member of socio-technical network”); (3) organizational context (“the setting within which the EPR is implemented” or “the EPR-in-use”); (4) clinical work (“decision making” or “situated practice”); (5) the process of change (“the logic of determinism” or “the logic of opposition”); (6) implementation success (“objectively defined” or “socially negotiated”); and (7) complexity and scale (“the bigger the better” or “small is beautiful”).

Conclusions: The findings suggest that EPR use will always require human input to recontextualize knowledge; that even though secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper may offer a unique degree of ecological flexibility; and that smaller EPR systems may sometimes be more efficient and effective than larger ones. We suggest an agenda for further research.

Keywords: Systematic review, electronic patient records, innovation.

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http://www.fiercehealthit.com/story/medco-pay-pharmacists-closing-medication-loop/2009-12-14?utm_medium=nl&utm_source=internal

Medco to pay pharmacists for closing medication loop

December 14, 2009 — 3:19pm ET | By Neil Versel

Pharmacy benefits manager Medco Health Solutions will deliver electronic alerts to pharmacies for patients who may not be following their doctors' orders and pay as many as 100 pharmacists in Illinois for coordinating care with physicians and counseling patients with chronic conditions. Medco also will work with the Illinois Pharmacists Association, the University of Illinois at Chicago (UIC) College of Pharmacy and Mirixa, a pharmacy-based patient care network, to study the efforts to close gaps in medication adherence over the course of a 26-week trial period.

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http://www.fiercehealthit.com/story/quaid-draws-plenty-attention-health-it-do-many-people-really-care/2009-12-14?utm_medium=nl&utm_source=internal

Quaid draws attention to health IT, but do people really care?

December 14, 2009 — 11:52am ET | By Neil Versel

Editors Choice

I've been thinking for some time now that in our celebrity-driven culture, it would take a big Hollywood name to latch on to health IT in order to get the masses--and the mainstream media--to make the connection between information technology and patient safety. A few candidates had been involuntarily brought to the fore with regards to EMR security breaches--Britney Spears, George Clooney and the dearly departed Farrah Fawcett come to mind--but I've been waiting for Dennis Quaid to make a splash.

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http://www.itweb.co.za/index.php?option=com_content&view=article&id=28898:health-smart-card-progress-stalls&catid=69:business&Itemid=58

Health smart card progress stalls

By Audra Mahlong, Journalist

Johannesburg, 14 Dec 2009

Health MEC Qedani Mahlangu has instructed lawyers to appeal the court's decision and prevent any payouts to the private consulting firm.

The Gauteng Health Department has been instructed to pay over R40 million to 3P Consulting for breach of contract and outstanding payments – delaying any decisions on the progress of its R609 million health smart card tender.

Health MEC Qedani Mahlangu noted that she would fight the decision of the Gauteng South High Court, and added that the money the department would have to pay 3P consulting would affect other projects.

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http://www.hc2d.co.uk/content.php?contentId=13541

iSoft ORMIS for Leicestershire provider

16th December 2009

NHS Leicestershire County and Rutland Community Health Services has implemented a wireless electronic patient record system which will provide paper-free processes in operating rooms across five of its hospitals.

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Enjoy!

David.

Latest Additions to the NEHTA December 2009 Information Barrage.

Passed on without comment.

Go here and be informed - or whatever else you derive from what they provide.

http://www.ehealthinfo.com.au/newsletters/dec-09/

David.

A Really Important Piece of Commonsense Many in Health IT Miss.

The following interview appeared a few days ago.

One-on-One With Virtua Health CIO Al Campanella,

Part I

Virtua is a multi-hospital healthcare system headquartered in Marlton, N.J. A non-profit organization, it employs 7,900 clinical and administrative personnel and has 1,800 physicians as medical staff members. Virtua is an early adopter of clinical and digital technologies, led on the IT side by CIO Al Campanella. Recently HCI Editor-in-Chief Anthony Guerra caught up with Campanella to see if HITECH was changing his strategic plans.

GUERRA: Can you give me the 10,000-foot overview of Virtua?

CAMPANELLA: Sure. Virtua has four hospitals with a little over 1,000 beds. We have a little over $1billion in revenue. We own 150 physician practices. We also have two nursing homes, a very large home health agency with 400 nurses, and we have two large ambulatory care centers.

GUERRA: And I would imagine there’s a large population of physicians down there that are independent and refer to the hospitals?

CAMPANELLA: Yes. We have 1,100 office-based physicians who are completely voluntary, and then we have another 600 that are employed by other health systems that also admit here, or they are hospital-based physicians such as anesthesiologists and pathologists, so roughly, 1,700 altogether. And then, separately, we have 150 employed physicians.

GUERRA: The employed physicians – the office-based physicians that are owned – are they allowed to refer patients to other hospitals or do they have to refer inside the Virtua network?

CAMPANELLA: No, they don’t have to refer to us. If we offer the service, then they’re encouraged to refer the patient here, but if we don’t offer the service, then of course, they can refer elsewhere.

Read the rest of the long and really spot on interview here:

http://healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=F51098097CA8442798C7774AEE420E82

If ever there was a truer word spoken about obtaining physician buy-in and adoption - this is it!

“Al Campanella says physicians aren’t opposed to the concept of EMRs, they just don’t want to make less money because of them.”

This is absolutely central to getting physician adoption in countries that have ‘fee for service remuneration - as Australia does.

The bottom line is that you hit the bottom line you loose - improve it you win with all but the tiny handful of zealots for technology who simply don’t care and love blinking lights!

And to provide maximum value as we go onto the new year here is the best paragraph I have seen for all of us who have staggered through the recent - and ongoing, believe me, GFC.

From Alan Kohler in the Eureka Report a day or so ago.

“I’m not suggesting that not losing money and diversifying to protect your capital from ignorance is a new idea. In 1933 Will Rogers famously said: “I'm not so much concerned about the return on my money as the return of my money.” And, of course, Warren Buffet’s two big rules of investing are: “Rule No. 1: Never lose money. Rule No. 2: Never forget Rule No. 1”

The core lesson here is to never take one’s eye off the ball - and with health IT the ball always has major elements of making sure the clinicians can feed the nippers!

And as another wise person once said - How do you get doctors to do what you want? Simple, stuff their mouths with silver!

The inevitable implication here is that you have to spend up front to get things to happen. Ms Roxon and Ms Halton seem to have missed that fundamental point.

Not hard at all really - and never to be forgotten.

David.

Weekly Australian Health IT Links - 21-12-2009

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

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http://www.theaustralian.com.au/news/nation/security-for-e-health-data/story-e6frg6nf-1225809982612

Security for e-health data

• Natasha Bita
• From: The Australian
• December 14, 2009 12:00AM

INSURANCE companies and employers will be locked out of the national health database planned to start next year.

Every newborn, as well as every Australian holding a Medicare card or Veterans Affairs card, will automatically be allocated a "healthcare identification" number that privacy groups have branded a de facto national ID card.

The number may eventually be linked to patients' medical records, but anyone who misuses the information will face two years' jail, under draft legislation released by Health Minister Nicola Roxon on Friday.

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http://www.theaustralian.com.au/australian-it/medical-professionals-ask-for-clarity-on-e-health/story-e6frgakx-1225810361299

Medical professionals ask for clarity on e-health

• Andrew Colley
• From: The Australian
• December 15, 2009 12:00AM

A BROAD coalition of health professionals believes it made progress in its quest for $6.3 billion in federal funding at the government's massive broadband conference in Sydney last week.

The Coalition for e-Health's hopes have been buoyed by strong indications it has support from Kevin Rudd, Health and Ageing Minister Nicola Roxon and Communications Minister Stephen Conroy.

Michael Legg, president of the Health Informatics Society, which convenes the CeH, said the group had been asked to hang tight.

Professor Legg said the group had been strongly encouraged by comments made by Department of Health and Ageing deputy secretary Jane Halton at the conference that indicated the department was behind the group.

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http://www.itwire.com/content/view/30010/53/

Old age problem gets new age solution

by Beverley Head

Monday, 14 December 2009

With 13.3 per cent of the Australian population now aged 65 or over, iSoft’s decision to launch its first end-to-end information system for aged care providers seems smartly timed.

The largest listed health IT provider in Australia launched its Aged Care – Enterprise Wide Health system, on the same day as the Australian Bureau of Statistics revealed that the median age of the Australian population had risen by more than five years to 36.9 over the last two decades.

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http://www.pharmacynews.com.au/article/psa-partners-with-gps-on-e-health/508721.aspx

PSA partners with GPs on e-health

17 December 2009

The Pharmaceutical Society of Australia (PSA) has joined forces with general practitioners to push forward the uptake and implementation of electronic prescribing.

During collaborative partnership talks in Canberra, PSA and the Royal Australian College of General Practitioners (RACGP) reaffirmed that electronic prescribing of medications could provide substantial benefits to consumers through better medication management and reduced medication errors.

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http://www.medicalnewstoday.com/articles/174280.php

Health Professions United On E-Health, Australia

17 Dec 2009

A high-level meeting of health organisations in Canberra has scoped the development of a robust, patient-centred e-prescribing system through a collaborative partnership between doctors and pharmacists.

The roundtable, hosted by the Pharmaceutical Society of Australia and the Royal Australian College of General Practitioners, reaffirmed that e-prescribing of medications can provide substantial benefits to consumers through better medication management and reduced medication errors, as well as improved communication between doctors, pharmacists and patients.
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http://nqr.farmonline.com.au/news/state/agribusiness-and-general/general/155m-boost-for-rural-nt-health/1707735.aspx

$15.5m boost for rural NT health

17 Dec, 2009 03:51 PM

REMOTE health service delivery is set for a $15.5 million boost under joint Territory and Federal Government funding, Minister for Information, Communications and Technology Policy Karl Hampton announced last Friday.

"This is one of the largest ICT milestones in the Territory's history that will help deliver life-changing services for thousands of remote Territorians," Mr Hampton said.

"Improved health service delivery in remote Territory towns such as Lajamanu, Dagaragu and Papunya will go a long way towards Closing the Gap in Indigenous Disadvantage.

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http://www.computerworld.com.au/article/329886/mandatory_isp-level_filtering_report_released

Mandatory ISP-Level Filtering report released

Enex TestLab finds that a "technically competent user" can circumvent filtering technology based on ACMA’s blacklist

Tim Lohman 15 December, 2009 16:32

After much delay the Federal Government has released the results of Enex TestLab’s test pilot into mandatory ISP-level content filtering, finding that a technically competent user could circumvent filtering technology based on ACMA’s blacklist.

According to the report, initially all filters had issues with loading the ACMA blacklist indicating a need for routine checking to ensure the blacklist is filtered correctly with each update.

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http://www.smh.com.au/technology/technology-news/internet-censorship-plan-gets-the-green-light-20091215-ktzc.html

Internet censorship plan gets the green light

ASHER MOSES

December 15, 2009 - 11:13PM

The Federal Government has announced it will proceed with controversial plans to censor the internet after Government-commissioned trials found filtering a blacklist of banned sites was accurate and would not slow down the internet.

But critics, including the online users' lobby group Electronic Frontiers Australia and the Greens communications spokesman Scott Ludlam, said the trial results were not surprising and the policy was still fundamentally flawed.

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http://www.ntnews.com.au/article/2009/12/14/109111_ntnews.html

Health service fined for info leak

NADJA HAINKE

December 14th, 2009

A TERRITORY health service has been charged thousands of dollars after a patient's private information was mistakenly released to his employer three times.

The information commissioner said the errors caused "embarrassment, hurt and humiliation" to the patient.

"On each occasion ... the complainant had been questioned about matters to do with the complainant's health status by staff at the complainant's employer," the commissioner's case note said.

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http://www.6minutes.com.au/articles/z1/view.asp?id=508475

GPs to get prescribing feedback

by Jared Reed

Almost 200 GP practices have signed up for a divisions-run scheme that will provide instant feedback on the quality of their prescribing decisions.

The pilot project, run by the National Prescribing Service and divisions, will analyse GPs’ prescription for chronic heart failure and hypertension against eight clinical indicators. These conditions were chosen because of evidence indicating under-prescribing of first-line recommended treatments.

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http://www.securecomputing.net.au/News/163197,privacy-must-be-addressed-for-innovations-sake.aspx

Privacy must be addressed, for innovation's sake

Liz Tay | Dec 18, 2009 11:50 AM

Privacy the only road-block to IT triumphs.

Unresolved privacy issues may be limiting technological and scientific progress, according to a prominent U.S. computer scientist.

Tom M. Mitchell of Carnegie Mellon University believes the rise of machine-learning algorithms during the past decade has yielded compelling potentials for mining and analysing real-time data.

Mitchell heads up Carnegie Mellon's Machine Learning Department, where he is researching uses for real-time location data from smart phones.

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http://www.itnews.com.au/News/162842,feds-to-deliver-digital-reform-agenda-within-six-months.aspx

Feds to deliver digital reform agenda within six months

Dec 14, 2009 2:48 PM

Conroy calls for cross-Government, industry cooperation.

Cooperation between the various levels of Government and industry bodies will be required to drive forth digital economic reform, Communications Minister Stephen Conroy has said.

Speaking at the closing of the Realising our Broadband Future forum in Sydney, Conroy outlined the Government's plans for ideas and content generated in the two-day physical and virtual gabfest.

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http://www.sciencealert.com.au/news/20091412-20404-2.html

Gaming to fight cancer

Monday, 14 December 2009

CSIRO

CSIRO is using the latest in computer gaming technology to help reduce the incidence of one of the most common cancers in Australia – bowel cancer.

According to CSIRO Preventative Health Flagship scientist, Dr Trevor Lockett, on average 90 Australians die from colon cancer each week.

"As such, early diagnosis has become a national health priority," Dr Lockett said.

He said timely and effective colonoscopy follow-up for National Bowel Cancer Screening Program subjects who test positive for blood in the stool is critical to helping this national initiative save lives.

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http://www.theage.com.au/national/cochlear-pioneer-canberra-must-listen-20091214-ksap.html

Cochlear pioneer: Canberra must listen

JULIA MEDEW

December 15, 2009

THE inventor of the bionic ear, Professor Graeme Clark, has called for the Government to fund cochlear implant replacements, saying it would be cruel to deprive deaf people of sound.

Professor Clark said he was shocked to learn last week that deaf people over the age of 21 who had a Government-funded cochlear implant did not receive funding to have it replaced when it stops working 10 to 15 years later.

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http://www.theaustralian.com.au/australian-it/business-baffled-on-national-broadband-network/story-e6frgakx-1225810372500

NBN leaves business baffled

• Mitchell Bingemann
• From: The Australian
• December 15, 2009 12:00AM

GOVERNMENT departments and bureaucrats were the main beneficiaries of last week's broadband gabfest, as keynote speakers failed to explain what business applications could be made possible by a national broadband network.

Australia Post corporate development manager Samantha Hannah-Rankin was one of a handful of local keynote speakers at the Realising our Broadband Future summit in Sydney, and the only speaker to really address how the government's $43 billion project could benefit business.

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http://www.computerworld.com.au/article/329699/department_health_aging_launch_indigenous_health_site?eid=-255

Department of Health and Aging to launch indigenous health site

Aims to address chronic disease among indegenous Australians

Tim Lohman 14 December, 2009 11:49

The Department of Health and Ageing (DoHA) is to launch a new Web portal aimed at providing an improved resource for managing chronic disease in indigenous Australians.

The site works toward achieving a measure under the Federal Government’s November 2008 $805.5 million Indigenous Chronic Disease Package aimed at supporting and promoting individual primary health care workers in the mainstream and Indigenous sectors to prevent and manage chronic disease in indigenous Australians.

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Enjoy!

David.

Anonymous Speaks Out Again and I Have to Agree!

Yesterday John Johnson of Pen Computing (a respected provider and developer of e-Health software) posted the following comment on the blog:

John Johnston said...

Pen Computer Systems IS NOT in the messaging business. We are in the business of providing ehealth solutions that are useful to providers and patients. Often we find that we have to build or collaborate to get something that is blocking the way. Our direction, of course, demands web services and our interest in WSMA is consistent with that. If WSMA is required by something we are doing we will use it. The main frustration for us is that NEHTA still has not got to a point where it can EASILY say "we need a tool to do X...who can we work with to build an X?" There are signs of this breaking down but there are sections within NEHTA who do not have the leadership to do this and it is holding us all up.

Sunday, December 20, 2009 7:45:00 AM

His post stimulated the following:

Anonymous said...

John Johnston said “there are sections within NEHTA who do not have the leadership to do this and it is holding us all up”.

Well if that isn’t stating the bleeding obvious I don’t know what is. For years the vendor community has mumbled and grumbled away about NEHTA but never been prepared to come out and state their views in the public arena for fear it might have negative consequences for their businesses. So nothing changes, NEHTA does what NEHTA wants and the doona mumbling continues unabated and nothing much changes.

This blogspot has consistently called for changes in NEHTA. Their current modus operandi is, as John says, “holding us all up” because “there are sections in NEHTA who do not have the leadership” required to fix this debilitating issue. So the whole system suffers and pays a high price in the process - government, developers, health providers, patients. Thank you John for having the courage to bring this issue into the open.

Sadly, you are but one lonely voice among the vendor community. When are your colleagues going to speak up?

Until that happens your business along with every other business will continue to be frustrated. If you want change to happen then insist on change, demand it and drive it home - because if you don’t you will just have to keep scratching your heads and asking yourselves “how can we get round these obstacles that are holding us up if we don’t do something to change the way things are being done”.

Oh, and one other thing - it is not appropriate to point the finger at “some sections within NEHTA”. Surely to goodness you understand that senior management determines the way NEHTA operates. That is the CEO’s job. He needs to know about these problems areas in NEHTA of which you speak, and he needs to seek help to fix them if he can’t fix them himself.

But until you find colleagues of like mind and courage to join you to insist on getting the leadership problems fixed then no improvements will be seen, the barriers to progress will remain and the outcomes for progress will not eventuate.

Sunday, December 20, 2009 10:58:00 AM

It is good to see such articulate, well informed and accurate commentary on the blog. All power to Anon for another really worthwhile effort.

Separately I am hearing that we now have NEHTA internally deciding that the “Year of Delivery” is to be taken as the financial and not calendar year - providing an extra bit of wiggle room. Additionally 2009 is to be the termed the year of “Internal Delivery”(all those .pdfs) and 2010 FY the year of “External Delivery”! What a giggle!

Additionally word is that - as we saw in the responses to the poll - there is not much confidence in the delivery of the IHI. To quote an informant (who I hope is sufficiently anonymous that they will not be hauled before the bosses as has happened to others who have now left the organisation) “None of the people in the trenches at NEHTA actually believe the IHI will get off the ground”. We will see in time I guess. Certainly if I was involved in the e-Health industry I would want to see a good deal more clarity about just what is going on before spending any money to integrate with what may be on offer!

Second lastly it was sad to hear the Karen Gibson has left NEHTA. She did some really good work over the years to get the Australian side of SNOMED off the ground. I am sure she will be missed.

Lastly have a look here:

http://www.nehta.gov.au/about-us/stakeholders

Seem stakeholders are not being talked to much in the last 5-6 months!

What a tangled web NEHTA weaves! Surely reform can’t be far off, can it?

David.

Vale Emeritus Professor (Louis) Charles Birch.

Charles Birch was the professor who in 1966 introduced me to the wonders of biology and ultimately was a catalyst of my studying Zoology, Biochemistry and Physiology which led me naturally to Medicine. The rest is now history.

He was an astonishing polymath and Australia has I believe lost a genuine living treasure. In 1990 he won the Templeton Prize (which is like a Nobel Prize in the area of Science and Religion).

He died this weekend at St Vincent’s Hospital in Sydney.

More details here:

http://en.wikipedia.org/wiki/Charles_Birch

I, for one, feel I have lost a link to all sorts of threads of my past. Go well Charles.

David.

Global Ranking for The Blog. – Surely they are Joking!

I checked this out today and was gobsmacked!

http://www.feedjit.com/myRank/

Check your Geoblogosphere ranking

NOTE: You must have Feedjit's Live Traffic Feed installed on your blog or website to be listed in the Geoblogosphere. You must not be an adult website and your site can not be web spam or contain any malware.

Enter your site hostname or URL below and hit "Check" to see where you rank in the Geoblogosphere. We also check if your site has been listed as spam, adult, containing malware or if you have been listed as a dangerous site with Google or any other companies

Blog: Aushealthit.blogspot.com.

You Rank #37 in: Sydney, Australia

You Rank #88 in: Melbourne, Australia

You Rank #113 in: Brisbane, Australia

You Rank #113 in: Adelaide, Australia

You Rank #116 in: Canberra, Australia

You Rank #303 in: Winnipeg, Canada

You Rank #456 in: Perth, Australia

Note: We analyze the cities that have sent you the most traffic recently. You may rank in many other cities in the Geoblogosphere.

----- End Extract.

A joke I am sure but fun!

David.

AusHealthIT Man Poll Number 3 - Results

The question was:

What Chance to You Give NEHTA / Medicare of Successfully Implementing Health Identifiers by July 2010

Results:

100% Chance of Success

- 14 (21%)

75% Chance of Success

- 8 (12%)

50% Chance of Success

- 5 (7%)

25% Chance of Success

- 13 (20%)

0% Chance of Success

- 25 (38%)

Total Votes 65

Comment:

Again, obviously blog readers are trying to tell NEHTA something here! I think NEHTA needs to do a little more work to convince the HI Community that they know what they are doing – and more than that that they have all the issues addressed.

Right now 65% of readers give this a 50% or less chance of happening on time.

We will see if anyone is listening.

Thanks to all who voted.

David.