Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, January 25, 2010

It Seems We Have Another Blogger Interested in E-Health in OZ!

I noticed the following post a day or so ago from the beautiful north coast of NSW.

Sunday, 24 January 2010

Australian Health Minister Nicola Roxon is not telling the truth about the Medicare e-card

Remember over the course of 2009 the Federal Health Minister Nicola Roxon assuring everyone within hearing that the new Medicare smart card would contain data and, give access to a database, which could be checked for accuracy by individual patients and that information would only be given out if the individual patient agreed to participate in the e-health scheme?

This is what the Minister was putting about at the time:

Eventually, the plan is for each person to have an individual e-health record, which holds their personal details; a summary health profile that can be shared with the person's permission between treating doctors; event summaries such as hospital discharge reports, care plans and test results, and a self-care management record where people can add their own material. and Ms Roxon has said participation in e-health records schemes would be voluntary and yet again All Australian residents will be allocated an Individual Healthcare Identifier (IHI) to support better communication between healthcare providers involved in patient treatment – but no patient will be forced to use it to access any health service.

Believed her did you?

Well, she told whoppers - barefaced and knowingly.

The proof is in the draft Healthcare Identifiers Bill 2010 which contains no precise provisions along those lines.

Much more here:

http://northcoastvoices.blogspot.com/2010/01/australian-health-minister-nicola-roxon.html

I have to say I am much attracted by the quotation provided in the side bar of the blog.

The Universal Declaration of Human Rights

Article 19

Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers. [Adopted and proclaimed by United Nations General Assembly resolution 217 A (III) of 10 December 1948]”

I had not realised blogging has such high level support and encouragement!

The rest of the blog is worth a browse to see what you think, but as I read it I think I am reading a blogger who is pretty unhappy about how the Rudd Government in general and Ms Roxon in particular are going about the e-Health task.

It is worth a mention that today’s articles describing Mr Rudd’s concerns about how the overall health sector is to be sustained and funded seem to even give e-Health the briefest comment.

See here:

http://www.theaustralian.com.au/news/kevin-rudd-in-alert-on-health-spend/story-e6frg6n6-1225823075398

Kevin Rudd in alert on health spend

  • Samantha Maiden, Online political editor
  • From: The Australian
  • January 25, 2010 12:00AM

KEVIN Rudd has declared 2010 a year of "major health reform", warning that health spending alone will outstrip state tax revenues within two decades.

In the latest in a series of speeches in the lead-up to Australia Day, the Prime Minister yesterday warned that Australia faced the choice of cutting pensions, health services and aged care; running massive deficits; or, his preferred option, boosting productivity as the population aged to help lift tax revenues.

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And here:

http://www.theage.com.au/national/states-face-health-cost-avalanche-20100124-msl7.html

States face health cost avalanche

MICHELLE GRATTAN AND LORNA EDWARDS

January 25, 2010

FEDERAL Government spending per person on health will rise in real terms from $2290 today to $7210 in 2050, with state governments at risk of being overwhelmed by rising costs, Prime Minister Kevin Rudd has said.

Treasury projects that, on present trends, the total health spending of all states will exceed all of their tax revenues, excluding the GST, by 2045-46, and possibly earlier in some states.

This year the Australian Government is spending the equivalent of 4 per cent of GDP on health, but the third Intergenerational Report, prepared by Treasury with projections to 2050, forecasts this will increase to 7.1 per cent in 2050.

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This is all a bit of a worry as e-Health is certainly seen around the world as one of the enablers of health system sustainability long term. Not with Rudd and Roxon it seems.

David.

Sunday, January 24, 2010

The NEHTA Spin Machine Pops A Gasket – And Tells Porkpies – With Its Latest Effort.

The following release dropped into view via the NEHTA RSS feed a day or so ago.

The original seems to have come from the Royal Australian College of General Practitioners.

Health Records Security Top Priority

22 January 2010

A general practice at the heart of the Black Saturday bushfires, awarded the Royal Australian College of General Practitioners (RACGP) 2009 Victoria General Practice of the Year Award, has worked tirelessly to get the practice back on its feet a year on from the fires.

One of the painfully slow after-effects of the Black Saturday bushfires has been to rebuild all of the vital community information that was lost, including the medical records of all the patients at the Marysville Medical Clinic, now located in Buxton.

When the Marysville Clinic burnt to the ground that day, along with it went all the files, paper records and patient history of many families and individuals living in the area.

Dr Lachlan Fraser, the solo rural GP in Marysville, had back-ups of the data, but the copies saved off-site were burned when his secretary lost her home and nearly her life in the township.

Thankfully they also had an old back up version that was kept in, Alexandra, half an hour north, an area that was also threatened with fire. But the clinic had still lost the past year and half of data, so along with the task of setting up and working from a temporary building, they has also had to re-establish vital medical data for patients.

“We perhaps had half of the information we would have liked and in particular it meant that we lost our recent records that involved patient pathology results or x-rays that we needed to follow up. It has meant that we needed to reconstruct patient histories which is a huge process and extra work during this difficult time for everyone,” said Dr Fraser.

Peter Fleming, CEO of the National E-Health Transition Authority (NEHTA) said that in the future, the difficult situation of starting to build patient files again will be one less thing that GPs have to worry about following a bushfire or natural disaster.

NEHTA is the lead organisation supporting the national vision for e-health in Australia.

“E-health is the electronic collection, management, use, storage and sharing of healthcare information instead of using paper records. A national e-health system will ensure that health information is safely and securely stored at all times.

“This means that the medical treatment for any person affected by a tragedy such as Black Saturday will never again have to be delayed while waiting for all information to be updated or assessed,” he said.

For this reason, the RACGP, which is the largest representative body for Australia's urban and rural general practitioners, is determined that GPs such as Dr Lachlan Fraser be a leader in the adoption of e-health in Australia.

“We are currently developing the next edition of the RACGP Standards for General Practices (4 th edition) and are working with NEHTA to make sure that the Standards are now fully integrated with e-health so that our RACGP members can deliver the highest standard of care to their patients,” said Dr Chris Mitchell, RACGP President and GP in northern New South Wales.

“The new RACGP Standards for General Practices will ensure that what the Marysville Medical Clinic and also GPs in flood affected areas of Australia have gone through will never have to be repeated.

“Trauma and grief counselling are high on the list of immediate services provided in these circumstances. However, maintaining high quality health services such as diabetes management and access to pathology results is very important, particularly for our patients with chronic diseases. The quick re-establishment of high quality general practice services can help high risk patients who lost everything back to health,” he said.

Dr Fraser agreed and added that electronic records would be a far better way to safeguard patient records which could then be accessed by healthcare providers anywhere in Australia and so helpful for those who did not re-settle in the same location.

Publication Date: 22 January 2010

Authorised By: Media

The release is found here:

http://www.racgp.org.au/media2010/35858

The release is also found here (complete with RACGP Logo)

http://www.nehta.gov.au/media-centre/nehta-news/590-bushfire-release

and it has appeared overseas here:

http://www.medicalnewstoday.com/articles/176861.php

With the title:

Health Records Security Top Priority, Australia

What just amazes me here is the arrant nonsense spouting from the mouth of NEHTA CEO.

Peter Fleming, CEO of the National E-Health Transition Authority (NEHTA) said that in the future, the difficult situation of starting to build patient files again will be one less thing that GPs have to worry about following a bushfire or natural disaster.

NEHTA is the lead organisation supporting the national vision for e-health in Australia.

“E-health is the electronic collection, management, use, storage and sharing of healthcare information instead of using paper records. A national e-health system will ensure that health information is safely and securely stored at all times.

“This means that the medical treatment for any person affected by a tragedy such as Black Saturday will never again have to be delayed while waiting for all information to be updated or assessed,” he said.”

This is just wrong, most especially the paragraph I have bolded. A severe fire anytime in the present, or next few fire seasons, would lead to the same outcomes and NEHTA knows it!

Now I, like all Australians, was greatly saddened, and horrified, by the awful loss of life and property in the Black Friday fires a little over a year ago.

This said there is just no excuse for this release. Nowhere in any NEHTA plan is the provision of off-site GP record archiving that has even been mooted let alone costed and funded, which is what is being suggested here.

An off-site summary record may be a twinkle in NEHTA’s eye, but after a year of trying they have not had that funded, let alone a more comprehensive provider record.

What is also undeniable is that if we sadly have another event like Black Friday in the next few years there is a high likelihood that there will be exactly the same outcome for the local GPs data – as there is nothing NEHTA has yet done or even planned, or will do in the foreseeable future, which would make the least bit of difference.

A different release from the College pointing out that natural disasters do happen, using this sad case as an example, and alerting GPs to think about secure cloud based encrypted backup over the internet would be much more sensible – as might be a review of possible providers of such services the College could endorse. Maybe such a suggestion for the next set of RACGP Standards?

The College should withdraw this present ill-conceived release in my view. I am sure many of those with serious e-Health knowledge and experience within the College, and there are many, would find this release rather opportunistic if not just offensive.

NEHTA should also apologise for making claims there is no way they can justify. I bet this release was not initiated by the College, but, of course, I am always open to surprises!

David.

Saturday, January 23, 2010

AusHealthIT Man Poll Number 6 – Results 23 January, 2010

The question was:

Does the Current Federal Health Minster Understand the Potential Importance and Value of E-Health?

Results:

Totally

- 2 (2%)

Pretty Well

- 8 (11%)

Marginally

- 32 (47%)

Not at All

- 25 (37%)

Votes: 67

Comment:

84 % it seems are not sure she ‘gets it’!

It seems there is a deep scepticism among readers that Ms Roxon has her head around e-Health in any useful way. Maybe that is part of the reason why we are having such difficulties.

Someone needs to provide her with a decent E-Health 101!

Thanks again to all who voted.

David.

Friday, January 22, 2010

An Uninformed Blog Takes a Shot at AusHITMan.

This dropped into view today.

Friday, January 22, 2010

'es mad about e health.

I got emailed an article in Computerworld this week, which seem

This article seems to be based on the rants of one individual who is blogging his way into retirement. The fact that one of the main objectives of this person's blog is to "provide commentary on what seems to have become the lamentable state of e-Health in Australia" and "to foster improvement" is hilarious. Obviously there will be a negative perspective of a topic irrespective of any merits of benefits there might be.

The blogger seems to be aiming target at NeHTA, as he has failed to recognise the challenges of being handed a poisoned chalice. Having been involved a little at NeHTA, it was easy to see that while every effort is being made to define pragmatic Australian standards for e-health information systems, numerous other parties will directly influence the likelihood of success. One instance that springs to mind was NeHTA had developed a simple directory service to identify nodes on the network. It was put forward as an Australian standard, but one vendor who had a hugely complex and excessively featured commercial non-standard product, vetoed the standard, forcing the market place to use it.

Lots more here:

http://rowlyemmett.blogspot.com/2010/01/es-mad-about-e-health.html

What to make of this?

Does he mention all the educational stuff I post?

Does he mention all the positive suggestions I make for improved leadership and governance etc.

Does he actually understand that lack of key stakeholder involvement is a death blow?

What ‘poisoned chalice’ cannot be sorted out after an organisation has been operational for 5+ years with competent management?

Has he actually read an understood more than the most recent 20 posts and the heading?

Anyone have a clue what this actually means?

“Dr More also seems unaware that as well as defining technical implementations, operational standards are also being defined to ensure the technical implementations are not compromised by poor work practices. Certainly, some areas in NeHTA (although I can't speak for all) recognise that no matter how well the system is designed, if the configuration, operational practices, support processes and policies are weak, the technical systems will be vulnerable.”

I sure don’t. Sounds to me like a consultant trying to sell something..but what would I know? (A very great deal as it happens is the answer).

When his has a blog with 50 sensible e-health posts I am sure we will all take him more seriously!

A worthy rant. I suggest readers make up their own mind if the “Procrastinator” has a clue. He has been on Blogger since 2002 and has never posted on e-Health and has only averaged 7 or 8 posts a year. Clearly travel to Fiji, testing stuff and not e-Health is the passion here!

And to the much broader point. Does this blogger think we are (in OZ) doing OK in e-Health and what is he doing to improve it – given he says I am doing nothing?

We all await a decent and coherent response!

David.

Note: The first paragraph of the post is messed up..not sure why.

D.

Thursday, January 21, 2010

It Seems The Professional Experts Agree with AusHITMan.

The following appeared yesterday.

Ovum: Australia needs to get national e-health act together

Research firm tips a big year for healthcare technology but Australia in danger of missing out on e-health opportunities

Spandas Lui 20 January, 2010 14:41:00

The global electronic health record (EHR) industry is set to blossom this year but Australia’s muddled national e-health strategy may stymie local growth, according to research firm, Ovum.

In its 2010 Trends to Watch: Healthcare Technology report, Ovum claims 2010 will be a pivotal year for EHR adoption. It credits worldwide government e-health initiatives and the recovering economy with spurring IT uptake by healthcare providers.

However, Ovum claims Australia risks sluggish EHR growth as the Federal Government fails to ratify a detailed direction for e-health. This will only be resolved when the National E-Health Strategy pushed by the Rudd government back in 2008 to standardise health record formats and integrating public and private health data is formalised.

While the country is already advanced in terms of healthcare and related IT systems, the e-health agenda has made little progress, Ovum research director, Steve Hodgkinson, said.

“[It’s] a lot of talk and not much action,” Hodgkinson, said. “Action is happening at a local and regional level with individual health organisations and hospitals implementing health record solutions but the issue is how they integrate together, which is the preoccupation of the strategy.

Hodgkinson said the Government was in the lurch as these kinds of issues required agreement amongst the various political parties. But without clear national directions the E-Health strategy has become an obstacle in healthcare technology investments.

“It is a two-edged sword,” he said. “The Government can speed things up if it makes effective and decisive decisions and funds are allocated to get things moving.

“I think it’s fair to say many people in the industry are frustrated by the time everything is taking and the lack of clarity of directions and people are holding off investment to wait and see what happens.”

More here:

http://www.arnnet.com.au/article/333166/ovum_australia_needs_get_national_e-health_act_together

Seems like the lack of leadership at the national level has been noticed. Ovum are a global firm and these comments read pretty clearly to me.

It seems to be a very sad situation when we find that assessed globally we are “sluggish!”.

Needless to say I strongly endorse their view!

David.

Weekly Overseas Health IT Links 20-01-2010

Here are a few I have come across this week.

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

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http://www.nytimes.com/2010/01/12/health/12denmark.html?scp=2&sq=Denmark&st=cse

Denmark Leads the Way in Digital Care

By SINDYA N. BHANOO

COPENHAGEN — Jens Danstrup, a 77-year-old retired architect, used to bike all around town. But years of smoking have weakened his lungs, and these days he finds it difficult to walk down his front steps and hail a taxi for a doctor’s appointment.

Now, however, he can go to the doctor without leaving home, using some simple medical devices and a notebook computer with a Web camera. He takes his own weekly medical readings, which are sent to his doctor via a Bluetooth connection and automatically logged into an electronic record.

“You see how easy it is for me?” Mr. Danstrup said, sitting at his desk while video chatting with his nurse at Frederiksberg University Hospital, a mile away. “Instead of wasting the day at the hospital?”

He clipped an electronic pulse reader to his finger. It logged his reading and sent it to his doctor. Mr. Danstrup can also look up his personal health record online. His prescriptions are paperless — his doctors enters them electronically, and any pharmacy in the country can pull them up. Any time he wants to get in touch with his primary care doctor, he sends an e-mail message.

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http://www.guardian.co.uk/society/2010/jan/13/online-health-records-saving-lives

Online health records can save lives

The crisis-hit £12.7bn NHS IT programme is under attack from the Tories, but it is working well in Scotland

Few tears were shed when the chancellor, Alistair Darling, appeared to sound the death knell last month for the hugely costly NHS national programme for IT. Yet it turned out to be a premature obituary for the £12.7bn scheme, which, instead of being scrapped, will have £600m – less than 5% – cut from its costs.

The programme, one of the most ambitious IT projects in the world, is designed ultimately to provide staff in hospitals and GP surgeries with potentially life-saving electronic health records on every­one in England. But it has been beset by problems since its inception in 2002. As a result, parts of it – including the core patient record project – are years behind schedule, it is costing several billion pounds more to implement than initially forecast, and has become mired in controversy over privacy issues.

Parts of the programme are running successfully, notably the computerised Choose and Book appointment booking service, the NHS N3 broadband network, and the electronic picture archiving and communications service (Pacs), which allows medical staff to quickly call up scans on a computer. As of March 2009, £4.5bn had been spent on these projects and other work.

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http://www.healthdatamanagement.com/news/meaningful_use_stimulus_arra_ehr-39634-1.html?ET=healthdatamanagement:e1132:100325a:&st=email

CIO Lays Out Incentive Game Plan

HDM Breaking News, January 12, 2010

Hospitals may well wish to hire a consultant to help them wade through the meaningful use rules and formulate a strategy for compliance. But John Halamka, M.D., gave the industry a 25-point cheat sheet for that strategy via a Jan. 3 posting on his Web blog, http://geekdoctor.blogspot.com/.

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http://www.healthdatamanagement.com/news/connectathon_interoperability_hie_vendors_ehr-39632-1.html?ET=healthdatamanagement:e1132:100325a:&st=email

Vendors Test Interoperability in Chicago

HDM Breaking News, January 11, 2010

Some 104 organizations including 95 software vendors are participating in the 11th Annual IHE North American Connectathon this week in Chicago, testing the ability of their products to transmit patient data to disparate information systems.

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http://www.healthcareitnews.com/news/brailer-proposed-meaningful-use-criteria-feel-right

Brailer: Proposed meaningful use criteria 'feel right'

January 11, 2010 | Patty Enrado, Special Projects Editor

SAN FRANCISCO – The "hand of thoughtful policy" created the proposed criteria for meaningful use, according to David J. Brailer, MD, former healthcare IT czar for the Office of the National Coordinator.

"It would have been easy to be symbolic rather than meaningful," the founder and chairman of the San Francisco-based healthcare investor firm Health Evolution Partners said. He expected the criteria to "be looser, less meaningful." Instead, he said, "I'm pretty impressed."

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http://fcw.com/articles/2010/01/13/hhs-electronic-health-records-ehrs-physician-notes.aspx

Key ingredient missing from e-health records, advisers say

A federal advisory panel says EHR regulations should include doctors' narrative notes

The Health and Human Services Department might have missed an opportunity to include a requirement for physician progress notes to be collected within subsidized electronic health records (EHRs) in its recent proposed regulation, according to members of a federal advisory committee that met today.

HHS’ Health Information Technology Policy Committee convened to discuss possible missed opportunities, areas needing clarification and other gaps in the proposed rule, which was released on Dec. 30, 2009.

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http://health-care-it.advanceweb.com/Editorial/Content/Editorial.aspx?CC=213723

The Future of Health Care Information Security

Health IT executives can determine the future of information security with the decisions they make today.

By Bryan Cline, PhD

Why do information security at all?

It's an interesting question.and one that's simple to answer. We "secure" or protect information that has value. Often-cited examples include national security information, battlefield intelligence and trade secrets. In the health care industry, patients and their families entrust us with their personal information along with their personal health and safety. A violation of this trust can have consequences ranging from personal embarrassment to medical identity theft.

For more than a decade, however, we've had another reason to protect personal information -- regulatory compliance. In 1996, the U.S. Congress passed the Health Information Portability and Accountability Act (HIPAA). A portion of HIPAA -- the Privacy Rule -- requires the protection of specific personally identifiable health information, referred to as protected health information (PHI). This caused an initial flurry of activity in the industry and was a driving force behind the creation of executive-level compliance and privacy offices in many health care institutions. Unfortunately, it had little impact on how PHI was protected once it became digital.

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http://www.modernhealthcare.com/article/20100113/REG/301139950

Computer medical records stolen from Kaiser

By Associated Press

Posted: January 13, 2010 - 11:00 am ET

Kaiser Permanente says a computer drive containing thousands of patient records was stolen from an employee's car.

Hospital officials said Tuesday the external drive stolen Dec. 1, 2009, held data on as many as 15,500 patients throughout Northern California, including the patient's name and Kaiser medical records number.

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http://www.modernhealthcare.com/article/20100114/REG/301149956

Stolen Tenn. BlueCross hard drives affect 220,000

By the Associated Press

Posted: January 14, 2010 - 9:15 am ET

Computer hard drives stolen from a BlueCross BlueShield of Tennessee closet in Chattanooga contain personal information on 220,000 members, and that count could more than double, an ongoing investigation shows.

A Wednesday statement from the state's largest health insurer shows that as many as 500,000 members, including some in other states, could eventually be identified as facing a risk of identity theft.

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http://www.modernhealthcare.com/article/20100115/REG/301159985

HIMSS program takes ‘HIT to the Streets'

By Andis Robeznieks / HITS staff writer

Posted: January 15, 2010 - 11:00 am ET

Implementation of health information technology is a means if not an end, with the end being healthcare reform, and with reform being defined as improved patient and public health outcomes and improved healthcare delivery, according to Judy Murphy, vice president of information services at Milwaukee-based Aurora Health Care.

"It's not about IT implementation, it's about practice change," Murphy said at the opening of a program held in Rosemont, Ill., titled "Takin' HIT to the Streets" sponsored by the Healthcare Information and Management Systems Society.

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http://fcw.com/articles/2010/01/12/hhs-health-it-strategic-plan-update.aspx

HHS panel to give fresh spin to federal health IT strategy

The update will address how health IT will be used to reduce errors and improve the quality of care

By Alice Lipowicz

Jan 12, 2010

A federal advisory panel to the Health and Human Services Department began considering a framework today to update the Federal Health Information Technology Strategic Plan guiding adoption of electronic health records. The updated plan is expected to be released by October.

HHS initially created a strategic plan for health IT in June 2008 to cover the period through 2012. Under the economic stimulus law, HHS’ Office of the National Coordinator for Health IT must update that plan.

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http://www.nextgov.com/nextgov/ng_20100111_6160.php

FDA nationwide electronic network will track safety of drugs and medical devices

By Aliya Sternstein 01/11/2010

The Food and Drug Administration is constructing a nationwide electronic system to continuously track the safety of drugs and medical devices using anonymous patient data, but federal officials and health care specialists say its usefulness might be limited without more personal information.

The Sentinel initiative, launched in May 2008, will complement existing systems that monitor side effects and other adverse changes in health linked to FDA-regulated products. The system will tie together information from various registries, including electronic health record systems and insurance claims databases, allowing FDA workers to query an issue quickly.

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http://healthplans.hcpro.com/content.cfm?topic=HEP&content_id=244916

CT AG's Office Suing Health Net for Member Data Breach

Les Masterson, for HealthLeaders Media, January 13, 2010

Connecticut Attorney General Richard Blumenthal is suing Health Net of Connecticut, Inc., after the insurer reportedly failed to secure private medical records and financial information of 446,000 Connecticut members and then did not promptly notify them of the possible security breach for six months.

According to the AG's office, the insurer learned that a portable computer disk drive disappeared from the company's Shelton office about May 14, 2009. The insurer contends that it was misplaced, but the AG's office says that it was stolen. The disk contained protected health information, social security numbers, and bank account numbers, according to the AG's office.

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http://www.modernhealthcare.com/article/20100113/REG/301139951

WorldVistA meeting set to begin Thursday

By Joseph Conn / HITS staff writer

Posted: January 13, 2010 - 11:00 am ET

Physicians, programmers and vendors interested in leveraging the public investment by the Veterans Affairs Department in health information technology will meet on the campus of Arizona State University this week for the 20th VistA Community Meeting. The four-day gathering begins Thursday.

Presenters and agenda items include:

Ignacio Valdes, a psychiatrist and developer of the new Astronaut family of tools to install enable clinicians to install and use open-source versions of the VA's Veterans Health Information System and Technology Architecture clinical information system, including a “cloud”-based instance of VistA.

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http://www.govhealthit.com/newsitem.aspx?nid=72911

Meaningful use panel ponders rule changes

By Mary Mosquera

Monday, January 11, 2010

A Health & Human Services Department advisory panel Friday explored potential clarifications and tweaks of its proposed meaningful use rules, the set of requirements healthcare providers must meet in order to qualify for thousands of dollars in federal health IT incentive payments.

It its first session on Jan. 8 following the release of the proposal, the meaningful use workgroup of HHS’s Health IT Policy Committee signaled it might revisit aspects of the plan, including the number of quality measures it requires and the effect on physicians trying to apply them.

But the panel said it would concentrate on “philosophical” comments instead of specific changes. “Clearly, clinical quality reporting and quality measures tied to outcome improvement is one of those big topics,” said Paul Tang, the workgroup co-chairman and chief medical information officer at the Palo Alto Medical Foundation.

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http://www.healthleadersmedia.com/content/TEC-244791/How-Ready-Are-Hospitals-for-Meaningful-Use.html

How Ready Are Hospitals for Meaningful Use?

Carrie Vaughan, for HealthLeaders Media, January 12, 2010

Every hospital leader that I have spoken with in the past six months or so has been confident that his or her organization is in a position to qualify for meaningful use and capture all of the incentive payments from the HITECH Act. Yet, both hospital and physician organizations have recently expressed concern about providers' abilities to meet the requirements of meaningful use defined by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator.

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http://www.e-health-insider.com/Features/item.cfm?&docId=323

Intelligent response

The Pre-Budget Report put some numbers on the scale of efficiency savings that the NHS will be expected to find over the next few years. Another reason for the NHS to get a grip on its data, says Daloni Carlisle.

The Pre-Budget Report in December 2009 threw a number of challenges to the NHS in general and to its chief executives, directors of finance and IT managers in particular.

Squirreled away beneath the hoo-ha over whether the National Programme for IT in the NHS was to be axed or trimmed by £600m or £500m, the PBR called for interim savings of £10 billion a year by 2012-13 through value for money initiatives.

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http://www.fierceemr.com/story/vista-powerful-it-adaptable/2010-01-14?utm_medium=nl&utm_source=internal

VistA is powerful, but is it adaptable?

January 14, 2010 — 11:36am ET | By Neil Versel

The lead in a Federal Computer Week story pretty well sums up the conundrum: "Is VistA a diva in disguise?" The open-source EMR at the heart of the Department of Veterans Affairs' health IT strategy "is the best health information system in the world, bar none," says Ed Meagher, a former VA deputy assistant secretary of information and technology, but, he adds, it's also an old system that's difficult to manage and very high-maintenance.

Meagher, now a private consultant, has been hired by VA CIO Roger Baker to lead a workgroup that will make recommendations on how to modernize VistA and make it more adaptable to the private sector. "VistA is very old technology. That does not mean it does not work or is not useful. It is not a perfect answer, but I think there are potential uses for it," explains Dr. David Kibbe, a health IT consultant to the American Academy of Family Physicians. "This is a very good trend that is occurring."

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http://www.ehiprimarycare.com/news/5532/cameron:_don%E2%80%99t_believe_google_scare

Cameron: Don’t believe Google scare

12 Jan 2010

David Cameron has said people should not believe “scare stories” about patients’ medical records being handed over to companies such as Google and Microsoft, if the Conservatives are elected.

In response to a question from E-Health Insider about how the party would deliver on its manifesto pledge to give people online health records, Cameron said: “Some of the scare stories you will have read in the papers that it will all be handed over to Google or some other company, don’t believe that.”

The Conservatives launched the first section of their draft manifesto last week. It dealt with the party’s pledges for the NHS, and said that patients would be able to check their health records as easily as their bank accounts and choose who to share them with.

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http://www.modernhealthcare.com/article/20100111/REG/301119980

Certification details for ‘meaningful' EHRs still unknown

By Joseph Conn / HITS staff writer

Posted: January 11, 2010 - 11:00 am ET

The massive new federal rule issued by the CMS on Dec. 30, 2009, has been getting most of the attention, but a smaller, companion rule by the Office of the National Coordinator at HHS also will affect providers and developers of electronic health-record systems.

The American Recovery and Reinvestment Act of 2009, also known as the stimulus law, requires the ONC to “keep or recognize a program or programs for the voluntary certification of health IT as being in compliance with applicable certification criteria adopted” by HHS.

And, according to ONC rule writers, HHS is obliged under the stimulus law to adopt standards, implementation specifications and certification criteria that will “enhance the interoperability, functionality, utility and security of health information technology.”

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http://www.ihealthbeat.org/features/2010/california-health-it-sphere-in-flux-in-wake-of-calrhio-shake-up.aspx

Thursday, January 07, 2010

California Health IT Sphere in Flux in Wake of CalRHIO Shake-Up

by George Lauer, iHealthBeat Features Editor

CalRHIO, one of the country's first organizations designed to oversee the exchange of digital health information, has been thrown into a state of flux after failing to win designation as California's lead health IT agency. Leaders and employees have left. Some of CalRHIO's board members may still be active in negotiations with the state, but the future of the organization is unclear.

The upheaval at the California Regional Health Information Organization leaves the recently reorganized California eHealth Collaborative as the front-runner in the race to win the state's nod to oversee billions of federal stimulus dollars for health IT projects. The first wave of federal money -- about $40 million -- is expected to begin flowing into California early this year. The state-designated agency could end up disbursing billions of dollars through a variety of federal programs over the next several years.

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http://www.healthdatamanagement.com/news/prescription_history_PHR_consumer_HealthVault_Walgreens-39624-1.html?ET=healthdatamanagement:e1131:100325a:&st=email

Walgreens Links to HealthVault

HDM Breaking News, January 7, 2010

Drug store chain Walgreens now enables its pharmacy patients to download their prescription history from the Walgreens.com Web site to a personal health record on the Microsoft HealthVault platform.

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http://www.nursingtimes.net/nursing-practice-clinical-research/acute-care/implementing-online-tools-and-resources-to-help-nurses-apply-evidence-based-care/5010233.article

Implementing online tools and resources to help nurses apply evidence based care

A global resource can enable nurses to translate healthcare evidence into practice at a local level. A project looked at how it was implemented and evaluated

Authors

Penny Bond, MSc, BSC, RN, is professional practice development officer; Jill French, MPH, BSc, MCSP, is project lead; both at NHS Quality Improvement Scotland.

Abstract

Bond P, French J (2009) Implementing online tools and resources to help nurses apply evidence based care. Nursing Times; 106: 1, early online publication.

While nurses may be aware of tools and resources for quality improvement, this does not necessarily mean they are used in practice. An alliance between NHS Quality Improvement Scotland and The Joanna Briggs Institute in Australia has been set up to promote and facilitate the use of online tools and resources designed to support the development of practice and ultimately to enhance care. This article summarises the tools available and discusses the implementation and evaluation of this project.

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http://www.healthcareitnews.com/news/stimulus-deals-great-start-healthcare

Stimulus deals off to 'great start' in healthcare

January 08, 2010 | Bernie Monegain, Editor

MINNEAPOLIS – Recent stimulus-induced EHR deals show sooner-than-expected adoption, especially in the hospital sector, according to investment firm Piper Jaffrey.

The second half of 2010 and all of 2011 are likely to show a large number of EHR deals, Piper Jaffrey analyst Sean Wieland wrote in his analysis Friday.

Wieland noted a growing trend of hospitals buying or subsidizing EHRs for physician practices.

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http://www.modernhealthcare.com/article/20100111/REG/301119979

Ambulatory survey shows slight uptick in EHR use

By Andis Robeznieks / HITS staff writer

Posted: January 11, 2010 - 11:00 am ET

A government survey indicates there was an 18.7% increase in the use of electronic health-record systems in physician offices to 41.5% in 2008 from 34% in 2007, but preliminary results for 2009 show only a slight increase up to 43.9%.

Doctors were asked, “Does this practice use electronic medical records or electronic health records (not including billing records)?” with options for answering “all electronic,” “part paper and part electronic,” “no” or “don't know.”

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http://www.bizjournals.com/sanjose/stories/2010/01/11/daily8.html?s=industry&i=health_care

Monday, January 11, 2010, 7:08am PST

NetApp, Stanford build gastric cancer registry

Silicon Valley / San Jose Business Journal

NetApp Inc. and the Stanford Genome Technology Center are building the country's first comprehensive gastric cancer registry, the company said Monday.

Sunnyvale-based NetApp (NASDAQ:NTAP) said the registry is powered by its storage technology, and the company donated more than $600,000 in hardware, software and services.

The Gastric Cancer Fund is working with the Stanford Comprehensive Cancer Center and Stanford Genome Technology Center to aggregate clinical and genetic data on gastric cancer patients and serve as a resource in developing strategies for this cancer's detection, treatment, and prevention.

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http://www.ehealtheurope.net/news/5511/tech_vital_to_medication_adherence

Tech vital to medication adherence

04 Jan 2010

Information technology has a vital role to lay in cutting medication-related errors and improving medication adherence among older people, suggests a recent report.

The report says that of the 3 billion medication prescriptions issued each year in the US, 12% are never picked up by the patient and 40% are not taken correctly.

Published by the US Centre for Technology and Aging in Oakland, California, the report says "widespread use" of technology aimed at older people has the potential to save thousands of lives and billions of dollars.

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http://www.e-health-insider.com/news/5529/stockport_becomes_seventh_lorenzo_site

Stockport becomes seventh Lorenzo site

11 Jan 2010

NHS Stockport has become the seventh site to implement iSoft’s Lorenzo electronic patient record system.

The primary care trust has gone live with Lorenzo Regional Care Release One (LRC 1) clinical documentation model.

This is being used by a community rehabilitation therapy team, following an implementation from local service provider, CSC, under The National Programme for IT in the NHS.

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http://www.who.int/goe/ehir/2010/12_january_2010/en/index.html

12 January 2010

eHealth Worldwide

Lots of interesting links.

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http://www.ihealthbeat.org/features/2010/no-shortage-of-material-for-satirical-health-it-web-sites.aspx

Wednesday, January 13, 2010

No Shortage of Material for Satirical Health IT Web Sites

by George Lauer, iHealthBeat Features Editor

After a fall vacation in the Caribbean, a restful holiday at home and a toast to the new year, the visionaries from SEEDIE and Extormity say they're ready to help usher in the digital age of U.S. health care.

If you're not already familiar with the work of these two health IT organizations, you should probably check out SEEDIE.org and Extormity.com before proceeding much further with this feature. What you're about to read will make a lot more sense, or at least you'll be better armed to appreciate the non-sense, after a visit to these sites.

SEEDIE is the Society for Exorbitantly Expensive and Difficult to Implement EHRs. Extormity is explained online like this: "At the confluence of extortion and conformity lies Extormity, the electronic health records mega-corporation dedicated to offering highly proprietary, difficult to customize and prohibitively expensive health care IT solutions."

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Enjoy!

David.

Wednesday, January 20, 2010

NEHTA Really Is A Great Example of The Worst in Public Sector Governance.

If you accept that NEHTA is actually a legitimate, legally authorised and constituted public sector organisation, the veracity of which I am somewhat suspicious, then there can be little doubt that its governance is a really bad model for achieving public sector driven reform outcomes.

I say this because I had occasion recently to have a closer look at the National Prescribing Service Limited (NPS) which on the surface is another non-profit limited company that is directly funded by Government, but which has a governance framework which is vastly superior, likely to deliver and sustainable in my view!

The key features of the governance are:

First, an elected board – with the Member Organisations electing the Board. The members are not just the jurisdictions –but a broad sweep of all those with an interest in what the NPS exists for – namely promotion of the Quality Use of Medicines and all that entails.

Here is the current list:

List of NPS member organisations

Our current Member Organisations are:

Second the board is an expert board – i.e. really knows the detail of what it is talking about. One can hardly say that about the current NEHTA Board.

NPS Board members

Members of the NPS Board serve a 3-year term, with a maximum of 3 terms, as defined by the NPS Constitution.

Current Board Members are:

· Dr Janette Randall (Chair)

· Mr Russell Edwards

· Dr Ross Maxwell

· Associate Professor Shane Carney

· Ms Kate Moore

· Dr Kay PriceDr Graeme Killer AO

· Dr Shiong Tan

· Ms Debbie Rigby

Virtually all Board the members have medical, pharmacy or nursing qualifications, with a good number having significant public sector management experience. Management has no capacity to ‘pull the wool’ over the Board’s eyes, which is always a bit of a worry with some of the decisions that come from NEHTA.

Third the organisation has a well defined clear reason for existence and a single source of funding which makes it focussed on achieving the goals it has been funded for – rather than the rather diffuse goal setting we see from NEHTA, and the intermittent and uncertain funding and manadate from COAG.

Fourth there are published evaluations and evaluation frameworks which are public and which are easily available:

See here:

http://www.nps.org.au/research_and_evaluation/publications/reports

The only serious assessment of NEHTA – the BCG Report some 2 years ago – is still to have many of its key recommendations implemented – e.g. at least 2-3 independent board members.

All in all a much better way of proceeding is seen with the NPS and their sort of approach that might actually lead to some success with NEHTA.

Mr Gonski and Ms O’Grady, are you listening? NEHTA could be reshaped to be way better governed than it is at present.

David.

Tuesday, January 19, 2010

Another Non Release from NEHTA. Yet Another Evidence Free Press Release with Vague Claims.

The following appeared from NEHTA today.

Patient privacy to improve under new system

19 January 2010. Confidentiality between doctor and patient will have even more safeguards in place under the new healthcare identifier system being proposed by the Federal Government, Dr Mukesh Haikerwal said today.

Dr Haikerwal, a clinical lead with the National E-health Transition Authority (NEHTA), said good clinical care depended on the absolute confidence that the privacy of each consultation is maintained.

This confidentiality is equally important to both health professionals and the people they look after and without this the system will not fly,’’ he said.

Patient confidentiality is vitally important to us in our work and the good thing about the healthcare identifier is that it not only makes the system safer, more accurate and up-to-date, but it also carries with it additional safeguards over and above what exists today.”

Dr Haikerwal, a medical practitioner and former federal president of the Australian Medical Association, said one feature of the proposed new system was that health professionals will have to be authenticated prior to accessing the system.

“There is also a very strict audit trail so that any individual can know that someone has accessed their record in the system which is an additional layer of security,” Dr Haikerwal said.

He also said that the identifiers are an essential element of any future electronic health record system, which will be patient controlled and not held on a centralised database.

Furthermore, the personal information associated with the identifier will be restricted to name, birth information, sex and address.

Dr Haikerwal said that he had personally been involved in consultations with a wide range of groups including privacy advocates over the past six months.

"You will never satisfy everyone in regard to privacy, but I have far more confidence in the future of e-health and the security of it's records than I do in the current system," he said.

"If confidentiality of the doctor-patient relationship is in anyway compromised I would have no part in it," Dr Haikerwal said.

ENDS

For more information contact Alison Sweeney Media Coordinator

The release and contact details are here:

http://www.nehta.gov.au/media-centre/nehta-news/585-patient-privacy

We all need to recognise this system is meant to commence in less than six months.

Just how are health providers to be properly authenticated – no information. Just why are we seeing differing messages about record content and record access.

The reason is pretty clear. Those involved do not have a clue what they are doing and more than that are not telling the public – in other than carefully spun press releases.

Mr Fleming you will be a former CEO walking out unless NEHTA dramatically transforms its communication of the details of what is planned and fully justifies the rationale of each of them!

How, in detail, will 600,000 health care providers be authenticated, how will it work, what will be the workflow impact, how will fraud be prevented and what exactly will it cost? More, why have these details not been in the public domain for a number of months so they can be considered?

Again – just hopeless! I am getting really tired of this. Where is the quality of openness and appropriateness of public administration we should be seeing?

David.