Weekly Australian Health IT Links - 28-03-2010.

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. Note also that full access to some links may require site registration or payment.

General Comment:

Things appear to have settled down a little after the utter waste of time we saw with the ‘Great Health Debate’ on Tuesday.

I really think it is just a joke that with an election coming in the next 5-6 months that the Labor Party is playing duck and drakes with releasing the details of its plans for the Health Sector. I fully understand why the States are being a bit hesitant is signing up to the plan when the details are not yet properly out there.

I especially would like to understand just how the proposed Heath Hospital Networks will interact with the Primary Care Sector, Private Hospital Sector and so on.

Of course I would also like to understand how e-Health will fit with all these new plans.

The Labor spokespeople keep saying they have a detailed plan, but I really don’t see significant detail just yet.

Of course we also presently have a substantial vacuum with respect to what the Opposition is planning. I have to say given Tony Abbott has 5 years of experience as Health Minister, I would have expected some decent policy be announced by now, and it needs to come soon.

On another topic it is interesting to see various interest groups coming out with comments in e-Health. It is really important we have an informed debate of all the topics around e-Health before we see too much in the way of legislation enacted. The more discussion and debate the better in my view.

Sadly there do seem to be some commentators who are not all that deeply across the issues they are spruiking. An example is the comment here from the College of Pathologists.

“They cite errors in the labelling of pathology results that have been linked to an estimated 150,000 to 200,000 identification mistakes every year.”

See article below.

Sadly there is no comment I could find on just how many of these ‘labelling errors’ will be fixed with the HI Service. I really struggle to see the linkage and I have to say the level of error in labelling seems to suggest some other major systemic issues. That is really a huge number of mistakes!

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http://www.smh.com.au/national/security-fears-may-delay-ehealth-patient-identifier-reforms-until-after-election-20100321-qo72.html

Security fears may delay e-health patient identifier reforms until after election

MARK METHERELL

March 22, 2010

A CENTREPIECE of the Rudd government's health reforms - the electronic patient identifier system - is at risk of delay until after the election amid concerns over security and privacy.

To shore up support for the e-health scheme, advocates have compiled dozens of examples of how the patient identifiers would save lives and end long delays in locating patient records for effective treatment.

They cite errors in the labelling of pathology results that have been linked to an estimated 150,000 to 200,000 identification mistakes every year.

The Royal College of Pathologists of Australasia has warned that such mistakes can endanger lives and have called for the urgent use of the identifiers.

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http://www.medicalobserver.com.au/index.php/news/hackers-try-to-capture-patient-bank-details

Hackers try to capture patient bank details

2nd Apr 2010

Andrew Bracey

GPs are being warned to remain vigilant in protecting patient files after one Melbourne practice encountered a computer virus that breached its security provisions and attempted to access patient bank details.

Melbourne GP Dr Graeme Baro said despite firewalls and antivirus software, his machines and servers contracted a virus, which had been designed to seek out patient bank details and send them back to a remote source. The virus, however, did not succeed in sending any patient information out of the practice.

“A couple of computers were having trouble with their functions… so our IT person checked and found a lot of viruses in them. We have firewalls to protect us but [viruses like this] can apparently still get in,” Dr Baro told MO. “[I’m told] one of the viruses was trying everything to get the information out – multiple times per second.”

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http://www.medicalobserver.com.au/index.php/news/new-standards-must-not-hurt-gps-hip-pockets

New standards must not hurt GPs’ hip pockets

22nd Mar 2010

Shannon McKenzie

NEW practice accreditation standards must not require GPs to invest in expensive new equipment or set tougher e-health criteria, doctors have told the RACGP.

As part of a review of the Standards for General Practice, the RACGP last week released the results of an online member survey, which asked GPs and practice managers how the standards could be improved, and what should or should not appear in the next edition.

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http://www.pharmacynews.com.au/article/pharmacy-urges-support-for-e-health-bill/514367.aspx

Pharmacy urges support for e-health Bill

25 March 2010 | by Simone Roberts

The Australian Pharmacy Liaison Forum has called on all sides of politics to support the Rudd Government's controversial Healthcare Identifiers Bill now before Federal Parliament.

The forum, representing the full range of pharmacy education and professional activity in Australia, met in Canberra this week and unanimously expressed support for the passage of the legislation. The legislation allows for unique 16 digit number to be assigned to all health care providers and consumers by the middle of this year.

"Individual healthcare identifiers within a strong privacy framework are vital building blocks to the introduction of national electronic health records," the forum said in a statement released yesterday.

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http://www.medicalnewstoday.com/articles/183144.php

College Of GPs Urges Politicians To Deal With Future Of Australia's Healthcare Now

23 Mar 2010

At a time of major health reform debate, the Royal Australian College of General Practitioners (RACGP) is urging Australia's politicians to make e-health and the implementation of a national Healthcare Identifiers Service a priority. Dr Chris Mitchell, RACGP President, said that individual healthcare identifiers and healthcare provider identifiers are the key that will unlock e-health for Australians.

"Without improvements in e-health and medical information management systems we will continue to expose patients to unnecessary risks, including adverse events and medication errors. Major cost saving can be achieved from a reduced number of tests and better management of chronic diseases supported by evidence-based guidelines," Dr Mitchell said.

"Every person in Australia should receive care that is informed by an electronic medical record. The passage of the Healthcare Identifiers Bill 2010 is an essential step to enable e-health innovation and efficiency.

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http://www.smh.com.au/technology/technology-news/facebook-linked-to-rise-in-syphilis-20100326-r17y.html

Facebook linked to rise in syphilis

ASHER MOSES

March 26, 2010 - 1:27PM

A British public health expert has blamed Facebook for a resurgence of the sexually-transmitted disease syphilis, but Australian STI researchers have called the claim "far fetched".

Data published by several British newspapers this week indicated that cases of syphilis had increased fourfold in Sunderland, Durham and Teesside - the areas of Britain where Facebook is most popular.

Professor Peter Kelly, director of public health in Teesside, told The Sun newspaper that "social networking sites are making it easier for people to meet up for casual sex".

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http://www.ehealthnews.eu/isoft/1985-isoft-wins-two-year-contract-renewal-with-nhs-body

iSOFT wins two-year contract renewal with NHS body worth $9.8 million

Sydney – Tuesday, 23 March 2010 – iSOFT Group Limited (ASX: ISF), Australia's largest listed health information technology company, today announced that NHS Shared Business Services (NHS SBS) has extended its contract for iSOFT Business Solutions to host its Oracle finance and purchasing applications by an additional two years.

This latest contract, worth £6 million ($9.8 million), extends the original $47.8 million agreement, signed in March 2008, to 2016. It expands the services offered and includes new HP hardware and infrastructure and a move to Oracle Release 12. The contract is for services only and excludes licenses.

NHS SBS provides services such as accounts payable, debt collection, bank account reconciliation, and account reporting for 30% of all NHS organisations. iSOFT has provided NHS SBS with a fully hosted managed service since 2002.

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http://www.theaustralian.com.au/australian-it/d-haptics-to-help-surgeons-feel-the-cutting-edge/story-e6frgakx-1225843983931

3D haptics to help surgeons feel the cutting edge

• Jennifer Foreshew
• From: The Australian
• March 23, 2010 12:00AM

AUSTRALIAN researchers are developing a universal simulator to bring a realistic sense of touch to simulations for medical procedures, defence and policing.

The simulator is based on force feedback technology, or haptics, which in its simplest form is used in arcade games to give players a sense of touch -- such as feeling the forces when going into a corner in a driving game.

Deakin University robotics engineer James Mullins has been developing the technology with the goal to make a simulation so close to the real thing that it can be used for training purposes.

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http://www.theaustralian.com.au/australian-it/hunter-region-trials-intel-home-care-unit/story-e6frgakx-1225843984761

Hunter region trials Intel home-care unit

Karen Dearne

From: The Australian

March 23, 2010 12:00AM

HEART patients in the NSW Hunter region are the first to trial an in-home monitoring system with potential to revolutionise medical care of people living with chronic illness.

Developed by Intel, the Health Guide home-care unit and online support system has been piloted by a private home-care service, Hunter Nursing, and 50 patients with congestive heart failure or chronic obstructive pulmonary disease.

Participants took a daily reading of their own blood pressure using a cuff attached to the device, and the data was automatically sent for review by medical professionals at Hunter Nursing, says director Margaret Scott.

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http://www.computerworld.com.au/slideshow/340728/pictures_intel_monitors_australia_e-health/?eid=-255

In pictures: Intel monitors Australia's e-health

By Georgina Swan

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http://www.theaustralian.com.au/australian-it/health-bill-papers-fall-off-government-websites/story-e6frgakx-1225843980761

Health bill papers `fall off' government websites

• Karen Dearne
• From: The Australian
• March 23, 2010 12:00AM

COMPUTER glitches on two government websites were blamed for key documents on the controversial Healthcare Identifiers Bill going walkabout last week.

Last Tuesday, following revelations in The Australian that Medicare Australia had provided the Senate inquiry on the HI bill with new details on suspected staff snooping, the document detailing data privacy breaches disappeared from the Senate Community Affairs committee website. Also missing were three National E-Health Transition Authority responses, posted the previous day, to questions on notice from the Senate inquiry.

The committee secretary said computer glitches had caused some documents to "fall off" the page for most of Tuesday.

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http://www.6minutes.com.au/articles/z1/view.asp?id=514136

Benzo use not affected by e-intervention

by Jared Reed

The move towards e-health is ramping up but when it comes to notifications about medicines and prescribing habits, it seems GPs might be suffering from alert fatigue, or they place a higher trust in their own clinical judgement.

Over a six-month period, Queensland researchers emailed GPs, nurses and pharmacists three fact sheets about benzodiazepines, with the aim of decreasing their use in aged care facilities towards “more appropriate” prescribing.

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http://www.theaustralian.com.au/business/rudd-roasts-conroy-over-the-national-broadband-report/story-e6frg8zx-1225843475077

Rudd roasts Conroy over the national broadband report

• Malcolm Colless
• From: The Australian
• March 22, 2010 12:00AM

KEVIN Rudd is believed to have told Communications Minister Stephen Conroy to come up with a strategy within two weeks to take the heat out of the political crisis building up around the government's $43 billion national broadband project.

Canberra sources said the directive followed a "difficult" meeting between Rudd and Conroy after the Prime Minister was shown a copy of the controversial $25 million implementation study into the development of the national broadband network.

Conroy has dismissed Senate demands to table the 500-page report prepared by KPMG and McKinsey & Co, arguing that he intends to discuss its findings with cabinet colleagues first.

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http://www.smh.com.au/technology/technology-news/conroys-internet-censorship-agenda-slammed-by-tech-giants-20100323-qt83.html

Conroy's internet censorship agenda slammed by tech giants

ASHER MOSES

March 23, 2010 - 4:38PM

Australia's biggest technology companies, communications academics and many lobby groups have delivered a withering critique of the government's plans to censor the internet.

The government today published most of the 174 submissions it received relating to improving the transparency and accountability measures of its internet filtering policy.

Legislation to force ISPs to implement the policy is expected to be introduced within weeks. The filters will block a blacklist of "refused classification" websites for all Australians on a mandatory basis.

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Enjoy!

David.

A Bit of a Landmark Passed. 250,000 Page Views!

The following are the statistics for the blog so far – since March 2006.

Thanks to everyone who has made this happen!

Australian Health Information Technology

VISITS

Total 147,354

Average Per Day 247

Average Visit Length 3:12 mins

Last Hour 12

Today 257

This Week 1,730

PAGE VIEWS

Total 250,099

Average Per Day 432

Average Per Visit 1.7

Last Hour 26

Today 578

This Week3,027

I reckon a quarter of a million page views is starting to be useful!

What is needed now is content that is richer than I can provide alone. Thus those who know what they are talking about (including NEHTA but excluding the PR Department) are encouraged to see if they want a guest slot to have their say. You will reach a reasonable audience if you do, and I want to foster open debate and discussion!

Think about it!

David.

The Blog Has A New Look

I have just been trying the experimental advanced blog template designer and have come up with a format I think is easier to read and so on.

Comments please as this is a work in progress.

David.

AusHealthIT Man Poll Number 13 – Results - 26 March, 2010

The question was:

How Happy Are You With the Senate Inquiry Recommendation To Just Pass the HI Service Bills?

Thrilled

- 14 (34%)

Happy

- 8 (19%)

Bit Concerned

- 6 (14%)

Wrong Thing to Do

- 13 (31%)

Votes 41.

Comment:

Well, that is pretty unclear. Almost a split vote (53% to 46%). This means there are more than a few that are not happy with what NEHTA and DoHA are trying to railroad through. They ignore this substantial body of concern at their peril!

Thanks again to all who voted.

David.

Weekly Overseas Health IT Links 23-03-2010.

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. Note also that full access to some links may require site registration or payment.

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http://www.fierceemr.com/story/study-e-prescribing-greatly-improves-accuracy-less-so-safety/2010-03-18?utm_medium=nl&utm_source=internal

Study: E-prescribing greatly improves accuracy, less so for safety

March 18, 2010 — 11:53am ET | By Neil Versel

It's a small study group, but the results are eye-opening nonetheless: Primary-care practices cut their prescription error rates from 42.5 percent to 6.6 percent in a one-year period by adopting e-prescribing technology.

That's the finding of researchers at Weill Cornell Medical College in New York City, as reported in the Journal of General Internal Medicine, who studied the prescribing accuracy of 12 primary-care practices in New York state. Six of the practices wrote prescriptions electronically, resulting in the major reduction in errors, while the half-dozen practices in the control group that stuck with paper prescription pads had a small uptick in their error rate, from 37 percent to 38 percent.

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http://www.modernhealthcare.com/article/20100319/NEWS/303199990

Broadband plan aims to improve HIT infrastructure

By Shawn Rhea / HITS staff writer

Posted: March 19, 2010 - 11:00 am ET

The Federal Communications Commission has laid out an ambitious 10-year plan for drastically improving broadband connectivity and usage that, among other goals, aims to improve healthcare delivery, patient outcomes and control medical costs nationwide.

In a chapter dedicated to healthcare information technology infrastructure and usage, the National Broadband Plan offered 11 recommendations for how the government could incentivize healthcare providers' use of e-care technology, which FCC officials estimated would save the country $700 billion over the next 20 years. The recommendations include reimbursement incentives that pay providers for adoption and use of e-care services, such as remote diabetes monitoring and mobile medical applications, that are proven to improve patient outcomes and save money. The agency also proposes setting up a dedicated healthcare broadband access fund that would help providers pay for broadband services in areas where connectivity is more expensive because of a dearth of available service providers.

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http://www.modernhealthcare.com/article/20100318/NEWS/303189990

Letter tells CMS to set more specific EHR goals

By Jennifer Lubell / HITS staff writer

Posted: March 18, 2010 - 11:00 am ET

To successfully implement the broad use of electronic health records, the CMS needs to make its health goals and targets more explicit, according to public comments submitted by healthcare leaders from 56 organizations on the agency's meaningful-use rule.

The Markle Foundation, the Center for American Progress and the Engelberg Center for Health Care Reform at Brookings were the three organizations that coordinated these comments and submitted them to the CMS in response to several rules governing meaningful use and certification of EHRs.

The rulemaking originated from the American Recovery and Reinvestment Act of 2009, also known as the stimulus law, which provided billions of dollars in federal subsidy payments to hospitals and office-based physicians for the purchase of EHR systems. HHS plans to administer the new subsidies beginning in 2011.

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http://www.computerweekly.com/blogs/tony_collins/2010/03/catering-staff-given-access-to.html

Catering staff given access to electronic health records

The Irish Independent says that catering staff were able to access confidential patient information held on a £54m health service record system which is being rolled out across Ireland.

The disclosure, under the Freedom of Information Act, has implications for the roll-out of Summary Care Records in England, as part of the NHS IT programme, NPfIT.

Smartcards for access to the Summary Card Records and other NPfIT systems are issued on the basis of "role-based" access. The idea is that only those staff with a legitimate professional relationship with the patient can use their smartcards to access that patient's records.

But local operational procedures may require that secretaries and reception staff who collect information on patients have smartcards.

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http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=217715

Getting Physicians and Patients Connected

The EHR rollout process has been a gradual - and successful - one for Kaiser Permanente.

By Mark McGraw

It's no secret that the concept of electronic health records (EHRs) hasn't been universally embraced throughout the physician community.

Despite the inevitable move to a digital health care environment, some doctors are holding on to the idea that EHRs will bog down their practices, limit the number of patients they see each day and depersonalize the doctor/patient relationship.

The findings of a recent Nuance Healthcare Solutions survey echo those concerns. The poll of nearly 1,000 physicians found that 96 percent of respondents expressed fear "about losing the unique patient story with the transition to point-and-click (template-driven) EHRs."

The survey also found that 93 percent of doctors "disagree" or "strongly disagree" that using an EHR has reduced time spent documenting care.

It's unlikely that many physicians at Kaiser Permanente share those sentiments, however, at least according to Jack Cochran, MD, executive director of The Permanente Federation, the national umbrella organization for the regional Permanente Medical Groups.

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http://www.healthleadersmedia.com/content/TEC-248084/AHA-Recommends-Changes-to-EHR-Standards-Implementation.html

AHA Recommends Changes to EHR Standards, Implementation

Andrea Kraynak, for HealthLeaders Media, March 16, 2010

Adding its voice to the EHR standards debate, the American Hospital Association asked for changes to proposed EHR standards, implementation, and certification.

The AHA sent its recommendations and comments regarding the interim final rule specifying the initial set of standards, implementation specifications, and certification criteria for EHR technology to the National Coordinator for Health IT in a March 15 letter.

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http://www.healthleadersmedia.com/content/MAG-247660/Hospitals-as-Software-Service-Providers.html

Hospitals as Software Service Providers

Health systems are stepping into a new role, offering software as a service to realize value from EMRs.

It's no secret that small physician groups and community hospitals are going to be hard-pressed to meet the meaningful use requirements in 2011. Not only do they lack resources—financial and workforce—to purchase, implement, maintain, and use these systems effectively, but their options for electronic medical record products are limited, as well. Many of the vendors that support smaller hospitals began by offering financial systems and now are adding the clinical components to those systems.

There are approximately 4,000 hospitals with fewer than 250 beds, and the products for those hospitals will take a lot of heavy lifting to get them certified for meaningful use, says Chuck Podesta, senior vice president and chief information officer at Fletcher Allen Health Care, a 562-licensed-bed academic medical center in Burlington, VT. "These smaller systems don't have a good clinical track record—especially with computerized physician order entry," he says.

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http://www.kaiserhealthnews.org/Daily-Reports/2010/March/17/Health-IT.aspx

Device Manages Care Online For Chronic Disease Patients

Mar 17, 2010

The Cleveland Plain Dealer: A pilot project at the Cleveland Clinic that monitored 250 patients with chronic diseases showed patients were able to increase the number of days between visits. The study used a medical device that shared daily patient data online with doctors and nurses and found that patients better managed their care using the system.

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http://www.sacbee.com/2010/03/16/2609490/sutter-hospitals-to-invest-in.html

Sutter hospitals to invest in electronic health records system

bcalvan@sacbee.com

Published Tuesday, Mar. 16, 2010

Sutter Health said Monday it will push forward with converting to electronic health records at its hospitals after delaying the project to save money during the recession.

The health system expects to spend $400 million over the next five years to expand its digital medical system, with Sutter Medical Center going online in 2013, when expansion of its 28th Street campus is complete.

While the economy is still very unpredictable, the hospital system will go forward with the project, said Pat Fry, the chief executive officer for Sutter Health.

"There's never going to be a great time, so let's give the value to our patients as quick as we can," Fry said.

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http://www.ehiprimarycare.com/news/5736/scots_gps_say_paper_should_guide_portals

Scots GPs say paper should guide portals

16 Mar 2010

GPs in Scotland have demanded that a series of security measures are introduced to protect patient confidentiality when their records are accessed electronically.

Last week’s Scottish Local Medical Committees’ conference heard that GPs are coming under increasing pressure to share information from their records with the introduction of clinical portals across Scotland.

However, GPs agreed that secondary care clinicians should not have access to the whole of the GP record. Instead, they agreed that only information that would normally be shared on paper should be available to them electronically.

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http://www.ehiprimarycare.com/news/5723/scots_mps_criticise_slow_progress_on_it

Scots MPs criticise slow progress on IT

11 Mar 2010

The Scottish Parliament's Health and Sport Committee has criticised the Scottish Government for the slow roll-out of its clinical portal and limited progress on telehealth.

In a two part report, ‘Clinical portal and telehealth development in NHS Scotland,’ the committee praises several Scottish health boards for developing clinical portal projects to enable greater access to patient information.

However, it says that: “The committee is disappointed that, given the differing states of readiness of various portal systems, clear timescales have yet to be established for the development of portal technology across Scotland.”

It also calls for the Clinical Change Leadership Group and the Clinical Portal Programme Board to work closely with the Scottish Academic and Research Community to design “a nationwide portal infrastructure.”

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http://www.telegraph.co.uk/health/healthnews/7408379/Patients-medical-records-go-online-without-consent.html

Patients' medical records go online without consent

Patients’ confidential medical records are being placed on a controversial NHS database without their knowledge, doctors’ leaders have warned.

By Kate Devlin, Medical Correspondent

Published: 10:20PM GMT 09 Mar 2010

At present 1.29 million people have had their details placed on the system. A further 8.9 million records are due to be added by June

Those who do not wish to have their details on the £11 billion computer system are supposed to be able to opt out by informing health authorities.

But doctors have accused the Government of rushing the project through, meaning that patients have had their details uploaded to the database before they have had a chance to object.

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http://www.guardian.co.uk/society/2010/mar/07/nhs-database-doctors-warning

NHS database raises privacy fears, say doctors

GPs say patients' rights are being overlooked

Doctors' leaders are warning government ministers that the NHS is jeopardising its relationship of trust with patients by creating a vast database of personal medical records. GPs say they fear patients' rights are being overlooked, that "scaremongering" is being used to get people's agreement for the database, and that hackers could illegally access the central computer.

The NHS wants more than 50 million people in England to agree to the creation of an individual summary care record (SCR). The idea is to improve the quality and safety of treatment provided by hospital staff and out-of-hours doctors by giving them access to information usually only held by a patient's doctor.

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http://www.modernhealthcare.com/article/20100316/NEWS/303169990

Doc, hospital groups press CMS on meaningful use

By Andis Robeznieks / HITS staff writer

Posted: March 16, 2010 - 11:00 am ET

To facilitate meaningful use of electronic health records, the CMS should abandon its all-or-nothing approach to awarding financial incentives, eliminate goals and measures that don't directly apply to EHR adoption, and widen the eligibility for certain hospital-based physicians, according to a letter sent to acting CMS Administrator Charlene Frizzera. The letter was signed by the American Medical Association and 95 other state and specialty medical societies.

The 37-page letter stated that “physicians are deeply supportive and committed to incorporating well-developed EHRs into their practices,” but the “aggressive” criteria included in the proposed requirements for federal EHR-investment subsidies will deter many physicians from participating in the incentive program, which was included in the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.
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http://www.healthleadersmedia.com/content/TEC-248027/ComputerControlled-Pancreas-Could-Close-the-Diabetes-Loop.html

Computer-Controlled Pancreas Could Close the Diabetes Loop

Gienna Shaw, for HealthLeaders Media, March 16, 2010

Aaron Kowalski is the vice president for glucose control research at the Juvenile Diabetes Research Foundation. He also has type 1 diabetes and, like many others who have the condition, he sometimes struggles to regulate his blood sugar levels.

"I'm a scientist and I work in the field and I don't achieve perfect glucose control," he says.

In that he is not alone: Some studies have found that even highly-managed diabetes—those who test their blood sugar more than eight times a day, still spend almost 70% of their day out of normal blood ranges—an average of more than eight hours with high blood sugar levels and two hours with low.

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http://ehealtheurope.net/news/5735/ehtel_calls_for_local_action

EHTEL calls for local action

16 Mar 2010

The European Health Telematics Association has called for more regional and local level approaches to eHealth across Europe.

Speaking to E-Health Europe at the World of Health IT conference and exhibition in Barcelona, a spokesperson for the non profit organisation, said that eHealth needs to be done from the bottom-up.

The spokesperson said: “We need to look at the level that we can start doing real things with eHealth and that is at regional level.

"It isn’t at member state because it’s too big. It can only be at regional or below because otherwise there are too many people and it’s too complex.”

The organisation’s comments come ahead of its board meeting and coincided with the signing of a declaration by European eHealth ministers.

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http://ehealtheurope.net/news/5734/eu_ministers_sign_ehealth_declaration

EU ministers sign ehealth declaration

15 Mar 2010

European Union health ministers have signed a declaration that recognises the strategic value of eHealth and commits to greater collaboration across Europe.

The declaration was signed at the high-level ministerial conference on eHealth in Barcelona, which is part of the World of Health IT conference being held this week.

It was driven the Spanish presidency of the EU, which wants eHeath to be an integrated part of European policies.

As part of the declaration, the ministers responsible for eHealth said that they recognised the “importance of fully integrating digital healthcare into the European policy portfolio and the development of the post 2010 European strategy.”

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http://ehealtheurope.net/news/5746/ec_urges_bigger_thinking_in_ehealth

EC urges bigger thinking in eHealth

17 Mar 2010

The European Commission has called for a change in the "mentality" that leads to thousands of small scale pilots being run in eHealth.

Speaking in Barcelona, at the World of Health IT conference and exhibition, Zoran Stančič, deputy director general of the European Commission’s DG INFSO, said that while the Commission is committed to support for eHealth in the future, smaller pilots need to be stopped.

Stančič said: “We need to think in terms of new mechanisms and instruments to foster innovation and deployment rather than just relying on small pilots. In order to do this, we need the strong political commitment, which has to be driven by deployment and a clear leader framework.

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http://www.govhealthit.com/newsitem.aspx?nid=73314

FCC broadband plan targets e-health expansion

By Brian Robinson

Tuesday, March 16, 2010

The Federal Communications Commission formally adopted and forwarded to Congress a plan to significantly upgrade U.S. broadband connections that could greatly boost the adoption rate of health IT.

The National Broadband Plan was mandated by the 2009 American Recovery and Reinvestment Plan, and is the result of an unprecedented level of public workshops, hearings and online interaction. The process to get to the plan generated some 75,000 pages of public comment.

The health care chapter of the plan (http://www.broadband.gov/plan/10-healthcare/) includes substantial changes to the FCC’s existing Rural Health Care Program, which already funds some broadband improvements. It has authorized funding of $400 million a year, but only a fraction of that is actually used.

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http://edition.cnn.com/2010/HEALTH/03/15/bronx.clinic.iris.scan/index.html?hpt=C1

At Bronx clinic, the eyes are windows to medical records

By Madison Park, CNN

STORY HIGHLIGHTS

• Bronx clinic uses iris scanners to identify patient to his/her medical records
• Clinic serves needy and had trouble with duplicative names
• Clinic has cut down on duplicating records and prevent medical frauds

(CNN) -- Rafael Fernandez walks into the Bronx, New York, medical clinic, with his eyes wide open.

Checking Fernandez in, a clinic employee scans his eyes using a handheld camera. Within seconds, the camera reads his iris patterns, and a computer locates his medical record.

Such iris identification technology is usually seen in international airports to allow registered passengers to fast-track through passport checks and immigration.

But far from the sleek European airports, the South Bronx clinic that receives federal funding and operates in one of the most impoverished U.S. areas uses the instruments to prevent medical record mishaps.

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http://www.modernhealthcare.com/article/20100315/NEWS/303159930

Patient safety must start in classroom: report

By Andis Robeznieks / HITS staff writer

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

Healthcare delivery continues to be unsafe and will probably remain that way for some time unless medical schools make substantial improvements in how they teach patient safety, according to Unmet Needs: Teaching Physicians to Provide Safe Patient Care, a new report issued by the National Patient Safety Foundation's Lucian Leape Institute.

The report charges that medical schools do an inadequate job of developing student understanding of concepts such as systems thinking, problem analysis and team collaboration that will help them become architects of patient-safety and quality improvement efforts.

Information technology does not get mentioned much in the report, but its importance is noted.

“They must realize the value of information technology in helping them deliver up-to-date, evidence-based care, and be able to use information technology tools to find pertinent literature, review guidelines, calculate patient risk factors, and apply clinical pathways,” the report states in a section that talks about doctors being life-long learners.
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http://www.modernhealthcare.com/article/20100315/NEWS/303159916

Group develops guidelines for CPOE standards

By Shawn Rhea

Posted: March 15, 2010 - 5:59 am ET

The Institute for Safe Medication Practices has developed a set of guidelines aimed at helping providers create drug-prescribing standards for their computerized physician order entry systems.

The guidelines, according to a news release, will address drug-safety problems that hospitals and other providers often encounter. They will allow providers to set well-defined prescribing standards for common patient conditions.

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http://govhealthit.com/newsitem.aspx?nid=73262

It’s official: Hampton Roads is next VLER community

By Peter Buxbaum

Tuesday, March 09, 2010

The Department of Veterans Affairs and the Department of Defense yesterday officially inaugurated Hampton Roads, Va., a nexus of veterans and active-duty military as well as government and purchased healthcare providers, as the next site of its Virtual Lifetime Electronic Record (VLER) community pilot project.

The Virginia project will bring together DoD, VA, and commercial healthcare providers Sentara Healthcare, Riverside Health System and Bon Secours Medical Group.

The new project, dubbed “Phase 1b” of VLER by its government sponsors, follows on Phase 1a, a San Diego, Calif.-based project began last year to test the exchange of electronic health records between the VA and the private Kaiser Permanente health network.

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http://www.healthimaging.com/index.php?option=com_articles&view=article&id=21190&division=hiit&division=hiit

HIMSS: HMS launches HMS Connex, showcase ambulatory EHR

Healthcare company Healthcare Management Systems (HMS) revealed its new interoperability product HMS Connex at the 2010 annual HIMSS conference in Atlanta. HMS Connex will enable the exchange of clinical data between third party systems, health information exchanges and public registries while assisting in qualifying for the American Recovery and Reinvestment Act (ARRA) of 2009 HITECH stimulus funds, according to the company.

Built around IT company Mirth’s open source technology platform and customized for the HMS product suite, HMS Connex is designed to help customers achieve Stage 1 meaningful use interoperability requirements; specifically reporting hospital quality measures to CMS, exchanging key clinical information among providers of care, submitting lab results to public health agencies and submitting data to immunization registries, according to HMS, of Nashville.

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http://govhealthit.com/newsitem.aspx?nid=73304

HHS group proposes national EHR safety database

By Mary Mosquera

Friday, March 12, 2010

A Health and Human Services advisory panel today proposed creating a national database into which clinicians could report patient data errors and unsafe conditions they encountered in their use of electronic health records.

Clinicians could use the system to report instances – noticeably inaccurate patient data or an EHR technical glitch, for instance – that they believed might compromise patient safety.

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http://www.healthcareitnews.com/news/five-features-missing-most-ehrs

Five features missing from most EHRs

March 12, 2010 | Nancy McCallum, Contributing Writer

While EHRs are increasingly essential for healthcare providers, their efficacy can be constricted by the nature of their design, their use and the interpretation of data.

Jerry Buchanan, Program Manager and Scrum Master at eMids Technologies, Inc., an IT and BPO consulting company, weighs in on some features that are missing from EHRs:

1. Information, not data

While EHRs hold data, that's not the same as holding information, Buchanan notes. Data needs to be converted into relevant information to be of practical use. However, there's also the possibility that EHRs can get overloaded with information. The goal, Buchanan says, is technology that organizes data in a way that assists healthcare providers most efficiently and effectively in making clinical decisions. This includes EHRs capable of providing alerts and alarms about patient conditions, given to caregivers in real time.

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http://www.ihealthbeat.org/features/2010/defining-moment-for-health-information-exchange-in-california.aspx

Monday, March 15, 2010

'Defining Moment' for Health Information Exchange in California

by George Lauer, iHealthBeat Features Editor

California achieved two major milestones last week on its march toward a digital future in health care.

On Monday, state officials unveiled a new private organization to fit the state's needs to manage California's health information exchange.

On Thursday, that new organization -- Cal eConnect -- had something of a coming-out party with stakeholders from all over the state and from all parts of the health care industry convening to discuss strategic and operational plans.

"This is a defining moment for California in many ways," said Jonah Frohlich, deputy secretary for health IT at California's Health and Human Services Agency and principal architect of the new not-for-profit.

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Enjoy!

David.

AusHealthIT Blog To Be Preserved by the National Library of Australia!

I have been told that the National Library have selected this blog as one (of many) the nation should keep, and that it will be archived for posterity!

To this end I have agreed they can capture all the material and make it available on their site.

This site can be found here:

http://pandora.nla.gov.au/

I don’t know how quickly this will happen but it seems like a nice idea to have all the various views, that we have seen on the blog, on Health IT and related matters being preserved.

If this archiving concerns you please get in touch.

David.

A National Expert Speaks out on the Looming Disaster NEHTA is Guiding Us Towards.

Dr Andrew McIntyre let me know (via Skype) he had posted this blog on the Medical Objects Web site about 12:20am this morning. Needless to say I was asleep at the time and picked up the instant message when I came down to the office this morning.

This is very serious stuff indeed I believe.

Over to Andrew.

NEHTA – On the road to nowhere?

National Health IT programs do not have a good record of success in general, and Australia has been a good example of that to date. I don’t think anything is about to change.

The reasons for this will no doubt be well understood in time, as history looks back and shakes its head in dismay at the wasted resources and opportunities. It’s hard to pinpoint the reasons for failure until you have success to contrast it with. I think a large part of the problem is the top down approach to a problem that can only be solved bottom up. By many measures Australia has been a leader in eHealth to date, but I don’t think any of that can be attributed to government policy or support as its mostly been bottom up. Certainly the National eHealth Programs of the past have failed to progress the situation and have in many ways just distorted the market for the worse.

While some will say the issue is “Change Management”, I think this is wrong. To have change management you need to have a change worth implementing and to date the quality has not been there to justify change. The quality needs to be in the software and eHealth is a complex beast to tame. To progress it we need to have the foundations to build on and currently they are sitting on swamp. Netha appears determined to adopt the tunnel vision of its “Stakeholders” i.e. The state health departments and ignore the bigger picture of the international markets and standards bodies. Despite ample evidence that the existing infrastructure is cobbled together and working in the most fragile manner conceivable they want to march on and implement national programs without any compliance agenda on the horizon for at least 2 years. Building anything on the current infrastructure without a resolute compliance program is a recipe for disaster.

Australia currently has good penetration of HL7 V2 messaging, but the quality is patchy and the interoperability extremely fragile. Any change to messages results in failures and in effect we are locked into a situation where only a few systems can handle compliant data. This is interconnectivity and is a long way from interoperability, it’s a road to nowhere and in reality the known errors in existing lab messages cannot be corrected because of the fear of breaking existing systems. Despite Australia having compliance testing available there appears to be a complete lack of understanding of its importance by Nehta. Rather than underpin the cracking foundations before trying to renovate the building Nehta is determined to add another 3 stories to the building. The earthquake in Haiti demonstrated the dangers of a city built without adequate building regulation. Nehta’s plans will result in major loss of life at the first sign of a tremor, even if they manage to build something (which they have failed to do to date).

Interconnectivity without interoperability is a recipe for disaster and this appears to be the agenda. Delivery at all costs appears to be the political motivation and I think it’s time to reject the short term political goals and try and attack basic compliance and quality now. The software term “Design by Contract” was never meant to mean a business contract, but a compliance contract. Nehta appears not to get this and wants to substitute “contracts to deliver a business plan” for “contracts to comply with standards”. Computers are quite bad at being politically correct and will reject business plans that lack credibility at the binary level.

The real issue in eHealth is a lack of quality, and subsequently a lack of interoperability and safety. There are fundamental engineering deficiencies in the real world and a lack of realization that only standards, and good compliance with standards can fix the flawed foundations. Foundations are not sexy, but getting the structure out of the ground is always the biggest hurdle on a building project. To improve the situation we need a focus on good software engineering practices and in the world of complex systems that means testing and more testing. The reality is that HL7 V2 is going to be around for many years to come and rather that march on with grand plans the priority needs to be getting a compliance program for existing standards up and running now. Moving to something new is an expensive diversion that will make the problem worse, not better. Someone needs to stand up and stop claiming they will deliver the 10 story masterpiece “next year” and start work on a compliance program for what is already in use. We need some solid foundations or the Haiti style devastation of eHealth will surely descend upon us within a few years.

The Nehta plan, as it stands will deliver fragile single purpose interconnectivity with little or no interoperability. It’s time we turned our existing interconnectivity into interoperability by a deliberate compliance agenda. Once that’s done we will be out of the ground and ready to do some real work. As it stands they are on a road to nowhere. We have been down that road and we know where it leads.

The original full posting is found here:

http://blog.medical-objects.com.au/?page_id=44

For those who don’t know here are a few words about Medical Objects:

About

Medical-Objects is an eHeath company dedicated to standards based EHR applications and messaging. Born out of frustration with the lack of progress we are working hard to get the standards and infrastructure in place to make the care of patients easier and more efficient. Our focus is clinical medicine and decision support and any missing infrastructure needed to implement this. While we are best known for our secure messaging, this is just (an important) building block that we need to enable our vision for advanced decision support.

----- End Quote

See here:

http://blog.medical-objects.com.au/?page_id=2

For more information see here:

http://www.medical-objects.com.au/Aboutus/tabid/105/Default.aspx

MO are one of the very few who have made major strides at a state-wide level making a difference in improving clinical communications and for them to be this worried should ring alarm bells everywhere.

It seems to me NEHTA is focussed on destroying working properly standardised clinical messaging providers (Argus, Healthlink, eClinic and MO to name a few) – while having nothing of their own to replace it while failing to work with what is already working and can do more, if allowed.

Read carefully and be alarmed, very alarmed!

David.

Now Here Would Be a Great Briefing To Attend and Ask Some Hard Questions.

I was alerted to this gathering today.

AIIA Healthcare Briefing

Tuesday 30 March 2010

North Sydney

“NEHTA progress report”

AIIA is supporting NEHTA in the introduction of better ways of electronically collecting and securely exchanging health information in Australian healthcare.

Today’s briefing is to have an update on the various initiatives on the NEHTA agenda that healthcare account managers in ICT companies need to be aware.

Lisa will provide an overview of the major projects, their progress and expected implement framework over the next twelve months. In particular, we have asked him (her ?) to give the outlook for Shared EHR. Lisa will also give information on jurisdiction and implementation issues and opportunities.

Our discussion will be on what companies need to be doing to be business ready to take advantage of the NEHTA developments.

Speakers

Lisa Smith, General Manager, NEHTA

Details

When: Tuesday 30 March 2010

When: 0800 - 0930

Where: Training Auditorium, Intel Corporation, Level 17, 111 Pacific Highway, North Sydney

The building between Miller and Walker Streets, North Sydney

Access: Parking is available in the nearby Greenwood Centre. North Sydney Railway Station is the nearest train station.

Bookings: There’s no need to rsvp – just turn up

Cost: complimentary

About AIIA Healthcare Briefings

Australia’s healthcare sector provides key commercial opportunities to AIIA’s member companies, and AIIA seeks to assist our member companies to grow in this marketplace. Our AIIA Healthcare Briefings typically cover sector developments: business issues, drivers and constraints, buyer identification, and sector research.

Designed for senior ICT executives, healthcare account managers, commercial and government account and sales leaders and managers, healthcare business development managers, healthcare business analysts, and consultants. Our Briefings are a great opportunity to catch up with colleagues and to meet new colleagues in the industry.

Intel Australia is a strong supporter of the AIIA Healthcare Briefings and kindly provides its City Office venue for our monthly briefings.

You are welcome to suggest speakers, or to volunteer to be a speaker, for these topics and speakers, or to suggest other topics.

----- End Announcement.

Sadly I won’t be able to attend but I am sure there are a number of readers who could drop in, have a coffee and ask the questions we would all like answers to.

These might cover just what the plans for the Shared EHR are, what is actually is, how it relates to the Person Controlled EHR so much beloved of the late National Health and Hospitals Reform Commission.

A question or two on when NEHTA expects some e-Health policy announcements might also be interesting.

Enjoy!

David.

Denmark Shows It How Might Be Done And Indeed is Actually Being Done!

The following long article appeared a few days ago.

Denmark physicians, specialists all use EHRs: report

By Joseph Conn / HITS staff writer

Posted: March 17, 2010 - 11:00 am ET

The European Organization for Economic Cooperation and Development, in its most recent, 2009 report on healthcare spending, pegs Denmark's total healthcare expenditures at 9.8% of its gross domestic product with spending on a per capita basis equivalent to $3,512 per year, compared with U.S. expenditures at 16% of GDP and $7,290 per capita per year.

Of course, Denmark's numbers are for a country of 5.5 million people with a universal healthcare system that is largely—but not entirely—paid for by government-raised taxes—or socialized medicine.

Danes pay slightly more out-of-pocket for their healthcare, on a percentage basis, at 13.8% of total household per capita healthcare spending, than do Americans, at 12.2%. But Danes are guaranteed health insurance from one of just two taxpayer-funded, government-run plans, while we Americans don’t allow bureaucrats to come between us and, well, you know the rest.

So, how is Denmark faring compared to the magic-of-the-market U.S. in the race to implement healthcare information technology?

As the U.S. is only just now embarking on its great experiment of socializing up to 85% of the cost of purchasing and installing electronic health-record systems in hospitals and physicians offices, the not-for-profit Commonwealth Fund reports that Denmark has—figuratively speaking—blown the doors off the U.S. in electronic health-record adoption, at least among office-based, primary-care physicians.

How did Denmark do it?

They did a lot of things right, things we should emulate, according to the Commonwealth report, “Widespread Adoption of Information Technology in Primary Care Physician Offices In Denmark: A Case Study, including using a combination of peer pressure, public awareness and, since 2004, a government mandate for physicians to adopt and use EHRs.

Today, according to the report’s authors, Denis Protti and Ib Johansen, virtually all primary-care doctors in Denmark use highly functional EHRs to order prescriptions, draft clinical notes about patient visits, send appointment reminders and communicate with hospitals and other physicians, including specialists.

Danish patients also have the ability to electronically access all of their medical information including medical records, tests results and hospital discharge instructions. They can also electronically schedule appointments and renew prescriptions, and have access to electronically enhanced, after-hours care when they need it.

In comparison to universal EHR adoption in Denmark, in the U.S., just 28% of U.S. primary-care physicians use an EHR, according to a Commonwealth Fund report last year. Meanwhile, an HHS-funded survey found that only 4% of U.S. office-based physicians used a “fully functional” EHR.

Commonwealth Fund President Karen Davis said she’s had an interest in the Danish approach to IT since being invited by the Danish parliament in 1999 to join a team of outside healthcare industry experts in critiquing the Danish healthcare delivery system.

“I was very impressed by their primary-care system, the fact that they rated highest of any country in Europe for satisfaction,” Davis said. She said she was particularly impressed with the Danes use of technology in its off-hours primary-care health service, which operates between 4 p.m. and 8 a.m. Patient information for the off-hours service is accessed through a national health portal run by the Danish healthcare IT firm MedCom, and available since 2005.

Vastly more here (Free registration required):

http://www.modernhealthcare.com/article/20100317/NEWS/303179990

The two paragraphs in italics say it all – and both the documents linked in the text are well worth a download and careful review.

Of course besides the obvious payoffs there are the less obvious ones.

Here is an example.

CSC wins Danish adverse incidents deal

19 Mar 2010

CSC has signed a major contract with the Danish National Board of Health to provide a national adverse incident system to allow patients and professionals to report adverse events encountered across the entire health service.

The contract, which was signed following an EU tender, will replace the current patient safety reporting system which only covers patient safety reporting across secondary care.

The web based system, will allow citizens, patients and healthcare professionals across primary and secondary care to enter information into the system in order to report problems they experience within the Danish health service.

Freddy Lykke, managing director of CSC Scandinavia, told E-Health Europe: “Everyone that is providing care and receiving care is providing this information, which enables it to be entered by one and then checked and cross checked by a number of others.

“So, if a patient received the wrong medicine and reported this, then the pharmacist who gave them their medication would also provide input to the system.”

The system called Risk Monitor Pro, has been developed by CSC’s partners rL solutions, who already provide the system to more than 600 clients worldwide.

However, Denmark’s National Board of Health will be the first European customer to go-live with the system in the summer.

The software also supports the examination of reported information that is reported within the system, which is then monitored and reviewed at locally, regional and at a national level.

It includes simple statistical reporting and automatic generation of different types of reports, such as types, locations and time periods when specific events occurred.

More here:

http://ehealtheurope.net/news/5750/csc_wins_danish_adverse_incidents_deal

Only when you have the basics in place can you start doing the really high impact, high value stuff!

Do note that this has all taken years and has been incrementally and carefully planned. There is a lot we can learn from all this I think.

David.