Weekly Overseas Health IT Links 07-04-2010.

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.

-----

http://www.healthcareitnews.com/news/obama-maine-tout-health-reform-governor-calls-it-critical

Obama in Maine to tout health reform, governor calls IT critical

April 01, 2010 | Mike Miliard, Managing Editor

PORTLAND, ME – President Barack Obama roused an enthusiastic crowd in support of his landmark health reform in Maine on Thursday, touting a new course that will "build on the system of private health insurance that we already have," making coverage "more secure and more affordable" for those who already have it, and allowing those who don't have coverage to "finally be able to get it."

As it does, he pledged, "costs will come down for families, businesses, and the federal government, reducing our deficit by more than $1 trillion over the next two decades."

The president's speech was primarily about the tax breaks that will allow small businesses to provide coverage to their employees (see more at Healthcare Finance News), and the new regulations that will set rules for who insurance companies must allow onto their rolls.

-----

http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=218327

HIE Connection Promotes Quality Care, Community Focus

Collaborative data-sharing among physician practices and Doylestown Hospital advances patient care.

By Richard D. Lang, EdD, and Rita Moran

A strong community connection has been evident at Doylestown Hospital in Doylestown, Pa., since its founding in 1923 by a local women's civic organization. Today, that organization is the only women's club in the nation to own and operate a community hospital.

Located near Philadelphia, Doylestown Hospital, a 208-bed facility, is on the leading edge of community benefit and involvement through the creation of the Doylestown Clinical Network (DCN). DCN is a health information exchange (HIE) that seeks to advance patient care through collaborative data-sharing among area physician practices and our hospital.

Our path down this road began in the late 1990s, when community physicians approached the hospital for help after realizing that billing systems for its practices could not make the Y2K transition. We decided to set up a separate applications services provider (ASP) organization, through which our medical staff could purchase a new practice management (PM) system at cost(should we say at "fair market value")?

-----

NHIN Direct Focus Is Health Data Exchange Specs

Nationwide Health Information Network (NHIN) Direct aims to develop interoperability specs, but not to replace statewide and regional health information exchanges.

By Marianne Kolbasuk McGee, InformationWeek

March 30, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224200787

The Nationwide Health Information Network (NHIN) Direct project unveiled last month will coexist with and not replace the federal government's ongoing vision for a robust, secure, and comprehensive national health data exchange, said a top government official.

NHIN Direct aims to develop interoperability specifications for simple, direct one-on-one data exchange between healthcare providers.

Earlier this month, the U.S. Department of Health and Human Services' Office of National Coordinator (ONC) for Health IT unveiled the NHIN Direct Project, an initiative to develop specifications and easy processes for local healthcare providers to exchange health data directly with other providers -- such as labs exchanging data with a doctor's office, or a primary care physician electronically sending a patient referral to a specialist.

-----

http://www.modernhealthcare.com/article/20100402/NEWS/304029993

Most HITS readers would consider open-source EHR

By Joseph Conn / HITS staff writer

Posted: April 2, 2010 - 11:00 am ET

Nearly two thirds of Health IT Strategist readers responding to our latest poll indicate they are keeping an open mind when it comes to open-source software.

Asked: “Would you consider using an open-source electronic health-record system in your hospital or physician office?” 93 of the 139 poll takers, or almost 67%, indicated “yes,” while 47 (not quite 34%) responded, “no.” (The percentages don't add up to 100 because of rounding.)

-----

http://www.e-health-insider.com/news/5784/st_george%E2%80%99s_gets_cerner_for_easter

St George’s gets Cerner for Easter

29 Mar 2010

St George’s Healthcare NHS Trust has gone live with Cerner Millennium, the strategic electronic patient record system provided by London's local service provider, BT.

In a statement, chief operating officer Patrick Mitchell said: “The first phase of the Cerner Millennium deployment at St George’s Healthcare NHS Trust went live as planned on Monday 29 March.

-----

http://www.healthdatamanagement.com/news/hie-state-plan-onc-hitech-40059-1.html?ET=healthdatamanagement:e1228:100325a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_033110

New Mexico First with HIE Plan

HDM Breaking News, April 1, 2010

The Office of the National Coordinator for Health Information Technology has approved New Mexico's strategic plan for health information exchange, making it the first state to get such approval.

-----

http://www.fierceemr.com/story/federal-panel-wants-national-reporting-emr-software-data-errors/2010-04-01?utm_medium=nl&utm_source=internal

Federal panel wants national reporting on EMR software, data errors

April 1, 2010 — 12:18pm ET | By Neil Versel

The Adoption/Certification Workgroup of the federal Health IT Policy Committee wants to require hospitals and physicians to report "hazards and near-misses" as a result of software malfunctions, beginning in 2013. Reporting would become part of demonstrating "meaningful use" of EMRs and thus a condition for receiving Medicare and Medicaid bonus payments.

While some would like to see a database on EMR and data glitches up and running sooner than that, some patient-safety advocates believe 2013 is unrealistic. "I think it will take a while to do this right," UCSF physician Dr. Robert M. Wachter tells the Huffington Post Investigative Fund. "The problem here is that there are potentially dangerous systems and we have no mechanism to figure out what they are or to force them to improve," he adds.

-----

http://www.healthdatamanagement.com/issues/18_4/regulation-ehr-contract_hospital-congress-fda-40004-1.html?ET=healthdatamanagement:e1225:100325a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_033010

Is 'Speak No Evil' a Contract Clause?

Sen. Charles Grassley frets that vendors use contractual clauses to hide software flaws - but he might not be getting the full story.

By Joseph Goedert

Health Data Management Magazine, 04/01/2010

Are electronic health records flawed and dangerous products sold by vendors that use onerous contractual provisions to absolve themselves of responsibility and muzzle user complaints? Or is an influential United States Senator barking up the wrong tree?

Sen. Charles Grassley (R-Iowa), ranking member of the Finance Committee, is investigating reports he has received that EHRs and computerized physician order entry systems are plagued with flaws that can result in patient or financial harm. The investigations is being conducted as federal officials implement provisions of the American Recovery and Reinvestment Act that will make tens of billions of dollars available to providers to significantly increase the adoption and use of EHRs.

That investigation took a sharp turn in late February when Grassley sent signals (see sidebar, page 30) that he might be considering Food and Drug Administration regulation of clinical information systems. Grassley, in letters sent to Health and Human Services Secretary Kathleen Sebelius, and the influential Healthcare Information and Management Systems Society trade association, asked for their views on a 1997 position paper that called for voluntary industry oversight of the integrity of clinical systems rather than regulation (see sidebar, page 30). The paper was published in the Journal of the AmericanMedical Informatics Association. The FDA, which started considering regulation in 1996, ultimately declined to do so amid industry opposition.

Grassley's also concerned with contractual "hold harmless" provisions that absolve vendors of responsibility for harm, and "gag orders" more commonly known as confidentiality or nondisclosure provisions that prohibit providers from publicly disclosing problems with their software. It should be noted that various types of confidentiality and hold harmless clauses are in virtually all I.T. contracts in all industries, consultants and attorneys who negotiate these contracts say. Grassley, however, wants to know if these clauses can be worded in a way that potentially could jeopardize patient safety.

-----

http://www.modernhealthcare.com/article/20100331/NEWS/303319993

‘High touch' tops tech with preventive care: study

By Andis Robeznieks / HITS staff writer

Posted: March 31, 2010 - 11:00 am ET

Primary-care practices who rely more on “high touch” principles such as patients seeing the same doctor and scheduling a “well visit” are likely to deliver more preventive services than those that rely on “high tech” principles such as using clinical decision-support tools and performing continuous quality improvement, according to a study in the Annals of Family Medicine journal of the American Academy of Family Physicians.

Researchers examined the records of 568 patients at 24 New Jersey primary-care practices participating in a study on improving colorectal cancer screening and concluded that the “relationship-centered aspects” of the medical home model “are more highly correlated with preventive service delivery” than were “information technology capabilities.” Of the practices in the study, 46% used electronic health records, though it's unknown what functions were used and how long the systems were in place.

-----

http://www.medscape.com/viewarticle/717818?src=mp&spon=18&uac=17738FT

The 2009 EHR User Satisfaction Survey: Responses from 2,012 Family Physicians

Robert L. Edsall; Kenneth G. Adler, MD, MMM

Posted: 03/19/2010; Family Practice Management. 2009;16(9):10 © 2009 American Academy of Family Physicians

Abstract and Introduction

Abstract

If you're shopping for an EHR system, you might appreciate this advice from a couple of thousand colleagues.

-----

http://govhealthit.com/newsitem.aspx?nid=73411

HHS awards PR firm $26M for health IT campaign

By Mary Mosquera

Monday, March 29, 2010

The Health & Human Services Department awarded public relations firm Ketchum Inc. a contract for $26 million to create a publicity campaign to educate the public about the privacy and security of their personal information contained in or managed by health IT systems.

The HITECH Act called for public education efforts to help drive the adoption and meaningful use of electronic health records. .

-----

http://www.healthcareitnews.com/news/study-names-100-top-performing-hospitals

Study names 100 top-performing hospitals

March 29, 2010 | Bernie Monegain, Editor

ANN ARBOR, MI – On Monday, Thomson Reuters released its annual study identifying the 100 top U.S. hospitals based on their overall organizational performance. The 10 areas measured, such as adherence to clinical standards and patient safety, are boosted by the use of information technology.

The Thomson Reuters 100 Top Hospital: National Benchmarks study evaluates performance in 10 areas: mortality, medical complications, patient safety, average length of stay, expenses, profitability, patient satisfaction, adherence to clinical standards of care, and post-discharge mortality and readmission rates for acute myocardial infarction, heart failure, and pneumonia. The study has been conducted annually since 1993.

"This year's study magnified the value that 100 Top Hospital award winners provide to their communities," said Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals programs at Thomson Reuters. "Even during the economic downturn, the 100 Top Hospitals maintained a profit from operations while raising the bar for clinical quality and patient satisfaction. The insistence of these hospitals' leaders – their boards, executive teams and medical staffs – on overall excellence makes the difference."

-----

Accenture Exec: EMR Targets Unlikely To Be Met

Today, only six percent of U.S. office-based physicians use a fully functioning electronic medical record system.

By Nicole Lewis, InformationWeek

March 29, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224200662

The government's goal to provide every citizen with an electronic medical record by 2014 is not likely to be met, according to Dr. Kip Webb, who leads Accenture's clinical transformation practice.

In an interview with InformationWeek, Webb noted that based on a recent survey, a substantial number of physician practices with 10 or fewer employees have said they will not embark on a program to adopt electronic medical records.

Asked if he felt the government's EMR goals were achievable, he replied, "I don't."

-----

http://www.e-health-insider.com/news/5793/bt_may_win_new_cerner_%E2%80%98greenfield%E2%80%99_deal

BT may win new Cerner ‘greenfield’ deal

31 Mar 2010

BT could be on the verge of being awarded a lucrative deal to install Cerner Millennium at three new hospital trusts in the south of England.

E-Health Insider understands a new deal is currently with Treasury pending approval, and the completion of the local service provider contract resets.

-----

http://www.ehealtheurope.net/news/5772/icn_and_ihtsdo_team_up

ICN and IHTSDO team up

25 Mar 2010

The International Council of Nurses has teamed up with the International Healthcare Terminology Standards Development Organisation to advance the use of standardised terminology and interoperability in healthcare IT.

The collaboration will see ICN actively work with the IHTSDO to facilitate involvement of the nursing community through the IHTSDO Nursing Special Interest Group.

David Benton, chief executive of ICN said: “ICN will embrace this collaboration as an important means of supporting nurses in providing quality care.

-----

http://www.ehiprimarycare.com/news/5783/choose_and_book_reaches_20m_referrals

Choose and Book reaches 20m referrals

30 Mar 2010

NHS Connecting for Health has announced that 20m referrals have now been made through Choose and Book.

The Department of Health’s IT agency said the achievement was a "key milestone" for the e-booking system, which was launched in 2004.

However, the figures also show that the system is currently used for around 50% of first outpatient appointments; well short of the 90% target originally set by the DH.

-----

http://www.healthleadersmedia.com/content/TEC-248742/DEA-Proposes-Allowing-Biometrics-to-Identify-EPrescribing-User

DEA Proposes Allowing Biometrics to Identify E-Prescribing User

Janice Simmons, for HealthLeaders Media, March 30, 2010

The Drug Enforcement Agency (DEA) is posting in the Federal Register on Wednesday an interim final rule that would permit hospitals, healthcare providers, and pharmacies to use electronic prescriptions in the dispensing of controlled drugs. Comments on the rule will be open for 60 days.

The rule is similar to a regulation proposed by DEA in June 2008 for e-prescribing. That provision ran into trouble when federal healthcare providers told DEA that the approach proposed for the private sector was inconsistent with their existing practices and did not meet the security requirements for federal systems.

-----

http://www.courant.com/business/hc-griffin0330.artmar30,0,1191216.story

Griffin Hospital Reports Breach Of 957 Patients' Records

By Matthew Sturdevant

msturdevant@courant.com

March 30, 2010

Medical information for 957 patients at Griffin Hospital in Derby was breached by a radiologist who broke into a computer archive system over a period of several weeks after he was terminated in February.

The hospital announced the security breach Monday on its website.

The doctor worked for a radiology group contracted by Griffin Hospital. His job ended Feb. 3, although it's not clear if he was fired.

His archive password was revoked when he lost his job, but he continued to access the system using passwords of other employees without their knowledge between Feb. 4 and March 5, the hospital said.

-----

http://www.modernhealthcare.com/article/20100330/NEWS/303309994

NHIN won't funnel information to CIA: Blumenthal

By Joseph Conn / HITS staff writer

Posted: March 30, 2010 - 11:00 am ET

Part one of a two-part series:

David Blumenthal, head of HHS' Office of the National Coordinator for Health Information Technology, has denied allegations that a framework for selecting data transmission standards for the proposed national health information network would configure the system to afford federal control over patient data and funnel that information to federal agencies, including the CIA, Justice Department and National Security Agency.

Blumenthal's remarks came more than three hours into the March 25 meeting of the Health IT Standards Committee. The committee is a federal panel created under the American Recovery and Reinvestment Act of 2009, also known as the stimulus law, to advise the ONC on matters concerning health IT standards.

Just before Blumenthal spoke, ONC staffer Doug Fridsma completed two lengthy presentations, followed by group discussions. One talk was on NHIN Direct, an ONC open-development project that had its startup meeting the day before.

NHIN Direct aims to develop specifications for simple information exchange tasks to afford less technologically advanced healthcare practitioners the means to perform basic clinical information-sharing required under a federal electronic health-record subsidy program, part of the meaningful-use criteria of the stimulus law.

-----

http://www.modernhealthcare.com/article/20100330/NEWS/303309993

Health IT group stresses patient-safety reporting

By Maureen McKinney / HITS staff writer

Posted: March 30, 2010 - 11:00 am ET

In its latest set of draft recommendations, the Certification/Adoption Workgroup of HHS' Health IT Policy Committee stressed the need for a standardized, transparent system for reporting patient-safety issues. During a March 29 meeting, the group also discussed the creation of a national patient-safety organization, which would serve as a clearinghouse for safety concerns from providers, vendors and patients.

“We believe patient safety is going to be more and more of an issue with the increasing use of health IT,” said Marc Probst, chief information officer of Intermountain Healthcare, Salt Lake City, and co-chairman of the work group. “We also think it's very important to create a safe, nondisciplinary environment so people don't try to hide errors.”

-----

http://www.healthleadersmedia.com/content/TEC-248583/Health-Reform-Brings-Changes-More-Work-for-HIM.html

Health Reform Brings Changes, More Work for HIM

Andrea Kraynak, for HealthLeaders Media, March 25, 2010

After an eventful week on Capitol Hill, HIM directors are likely wondering how health reform will affect them. Understanding what is in the bill is an important first step to figuring out what is on the horizon. Only then can HIM directors begin to figure out how to manage those changes.

"It will be awhile until all of this is flushed out and there is a clearer picture for the impact on HIM or other healthcare professionals," says Darice Grzybowski, MA, RHIA, FAHIMA, president of HIMentors, LLC, in Westchester, IL. After all, many of the provisions don't go into effect until several years in the future.

While a few details are still being worked out regarding EHR-related legislation, Congress took care of most of that in ARRA's HITECH Act. However, new healthcare reform legislation does address the topic briefly.

-----

http://www.healthleadersmedia.com/content/TEC-248746/Can-Broadband-Really-Save-Healthcare.html##

Can Broadband Really Save Healthcare?

Gienna Shaw, for HealthLeaders Media, March 30, 2010

The government is super stoked about the potential of greater broadband access to improve the U.S. healthcare system. Part of the 376-page National Broadband Plan report released by the Federal Communications Commission (FCC) last week gushes about health IT, e-health, m-health, telehealth, and electronic medical records (EMRs).

Can broadband really save healthcare? Well, technology is part of the solution for some of the industry's problems, such as physician and specialist shortages and disparities in access to care. But it's only part of the solution. And it comes with problems of its own. (Read more about wireless health, telehealth, and more in the March HealthLeaders magazine cover story, Medical Breakthroughs That Will Change Healthcare.)

-----

http://www.ihealthbeat.org/features/2010/blumenthal-discusses-federal-health-it-strategy-timeline.aspx

Tuesday, March 30, 2010

Blumenthal Discusses Federal Health IT Strategy, Timeline

by Kate Ackerman, iHealthBeat Senior Editor

In a recent interview with iHealthBeat, National Coordinator for Health IT David Blumenthal discussed the timeline for issuing final rules on "meaningful use," standards and certification criteria and the certification process, as well as "NHIN Direct," the health IT work force and the likelihood of the country meeting President Obama's goal of providing all Americans with an EHR by 2014.

Blumenthal said that CMS has received more than 2,000 comments on the notice of proposed rulemaking describing how health care providers can demonstrate meaningful use of certified electronic health records to qualify for incentive payments under the 2009 federal economic stimulus package and that the Office of the National Coordinator for Health IT has received more than 300 comments on the interim final rule describing required certification standards for EHR technology.

-----

http://www.healthdatamanagement.com/news/cms-administrator-berwick-nominate-40035-1.html?ET=healthdatamanagement:e1223:100325a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_032610

Reports: Berwick to Lead CMS

HDM Breaking News, March 29, 2010

President Obama will nominate Donald Berwick, M.D., president and CEO at the Institute for Healthcare Improvement, as administrator of the Centers for Medicare and Medicaid Services, according to numerous published reports over the weekend. Charlene Frizzera, COO of CMS and acting administrator since January 2009, will remain COO once Berwick becomes administrator, according to a spokesperson.

Based in Cambridge, Mass., the Institute for Healthcare Improvement is an independent, not-for-profit organization that brings together stakeholders to share lessons, and identify gaps in quality and best practices.

-----

EMR Data Theft Booming

Fraud resulting from exposure of electronic medical records has risen from 3% in 2008 to 7% in 2009, a 112% increase, researcher says.

By Nicole Lewis, InformationWeek

March 26, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224200494

Acceleration in the use of electronic medical records may lead to an increase in personal health information theft, according to a new study that shows there were more than 275,000 cases of medical information theft in the U.S. last year.

Unlike stealing a driver's license or a credit card, data gleaned from personal health records provides a wealth of information that helps criminals commit multiple crimes, according to Javelin Strategy & Research, a Pleasanton, California-based market research firm.

Information such as social security numbers, addresses, medical insurance numbers, past illnesses, and sometimes credit card numbers, can help criminals commit several types of fraud. These may include: making payments from stolen credit card numbers and ordering and reselling medical equipment by using stolen medical insurance numbers.

-----

http://www.govhealthit.com/newsitem.aspx?nid=73370

Healthcare reform legislation awash in IT

By John Moore

Wednesday, March 24, 2010

The healthcare reform legislative package signed into law yesterday by President Obama hinges on information technology for some of its most far-reaching changes.

The President yesterday signed the Patient Protection and Affordable Health Care Act, which includes IT-dependent projects that run the gamut from proposals to build state-run insurance “exchanges” to modern long-term care facilities.

Health IT is likely to play a key role in all these efforts. For example, the new law tasks the Department of Health and Human Services with creating a Web portal through which a resident in any state will be able to locate “affordable health insurance coverage options.”

-----

http://fcw.com/articles/2010/03/25/hhs-panel-considers-central-authority-for-health-it-vocabulary.aspx

HHS panel considers central authority for health IT vocabulary

Advisers examine who will decide the vocabulary and resolve disputes

• By Alice Lipowicz
• Mar 25, 2010

A federal advisory task force is considering whether a central authority is needed to define and enforce medical vocabulary terms to be used in health care messaging, records and data exchange.

The Health and Human Services Department’s Vocabulary Task Force heard testimony from the National Library of Medicine, Centers for Disease Control and Prevention, National Cancer Institute, Joint Commission, and several other organizations March 23. The goal was to review options for creating and updating a common vocabulary for health information systems.

Experts say free and standardized terminology is needed for interoperability between health record systems. Currently, there are vocabularies for clinicians who identify patient problems, for medication terms and for lab orders, among others. Issues that haven't been resolved include governance, such as who decides what goes into the vocabularies, and how disputes are resolved.

-----

http://www.eweek.com/c/a/Health-Care-IT/Job-Demand-for-Health-Care-IT-Expanding-in-2010-and-Beyond-405743/

Job Demand for Health Care IT Expanding in 2010 and Beyond

By: Don E. Sears

2010-03-21

Hospitals, medical clinics, doctor's offices and other health care organizations are facing government-mandated deadlines in a host of areas such as electronic medical records, clinical systems and new privacy and medical-coding standards. IT is expected to reap some of the benefits of this health care growth spurt. Evidence from a couple of new reports from health care IT industry organizations shows demand for health care-related technology jobs is on the rise.

It's not uncommon to hear about the high demand of medical-related jobs such as nursing. With an aging Baby Boomer population, the expectation for growing demand in health care jobs is real, according to the Department of Labor's Bureau of Labor statistics, which predicted "3.2 million new wage and salary jobs between 2008 and 2018, more than any other industry, largely in response to rapid growth in the elderly population" in an updated February report. IT is expected to reap some of the benefits of this health care growth spurt. Evidence from a couple of new reports from health care IT industry organizations shows demand for health care-related technology jobs is on the rise.

-----

Enjoy!

David.

Victoria Makes A Counter Offer to The Commonwealth on Health Reform. Lots of E-Health!

The following was released today.

VICTORIA’S HEALTH PLAN PUTTING PATIENTS FIRST

From the Premier

Thursday, 08 April 2010

The Premier, John Brumby, today released Victoria’s health proposal - Putting Patients First – which outlines Victoria’s plan to drive an efficient, effective and accountable health system that delivers the best possible health care to patients, now and into the future.

Mr Brumby said Putting Patients First provided practical reforms that would continue to drive important improvements in the healthcare we deliver today and in the years to come.

“Our government understands how important it is for Victorian families to access the very best health services, regardless of where they live,” Mr Brumby said.

“That’s why we have increased funding to our health services by more than 130 per cent over the past 10 years to create Australia’s best and most responsive health system.

“However, the challenges of an ageing, growing population and the rise of chronic disease demand improvements to our health system now.

“Our health system needs more support from the Commonwealth Government now, in services and resources so we can treat more patients, sooner.

“With additional support from the Commonwealth now, we can ensure our local hospitals and health services remain flexible and responsive to the needs of their local communities.”

Key features of the Putting Patients First plan include:

• Transparent and accountable financing – including an increase in the Commonwealth effort to match the states – a real 50-50 funding partnership for our hospitals. This would deliver an extra $1.2 billion for Victorian patients next year, which could be used to treat patients faster in emergency departments and operating theatres;
• Real accountability – making sure Victorians know exactly who is responsible for the planning and delivery of health services - the Victorian Government;
• Taking action to keep people well and out of hospital - investing in prevention programs such as the successful WorkHealth initiative to help people stay healthy, and avoid chronic illnesses which can result in unnecessary hospitalisation;
• Investing in primary and aged care – for patients who would receive more appropriate care in a non-hospital setting such as a GP clinic or a residential aged care service, reducing pressure on public hospitals;
• Improvements to the building blocks of our health care system – including improvements to the workforce, buildings and equipments, and innovation.

Mr Brumby said the plan outlined an alternative funding model to the one proposed by the Commonwealth – a 50-50 partnership starting today that would significantly increase access to services and deliver better healthcare for everyone.

Lots more follows:

The full release is here:

http://www.premier.vic.gov.au/newsroom/9991.html

The full report is available here:

http://www.premier.vic.gov.au/images/stories/media/Putting_Patients_First.pdf

The E-Health component is a real 'curate's egg' (Page 29)

New technology

Victoria supports the rollout of the National E-health Strategy and action to deliver individual electronic health records

To provide world-leading health care, Australia must put the patient at the centre of its services. The 21st century offers us new technologies that can be used to coordinate, integrate and improve the quality of health care, instead of treating people’s one-off health complaints. That’s why Victoria strongly supports the introduction of e-health, and in particular individual electronic health records (IEHR).

E-health means that when a person visits a doctor, hospital or other health care provider, vital information such as test results, prescriptions, hospital discharges, vaccinations and medical treatment can be electronically recorded and compiled into an IEHR. With the patient’s consent, this information can be shared between health care providers ensuring all relevant health professionals can access an accurate and up-to-date picture of the person’s needs, improving clinical decision-making, timeliness and patient outcomes.

E-health will result in:

· Improved access to services for patients living in rural and remote locations, and additional support for providers located in these regions;

· Increased safety through reducing avoidable medical errors and deterioration of chronic conditions caused by a lack of patient information; and

· Increased patient involvement by supporting self-management and informed decision-making.

A business case for IEHRs for every Australian is ready for consideration by COAG. Victoria strongly supports COAG endorsing the business case as part of the overall health reform package, and the Commonwealth funding it from the Health and Hospitals Fund, with additional support from States. Victoria strongly supports the rollout of the National E-Health Strategy and the adoption of IEHR, and is confident that the appropriate privacy measures are in place.

The really good bit is support for the National E-Health Strategy.

The really bad bit is giving an unreformed and unaccountable NEHTA a single extra cent.

I hope the good part is actually done – as that demands major NEHTA reform and that the E-Health Strategy approach is followed. IEHR’s are a very late idea in this – to follow sorting out all sorts of other things first.

I wonder do the Victorians really understand what they are asking for here?

Also a pity we still don’t know what the Rudd / Roxon team plan in this area.

David.

Now Here Is a Good Place for Mr Rudd to Spend some Health Funds!

Again, today we have a major spending announcement from the Federal Government as we head towards the COAG Health System Summit on the 19^th of April, 2010.

See here:

PM announces towns to get cancer centres

April 7, 2010 - 1:04PM

AAP

Kevin Rudd and his team have taken to regional Australia to spread the word about which bush centres will get new or upgraded cancer treatment facilities.

The cancer treatment centres will be funded through a $560 million fund, announced in last year's budget.

The prime minister is in Townsville on Wednesday spruiking his health and hospital reform plans.

The government is continuing a slow release of health announcements as part of its strategy to win over premiers to the plan, which would see the commonwealth take over majority funding of public hospitals.

They need to get on board before a Council of Australian Governments (CoAG) meeting on April 19.

In a statement, Mr Rudd said patients in the bush had higher mortality rates with some cancers.

"With some cancers, patients from rural areas are up to three times more likely to die within five years of diagnosis than their urban counterparts," he said.

"Regional Cancer Centres will enable regional Australians to receive care closer to home and their community."

Full article is here:

http://news.smh.com.au/breaking-news-national/pm-announces-towns-to-get-cancer-centres-20100407-rr0f.html

I guess as we see the odd ½ billion here and there pretty soon it will add up to ‘real money’. Don’t get me wrong this is vitally needed infrastructure for a segment of the population who have fallen well behind in clinical outcomes.

However I have a suggestion for a few percent of that amount which would also make a difference.

Yesterday the US announced the following:

ONC awards $84 million to expand health IT workforce

By Mary Mosquera
Monday, April 05, 2010

The Office of the National Health IT Coordinator last week awarded $84 million in grants to 16 universities and junior colleges to develop education and training programs to boost the number of skilled health IT workers available to help healthcare providers over the hurdles of adopting health IT.

ONC aims over time to reduce an estimated shortage of 50,000 workers in the health IT sector of the economy. That workforce is an important part of making the meaningful use of electronic health records a reality, said Dr. David Blumenthal, the national health IT coordinator, in the announcement April 2.

Among the grant awards, five community colleges received $36 million to establish a multi-institutional program within each designated region, totaling up to 70 community colleges participating. The awardees included Pitt Community College in North Carolina, and Bellevue College in Washington.

Each college will create non-degree training programs that can be completed in six months or less. The training program will focus on people who already have some background in health or information technology. Another $34 million will be available to the community colleges in the second year.

Lots more detail here

http://www.govhealthit.com/newsitem.aspx?nid=73461

Now I am sure for an amount of less than $10 million we could establish and staff 3-4 lead centres across the country and leverage what we already have into a real capability that could really stimulate interest and provide the skills we will surely need at some time in the future.

Of course I am sure a good deal of the course development work being done in the US could also be of much use here!

Some small seeding funds could build the relationships etc needed to make a serious start!

I know work has been done on all this by the Australian Health Informatics Education Council

See:

http://www.ahiec.org.au/

Also see here for a recent document looking at the area globally.

http://www.ahiec.org.au/docs/HI%20lit%20review%20-%20workforce%20and%20education%20initiatives.docx

National and international health informatics workforce and education initiatives, methodologies used and outcomes achieved:

a review of the literature

Prof Evelyn J S Hovenga

Project Officer for the ACHI Education Committee

A draft for presentation to and input by members of the interim AHIEC

January 2010

Additionally DoHA has also undertaken some workforce assessment ages ago under the Australian Health Information Council banner:

See here:

http://www.health.gov.au/internet/hconnect/publishing.nsf/content/7746B10691FA666CCA257128007B7EAF/$File/wcbnap03-04.pdf

Since then there has also been other sporadic work over time culminating in a major review undertaken by HISA and funded by DoHA.

See here:

http://www.hisa.org.au/system/files/u2233/Australian_Health_Informatics_Workforce_Review_v1_1.pdf

Essentially we have had enough reports. Time for action and the spending of a few dollars! Of course I am also a bit worried that all the free money will be used up - we do have a few dollars of debt at present, post GFC you know! - and that there will be nothing for e-Health!

David.

Weekly Australian Health IT Links - 06-04-2010.

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:

In general it has been a pretty quiet week, except for the announcement of the modified care delivery model for Diabetics which has been announced by the Federal Government.

As with the other announcements the reaction has been a bit mixed.

See here:

http://www.theaustralian.com.au/news/health-science/gps-see-rudd-diabetes-plan-as-perverse-bait/story-e6frg8y6-1225848236706

GPs see Rudd diabetes plan as `perverse' bait

• Adam Cresswell
• From: The Australian
• April 01, 2010 12:00AM

NURSES are pleased but doctors' organisations have split over Kevin Rudd's recipe for improving diabetes care amid warnings that it may tempt some GPs to minimise treatment to reap a profit.

Chris Mitchell, president of the Royal Australian College of General Practitioners, said that the college was keen to push reform, but was concerned about "perverse" incentives in the latest plan.

---- end extract.

I have to say the move to a disease based capitation approach does signal a pretty dramatic change from the fee for service model we have seen for the last 40 or so years under Medicare and the like.

The IT implications for GPs choosing to enrol such patients are interesting as they will need to keep track of the various activities being undertaken for the apparently fixed fee.

It is not clear present systems are set-up to optimally handle what is essentially a ‘managed care’ model for these patients.

It is also not clear just what the story is with diabetics who also have another major disease (cancer for example).

In the broader picture we are still in the dark as to the e-Health plans and it seems Victoria, NSW and WA are still not by any means totally convinced by the big picture.

The other news for the week has been a series of apparent wins and losses for iSoft. As the company is our largest Health IT company (and as I am a small shareholder) it is important to keep an eye – for me at least – on what is happening. The long interview (Item 3) is helpful is understanding what is apparently being planned and where things are up to from the CEO (Gary Cohen) directly.

-----

http://www.theaustralian.com.au/australian-it/government-injects-48m-to-support-troubled-easyclaim/story-e6frgakx-1225847165984

Government injects $48m to support troubled Easyclaim

• Karen Dearne
• From: The Australian
• March 30, 2010 12:00AM

THE federal government has spent $48 million propping up the troubled Medicare Easyclaim system, intended to allow patients to lodge claims for a rebate direct from the doctor's office.

So far, only 25 per cent of all patient claims for rebates are handled electronically, half of all claims still dealt with face to face in a Medicare office anda quarter lodged via phone or post.

Medicare Australia says Easyclaim handles 25 per cent of all patient claims initiated electronically at the doctor's front desk, compared with 75 per cent of e-patient claims lodged via Medicare Online, the channel traditionally used by practices for bulk-billing.

-----

http://www.zdnet.com.au/queensland-health-cio-appoints-seconds-339302179.htm

Queensland Health CIO appoints seconds

By Renai LeMay, Delimiter.com.au on March 31st, 2010

Queensland Health chief information officer Ray Brown has poached several senior Queensland IT executives to help him lead the department's IT division.

The CIO confirmed in an emailed statement yesterday that Qld Department of Premier and Cabinet CIO Phil Woolley and Brisbane Council manager of ICT Strategy Susan Heath have been appointed to roles within Brown's intimate team.

Woolley, who now holds the position of executive director, Information Division, will work closely with clinicians and corporate staff "to advance patient outcomes arising from ongoing advancements in technology service delivery", said Brown.

-----

http://histalk2.com/2010/04/01/histalk-interviews-gary-cohen/

HIStalk Interviews Gary Cohen

Gary Cohen is executive chairman and CEO of iSOFT of Sydney, Australia.

iSOFT is a significant global player in healthcare software, but not maybe as well known in the US. I’m interested if you have plans to increase the visibility and presence now that you’ve started with iSOFT Integration Systems.

I think that the US is the process of going through an enormous transformation both in healthcare reform, as we speak, and obviously in relation to some of the effects of the ARRA legislation in relation to how healthcare IT can change the way healthcare is delivered across the US. There is quite a lot of disruption, I suppose, in terms of the US health economy, which is bringing change.

I think that is probably the point I wanted to emphasize. I think that provides significant opening for us, I believe, particularly where we have specialized around socialized healthcare or healthcare that is more distributed rather than just obviously utilized in the hospital, or utilized in a private care facility, or whatever. But the movement of information around that network, whether it’s between the various facilities inside a hospital or the various facilities that can make it to a hospital or may interact with that hospital, such as community and so on.

The architecture and the way in which we have built our latest generation solution, Lorenzo, has obviously been around that socialized healthcare model. I think when you look at one of the requirements for Meaningful Use and a lot the climates for performance-type process; you’re going to need — particularly, as chronic illness processes involve a lot more interaction with many multidisciplinary people in a healthcare environment — solutions that enable that sort of coverage. I think that’s where we do see a significant value.

-----

http://www.computerworlduk.com/management/government-law/public-sector/news/index.cfm?newsid=19642

NHS £13bn IT contractors in string of critical failures

BT and CSC miss deadlines and fail on service

By Leo King, www.computerworlduk.com">www.computerworlduk.com

BT and CSC, contractors on the £12.7 billion NHS National Programme for IT, have been listed as making over 112 serious failures in the last fifteen months.

The contractors either failed to hit key milestones or provided a service that was significantly below what was paid for.

The programme is already over four years behind schedule, has a spiralling budget and has been branded in the press as being "close to imploding".

-----

http://www.abnnewswire.net/press/en/62540/iSOFT_Group_Limited_%28ASX:ISF%29_Agrees_On_A_A2_Million_Deal_With_ACT_Health_Australia.html

iSOFT Group Limited (ASX:ISF) Agrees On A A$2 Million Deal With ACT Health, Australia

Sydney, Mar 31, 2010 (ABN Newswire) - iSOFT Group Limited (ASX:ISF), Australia's largest listed health information technology company, today announced a contract worth more than A$2 million with ACT Health in Australia for new patient and emergency software applications at Calvary Public Hospital.

The agreement is for the installation of iSOFT Patient Management and iSOFT Emergency at the 280-bed Calvary Hospital this year. About A$900,000 of the total consists of license fees. The agreement also has an additional component for support and maintenance.

The deal follows the roll out of similar solutions at Canberra Hospital and across community health initiatives in the Australian Capital Territory (ACT), and meets ACT Health's goal of providing integrated patient care across all services. Emergency department specialists, who routinely work at both the Calvary and Canberra hospitals, will benefit from a common system.

-----

http://www.theaustralian.com.au/australian-it/isoft-bags-2m-act-deal/story-e6frgakx-1225848006076?referrer=email&source=AIT_email_nl&emcmp=Ping&emchn=Newsletter&emlist=Member

iSoft bags $2m ACT deal

• Karen Dearne
• From: Australian IT
• March 31, 2010 1:43PM

LISTED health IT firm iSoft Group has won a $2 million-plus contract to supply new patient management and emergency department software at Calvary Public Hospital in the ACT.

ACT Health chief information officer Owen Smalley said iSoft's products formed the base for integrated healthcare services across the territory, with a common system giving medical staff access to patient information across acute and community settings.

Emergency doctors routinely work at both the Calvary and Canberra hospitals, with Canberra Hospital adopting iSoft systems some time ago.

-----

http://www.e-health-insider.com/news/5790/isoft_7_to_extend_contracts

ISoft 7 to extend contracts

31 Mar 2010

All seven of the “out of cluster” trusts in London and the South of England that installed iSoft systems ahead of the National Programme for IT in the NHS are due to sign a new deal for iSoft systems.

In 2006, CSC and iSoft signed a deal that gave them responsibility for the seven trusts and enabled them stay with their existing systems instead of moving to Cerner Millennium, the strategic electronic patient record for London and the South.

-----

http://www.abnnewswire.net/press/en/62546/iSOFT_Group_Limited_%28ASX:ISF%29_Signs_A66_Million_Lorenzo_Renewal_At_St_Jansdal_Netherlands.html

iSOFT Group Limited (ASX:ISF) Signs A$6.6 Million Lorenzo Renewal At St Jansdal, Netherlands

Sydney, April 1, 2010 (ABN Newswire) - iSOFT Group Limited (ASX:ISF), Australia's largest listed health information technology company, today announced that St Jansdal Hospital in the Netherlands extended its contract for iSOFT's Lorenzo solution for a further three years, in a deal worth EUR4.5 million (A$6.6 million).

iSOFT will implement additional Lorenzo patient management and clinical decision support functionality at the 340-bed public hospital at Harderwijk. Support for existing hospital information systems will continue while they are being replaced with Lorenzo solutions.
-----

http://www.fiercemobilehealthcare.com/story/uk-looks-telehealth-address-aging-boomer-population/2010-03-30

UK looks to telehealth to address aging boomer population

March 30, 2010 — 11:57am ET | By Neil Versel

England's National Health Service faces a funding shortfall of as much as 20 million pounds ($30.2 billion) over the next few years as the country's baby boomers age. "This is making telehealth systems a subject of great interest for governments and healthcare systems looking for answers to the seemingly intractable problems that they face; in both developed and developing countries," London-based E-Health Insider reports.

But demonstration projects in three British locales have failed to recruit enough participants, so telehealth and personal-monitoring vendors are pushing the NHS to make telehealth "mainstream rather than marginal." Growth in industry organizations like the Continua Health Alliance, which is touting standards-based device interoperability, provides some cause for optimism, though.

-----

http://www.e-health-insider.com/news/5796/csc_misses_march_morecambe_bay_deadline

CSC misses March Morecambe Bay deadline

01 Apr 2010

CSC's future in the £12.7 billion NHS IT programme is in doubt after it failed to hit a critical end of March deadline to install Lorenzo Regional Care Release 1.9 at University Hospitals of Morecambe Bay NHS Trust.

As a result, the Department of Health has decided not to award CSC, the local service provider for three-fifths of the NHS in England, a renegotiated LSP deal. It must now provide a credible remedial plan or risk being replaced.

Christine Connelly, the Department of Health's chief information officer, said late yesterday that the March deadline at Morecambe Bay, which she set last April, has been missed and that consequently no new deal with CSC has been signed.

“CSC has not gone live with Lorenzo 1.9 at Morecambe Bay,” said Connelly. “As a result we are not in a position to sign an MOU [Memorandum of Understanding] with CSC and will not do so.”

-----

http://www.theaustralian.com.au/business/industry-sectors/coalition-would-not-roll-out-national-broadband-network/story-e6frg9hx-1225847177482

Coalition would not roll out national broadband network

• Mitchell Bingemann
• From: The Australian
• March 30, 2010 12:00AM

THE federal Coalition, if elected, would honour national broadband network contracts already in place but would stop short of rolling out the Labor government's ambitious $43 billion fibre plan.

Opposition communications spokesman Tony Smith said a Coalition government would adopt a non-interventionist approach to competitive broadband markets such as capital cities.

It would favour mobility over speed, and aim for a swift construction timetable.

The plan will mainly benefit rural and regional Australians, whom the opposition believes have been left out as the Rudd government continues with its election promise to build an NBN.

-----

http://www.theage.com.au/technology/sci-tech/prototype-bionic-eye-has-vision-for-the-future-20100330-rbhy.html

Prototype bionic eye has vision for the future

BRIDIE SMITH

March 31, 2010

MORE than anything else Leighton Boyd wants to see those that mean the most to him - his wife and children.

''That'd be pretty special to see them,'' he said yesterday.

Mr Boyd, 57, was diagnosed with the eye disease retinitis pigmentosa at the age of five. He now has very little vision and walks with a cane. The inherited condition has robbed him of his independence. He has never driven or worked in his trained field of electronics.

-----

http://www.theage.com.au/victoria/first-glimpse-of-bionic-eye-today-20100330-r8uk.html

First glimpse of bionic eye today

March 30, 2010

A Melbourne consortium will today unveil its prototype for a bionic eye.

The prototype will be revealed at the Melbourne launch of Bionic Vision Australia, which aims to improve the sight of people suffering degenerative vision loss.

Researchers hope to achieve an Australian first to implant the prototype into Australia's first bionic-eye recipient.

-----

Enjoy!

David.

Health Affairs Publishes A Issue Covering Health IT – A Must Read!

Health Affairs is one of the best journals globally on health policy.

They have just published an issue with a large amount of coverage of the area and what the current plans of the Obama Administration mean for Health IT in the USA.

The Issue Title is:

Health IT: The Road to 'Meaningful Use':

April 2010; Vol. 29, No. 4

The Table of Contents is available here:

http://content.healthaffairs.org/content/vol29/issue4/index.dtl?etoc

Some of the articles appear to be freely accessible and the whole issue will be available via most university libraries and services like CIAP.

Enjoy.

David.

A Question That Has Been Confusing Me!

It's pretty simple.

If the proposed reforms to the national Health Care System are so well considered and desirable why is it that the States, who have a lot of experience in operating hospitals, are not happy with what is proposed and are being provoked and swiped at with threats of Referendums and the like?

Is it that they are just stupid or might it be they lack important information and would like to see a fuller explanation of the total picture of what is being proposed before signing up?

Seems to me that with the Federal Government waving a big stick, rather than providing full information, including proposals on e-Health makes a lot of sense to be very careful about what you sign up for!

See here for the very recent NSW view.

http://bigpondnews.com/articles/Politics/2010/04/05/Keneally_steels_herself_for_COAG_448097.html

She certainly would like to know a lot more and she is a Labor premier!

David.

Last Chance to Comment on E-Health and the NHHN Article.

First thanks to all who commented. New version addresses those comments and adds material on the recently announced diabetic treatment approach.

----- Begin Article

The Australian National Health and Hospitals Network - Where Does E-Health Fit?

(Version 2.0)

In the report published in early March on the Commonwealth Government’s National Health Reform Plan there were a major set of structural reforms announced.

In brief these are (taken from page 9) of the report the Commonwealth Government:

• becomes the majority funder of public hospitals;
• takes over all funding and policy responsibility for GP and primary health care services;
• dedicates around one third of annual Goods and Services Tax (GST) allocations currently directed to state and territory governments (referred to throughout this document as ‘states’) to fund this change in responsibilities for the health system;
• changes the way hospitals are run, taking control from central bureaucracies and handing it to Local Hospital Networks; and
• changes the way hospitals are funded, by paying Local Hospital Networks directly for each hospital service they provide, rather than by a block grant from the Commonwealth to the states.

As with many such large scale reform proposals the more detailed revelations as to what is actually planned seem not to come in the initial document release and in the case of e-Health the report specifically notes that there are more detailed announcements in this specific area to come.

That Information Technology is an area to be addressed is seen on page 19 where “improved integration of information technology across our health system” was a key element of feedback received from the consultations held following the release of the NHHRC Final Report. This is confirmed in the press release associated with the report’s release where we find the following.

“On the basis of these reforms, over the coming weeks and months, the Government will announce critical additional investments to:

• train more doctors and nurses;
• increase the availability of hospital beds;
• improve GP services; and
• introduce personally-controlled electronic health records.”

As I write this, in early April, 2010, we have also seen the additional clinical training announcement, part of the preventive care announcement – on Diabetic Care - but are still waiting for the others to fill in details in areas like e-Health and primary care.

It seems a major part of the final e-Health plan is to introduce “personally-controlled electronic health records” and that this is a key thrust of a relatively imminent announcement. Just what these actually are and the implications of this plan are totally unclear at this point.

Before commenting specifically on this specific proposal we need to flesh out the other aspects of the plan a little. The reform plan talks of small networks of public hospitals of 3-5 or so hospitals. (It is mute on how these will relate to primary care and the private service sector (hospitals, radiology, pathology etc). According to the AIHW there are 736 public hospitals so we can assume that there will be around 170 Local Networks formed.

On the basis that we do not as yet have an e-Health plan announced what needs to be included?

First, any new plan needs to closely review the directions which have been agreed by the States and Territories to date in the form of the National E-Health Strategy which was released late in 2008.

Second any new plan needs to recognise that there are significant ‘facts on the ground’ already in place and in process and these, where appropriate, need to continue on uninterrupted.

Third the plan needs to properly address coordination of care and information flows between all the various elements of the health sector. It needs to be genuinely inclusive of the public, private and community health sectors.

Forth there is a major issue in e-Health regarding just what should be addressed at a national level and what is appropriate for local decision making and governance. My preference here is for a high degree of local autonomy within a pragmatic, flexible and responsive national e-Health standards and governance framework. If this is not addressed the risks of all sorts of failures is very high. Careful decision making will be required to determine the correct scope of national versus local provisioning and infrastructure etc. It will be important to avoid both inefficiency if the scale of e-Health service delivery is too small, while at the same time ensuring any larger service delivery agencies that are developed are both responsive and genuinely efficient.

Fifth any concept of shared personal health records needs to be deferred until the automation of all public and public care providers, and clinical messaging is well advanced and consistently standardised. Once this is achieved is the time to take the next steps of clinical information sharing with very high levels of consumer consultation around areas such as security and privacy. This is very much a walk before you run, essentially bottom / middle up approach rather than top down in most aspects.

Even with this limited ambition there are a range of problems that will need to be addressed.

An obvious one is that even if the number of local networks is only half of what seems to be planned there are a range of infrastructural elements which will be too small to be efficient and practical. E-Health is very likely in that basket.

A possible solution to address what is needed may be to adapt the Health Information Exchange (HIE) Model which is seemingly being quite successful in the US. In this model primary care computing and care co-ordination is central – empowered by secure information flows, with patient consent, between health care providers.

Appropriate aspects of the information flows can also made available to consumers via clinical portals and a Personal Health Records (PHRs). Everyone needs to realise PHRs are still a very unproven technology and may not actually prove to be all that useful or valuable in the longer term.

Appropriately sized Health Information Exchanges – maybe covering four or five local networks are both feasible and demonstrably effective. Of course the governance, leadership, funding and resourcing in terms of implementation, project and change management skills would be critical if success is to be assured.

If we do not see a proposal similar to this emerge from the Government in response to the NHHRC report and the National E-Health Strategy I will be very disappointed.

It also should be noted that the plan for diabetic care announced late March has some quite direct e-Health implications.

This announcement has to be seen as signalling a move to a disease based capitation approach from the from the fee for service model we have seen for the last 40 or so years under Medicare and its predecessors.

The IT implications for GPs choosing to enrol such patients are interesting as they will need to keep track of the various activities being undertaken for the apparently fixed fee of some $1200 per annum for a total package of diabetic care.

It is not clear present systems are set-up to optimally handle what is essentially a ‘managed care’ model for these patients. As enrolment is voluntary there will need to be the capacity to manage that process as well as ensure all the relevant preventive and treatment interventions have been delivered. Additionally there will presumably be an increased record keeping role to ensure that the outcomes sought by the overall $10,000 practice incentive payment are being achieved. Again a good deal more detail will be needed to see what precisely will be needed.

As the plans already announced have a considerable care coordination aspect it seems likely there will also be implications for inter-provider messaging and communication which will also need to be addressed electronically.

It seems highly likely that the planned announcements in the primary health space will have further e-Health implications separate from any particular strategic direction, and bringing all this together is a considerable task which is going to be important to get right if the still somewhat vague overall vision is to be successfully delivered.

References:

National E-Health Strategy – September, 2008

http://www.health.gov.au/internet/main/publishing.nsf/Content/e-health_strategy_toc

National Health And Hospitals Network Report – March, 2010

http://www.health.gov.au/internet/main/publishing.nsf/Content/nhhn-report/$FILE/NHHN%20-%20Full%20report.pdf

Ministerial Press Release – March 03, 2010

A National Health and Hospitals Network for Australia’s Future

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr038.htm?OpenDocument&yr=2010&mth=3

Primary Care Based Health Information Exchange (see for example).

http://www.healthdatamanagement.com/issues/18_3/247-primary-care-39835-1.html?portal=information_exchange

Ministerial Press Release – March 31, 2010

$436 Million To Take Pressure Off Our Hospitals By Delivering Personalised Care For Diabetics

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr057.htm

Biography:

Dr David More is a Health IT consultant with over twenty years experience in the e-Health area who blogs on all matters e-Health at www.aushealthit.blogspot.com. He may be contacted via the links provided on the blog.

----- End Article.

Comments welcome for a few days.

David.

AusHealthIT Man Poll Number 14 – Results - 5 April, 2010.

The question was:

How Happy Are You With The Overall Direction of the Rudd / Roxon Health Reform Plan?

100% Happy

- 3 (10%)

75% Happy

- 11 (36%)

50% Happy

- 4 (13%)

25% Happy –

- 5 (16%)

Not Happy At All

- 7 (23%)

Votes : 30

Comment:

Well, that is pretty unclear. Almost a split vote (46% Pro, 13% Neutral, 39% Not Really Happy). This means there are more than a few that are not happy with what Kevin and Nicola are planning and are trying to railroad through with the Premiers. They ignore this substantial body of concern at their peril – I suspect that unless a good deal more clarity emerges on the total package the COAG meeting in a couple of weeks could be quite interesting - and very long! We shall see.

Thanks again to all who voted.

David.

Consent is Not Going Away as an Important Issue. A Very Useful US Report.

The US Office of the National Coordinator for Health IT commissioned and has now published a very useful review of the consent issued around Health Information Exchange.

“Consent” issues may complicate PR efforts

By Jeff Rowe, Editor

Federal officials recently announced a two-year PR effort to educate the public about the benefits of HIT, but a recent report prepared for ONC shows how complicated that task may be.

Prepared by the George Washington University Medical Center’s Department of Health Policy, “Consumer Consent Options for Electronic Health Information Exchange: Policy Considerations and Analysis” describes the potentially confusing array of options with which patients may be faced as they try to maintain control of their personal health information.

As the Executive Summary succinctly puts it, “A range of consent models can be applied in different contexts of electronic exchange in the U.S. . . .There is also considerable variation in the type of information exchanged, ranging from the more basic (e.g., lab results) to the more mature and complex (e.g., a wide array of health information).

In other words, straight from the start of their experience with EHRs, patients can be faced with difficult decisions to make concerning how much of their personal health information they’re willing to share.

And those decisions may vary depending on the HIT system their provider is using. According to the report, current consumer consent options include “No consent”, “Opt-out”, “Opt-out with exceptions,” “Opt-in”, and “Opt-in with restrictions”.

More here:

http://ehr.healthcareitnews.com/blog/%E2%80%9Cconsent%E2%80%9D-issues-may-complicate-pr-efforts

The US Government site with additional documentation is here:

http://healthit.hhs.gov/portal/server.pt?open=512&objID=1147&parentname=CommunityPage&parentid=32&mode=2&in_hi_userid=11113&cached=true

This is well worth a visit and download.

This report is certainly a useful contribution to the debate we had a few days here:

http://aushealthit.blogspot.com/2010/03/serial-commenter-who-has-something.html

Given the number of comments the area is of interest to many readers. The debate in the US certainly has many similarities to the discussions that we have seen in Australia recently.

David.

The US Produces Another Interesting Report and Also Shows How Health IT Should be Progressed Long Term.

First a really interesting report:

Think tank finds complex benefits and risks in health IT

HHS' push for digital records provides benefits but also creates new problems

By Alice Lipowicz

Apr 01, 2010

Installing health information technology systems in a doctor’s office or hospital provides capabilities that are not well understood and offers a complex array of potential benefits and cost savings, according to a new think tank report.

“Although many proponents discuss the perceived benefits of health IT, missing from the debate is an honest discussion of experiences with actual HIT systems, and the obstacles and pitfalls of poorly designed systems,” states the study from the National Center for Policy Analysis, a nonpartisan think tank based in Dallas. The report was released today.

For example, although many digital record systems may prevent common errors, they also have the potential to introduce new and serious errors. They also can increase exposure to privacy and security risks, the report said.

On the other hand, the systems can improve communication and collaboration and speed the scheduling and delivery of tests and treatments, the report said, adding that they also can improve access to care by using IT and mobile devices to remotely deliver care.

More here:

http://fcw.com/articles/2010/04/01/think-tank-finds-complex-benefits-and-risks-in-health-it.aspx

This report was produced by a slightly ‘to the right’ think tank but does provide a useful set of views and a pretty comprehensive reference list. Well worth a download.

Also of even more interest is the following announcement:

SHARP: Confronting IT Challenges Head-on and Investing in the Future of Health Care

Friday, April 2nd, 2010 | Posted by: Dr. Charles Friedman | Category: HITECH Programs

Getting health IT “right” is difficult. Thousands of brilliant, creative and industrious people around the world have been working for several decades to realize the vision of making the technology a companion to care providers and patients, helping them make better decisions in support of better health. A scientific field of biomedical and health informatics has evolved around these efforts. Although great progress has been made, great challenges remain. While the health IT of today is largely equal to the task of supporting meaningful use as envisioned for 2011, current technology will be challenged by the more ambitious meaningful use visions of 2013, 2015, and beyond. Ongoing research and innovation will address these challenges

To that end, we announced in December the Strategic Health IT Advanced Research Projects (SHARP) program, as part of our HITECH initiatives. We identified four areas where breakthroughs are required: health IT security, patient-centered cognitive support of clinicians, innovative application and network-platform architectures, and secondary use of EHR data that maintains privacy and security. We invited the public and private sectors to propose collaborative research programs with the goal of developing “breakthrough” innovations. We further challenged applicants to bring the best minds in the country to bear on these key problems.

The response to our call was extraordinary in quality and quantity. The resulting competition was very keen. Today, after careful objective review, we awarded these very significant grants to four leading research institutions that submitted the most outstanding applications: Mayo Clinic of Medicine (for secondary use), Harvard University (for platform architectures), the University of Texas Health Science Center at Houston (for cognitive support), and University of Illinois at Urbana-Champaign (for security). All four projects will develop innovative solutions that will find their way into working systems in two years, while also exploring more fundamental problems that require longer term study.

As an informatics researcher and, formerly, a software developer, I am fully aware of how much we are expecting of these four projects. At the same time, I am fully confident that all four awardees are equal to our ambitions for SHARP, and that over the coming years, we will see from these centers breakthrough innovation and published research that will stimulate equally creative work by others.

The blog entry is found here:

http://healthit.hhs.gov/blog/onc/index.php/2010/04/02/sharp-confronting-it-challenges-head-on-and-investing-in-the-future-of-health-care/

This post reveals very clearly that when you have a plan and some serious commitment you not only worry about the ‘here and now’ you also put in train the research and development to position for the future.

With these sort of funds it is clear this is exactly what the US is doing. It is also clear we are not. NEHTA and DoHA would not know how to even start tackling these sorts of issues and sadly, as I type, we don’t have enough the basic infrastructure (staff, skills, relevant grants and expertise) around the country to even have a chance. Worse with this type of effort being begun over there, watch for the brain drain! I am glad the US is now starting to do some of the serious heavy lifting.

Sad that we will again slip behind I fear!

David.