Quote Of The Year

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

or

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

Friday, June 04, 2010

Weekly Overseas Health IT Links 02-06-2010.

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.healthcareitnews.com/news/study-health-it-care-coordination-key-meeting-national-cholesterol-guidelines

Study: Health IT, care coordination key to meeting national cholesterol guidelines

May 14, 2010 | Molly Merrill, Associate Editor

DENVER – Kaiser Permanente is crediting healthcare information technology and care coordination as helping more than 40 percent of very high-risk patients reach national cholesterol guidelines – a feat that past studies indicate is difficult to achieve.

In 2004 the National Cholesterol Education Program issued revised cholesterol goals recommending people at very high-risk for heart disease move their target LDL or "bad" cholesterol from 100 mg/dL to 70 mg/dL to reduce the risk for another heart attack.

Many health experts have questioned the legitimacy of such an aggressive goal. Previous research has found only between 15 and 30 percent of patients were able to get their cholesterol to the recommended goal.

The study, which is the largest to date demonstrating how many patients can get to the lower goal, found that of the 7,247 Kaiser Permanente patients studied, 43.4 percent lowered their bad cholesterol to less than 70 mg/dL. The majority of patients who attained an LDL less than 70 mg/dL in the study were receiving a statin or a combination of statin and other cholesterol-lowering therapies.

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http://www.fiercehealthit.com/story/battle-over-privacy-de-identified-data-continues/2010-05-24

Battle over privacy of de-identified data continues

May 24, 2010 — 12:03pm ET | By Neil Versel

Think the tug-of-war between vendors, health systems and privacy advocates over data mining and de-identification of patient records is subsiding? Think again.

The outspoken Dr. Deborah Peel has a memorable line that she often repeats: "Once your information is released, it's like a sex tape that lives in perpetuity in cyberspace," she says in a Dallas Morning News story. "You can never get it back." The Morning News last week took a look at the contentious struggle for control of data that must be resolved before the healthcare industry is to fulfill President Obama's vision of a nationwide, interoperable system of EMRs and health information for all Americans.

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http://www.modernhealthcare.com/article/20100524/NEWS/100529968/1029

Working on IT

By Joseph Conn / HITS staff writer

Posted: May 24, 2010 - 12:01 am ET

The American Recovery and Reinvestment Act of 2009, commonly known as the stimulus law, has a host of tight deadlines for its myriad health information technology subsidy and IT network development initiatives.

Nearly all of them are timed to help fulfill the ambitious goal set by former President George W. Bush in 2004 and adopted by President Barack Obama last year to make electronic health records available to most Americans by 2014.

Not surprisingly, a federally funded health IT workforce training effort is both part of the overall program and caught up in its mad rush.

“We are moving fast,” said Patricia Dombrowski, director of the Life Science Informatics Center at Bellevue (Wash.) College, which is leading a consortium of community colleges that applied for and won $3.4 million in workforce training grants funded by the stimulus law—covering career paths from information management to IT hardware installation.

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http://www.modernhealthcare.com/article/20100525/NEWS/100529949

50,000 new health IT workers might be needed

By Joseph Conn / HITS staff writer

Posted: May 25, 2010 - 12:01 am ET

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

Along with the push to ramp up the use of health information technology in hospitals and doctors' offices comes the need for a highly skilled labor force to get the job done.

Claire Dixon-Lee is executive director of the Commission on Accreditation for Health Informatics and Information Management Education; the CAHIIM is a division of the American Health Information Management Association that accredits 281 health information management certificate and baccalaureate degree programs at schools across the country. In the past, health information management workers dealt with managing paper records, but their jobs have changed with the times.

Dixon-Lee said that today many AHIMA members are doing the work of IT specialists at their hospitals and physician offices while others can be retrained for these new positions. CAHIIM-accredited programs graduate between 3,000 and 3,500 students a year, of which 600 receive bachelor's degrees and the rest associate's degrees, she said.

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http://www.vintoniowa.org/Business/article738.html

Training for a New Health Care Information Era

By Steve Carpenter, Kirkwood Tuesday May 25th, 2010

Training for a New Health Care Information Era:

Kirkwood receives major Federal grant, part of regional and nationwide program

Kirkwood Community College will soon launch a training program to boost skills and advance careers in health information technology. A grant from the U.S. Department of Health and Human Services will put more than a half million dollars toward training programs for IT professionals in hospital, clinical and other health care settings.

Kirkwood is one of 17 community colleges across the Midwest putting the training program into action. The grant provides $512,000 in Kirkwood support for two years of training sessions. The educational program will focus on non-credit, short-term training.

Cuyahoga Community College of Cleveland, Ohio is the lead institution in the Midwest portion health care information training project. The total grant award to the 17 Midwest community colleges totals $36 million, with an overall goal of more than 50,000 new health IT professionals in the workforce by mid-2012. The larger scope of this grant includes 70 community colleges across the U.S.

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http://www.healthcareitnews.com/news/interoperability-key-better-patient-care

Interoperability key to better patient care

May 20, 2010 | Kyle Hardy, Community Editor

ANDOVER, MA – Interoperability is a major part of the HITECH Act, the healthcare IT portion of the American Recovery and Reinvestment Act, passed in February of 2009. And according to Dale Wiggins, chief technology officer of Philips Healthcare Patient Care and Clinical Informatics, it all starts with modalities.

"It's important to providers that modalities (PACS, MRI, CT scans) integrate with the other legacy systems at their facilities," said Wiggins. "Providers have orders that need to be filled and Philips is moving to make sure work flow is not interrupted."

Interoperability has been touted as having much potential in improving the quality of care for patients. Providers are looking at integrating new systems with their existing IT infrastructure to reduce waiting room times, provide clinical decision support for physicians and ultimately reduce costs.

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http://www.healthcareitnews.com/news/automated-home-monitoring-lowers-high-blood-pressure-study-finds

Automated at-home monitoring lowers high blood pressure, study finds

May 21, 2010 | Mike Miliard, Managing Editor

DENVER – The use of at-home blood pressure monitors and Web-based reporting tools that connect patients and clinicians appears to significantly improve patients’ ability to manage their hypertension down to healthy levels, according to new research.

The study, which was led by Kaiser Permanente Colorado in collaboration with the American Heart Association and Microsoft, followed 348 patients, ages 18 to 85, with uncontrolled high blood pressure. The initial study data was presented today by Kaiser Permanente Colorado researchers at the American Heart Association’s 11th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.

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Performance Monitoring Aims To Improve EHR Satisfaction

By monitoring system performance on the backend, an Alabama health system hopes to make its e-health record rollout go smoother for users.

By Marianne Kolbasuk McGee, InformationWeek

May 25, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=225200081

When rolling out a new e-health record system, the last thing a healthcare organization wants is for clinicians to complain about how slow the system is, or even worse, being unable to access digitized patient information.

As it is, making the switch from paper records -- and paper-based processes -- to computerized record keeping, prescription ordering, and a digitized workflow can be disruptive and challenging enough for a doctor practice or hospital department. Throw in systems performance problems on the backend and the frustration will only escalate.

Avoiding those kinds of problems from the get-go is the plan at Baptist Health System of Birmingham, Ala., which operates four hospitals in the state and about 35 doctor practices and health centers.

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http://www.un.org/apps/news/story.asp?NewsID=34802&Cr=itu&Cr1=

UN urges improved access to information technology in hospitals, schools

25 May 2010 – Health institutions and schools in developing countries continue to have limited access to information and communications technology (ICT), the United Nations telecommunication said in a report issued today, calling for greater efforts to improve access to high-speed Internet services.

“The health sector stands to benefit greatly from the use of ICTs and ICT applications, for example through the more efficient delivery of health-care services and the provision of health information to the general public,” the UN International Telecommunication Union (ITU) said in its 2010 report.

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http://www.who.int/goe/ehir/2010/25_may_2010/en/index.html

e-Health Intelligence Report

25 May 2010

Scientific Articles

:: eHealth portals: who uses them and why? (Am J Health Promot. 2010 May-Jun;24(5):TAHP1-7, iii.)

The role of the Internet and specifically ehealth portals continue to expand at a significant pace. The various major functions of ehealth portals are identified, along with the results of an online survey conducted among employees of eight major U.S. employers. Demographic variables, job characteristics, reasons for use of the portal and selected behavioral outcomes are presented from a sample of more than 20,000 employees, with a response rate in relation to the entire employee population of 19%. Major implications from the survey findings are then identified, with an intention of enhancing the health improvement effectiveness of the ehealth portal.

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http://www.zdnet.com/blog/healthcare/intel-health-trying-carrier-strategy-in-europe/3677

Intel Health trying carrier strategy in Europe

By Dana Blankenhorn | May 26, 2010, 6:57am PDT

Intel Health, which is struggling to find a winning business model in the U.S., is entering Europe with a carrier strategy.

The company announced marketing deals with Telefonica of Spain, BT of England, and Orange in France as part of its entry to the continent’s e-health market.

Other strategic partners listed in the release are GE Healthcare, which will work with it in England, and Asklepios Hospital Group of Germany, one of the region’s largest private hospital groups.

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http://news.discovery.com/tech/are-electronic-medical-records-safe.html

Are Electronic Medical Records Safe?

By Cristen Conger | Wed May 26, 2010 01:56 PM ET

In 2008, a hospital employee at UCLA Medical Center was fired for leaking details of Farrah Fawcett’s cancer treatment.

But the information didn’t come from someone directly involved with the late actress’s caretaking. Instead, the person in question hacked into Fawcett’s electronic medical record in the hospital’s patient database.

As the national initiative to create electronic medical records for every American moves forward, the Fawcett incident exemplifies the worst-case scenario for putting people’s most personal and sensitive health records in a digital format.

Unless electronic medical records are safe, they could end up in the wrong hands, opening the door to medical identity theft, insurance fraud and other breaches of privacy.

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http://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/571-community-pharmacies-to-be-linked-with-launch-of-provincial-pharmacy-network

Community pharmacies to be linked with launch of provincial Pharmacy Network

May 26, 2010 (St. John’s, NL) – Newfoundland and Labrador has officially begun connecting community pharmacies to the provincial Pharmacy Network, the Honourable Jerome Kennedy, Minister of Health and Community Services announced today. Minister Kennedy was joined by Mike Barron, CEO of the Centre for Health Information, Don Rowe, Newfoundland and Labrador Pharmacy Board, Don Sweete, Canada Health Infoway’s Executive Regional Director for the East, and Paul LePage, Vice President and General Manager of Healthcare Delivery Solutions, TELUS. The Pharmacy Network is a provincial drug information system that contains a record of patient medication information and comprehensive drug information which will assist pharmacists in identifying potential adverse drug interactions.

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http://www.blogher.com/how-electronic-medical-records-will-improve-your-health-care?wrap=blogher-topics/office&crumb=32392

How Electronic Medical Records Will Improve Your Health Care

May 25, 2010 8:41 am by in Tech

There are fewer things in life more important than our health. And yet, most of us have never even peeked at those records. In the five -- make that nearly six decades -- that I've been seeing physicians, I have never once looked at a single page in my medical record. Not one page. Ever.

How bizarre is that? What if there is something in there that's inaccurate? What if there is something in there that I should know but have forgotten? Until recently, it never even occurred to me that I should review these records. It just wasn't on my radar.

My medical records probably are skinnier than most. I have no chronic diseases. Don't take medications on a regular basis. Have had a couple of surgeries. A concussion. A couple of pregnancies. The most significant medical event was a case of shingles on my facial nerve that created a rather thick file for my ophthalmologist. To the best of my knowledge, that file has never been shared with my regular physician. Maybe there is something in there in how I responded to treatment that would be important for future medical episodes.

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http://govhealthit.com/newsitem.aspx?nid=73799

Privacy panel advocates encryption for simple HIE

By Mary Mosquera

Monday, May 24, 2010

Healthcare providers should encrypt patient information when they share it with another provider, even in a case of the direct exchange of personal health information or data that is not facilitated by a health information exchange or other third-party organization.

The recommendation for guarding patient information privacy in a simple health information exchange was made by the privacy and security workgroup of the Health IT Policy Committee at a May 19 policy committee meeting.

In recent weeks the workgroup has been wrestling with determining at what point in a health information exchange it becomes necessary for providers to obtain consumer consent to approve an exchange a transaction.

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http://www.healthcareitnews.com/news/what-do-data-top-mind-healthcare-execs

What to do with data top of mind with healthcare execs

May 24, 2010 | Bernie Monegain, Editor

BOSTON – No issue is more important to healthcare providers than data management, according to a new global survey of healthcare executives, conducted by BridgeHead Software, which develops and markets healthcare storage virtualization solutions.

Forty-four percent of respondents to BridgeHead Software's Healthcheck 2010 Survey of hospitals and healthcare organizations worldwide indicate that data backup/business continuity/disaster recovery is their top IT investment priority throughout 2010 and likely beyond.

The Healthcheck 2010 survey gauged the opinions of 133 healthcare executives on their most pressing IT needs. Nearly 50 percent of respondents were from the IT executive or director/manager level, and approximately 10 percent were non-IT executives. The rest included technology and medical professional with a spattering of titles and responsibilities.

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http://online.wsj.com/article/SB20001424052748704113504575264340355395642.html#mod=todays_us_marketplace

Internet Tool to Curb Waiting-Room Time

Web Alerts When Doctors Run Late

By SHIRLEY S. WANG

A new Web-based tool seeks to help patients spend less time in the waiting room before seeing their doctor. The application, called MedWaitTime, allows patients to check before their appointment whether their doctor is running late, akin to getting a flight-status update before going to the airport.

Patients can access the site, medwaittime.com, up to two hours ahead of their appointment. If the doctor is running late, patients can be instructed to arrive later than their scheduled appointment.

Patients can also enter their cellphone number into the system for alerts through text messaging.

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Dossia Expanding EHR Platform Reach

The employer consortium is offering its e-health record software to other companies via the cloud and is also developing an EHR package for small and mid-size businesses.

By Marianne Kolbasuk McGee, InformationWeek

May 24, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=225100002

Dossia, the consortium founded several years ago by nearly a dozen large employers to develop and offer e-health records to their workers, is now making that software platform available to other companies.

Via a software-as-a-service, multi-year subscription-fee model, the Dossia Personal Health Platform is now being offered to a wider range of employers that want to provide EHRs to their workers, said Steve Munini, Dossia chief operating officer. Those customers will be offered the same bells and whistles that founding members are provided, he said. That includes an array of applications that have been developed for or are available via the Dossia platform by third parties, including Mayo Clinic, Allviant, and MediKeeper.

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http://www.ehealtheurope.net/news/5938/ec%E2%80%99s_puts_health_on_digital_agenda

EC puts health on Digital Agenda

26 May 2010

The European Commission has set out its Digital Agenda, which includes measures to use technology to address rising healthcare costs and help member states to cope with their ageing populations.

The action plan says the smart use of technology and the exploitation of information will help to address these and other challenges facing society, including climate change.

The EC will set up wide-scale pilots to take forward the ideas in the Digital Agenda. One of these will aim to give Europeans secure, online access to their medical health data so they can share it with doctors. The action plan says the planned delivery date for this initiative is 2015-20.

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http://www.ehiprimarycare.com/news/5930/nhs_it_pros_urged_to_%E2%80%98keep_the_faith%E2%80%99

NHS IT pros urged to ‘keep the faith’

21 May 2010

The head of Kaiser Permanente’s Innovation Centre has urged NHS professionals engaged in health IT implementations to ‘keep the faith’, as the benefits to patient care are worth the effort.

In an exclusive video interview broadcast today on EHI TV, Dr Yan Chow of leading US healthcare network Kaiser Permanente tells EHI editor Jon Hoeksma, how KP has just completed a seven year $4 billion implementation of electronic medical records that is already proving transformational.

Dr Chow, the director of innovation and advanced technology, Kaiser Permenente Information Technology, says that his organisation has completed the roll-out of EMRs in the last few weeks and already has hundreds of published studies showing the benefits to the quality of patient care, patient experience and delivery of services.

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http://www.fierceemr.com/story/study-emr-speeds-treatment-stds/2010-05-27

Study: EMR speeds treatment of STDs

May 27, 2010 — 1:52pm ET | By Neil Versel

Sex sells. Apparently, that's even true when it comes to EMRs. How else to explain U.S. News & World Report picking up a HealthDay News report on the effect an EMR has on treatment? That's because the disease in question is chlamydia.

A study published online today in the journal Sexually Transmitted Infections finds that an EMR cut the average treatment start time to 3.5 days from 11.5 days following a chlamydia diagnosis at a sexual health clinic in the UK. The percentage of patients getting treatment within two weeks of their diagnosis rose to 94 percent with the EMR from 38 percent before the clinic installed the system.

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http://www.fierceemr.com/story/new-book-focus-emr-adoption-not-just-implementation/2010-05-27

New book: Focus on EMR adoption, not just implementation

May 27, 2010 — 11:29am ET | By Neil Versel

Anyone in the biz knows that you don't just put in an EMR and expect success. The federal subsidies, which require "meaningful use" of EMRs, up the ante. Still, implementations continue to fail, or at least not live up to expectations.

A new book, Beyond Implementation: A Prescription for Lasting EMR Adoption, examines the pitfalls of EMR projects and discusses why and how organizations should focus on user adoption, not just implementation. The authors, Heather Haugen and Dr. Jeffrey Woodside, spoke at length about the book with CMIO magazine.

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http://www.fierceemr.com/story/srssoft-exec-most-emrs-are-poorly-designed-complicate-meaningful-use/2010-05-27

SRSsoft exec: Most EMRs are poorly designed, complicate 'meaningful use'

May 27, 2010 — 12:07pm ET | By Neil Versel

It's likely a combination of reluctance to change and poorly designed systems that has held back wider EMR adoption, though opinions do differ greatly. Jack Callahan, executive VP at "hybrid" EMR vendor SRSsoft, Montvale, N.J., clearly believes that systems design is more at fault.

In response to a recent discussion of slow EMR uptake on the EMR and HIPAA blog, Callahan wrote what blog author John Lynn calls a "passionate" email, which Lynn published on his related EMR and EHR blog. "A major reason why the rate of EMR adoption is so slow is that, despite vendor claims, the actual needs and priorities of the busy, practicing provider are not built in," Callahan says. "I've worked closely with three EMR companies, and am aware of more than 300 EMR products, almost all of which, like lemmings, have decided to follow the old CCHIT design-and-development pathway over the cliff," adds Callahan, clearly no fan of the prevailing certification process.

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http://allafrica.com/stories/201005280149.html

Rwanda: We Can Make e-Health a Reality-Rector

Stevenson Mugisha

28 May 2010

Kigali — The Rector of Kigali Institute of Science and Technology (KIST) has called on all stakeholders in the e-health sector become a global reality.

Addressing a workshop organised for e-Health Centre of Excellence stakeholders in Kigali yesterday, Prof. Abraham Atta Ogwu told participants that the centre is meant to help improve the health sector in the country.

"The main objective of this workshop is to bring together you as stakeholders in your respective capacities to create awareness that Rwanda has progressed and has become a part of the Global Health Informatics programs"

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http://www.modernhealthcare.com/article/20100528/NEWS/100529922

Health IT panel gets an earful on plan

By Joseph Conn / HITS staff writer

Posted: May 28, 2010 - 12:01 am ET

The federally chartered Health IT Policy Committee heard last week from its Strategic Plan Workgroup, which delivered advice to the Office of the National Coordinator for Health Information Technology for an annual update to the Federal Health IT Strategic Plan.

At a full-committee meeting May 19, the Health IT Policy Committee took under advisement the work group's recommendations to make several tweaks to the plan. ONC head David Blumenthal said a final vote on the recommendations could come at the policy committee's next meeting, scheduled for June 25. The Health IT Policy Committee was created under the American Recovery and Reinvestment Act of 2009 to advise the ONC on IT policy issues.

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http://govhealthit.com/newsitem.aspx?nid=73807

Health data exchange build starts this summer

By Nancy Ferris

Wednesday, May 26, 2010

By early July, the Office of the National Coordinator will announce the winners of 11 contracts for developing a health information exchange framework based on a model originated by federal homeland security agencies for sharing sensitive information over the Internet.

The National Information Exchange Model, or NIEM, is a technical approach to information sharing that federal agencies developed during the last decade, prompted by the need to share homeland security information quickly and securely. It is based on XML standards.

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http://www.healthdatamanagement.com/news/mobile-ipad-content-webmd-40338-1.html

WebMD Supports iPad

HDM Breaking News, May 27, 2010

Medical information content vendor WebMD has introduced a free mobile application to access its content on the Apple iPad.

The WebMD for iPad application is in addition to the New York-based vendor's previous offering for iPhone users, called WebMD Mobile. Both services feature the company's Symptom Checker, content on more than 1,000 conditions, drug information including side effects and interactions, and first aid information.

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http://www.healthcareitnews.com/news/enterprise-hie-market-poised-soar

Enterprise HIE market poised to soar

May 25, 2010 | Diana Manos, Senior Editor

FRAMINGHAM, MA – A recent study of health information exchange solution vendors shows enterprise HIEs serving integrated delivery networks, health, or hospital systems will be the fastest-growing market segment of HIE organizations in the coming two years.

The study, "Vendor Assessment: Industry Short List for Health Information Exchange Technologies," was conducted by IDC Health Insights, a Framingham, Mass.-based market research firm.

IDC researchers said enterprise HIEs are unlike regional health information organizations (RHIOs) and statewide or national HIEs, because they can establish a sustainable business model and are not as encumbered by organizational and data governance issues.

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http://www.healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications::Article&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=011CD5973F724C74813149F25301C2F7

Issue Date: June 2010

CPOE Revelations

Results of an important new study dispel some major assumptions about clinical IT implementations

by Mark Hagland

The logic in the argument would appear to be unassailable: given that there is inevitably a range in the experienced functional quality of various electronic health record (EHR), computerized physician order entry (CPOE), and other clinical IT products on the market, the better the quality of particular clinical IT products, the more fully those individual products should help hospital organizations to achieve better patient safety and care quality, correct? Indeed, such assumptions would seem to be supported by the results of such important industry resources as the regular reports coming out of the Orem, Ut.-based KLAS Research, for example.

Yet the results of a new study by researchers at the Falls Church, Va.-based CSC Healthcare seem to portray a far more complex picture of what actually happens once hospitals implement clinical information systems. Despite the strong value of knowing the quality rankings of various products, some CSC researchers recently found that, when it comes to the end results around reductions in physician order entry-related medical errors, researchers found only a slight correlation between buying a “quality” EHR/CPOE product and error reduction. In other words, the bulk of the difference in actual error reduction relates to a complex knot of processes and issues separate from the brand name of a particular system an organization is implementing or has implemented. But very bluntly, a hospital can buy a very “high-quality” EHR product and customize it very poorly; or take a “mediocre” product and achieve considerable success with it.

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http://www.kaiserhealthnews.org/Stories/2010/May/24/Blumenthal-Health-IT.aspx

Obama’s Health IT Leader Says Doctors Will Embrace Change

David Blumenthal Guides Billions Of Stimulus Dollars To Help Doctors And Hospitals Adopt Electronic Medical Records

May 24, 2010

Dr. David Blumenthal was not happy to find a new computer installed on his desk when he showed up for work one morning eight years ago at Massachusetts General Hospital in Boston. He knew the hospital had been hard at work on developing an electronic medical record (EMR) system, but Blumenthal wasn't keen on changing practices that had served him and his patients just fine over the years.

Quickly, though, he found himself to be odd man out at staff meetings where younger colleagues eagerly exchanged tips on how to retrieve patient histories, test results and consults with other physicians.

"I realized I was going to have to get on board," Blumenthal recalled in an interview. Still, he approached the task of converting paper-based notes and patient records to the electronic system as more obligatory than clinically useful. The "aha" moment, which Blumenthal frequently mentions in speeches, came on the day he entered orders for a CT scan and his computer screen flashed a reminder that the patient had already had one.

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http://industry.bnet.com/healthcare/10002791/healthcare-it-even-the-experts-cant-figure-out-whats-going-on/

Healthcare IT: Even the Experts Can't Figure Out What's Going On

By Ken Terry | May 24, 2010

Trying to follow the ins and outs of healthcare information technology — a complicated morass of electronic health records, patient and medical-management systems, federal subsidies and mandates and a whole lot more — has been like assembling a giant jigsaw puzzle whose pieces are delivered in random order. It’s some comfort, though not much, to realize that this mess baffles the experts, too.

A recent Microsoft (MSFT) press conference that included David Brailer, the first national health IT czar, put the current state of this jigsaw puzzle in a high-level perspective. But it was only slightly less confusing after Brailer and Peter Neupert, vice president of Microsoft Health Solutions, expounded on their views.

Let’s start with electronic health records, or EHRs. Last year’s stimulus bill included incentives for physicians and hospitals to acquire EHRs — but healthcare providers first have to show they’ll be using the information systems in “meaningful” ways. The draft “meaningful use” regulations, published in January, drew negative comments from many medical societies and other healthcare organizations. Providers believe it will be too difficult for them to meet the criteria within the specified time frame, and they feel it’s unfair that they have to satisfy every requirement to get the government funds.

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http://www.healthleadersmedia.com/content/LED-251355/Patient-Information-Breaches-Leaderships-Responsibility.html

Patient Information Breaches: Leadership's Responsibility

Philip Betbeze, for HealthLeaders Media, May 21, 2010

Let's stipulate, before I go on, that I don't know much about technology or how computers work. I can run routine maintenance on my computer, but that's about it. In fact, a good (and patient) friend of mine is coming over tonight to help me hook up my wireless internet router, which really isn't all that difficult for him, but gives me hives just thinking about it. Give me a lawnmower engine to rebuild or a set of brakes to change, and I'm your man. Give me a computer to work on, and you'll get a blank stare in return.

I'm guessing many of the readers of this column fit the same mold, minus perhaps, the car repair abilities, and plus the overwhelming responsibility of being in charge of a health plan, a hospital, a physician practice or health system. No, you're not likely a computer security guru, but given the almost weekly news item about embarrassing and costly patient health information breaches in healthcare, it's appropriate to remind those of you who are in charge of your hospital, health system or physician practice: protecting this data is YOUR responsibility. I know you depend on delegates to get these jobs done, and you pay them well. You can't micromanage this stuff.

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http://www.healthleadersmedia.com/content/TEC-251483/Ready-or-Not-TechSavvy-ePatients-are-Coming.html

Ready or Not, Tech-Savvy e-Patients are Coming

Gienna Shaw, for HealthLeaders Media, May 25, 2010

The patient of the future—also known as the e-Patient—is technologically savvy, information hungry, and has a sense of entitlement about the level of service and the types of services they want. They'll demand up-to-date, easy-to-understand, and easy-to-access information about the cost of care and billing, online appointment scheduling, the ability to e-mail their physicians, and hospital Web sites that have more information than can be found on Google maps. The patient of the future will put plenty of demands on healthcare organizations in general and healthcare IT departments in particular.

Donna Cryer is one such patient. A liver transplant recipient who's had to deal with multiple and complex health issues starting when she was just 13, she wants to be cared for in ways that can only be delivered with data-sharing and expedited communication.

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http://www.healthdatamanagement.com/news/certification-ehr-comment-ehnac-edi-40327-1.html

EHNAC: Move Certification Beyond EHRs

HDM Breaking News, May 25, 2010

The Secretary of Health and Human Services should consider creating information technology certification programs beyond those being adopted for complete electronic health records systems and EHR modules, according to the Electronic Health Network Accreditation Commission.

Farmington, Conn.-based EHNAC, which certifies transactions processors for meeting specific performance criteria, in a comment letter makes the case for certification of other I.T. services. These could include claims clearinghouses and value-added networks, financial services, electronic prescribing, and health information exchanges, among others.

The organization understands the reasoning for the proposed certification rule's definition of an accredited certification body that is limited to certifying EHRs and EHR modules. EHNAC, however, is concerned that a "minimum" definition in a final rule will eliminate itself and other entities from consideration if HHS designates organizations to certify HIEs.

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http://www.ihealthbeat.org/perspectives/2010/has-the-time-come-to-embrace-telehealth-as-a-system-solution.aspx

Monday, May 24, 2010

Has the Time Come To Embrace Telehealth as a System Solution?

A growing number of health care providers say that telemedicine is the key to health reform, arguing that the technology can enhance record keeping, reduce waiting times, cut unnecessary hospitalizations and reduce costs.

There also are those who view telemedicine as an expensive, intrusive technology, ostensibly a gimmick promoting exotic health care reform.

U.S. Health Care Spending

As background, the U.S. devotes 16% of its gross domestic product to medical care --- more per capita than any other nation. The total U.S. health care spending in 2009 was $2.5 trillion --- some $650 billion above expected levels. Two-thirds of the "excess" health care spending went toward outpatient care -- the fastest-growing categories being same-day hospital care and physician office visits.

Looking at the issue from another dollar perspective, reportedly 20% of all ailments represent 80% of the health costs. Typically, health care for the elderly and treatment for chronic diseases account for 75% of health care spending. The high costs are attributed to multiple readmissions caused by a fragmented health system focused on acute care.

-----

Enjoy!

David.

AusHealthIT Man Poll Number 21 – Results – 4 June, 2010.

The question was:

Has NEHTA Spent The Funds It Has Been Allocated Effectively and Wisely?

You Bet!

- 5 (11%)

Probably

- 6 (13%)

I am On the Fence

- 1 (2%)

Not Really

- 7 (16%)

No Way

- 24 (55%)

Votes: 43

Poll closed

Comment:

This is a pretty clear result. 76% are essentially saying NEHTA has not been spending wisely and 24% say it has.

Again, many thanks to all those who voted

David.

Thursday, June 03, 2010

Senate Estimates Hearing - June,3 2010 - Preliminary Notes.

The e-Health component ran from about 3.00pm up until about 3:40pm

Questioning began by Senator Boyce at 3.00pm.

Others who asked most questions were Senator Furner and Senator Fierravanti-Wells.

The two main areas of questioning were around the Personally Controlled EHR (PCEHR) and the HI Service.

Personally Controlled EHR

We discovered the following:

A PCERH is a personal health record owned and controlled by the patient.

It will be voluntary to have one.

The PCEHR is apparently planned to be accessible via a portal.

Access will be possible by anyone who has been authorised by the patient and it is planned access via the internet will be possible from home, public libraries.

It was suggested that maybe Google or Microsoft would offer the service and this was denied. (Note: a correspondent has suggested that I may have misheard - and that the question was not really answered directly) The net outcome is I think it is possible but not plan A at the moment - time will tell!

DoHA has not yet worked out how infrastructure for the PCERH will be built.

When asked about the relatively small amount of money, we were told the $467M was consistent with Larger PCEHR Business Case which ran for more years. It was also clear that there was, as yet, no real idea as to how the money would be spent and on what.

It was made clear that e-Health development would be “incremental rather than small steps”. (Whatever is meant by that!)

Comment:

No comments made on where the health information to populate the record would come from and no real discussion on what functionality the portal would provide.

I was left with the distinct impression that the Business Case that was talked about was not the IEHR plan developed by NEHTA.

Health Identifier Service

Use of HI Service Number.

The plan it to allocate the IHI numbers once the legislation is passed and regulations are approved.

It was the plan that provider would be also allocated numbers and they would be major users initially.

It was quite clear there would be little happen for a good while after July 1, even if legislation is passed.

Status

To date no live system had been tested.

Amazingly only 3 software providers had signed ‘Developers Licences’ to access the Medicare HI Service Development system.

No indication was provided on how promotion of the HI Service would be undertaken of funded but Senators mentioned that NEHTA had released an Implementation and Communication Plan.

See here:

http://www.nehta.gov.au/component/docman/doc_download/1012-hi-service-implementation-approach

And here:

http://www.nehta.gov.au/component/docman/doc_download/1011-hi-service-communication-plans

If legislation not passed – impact on scheme was recognised to be substantial and it was agreed that it was being talked about rather optimistically.

Other Matters:

Senator Fierravanti-Wells asked a number of details on NEHTA funding, plans etc (Other questions were also asked on the total cost of e-Health since 1993) so the answers on notice to those will be interesting when they arrive.

Senator Furner asked a good set of questions based on the Booz E-Health Report. All the bureaucrats agreed E-Health was vital and important in saving lives and money. That was good to get on the record!

See here:

http://aushealthit.blogspot.com/2010/05/major-study-confirms-value-from-e.html

Overall:

Not really enough time but some interesting points. We really need more time than this and we need NEHTA to turn up!

David.

Wednesday, June 02, 2010

The Government Moves a Little on HI Service Legislation. – A Good Start?

The following release appeared a little while ago.

ANDREW SOUTHCOTT MP

Shadow Parliamentary Secretary for Regional Health Services, Health and Wellbeing

Federal Member for Boothby

012/10

Roxon Masters the Backflip and Backdown

02 June 2010

The Coalition welcomes the decision of the Rudd Labor Government to adopt some of the amendments put forward by the Coalition on the Healthcare Identifiers legislation.

This is an admission by the Rudd Government that their initial legislation was too broad and too loose.

“We’ve come to expect little more than policy on the run from this Government”, Andrew Southcott said.

The Coalition’s amendments aim to improve privacy of information and protect against function creep, by enshrining provisions on the use of healthcare identifiers within the legislation, as opposed to the regulatory approach previously favoured by the Government. Whilst the Government has attempted to address these concerns, they have failed to adopt some of the other key amendments put forward by the Coalition. These are outlined below:

· ‘The requirements for assigning a Healthcare Identifier to a healthcare provider or to a healthcare recipient shall be prescribed in the Bill as a schedule’;

· confirming the operator of the health identifying service could only be changed by legislation;

· There is no guarantee of a right of appeal or review under section 9 of the proposed legislation. This is a serious omission; and

· deleting the provisions which allows the health identifier to be released if allowed under any other law.

We are pleased Labor has adopted some of our amendments, however, the Coalition will still proceed to move and insist on any amendments the Government hasn’t addressed.

End Release.

Good to see some talking is actually happening on all this.

Here is the Government Press Release:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr118.htm?OpenDocument&yr=2010&mth=6

Healthcare Identifiers

2 June 2010

The draft regulations for the national healthcare identifiers have been revised and the Government will propose amendments to the Healthcare Identifiers Bill to respond to issues raised during public consultation.

The amendments will make the legislation safer and more secure and increase parliamentary oversight of the Healthcare Identifiers Service.

The changes to the proposed regulations will provide:

  • greater clarity for healthcare organisations in how they would liaise with the new Healthcare Identifiers Service;
  • streamlined administrative requirements for healthcare providers that would maintain appropriate processes, monitoring and enforce penalties for unauthorised access; and
  • a new right-of-review provision for healthcare providers without healthcare identifiers in relation to some decisions.

In proposing amendments to the Healthcare Identifiers Bill and regulations, the Government has considered recommendations by coalition members of the Senate Community Affairs Committee and the changes specifically address two of these recommendations.

The first proposed change will give increased parliamentary oversight of the Healthcare Identifiers Service, ensuring that any change to Medicare Australia’s role can only be made through legislation.

The second will create more flexible arrangements for review of the assignment of identifiers to some healthcare providers.

Other Coalition recommendations would make it difficult for the Healthcare Identifiers Service to operate or are contrary to the intent of the legislation and have not been adopted.

The Government will also propose an amendment to the Bill to enable information management services that are contracted to support healthcare providers to continue to provide those services but within the strict security and privacy protections of the new system.

The legislation has strong provisions to restrict the use of healthcare identifiers. No uses of the identifiers will be permitted other than those set out in the Bill. Any additional uses would require changes to the legislation, providing strong protection against ‘function creep’.

More on the DoHA Site

David.

Senate Estimates Alert – e-Health Moved to Thursday Afternoon.

I have now been told e-Health will be on a bit later than initially notified.

It will be on Thursday, June 3, 2010 in a slot between 2.30pm and 4.30pm.

It is in DoHA Session – Outcome 10 (Health System Capacity and Quality).

Sadly there are other programs being covered apart from “e-Health implementation”; namely Chronic Disease-Treatment; Health Information; International Policy Engagement; Palliative Care and Community Assistance; Research Capacity and Health Infrastructure.

This may mean there is not as much time as we may like spent on our favourite topic.

The following link provides access to a .pdf of the program.

http://www.aph.gov.au/Senate/estimates/budget1011/schedule.pdf

Senate estimates hearings are broadcast live over the Internet. Details can be found at www.aph.gov.au/live

Enjoy.

David.

Tuesday, June 01, 2010

NASH - This is A Sleeper Of a Problem I Believe – Cost and Implementation Timetable Wise!

In parallel with the implementation of the National Health Identifier Service (Hi Service) we have been led to believe there will be implemented a robust individual provider authentication system (termed the National Authentication Service for Health – NASH for short).

The intent of having this authentication service is so that access to the planned HI Service for now, and later for the proposed, but still a bit vague, PCEHR Service, can be robustly controlled and appropriate audit trails put in place to assure public confidence as to who has accessed their private health information and who has modified and update information contained in such a system.

It is clear that without NASH (or some equivalent) this system being available there will be major issues and concerns about how any information leakage or abuse can be properly detected.

From this link you can read what was initially planned for NASH.

http://aushealthit.blogspot.com/2010/03/for-all-those-who-think-it-will-be-easy.html

More recently (AAPP Forum – March 11, 2010) we have been told:

The National Authentication Services for Health (NASH) provides the required strong authentication of healthcare providers and organisations, and is an important foundation service in the developing e-health community.

Establish a national supply of trusted digital credentials available to all entities in the health sector

(Slide 20). Logo of NEHTA, DoHA and IBM at the bottom of the slide.

We are also told (next slide) NASH will:

Support software vendors to transition their products to use nationally recognised digital certificates;

Provide sufficient flexibility to leverage investment from organisations such as Medicare Australia; and

Encompass the current use of PKI by Medicare and in the future National Individual credentials.

Services will be available to support required functionality of HI Services and Secure Messaging

(Slide 21)

You can review the whole presentation from here (other interesting stuff also):

http://moreassoc.com.au/downloads/AAPP%20Presentation-Forum11-3-10%20vSumm.pdf

For some reason, it does not seem to be on the NEHTA’s web site but it is also here:

http://www.communiogroup.com/aapp/AAPP%20Presentation-Forum11-3-10%20vSumm.pdf

It is not clear why the Communio Group is hosting the file.

Even more interesting when hunting around for hints of progress with NASH I came across brief descriptive resume for a developer of the NASH.

Gil Carter

.....

Previous roles with the National eHealth Transition Authority (NEHTA) included undertaking the development of successful multi-million business case proposing the development of a new smartcard service to be used by doctors when accessing sensitive electronic health information. The NASH program is noted as a key piece of national e-health infrastructure in the National E-Health Strategy (2008) and is leveraged by a number of other e-health programs, including NEHTA's Unique Healthcare Identifiers service.

Gil has been a frequent public presenter on NEHTA and NASH program - e.g., CeBIT (May 2008) and Australian Smartcards Summit (July 2008), Identity Management Summit (Feb 2009).

See here:

http://www.businessaspect.com.au/key-people

So NASH is to be smartcard based, funding for millions has been secured and those who are to use this service (Docs, Nurses and So on) are still in the dark! Additionally a key manager (Gil Carter) in the area seems to have left.

I understand there are upwards of 600,000 professionals and support staff who may need to be issued a smart card. The cost of those cards, checking ID’s and maintaining all the infrastructure – your guess is as good as mine. Even $2 per card + $5 per 10 mins to confirm ID get to close to $5M. Then of course there is the mandatory ‘public information campaign’ at who knows how much .

With just one month until the HI Service is meant to start, the chance of any real security around it looks a bit illusory to me.

Just typical is all one can say.

David.

Monday, May 31, 2010

Weekly Australian Health IT Links - 31-05-2010.

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:

The most fun we are going to have in the near future is coming up with Senate Estimates as mentioned in a blog a day or so ago. See here:

http://aushealthit.blogspot.com/2010/05/senate-estimates-alert-wednesday-june-2.html

I am hoping that we will get some clarity from these sessions as to just what the Government is planning for the e-Health space.

Other than this anticipated future fun there is of course just the ongoing concern about just how well the implementation of the larger health reform agenda is going.

I note the drip feed of announcements is continuing with the announcement of another $58M to support so called clinical leadership groups.

http://news.smh.com.au/breaking-news-national/pm-flags-leadership-groups-for-hospitals-20100528-wk4m.html

PM flags leadership groups for hospitals

ISABEL HAYES

May 28, 2010 - 6:09PM

AAP

Prime Minister Kevin Rudd has pledged more funding for the federal government's health reform program, after fronting the nation's largest doctors group.

Speaking at the Australian Medical Association (AMA) annual conference on Friday, Mr Rudd promised an additional $58 million to create lead clinician groups to guide local hospital networks.

The move was welcomed by the AMA, with President Dr Andrew Pesce saying it meant doctors would have a stronger voice in the management of public hospitals.

----- End Extract.

Why wasn’t the need for this discovered during the policy development and consultation process?

Why is it we keep having this drip feed rather than a coherent and planned policy? One really wonders about the quality of the policy formation process in DoHA if this keeps happening – and who knows what the same problem might cause with e-Health?

Just another minor gripe. Why is it that we keep getting press releases saying a solution to some major problem has been found (e.g. the CSIRO / SNOMED releases below) when whatever is being promoted is only a small part of the solution? Overhyping such information does nothing for credibility and public understanding!

-----

http://www.itwire.com/it-policy-news/government-tech-policy/39307-e-health-reforms-demand-proper-chief

E-health reforms demand proper chief

Australia’s urgent need for a chief to drive e-health reforms was highlighted today, by the chief information officer of Singapore’s Ministry of Health Holdings who is driving a ten year investment strategy for the nation costed at up to S$1.5 billion.

Speaking about Singapore’s move toward an electronic health record Dr Sarah Muttitt told a packed session at CeBIT today that such reforms; “Clearly need someone at the helm to influence the decisions...and try to do master IT planning.”While Muttitt was speaking about progress in Singapore her remarks would resonate for many locals who are still wondering who is in charge of e-health here.

Many consider NEHTA – the national health transition authority – led by Peter Fleming and chaired by David Gonski as the natural candidate, but it would need its mandate expanded and more clout. At present the organisation has been focussed on developing health identifier numbers for the national e health record, and acting as a form of clearing house for discussions on e-health governance, standards and the like.

Comment: What a silly suggestion – where is the evidence of capable leadership from NEHTA?

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http://www.itwire.com/it-industry-news/market/39306-cebit-opens-with-gonski-innovation-plea

CeBIT opens with Gonski innovation plea

IT Industry - Market

David Gonski, chairman of Investec and also the chairman of the National e-Health Transition Authority, gave the keynote at this morning’s opening of CeBIT in Sydney, with an impassioned plea for the nation to lift its game in terms of innovation.

CeBIT Australia 2010, which has brought together 500 companies to showcase their wares, and organisers hoping they can attract more than 35,000 attendees, was officially opened by NSW premier Kristina Keneally. While the focus of the exhibition is innovation in ICT and the way that is leveraged by business and government, Gonski lamented Australia’s relatively poor international innovation ranking.He called for continued investment in infrastructure in Australia – particularly in the area of the national broadband network and an e-health network. Although the Opposition has in recent days pledged to dismantle these and the Digital Education Revolution investment of the Rudd Government, Gonski said that “In my role as the chair of NEHTA I am acutely aware of the NBN and what an e-heath strategy could achieve.”

Comment: Pity David Gonski is not aware we already have one! Jinx even.

-----

http://www.reportageonline.com/2010/05/e-health-system-raises-privacy-concerns/

E-Health system raises privacy concerns

24 May 2010 No Comment

A recent boost in federal funding for a shared e-Health report system has re-opened the debate about the protection of patient medical records. Alberto De Angelis reports.

CeBit Australia, the annual global business conference begins today at the Sydney Convention and Exhibition Centre and will be running e-Health workshops and conference to discuss the potential for a nationalhealth record database.

The Federal Government’s $467 million push for the establishment and implementation of an e-Health system however, has raised questions over the protection and control patients will have over their medical records.

The database would allow the health details of voluntarily registered users to be viewed and added to, by registered healthcare providers.

However, while the sharing of healthcare records is voluntary, every person who is in the database will still be issued a healthcare identifier.

These identifiers are numbers that not only link an individual to their health records, if they have volunteered to do so, but also personal information such as name, gender and date of birth.

Dr Chris Mount, acting assistant secretary of the e-Health branch of the Department of Health and Ageing confirmed the automatic assignment of identifier numbers at a privacy forum last week.

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http://www.smh.com.au/national/patient-data-under-threat-say-auditors-20100524-w85r.html

Patient data under threat, say auditors

May 25, 2010

FEDERAL government auditors have overruled Medicare, calling on the agency to improve security of patient details held by pharmacists.

Patient information on the 2o0 million prescriptions pharmacists dispense each year are largely electronically held, which the Auditor-General, Ian McPhee, says ''continues to be an area of growing threats''.

In an audit report on the administration of the Pharmaceutical Benefits Scheme released yesterday, Mr McPhee revealed a long-running turf war among three health agencies over responsibility for the PBS.

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http://www.networkworld.com/news/2010/052610-patients-key-to-nurse-national.html

Patients key to nurse national e-health

By Darren Pauli, Computerworld Australia

May 26, 2010 10:53 AM ET

Health experts have warned that Australia's national $466.7 million e-health records system is being rushed and lacks a consumer focus.

Industry pundits from Australian health services joined representatives from the UK National Health Service (NHS) and the Singapore Ministry of Health at the CeBIT 2010 conference in Sydney today in proposing the Federal Government should engage consumers before deploying its e-health initiative.

NHS "Connecting for Health" clinical architect, Dr Mike Bainbridge, said the government needs to engage consumers now about how e-health should be deployed.

"You have to move now to engage citizens," Dr Bainbridge said. "You don't have the luxury of 7 years of mistakes like we did."

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http://www.computerworld.com.au/article/348255/cebit_2010_barcodes_pushed_national_medicine_recalls/?eid=-6787

CeBIT 2010: Barcodes pushed for national medicine recalls

National medicines body looks to implement national barcoding system to ensure recall compliance

The Therapeutic Goods Administration (TGA) may introduce a new barcode-based product recall notification system as early as June next year, according to the company that built it.

The new system will be based on a global product database created by not-for-profit organisation, GS1, which is also used in sectors ranging from grocery and retail to transport and defence supply chain management.

According to GS1 Australia's chief executive officer, Maria Palazzolo, the RecallNet system would ensure compliance among individual healthcare providers for pharmaceutical and medical goods.

-----

http://www.computerweekly.com/blogs/tony_collins/2010/05/officials-nervous-over-morecam.html

Officials nervous over Morecambe Bay's planned go-live

By Tony Collins on May 27, 2010 10:58 AM

NHS staff and executives at University Hospitals of Morecambe Bay NHS Trust are planning for an important go-live of iSoft's Lorenzo system this Bank Holiday weekend.

A spokeswoman for the Trust said this morning (27 May 2010) that she was unaware that any definite decision for a go-live had yet been taken, but all the signs are that the Trust wants it to happen this weekend.

Not all officials at Richmond House, the headquarters of the Department of Health, share Morecambe Bay's conviction that a go-live this weekend is a good idea.

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http://www.theage.com.au/national/mentally-ill-turn-to-etherapy-20100529-wml9.html

Mentally ill turn to e-therapy

JILL STARK

May 30, 2010

MENTALLY ill Australians are increasingly being diagnosed and treated online in virtual psychiatric clinics, without ever seeing a doctor.

Patients suffering from depression, anxiety and post-traumatic stress disorder are being assessed by computer and given ''e-prescriptions'' for online counselling courses instead of medication or treatment sessions with a psychologist or psychiatrist. Doctors who provide e-therapy say it produces better results than face-to-face treatment but at a fraction of the cost.

Private appointments with mental health specialists cost an average of $100 an hour.

With e-therapy, patients are clinically diagnosed after completing psychiatric reviews by answering online questions. They then have the option to enrol in a free electronic self-help treatment program or receive assistance from an online therapist at limited cost.

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http://www.medicalobserver.com.au/news/coalition-claims-commitment-to-ehealth-despite-plan-to-axe-erecords

Coalition claims commitment to e-health, despite plan to axe e-records

24th May 2010

AAP

THE federal Opposition says it believes in electronic health records - even though it's promised to reverse Labor's decision to introduce them by mid-2012 if elected to government.

Earlier this week, the Coalition announced it would "abolish individual electronic health records" as a way of saving $467 million over the next two years.

The announcement drew criticism from health experts, and from the Government, which took the opportunity to underline that in 2007, then Health Minister Tony Abbott said “failure to establish an electronic patient record system within five years... would be an indictment against everyone in the system”. (Abbott attracts criticism for plan to axe e-health program, MO 21 May)

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http://www.misaustralia.com/viewer.aspx?EDP://1274916228102&section=news&xmlSource=/news/feed.xml&title=Crisis+meeting+over+Qld+Health+payroll+software

Crisis meeting over Qld Health payroll software

Queensland nurses are to hold an urgent meeting with health authorities at the state's Industrial Relations Commission (QIRC) on Thursday.

-----

http://www.zdnet.com.au/qld-health-must-stop-system-docking-pay-339303504.htm

QLD Health must stop system docking pay

By Josh Taylor, ZDNet.com.au on May 28th, 2010

The Queensland Industrial Relations Commission (QIRC) has ordered Queensland Health to stop making unauthorised deductions from employees' pay, as troubles with the roll-out of the agency's new payroll system continue.

The Queensland Nurses Union (QNU) summoned Queensland Health to a meeting at the QIRC yesterday to address member concerns that the SAP-based payroll system had been making deductions from employees it incorrectly deemed to have over-paid.

Employees who had been underpaid using the payroll had been given ad-hoc payments. The system had taken these ad-hoc payments as overpayments above the normal wage, and had deducted that amount from the employee's next pay cheque.

-----

http://www.itwire.com/it-policy-news/government-tech-policy/39354-e-health-experts-fan-hospital-waiting-list-style-rage-

e-health experts fan hospital waiting list style rage

To properly engage Australians in the e-health debate, it has to become an issue as significant to voters as hospital waiting lists, according to experts in the field speaking at CeBIT today.

During a panel session bringing together international experts on e-health, Mary Foley the national health practice leader for PricewaterhouseCoopers, said that although its recent surveys had found that 36 per cent of Australians supported having an electronic file containing their health records in a doctor’s office or hospital , and 30 per cent would like web based access to those records, the e-health sector was guilty of largely speaking to itself rather than the broader community.

She suggested electronic health records had to become as important an issue to the community as were hospital waiting lists in order to really engage health care consumers or patients.

------

http://www.theaustralian.com.au/australian-it/opposition-to-address-e-health-privacy/story-e6frgakx-1225871225136

Opposition to address e-health privacy

  • Karen Dearne
  • From: Australian IT
  • May 25, 2010 5:19PM

THE federal Opposition plans to tighten up aspects of the controversial Healthcare Identifiers Bill before debate in the Senate next month.

Coalition spokesman for regional health services Andrew Southcott said while supporting the Bill's intent, a number of amendments aimed at greater parliamentary oversight would strengthen protections for patients.

"In particular, the Bill as it stands continues to raise concerns about privacy and the possibility of function creep," Mr Southcott said in a statement.

-----

http://www.theaustralian.com.au/australian-it/e-health-the-right-thing-to-do-expert/story-e6frgakx-1225871204272

E-health the 'right thing' to do: expert

  • Andrew Colley
  • From: Australian IT
  • May 25, 2010 4:42PM

THE economic arguments for rolling out tele-health services in Australia maybe tough to prove, a US e-health expert has warned.

Robert Bosch Healthcare business development director Suneel Ratan today warned that the economics of rolling out tele-health were strongest in the US where healthcare costs were high relative to other markets.

Mr Ratan was commenting on RBH's experience providing healthcare services for the US Department of Veteran Affairs at the CeBIT technology conference in Sydney.

-----

http://www.news.com.au/technology/e-health-needs-a-lot-of-work-to-become-reality/story-e6frfro0-1225871119889

'E-health needs a lot of work to become reality'

NEW e-health initiatives to connect patients with doctors won't work because of a lack of infrastructure, experts say.

Health and IT experts at the CeBIT expo in Sydney yesterday met to discuss the need for tele-health initiatives such as video conferencing to take pressure off the current Australian health system.

Brendan Lovelock, health practice Head at Cisco Systems, said Australia’s current health system was not sustainable for the future.

"There are not, and will not be, sufficient resources to meet our expectations of care in Australia," Mr Lovelock said.

-----

http://www.reportageonline.com/2010/05/australia-not-ready-for-e-health/

Australia not ready for e-Health

25 May 2010 One Comment

By Alice Downey | Health Editor

New E-Health initiatives to connect patients with doctors won’t work because of a lack of infrastructure, experts said at the CeBit Conference in Sydney yesterday.

One of these initiatives is the implementation of Tele-Health practices such as video conferencing to take pressure off the current Australian health system.

Brendan Lovelock, the Health Practice Head at Cisco Systems, says Australia’s current health system is not sustainable for the future.

-----

http://news.smh.com.au/breaking-news-technology/web-portal-warrior-gateway-helps-digitalage-vets-20100524-w48r.html

Web portal Warrior Gateway helps digital-age vets

BARBARA ORTUTAY

May 24, 2010

For young veterans returning from duty in Iraq or Afghanistan, the process of re-entering society can be daunting, especially if they have been injured or have struggled with mental health problems.

A new, free Web portal wants to help these warriors find the services they need in an environment they are comfortable in: the Internet.

Warrior Gateway is designed with Google Inc. and social media in mind to make its intended audience as comfortable as possible. Veterans returning from Iraq and Afghanistan, generally in their mid-20s, grew up with e-mail, keep in touch using Facebook and are familiar with online communities that stretch across time zones.

-----

http://www.nehta.gov.au/media-centre/feature-story/644-act-ug

Opportunity to join the new NEHTA Australian Clinical Terminology User Group (ACT-UG).

The purpose of the group is to:

  • Harness the Australian Clinical Informatics Community’s interest and willingness to contribute to the development of clinical terminology components that support the national e-health agenda.
  • Support safe, effective and efficient implementation of clinical terminology in Australian healthcare.
  • Disseminate information and feedback between the IHTSDO, other relevant clinical terminology standards bodies and the Australian Clinical Informatics Community.
  • Through the above, help expand the pool of clinical terminology expertise available in Australia to support the national e-health agenda.

The first meeting of the ACT-UG will be held on 30 June 2010, via web and teleconference, with agenda items covering rationale for the group; terms of reference, meeting schedules and calls for Co-Chair nominations. We will also use this opportunity to brief participants on current NEHTA and IHTSDO structures and goals. For those who would prefer to attend in either Sydney, Brisbane or Canberra meetings rooms can be made available. Please advise if you do wish to use this facility.

-----

http://www.cio.com.au/article/347554/nehta_snaps_up_csiro_technology_e-health_records_system_upgrade/

NEHTA snaps up CSIRO technology for e-health records system upgrade

Software will help computers ‘talk the same language’

The federal government’s national e-health transition authority (NEHTA) is using CSIRO software in its SNOMED CT infrastructure.

SNOMED CT, or systematised nomenclature of medicine - clinical terms, provides a consistent framework from which healthcare providers can share health records.

Inaccurate or missing data from patient records in previous systems led to unnecessary hospitalisations and a waste of about 25 per cent of clinicians’ time, according to the CSIRO.

-----

http://www.environmental-expert.com/resultEachPressRelease.aspx?cid=25559&codi=170362&lr=1

Relieving the electronic health records headache

Source: CSIRO, the Commonwealth Scientific and Industrial Research Organisation

May 21, 2010

Inaccurate or missing data in patient records has resulted in people being hospitalised unnecessarily and wastage of an estimated 25 per cent of clinicians' time spent collecting patient data.

As part of the Federal Government's e-health initiatives, the National E-Health Transition Authority (NEHTA) is implementing an internationally agreed standard for the dictionary of clinical terms used in electronic health records software, called SNOMED CT.

CSIRO E-Health Theme Leader, Dr David Hansen, said that while SNOMED CT has been customised for Australia, health practitioners are still encountering problems with the system.

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http://www.smh.com.au/opinion/society-and-culture/little-scientific-credibility-behind-health-scare-headlines-20100523-w3w3.html

Little scientific credibility behind health scare headlines

ZOE WILLIAMS

May 24, 2010

News reports about mobiles giving you cancer aim to entertain.

MOBILE phones give you brain cancer, and a bacon sandwich a day puts up heart disease by a half. It makes the choice pretty simple: bacon is tastier than ceaseless phone chat, and myocardial infarction a lot less painful than a brain tumour. That said, it would be foolish to rule out the possibility that you've eaten a bacon sandwich while on the phone - in which case it's not a choice but a double whammy.

Both of these appeared as headlines in the right-wing London tabloid The Daily Mail: on the mobiles and brain cancer risk, its report was a marked contrast to those of the broadsheets, who agreed that the study on which the story was based had found no statistically significant raised risk. The author of the study, Professor Anthony Swerdlow of Britain's Institute of Cancer Research, clarified the findings for me (as he had already, in a press conference - the misreporting here isn't accidental): there were 10 usage groups, ranging from very low to very high. In the very highest group - those reporting using their phone for 12 or more hours a day - there was a raised chance of both glioma and meningioma.

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http://www.smh.com.au/opinion/politics/filtering-by-computer-fails-on-judgment-20100524-w7w1.html

Filtering by computer fails on judgment

GEORGE WILLIAMS

May 25, 2010

The plan to filter the internet for material refused classification under Australian law is legally flawed. Australia's classification law is not compatible with the Rudd government's proposal, and in fact has its own problems that make it unsuitable as a basis for any internet ''clean feed''.

Publications, movies and computer games ''refused classification'' cover a wide spectrum. They deal with child pornography, explicit sex and extreme violence, and controversial areas such as euthanasia and abortion which are outlawed in all or part of Australia.

Working out whether something should be refused classification cannot be undertaken in any mechanical or formulaic way, like using word recognition or other automated techniques. The decision requires a personal, individual judgment that is, by its nature, highly subjective.

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http://www.theaustralian.com.au/australian-it/commercial-filters-on-the-side-of-web-censorship/story-e6frgakx-1225871515849

Commercial filters on the side of web censorship

  • Karen Dearne
  • From: Australian IT
  • May 26, 2010 12:08PM

GOVERNMENT firewalls and censorship are not the only threat to online freedom, with commercial filters increasingly blocking user access to websites, Tor Project founder Roger Dingledine warns.

As companies and public-sector organisations adopt unified security products and web content security, many more employees may find legitimate websites are blocked, along with known nasties.

"The Tor Project website is often blocked by filters used by news organisations, for example," he said.

"Journalists in the US are being censored by commercial filters such as SmartFilter or Websense which prevent access to the internet as the rest of the world sees it.
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Enjoy!

David.