Yippee! A Win for the Common Sense!

On June 25, 2007 – just after the emergency intervention following the “Children and Sacred Report” release, I wrote an article entitled How Could e-Health Help in the Northern Territory.

When I wrote the article I e-mailed it to relevant people in the appropriate branch of the Department of Health and Ageing.

While not wanting to take credit for stating the ‘bloomin’ obvious’, it is wonderful to see something is actually happening.

The following article provides some detail.

http://www.australianit.news.com.au/story/0,24897,22274844-16123,00.html

Remote e-health plan unveiled

August 20, 2007

THE federal Government says a new internet-based health system for remote areas will ensure health issues identified in Aboriginal children are properly followed up.

At the Australian Health Summit in Sydney, Health Minister Tony Abbott announced an electronic health record initiative for remote indigenous towns.

An investment of $25 million over the next three years would see the Medicare records and health concerns of more Australians dealt with online, Mr Abbott said.

Better equipped GPs would be able to receive lab results and X-rays via the internet, as well as sending referrals and writing prescriptions online.

However, Mr Abbott admitted the government had not been moving quickly on this issue, because he had urged similar internet streamlining in his maiden speech as health minister in November 2003.

….. (see URL for full article)

It will be fascinating to see how the implementation is approached. We have all had a lot of time to consider the issues surrounding Shared Electronic Records and it would be good to see this present initiative carried out in the light of all the learning and experience in thinking about the issues is available.

I will be following this with the keenest interest indeed!

Well done to those who got the idea up with the Minister. I hope they read the older blog article carefully for some alerts and insights on what needs to be carefully considered, in my view, as a project of this type is begun.

I do not believe it will be at all easy to deliver this project promptly as is ideally required. DoHA seems to recognise this – given that the funding is to run over three years. A careful review of proven solutions from overseas that I mentioned previously is certainly warranted as rapid results are possible with those proven tools.

David.

Some Brief News Follow-Ups – All Good News!

MedInfo2007 is in full swing for the next few days. I hope all those attending in Brisbane have a profitable and intellectually stimulating time. I look forward to hearing all about it!

I have had great reports on the First World Congress on Pathology Informatics which ran on
August 16 -17 August, 2007.

For those who are interested there is a rich store of downloads of presentations available for download here.

I am told the key outcome from the Congress (the Conference Communiqué ) made three major points:

1. There will be an increased reliance on the laboratory (including genetics) and medical imaging and these will converge as disciplines and do things that humans cannot do without informatics.

2. Pathology informatics is a discipline in its own right and training is required – but policy makers do not know what they don’t know.

3. There is going to be an enormous workforce problem.

I must say – having browsed many of the presentations – how true this is!

It seems the next Congress is to happen in two years (somewhere in the USA) and that IMIA is going to offer support with the creation of a specialist working group.

It is great to be able to report there were 134 attendees from a zillion different places at the Congress and that in addition to all the tutorials etc 15 new scientific papers were also presented.

Well done to the organising team!

Lastly I need to report the usage of the blog passed 20,000 visits since March 2006 on the weekend with well over 33,000 page reads in the same period. Obviously more than my Mum is reading!

Thanks for all for the support.

David.

Useful and Interesting Health IT Links from the Last Week – 19/08/2007

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

http://www.australianit.news.com.au/story/0,24897,22239776-15319,00.html

Investment in health freezes over

Ben Woodhead | August 14, 2007

INVESTMENT in health information systems has stalled at $2 billion a year despite an increase in spending on medical care and claims that new technology could save thousands of lives.

Analysts say budgetary constraints are preventing spending on life-saving systems

Market researcher IDC reports that information technology spending in the health sector will remain flat until 2011, even as Australia's ageing population puts a heavier burden on scarce resources.

The report, IDC Analysis, Australian Healthcare ICT Market 2007, says spending on information and communication technologies in the health sector will total $2.03 billion in 2011, down from $2.06 billion this year.

In contrast, total investment in healthcare is increasing at more than 3 per cent a year after inflation, and IDC estimates the Australian IT and communications market is growing at 2.3 per cent annually.

…..( see the URL above for full article)

This is a really concerning report. If investment in Health IT is slipping, given the rise in technology costs and salary costs, then it is likely the impact, over time, will be damaging and significant. One must wonder just what is being cut back on and what impact this might have on the quality and safety of care.

Second we have:

http://www.nytimes.com/2007/08/14/technology/14healthnet.html?_r=2&ref=health&oref=slogin&oref=slogin

Google and Microsoft Look to Change Health Care

By STEVE LOHR

In politics, every serious candidate for the White House has a health care plan. So too in business, where the two leading candidates for Web supremacy, Google and Microsoft, are working up their plans to improve the nation’s health care.

By combining better Internet search tools, the vast resources of the Web and online personal health records, both companies are betting they can enable people to make smarter choices about their health habits and medical care.

“What’s behind this is the mass consumerization of health information,” said Dr. David J. Brailer, the former health information technology coordinator in the Bush administration, who now heads a firm that invests in health ventures.

It is too soon to know whether either Google or Microsoft will make real headway. Health care, experts note, is a field where policy, regulation and entrenched interests tend to slow the pace of change, and technology companies have a history of losing patience.

And for most people, typing an ailment into a Web search engine is very different from entrusting a corporate titan with personal information about their health.

…..( see the URL above for full article)

This is an interesting long article on how the masters of the internet are exploring how they can add value to, and make profits from, the health sector.

Given in the US health care is 16% of the economy it must be irresistible for these companies to try to come to grips with the sector and identify where progress can be made. How this will play out, and what will be successful, is hard to identify at this stage.

Expect the unexpected is what I would suggest – and I suspect it will be a small start-up, bought by one of the majors, who will probably come up with the best and most useful approach(es).

Third we have:

http://www.e-health-insider.com/comment_and_analysis/249/everything_you_know_is_wrong

Everything you know is wrong

14 Aug 2007

For those of you about to (finally) begin to implement any element of the National Programme for IT (NPfIT) then you need to be aware that this experience is likely to be very different to anything you have endured before. All your past experiences of implementing information systems will be challenged in a very different environment which is far removed from the traditional customer-supplier relationship.

The experiences at Milton Keynes General Hospitals NHS Trust in being the third site in the Southern Cluster to implement PACS and fourth to deploy CRS came with many lessons learnt and worth sharing. If you start from the premise that your past experience counts for little then you will be better prepared for that which is about to happen to you.

…..( see the URL above for full article)

This is a valuable summary of the experiences of one senior player in the NHS National Program for IT. The practical issues faced are not new and are seen in all large and complex implementations. The advice for managing some of the issues that inevitably arise seems to me to be very sound.

Fourth we have:

http://www.ehealtheurope.net/news/2963/german_smartcard_rollout_brought_forward

German smartcard rollout brought forward

17 Aug 2007

In a surprise move, the German health IT agency Gematik has accelerated the schedule of the German national smartcard project to April 2008.

The nationwide rollout of smartcards for all citizens will now start in the second quarter of 2008. “It could easily be finished by the end of 2009”, says Michael Martinet, head of IT at Germany’s second largest health insurance company 'DAK'.

The decision was taken by the board of directors of Gematik earlier this week. It was not made public until yesterday, though, when state secretary Klaus-Theo Schröder of the national ministry of health announced the new accelerated timetable.

Among the directors of the Gematik are the heads of two medical associations, the head of the national hospital association 'DKG', and the heads of the associations of insurance companies.

The German smartcard project is ultimately planned as an online system. Patients will go to their doctor and identify themselves with their smartcard, the ''elektronische Gesundheitskarte' (electronic health insurance card).

The doctor will then be able to store electronic prescriptions, personal medical data, referrals and discharge letters within a server-based network. To do so, he will use a second smartcard, the “health professional card”.

…..( see the URL above for full article)

This is a very interesting update on what appears to be the most advanced smartcard based e-Health initiative. It is well worth keeping a close watching brief on how the project plays out over the next eighteen months.

Fifth we have:

http://www.bizjournals.com/philadelphia/stories/2007/08/13/daily28.html?surround=lfn

Hospital using barcode technology to reduce medicine errors

Philadelphia Business Journal - 1:48 PM EDT Thursday, August 16, 2007

Doylestown Hospital on Thursday unveiled an initiative aimed at reducing potential medication errors: electronic medication administration record, or eMAR, technology.

The Doylestown, Pa., medical center said its investment in the eMAR system was more than $500,000.

The eMAR system combines Bluetooth wireless technology and hand-held scanners to read barcodes -- just like the barcodes used in supermarkets. Under the system, individual dosages of drugs are bar coded in hospital's pharmacy, then tracked from the pharmacy to the nursing unit to the patient's bedside.

At admission, all patients are given barcoded bracelets to be used for identification. The nurse scans a patient's bracelet at the bedside before medications are administered. If the nurse scans the wristband and medication, and the software detects a medication interaction, incompatibility or allergy, the eMAR system alerts the nurse.

…..( see the URL above for full article)

This is just a reminder that barcode technology can make a very useful contribution to patient safety in quite simple ways.

Lastly we have:

http://www.govtech.com/gt/articles/129711

N.Y. Launches Comprehensive Health Information Technology Program

Aug 8, 2007, News Report

Health Commissioner Richard F. Daines, M.D., today announced the launch of a comprehensive health information technology program, part of Governor Eliot Spitzer's agenda to advance patient-centered care and enable improvements in health care quality, affordability and outcomes for each person, family and business in New York.

An initial $106 million will be invested in the health care community during 2007-2008 to support the implementation of health IT tools to allow portability of patients' medical records and new tools to assess and target improvements in health care quality.

The commissioner has charged his new Office of Health Information Technology Transformation with coordinating health IT programs and policies across the public and private health care sectors. These programs and policies will establish the health IT infrastructure and capacity to support clinicians in quality-based reimbursement programs and new models of care delivery.

…..( see the URL above for full article )

Very interesting to see yet another state deciding to get its Health IT planning act together. Quite a useful summary of the directions that are being pursued is found in the full article.

All in all not a bad lot to start the week!

More next week.

David.

Thoughts on the Paediatric EHR and Paediatric e-Prescribing.

In the last few days a useful pair of documents on the differences between Electronic Health Records (EHR) and e-Prescribing for adults and children have appeared from the Council on Clinical Information Technology of the American Academy of Pediatrics.

The broad outline of the contents of the two documents is found here:

http://healthdatamanagement.com/html/news/NewsStory.cfm?articleId=15584

Report Details Pediatric EHR Needs

(August 10, 2007) A recent report in Pediatrics, the journal of the American Academy of Pediatrics, explains the special functionalities necessary in electronic health records systems to support pediatric care.

“Child health care providers often find that clinical information systems have limited usefulness in pediatrics because they seem to be designed for adult care,” according to the report.

The report covers necessary EHR functions in such areas as immunization management, growth tracking, medication dosing, patient identification, norms of pediatric measurement data that change over time, privacy, pediatric terminology, and precision of the data being collected and presented.

……

The Elk Grove Village-based association also has published a policy statement on the rationale and functionality requirements of electronic prescribing systems for pediatrics.

See the URL above for the full article.

The original articles can be found here (e-prescribing) and here (Paediatric EHR Functionality).

The first article is entitled: “Electronic Prescribing Systems in Pediatrics: The Rationale and
Functionality Requirements”

The abstract reads:

“The use of electronic prescribing applications in pediatric practice, as recommended by the federal government and other national health care improvement organizations, should be encouraged. Legislation and policies that foster adoption of electronic prescribing systems by pediatricians should recognize both specific pediatric requirements and general economic incentives required to speed the adoption of these systems. Continued research into improving the effectiveness of these systems, recognizing the unique challenges of providing care to the pediatric population, should be promoted.”

The article is available on-line (in full and free) and makes very interesting reading in thinking about just what complexity the paediatric patient brings to health IT implementation.

The second article really extends the theme!

It is entitled: “Special Requirements of Electronic Health Record Systems in Pediatrics”

The abstract reads:

“Some functions of an electronic health record system are much more important in providing pediatric care than in adult care. Pediatricians commonly complain about the absence of these "pediatric functions" when they are not available in electronic health record systems. To stimulate electronic health record system vendors to recognize and incorporate pediatric functionality into pediatric electronic health record systems, this clinical report reviews the major functions of importance to child health care providers. Also reviewed are important but less critical functions, any of which might be of major importance in a particular clinical context. The major areas described here are immunization management, growth tracking, medication dosing, data norms, and privacy in special pediatric populations. The American Academy of Pediatrics believes that if the functions described in this document are supported in all electronic health record systems, these systems will be more useful for patients of all ages.”

Each of the major areas discussed in the full article (available on-line for free) brings up surprising issues. Questions I had never really thought of such as just what is the level of precision required in medication dosage recording when dealing with a neonate and how best should the sex of a child be recorded when the genitalia are ambiguous.

Even more interesting are the privacy issues that are raised when an EHR is used to record potentially sensitive information on adolescents – especially when different laws apply in different States (both here in the US).

All in all, a valuable exercise in getting together in one place a large range of issues which, if addressed, will much improve paediatric practice support.

It is, of course, important to bear in mind that, given the paediatric component of General Practice , virtually all the features and functionality cited in these articles are important in all GP systems.

David.

South Africa Showing Some Leadership in e-Health!

A recent report from South Africa has really brightened a dull day.

The report can be found here.

What the report suggests is the SA is moving steadily, and in a planned way, towards the procurement and implementation of a National Health Information System (NHIS).

It seems that more than Ireland and Lithuania have developed the e-Health bug (as reported in the weekend roundup)!

We are told that “The NHIS is intended to provide the country an overall patient information system, linking the private and public sector at local, district, provincial and national level. The public sector alone includes 369 general and 54 specialised hospitals, as well as 3 143 clinics and a number of support institutions such as medical laboratories.”

We are also told that the health department tender documents say this includes procurement of a major of a National Healthcare Management Information System (NHCMIS) which is to be installed and initiated in all the major public hospitals.

With this done an appropriately scaled-down version of the same NHCMIS in all the smaller hospitals and primary healthcare centres.

Modules selected for fast-tracking include those for patient registration, a core patient record data set, appointment scheduling and patient billing.

Priority is also be given to information systems related to disease surveillance and facility management. This makes a great deal of sense in a country that is battling and AIDS pandemic and which clearly needs to manage the available facilities as well as possible.

It is really a good thing in my view that a country such as South Africa is working to leverage what Health IT can offer and at least seems to have a plan!

A nice touch is the last paragraph of the article!

“The NHIS was dragged into the news at the weekend, when a health ministry spokesman suggested deputy health minister Nozizwe Madlala-Routledge was sacked in part for her alleged failure to produce a health IT policy.”

While part of the down fall of the minister may be related to some very strange views on the causation of AIDS, oh! if only we could see similar political accountability for inaction in the e-Health domain Australia!

David.

Note: The comment provided following this post suggests I may have got the role of the Deputy Health Minister regarding AIDS wrong. Please review the comments found on this post.

D.

Poor Little Tasmania – Political Football de Jour!

Having been around for a few years and actually being able to recall the election of the Whitlam Government and all those since, I think I can recognise the signs of national governmental policy implosion and rising political desperation – and that is just what I am seeing now.

The utterly unprecedented intervention to “save” the Mersey Hospital at Devonport is really a complete nonsense seen in any other light that as a political act of the most extreme desperation.

The whole situation is calmly reviewed and dissected by Professor Geoff Richardson is a stunning, lucid and rational piece that can be found here.

Key facts are:

1. Population of NW Tasmania which is served by the hospitals at Burnie and Devonport is about 105,000.

2. The Devonport Catchment is 43,000 people

3. This leaves Burnie with a catchment area of 62,000. With much greater capacity already, it is the obvious location for any single centre of excellence.

4. Even a population of 105,000 is probably not enough to provide a large enough drainage area to provide most specialists with an adequate case load, and to provide them with the support and peer group they need to do their job well , on which the quality of care and development of quality clinical teams depends (you need 200,000+) for this to really happen.

So what will happen we will have two non viable hospitals, both of which will kill more people than they should and save less people than they might have been able to.

What should have happened?

If the federal government had said here is $45M p.a. for your regional Hospital System. You in NW Tasmania allocate it to optimally support your hospital system, we could have had a really excellent and sustainable outcome. They would have even got lots of political points. Sadly this will not happen with these politically driven policy clowns in charge.

Can I say that when I see those ‘right-wing’ AMA types and those ‘left-wing’ academic types in violent opposition to the same plan I am always sure no good will come of any of it.

Oh! - and yes - what Prof. Richardson says about less patient safety and more patient suffering - he is dead right, if you forgive the pun!

Why is all this related to Health IT. Only in the sense that if this is the style of health policy presently emitting from this dying government, we had all better just sit back and wait for change. No good will happen in e-health with this mob running things in their present desperate mood.

David.

Australia’s Peak Professional Health IT Organisation Speaks on the NEHTA Review.

While contributing to the recently released Health Information Society of Australia (HISA) Submission to the NEHTA Review, the Australian College of Health Informatics (ACHI) has also developed its own submission.

The submission can be found here.

In addressing the question of whether NEHTA is meeting is objectives the submission points out:

“When we consider each of the objectives in S3.2 of the NEHTA constitution, the report card is not very impressive. Some progress is seen in the work on clinical data standards and terminologies. However, it is the continuation of work already started on SNOMED CT, which only became official in May 2007. The implementation program is neither explicit nor transparent, which precludes any informed comment on actual progress on the ground.”

The report then goes on to say there is uncertainty as to where other major initiatives are presently situated saying “However, lack of information sharing (by NEHTA to the e-Health Community) prevents informed comment as to whether the R&D is sound and consistent with parallel developments in national and international standards programs.”

When asked to address the question of whether NEHTA was given the appropriate objective the ACHI report remarks:

“When a NEHTA was recommended following the BCG report in 2004, our expectations was that all the R&D done to date by a range of agencies would be harnessed into a national implementation strategy and plan, along with a compelling business case. A role of a NEHTA would be to coordinate the development of this plan as a matter of urgency and get down to the business of implementing and monitoring the success of the implementation plan.”

As is now well known, of course, this plan never happened, or if it did it was never made available to the e-Health Community.

ACHI is also moved to point out that:

“It would be fair to say that there has been little substantial progress during NEHTA’s tenure as a player in this standards and infrastructure domain. NEHTA has delivered a number of summary documents of existing work and re-badged plans for the future. These are general and basic documents not just to the Health Informatician but also to computer science students who have been asked to examine them for academic purposes. “

ACHI also notes that while there has been progress with SNOMED CT and some apparent work in the area of e-Health Benefits Realisation the actual cumulative progress is very hard to estimate.

Among other key points ACHI notes the lack of consultation or inclusiveness with the ACHI membership despite a number of offers and meetings.

I will quote the final Summary in full:

Summary

“ACHI believes that NEHTA has not achieved what it was tasked to do and is unlikely to do so if it continues as is. The reasons include the vagueness of what was prescribed in the constitution of NEHTA in the first place, the lack of a clinical or health focus, a poor communication and engagement strategy, a governance structure which emphasised the jurisdictions and hospital-based systems, a lack of emphasis on capacity building, a lack of quality monitoring and evaluation, and a lack of clear deliverables and key performance indicators (KPIs). The key factor is a lack of national direction, leading to a lack of a national vision for the EHR system, and therefore a lack of a national implementation plan, budget and support.

We believe that what NEHTA is supposed to be doing is very important but that NEHTA is not doing it well. Along with the HISA survey, we believe that this is a widespread and consistent view from informed stakeholders, whose support is essential to achieve the objectives tasked to NEHTA.

There needs to be a concerted shift to a program of systematic implementation and management of the change to the health system as the implementation gets underway. Capacity building and a safety and quality improvement culture is essential, with built-in data collection and monitoring processes and systems to provide the evidence of improvement to cost-efficiencies and health outcomes.

ACHI stands ready to contribute to the development, implementation and monitoring of this nationally agreed implementation plan for a national EHR system and e-Health program”

Where does all this leave us?

I would suggest that, with both the earlier HISA and ACHI submission virtually totally aligned on all the key points under review, fundamental change in the way NEHTA operates and the objectives it pursues needs to be very fully re-assessed.

It seems clear to me it is the clear expectation of the e-Health Community that fundamental and deep change is both underway and required.

For the NEHTA Board to continue in its mode of denial and obfuscation is becoming increasingly un-tenable. Definitive action to access the broad range of e-Health skills available outside NEHTA is vital and is required and sooner rather than later! Facilitated by the BCG, the Board should engage in an inclusive Strategic Planning Process to minimise any further waste of NEHTA work and get the overall direction of e-Health back on a track that has the vast majority of stakeholder support. Without such a process no one can know what can best be done with what we now have in NEHTA and how it can best be shaped to serve the National E-Health Agenda in the future.

David.

Useful and Interesting Health IT Links from the Last Week – 12/08/2007

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

http://www.theaustralian.news.com.au/story/0,25197,22225026-23289,00.html

Girls seek thinspiration on web

Helen Nugent, London | August 11, 2007

CHARITIES involved with eating disorders have called for tighter controls on the internet after it emerged that sites such as MySpace and YouTube were being used to promote anorexia.

Pro-anorexia websites, on which girls exchange extreme dieting tips and view "thinspiration" videos featuring alarmingly thin women, had always been difficult to find and the people posting on them had remained anonymous.

But pictures and footage of underweight teenagers are appearing on more mainstream sites, reaching a potential audience of tens of millions.

On Facebook, some groups extol the virtues of anorexia as a lifestyle choice.

Thousands of people have viewed film clips of emaciated teens and 20-something women on YouTube which, along with the other networking sites, has rules against posting harmful content. The two-minute to 10-minute videos often feature the more slender celebrities such as Victoria Beckham and Kate Moss, and show images of underweight women in their underwear.

Eating disorder charities have called on social websites to look closely at their online material.

Susan Ringwood, chief executive of the charity Beat, said: "Pro-anorexic sites weren't easy to find and most responsible internet providers would cut them out. But on the networking sites, there isn't the same control over them.

…..( see the URL above for full article)

This is a worrying article on a trend where really stupid people try to exploit you insecure teenagers on the web – oh and buy the way we will make money out of their distress. Pretty sad.

Second we have:

http://www.computerworlduk.com/management/it-business/services-sourcing/news/index.cfm?newsid=4422

iSoft will deliver NHS system to CSC 'in new year'

Troubled software supplier confirms Lorenzo handover timetable

By Tash Shifrin

Troubled NHS software supplier iSoft will deliver its Lorenzo care records system to CSC by early 2008, it has said. This will leave the way clear for CSC to start rolling it out to the NHS National Programme for IT from mid-2008 onwards.

It set out the timetable in posting a 13% drop in revenues to £175.2m and a 50% fall in “normalised operating profits” as it limps towards its acquisition by German firm CompuGroup.

The software supplier is contracted to provide the Lorenzo care records system as the core part of the NHS’s £12.4bn National Programme for IT (NPfIT) in three out of five regions where CSC is the lead contractor.

But the turmoil surrounding the company has increased concern about the delivery of Lorenzo, which is already running more than two years late.

Last month, iSoft announced its shock sale to CompuGroup, abandoning previous moves to sell to Australian firm IBA.

The full-year figures for iSoft figures a pre-tax loss of £22m, mainly as a result of restructuring efforts, but this is down from the dramatic £343.8m loss posted by iSoft last year.

…..( see the URL above for full article)

It seems the outcome with iSoft is pretty much settled and it now seems at least hopeful that the regions who were to get iSoft software will now get a working product. We can only hope so. For IBA the time has now come to work out what is best done with the additional capital they now have for the benefit of their shareholders (of which I am one).

Further information is found here:

http://www.whatpc.co.uk/computing/analysis/2196243/lorenzo-software-vital-isoft

Lorenzo software vital to iSoft's future

Healthcare supplier relies on NHS developments for future revenue growth, reports Dave Friedlos

Dave Friedlos, Computing 09 Aug 2007

…..( see the URL above for full article)

Third we have:

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20070808/FREE/308080001/1029/FREE

Six EMRs have CCHIT seal of approval so far

By: Andis Robeznieks / HITS staff writer

Story posted: August 8, 2007 - 5:59 am EDT

So far, six ambulatory electronic medical-record products have passed muster with the Certification Commission for Healthcare Information Technology's 2007 criteria for functionality, interoperability and security.

Those products are:

• Auburn, N.Y.-based Community Computer Service's Medent 17.
• Austin, Texas-based e-MDs' Solution Series 6.1.2.
• Carrollton, Ga.-based Greenway Medical Technologies' PrimeSuite 2007 R2.
• Alpharetta, Ga.-based McKesson Provider Technologies' Practice Partner 9.2.1.
• Horsham, Pa.-based NextGen Healthcare Information Systems' EMR 5.4.29.
• St. Louis-based Purkinje's CareSeries EHR 2.0.
• 
  

Some 89 ambulatory EHR products were certified under the 2006 criteria. If vendors want to continue marketing those EHRs with the 2006 CCHIT seal of approval beyond a 12-month period, commission spokeswoman Sue Reber said they will need to pay a $4,000 "maintenance" fee. Vendors seeking to keep old products certified and eligible for the 2006 seal while submitting new versions of the product for testing under the new criteria will need to pay a $4,000 maintenance fee plus the $28,000 fee for the certification test.

…..( see the URL above for full article)

Just a reminder that the Certification Commission for Healthcare Information Technology in the US is steaming on progressively improving the quality and usability of ambulatory systems available to US clinicians. Good if was saw such a rational process set up on OZ!

Fourth we have:

http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyid=2007-08-07T192933Z_01_N07236643_RTRUKOC_0_US-DISEASE-PREVENTION.xml&src=nl_ushealth1100

Preventive steps could save 100,000 U.S. lives: study

Tue Aug 7, 2007 3:29 PM ET

By Julie Steenhuysen

CHICAGO (Reuters) - Increased use of just five preventive services would save more than 100,000 lives every year in the United States, health experts said in a report released on Tuesday.

Of the five prevention tips, the biggest impact would come if adults took a low dose of aspirin every day to prevent heart disease, a step that could save 45,000 lives a year.

The report by the Partnership for Prevention, a nonprofit health policy group, also calls for renewed efforts to help smokers quit, more colorectal cancer and breast cancer screening and annual flu shots for people over 50.

"This shows so dramatically the potential impact of prevention," said Dr. Kathleen Toomey of the federal Centers for Disease Control and Prevention, which helped fund the study along with the Robert Wood Johnson Foundation and the WellPoint Foundation.

"These are really very modest, low-cost interventions that have such potentially dramatic impact on improving the health of the public," Toomey said in a telephone interview.

The study underscores the tendency in the United States to treat disease, rather than prevent it.

"Our nation has never truly invested in prevention," Toomey said.

…..( see the URL above for full article)

A useful reminder of the importance of preventative health care – which, of course – is an area where e-health applications can make a major difference.

Fifth we have:

http://www.ehealtheurope.net/news/2935/ireland_to_invest_euros_500m_in_e-health

Ireland to invest Euros 500m in e-health

08 Aug 2007

The Irish Government will commit almost half a billion Euros of investment to e-health when it publishes its National Development Plan for health.

Investment will be focused on systems that improve patient care in hospital or community settings, with a particular focus on supporting community-based health professionals.

As part of the National Development Plan (NDP) the Irish Government plans to invest Euros 490m in e-health over the next seven years, at a level of Euros 70m a year.

After a lengthy planning and tendering process, the new investment programme will be formally announced when Ireland unveils its Health Information and Communication Technology sub-programme in the NDP for 2007-2013.

The six-year investment plan is intended to provide the funding to deliver Ireland's National Health Information Strategy, first published in 2004. The document is expected to lay out detailed updated plans for implementing the 2004 e-health strategy.

…..( see the URL above for full article)

An now we have countries with only 4.1 million people planning to actually get moving in e-health. If scaled to the size of the Australian Population this amounts to $2.5 Billion Euro (i.e. $A 4.0 Billion). Nice it we had a national government with similar vision.

Lastly we have:

http://www.govhealthit.com/article103468-08-10-07-Web

Report: EMRs should have anti-fraud features

BY Nancy Ferris

Published on Aug. 10, 2007 A contractor is recommending that the Health and Human Services Department beef up its anti-fraud efforts with respect to health information technology and medical billing.

The contractor, RTI International, delivered to HHS’ Office of the National Coordinator for Health IT a report listing 14 kinds of features that should be built into electronic medical records to prevent fraudulent billing and help spot fraud once bills have been transmitted for payment.

Of the 14 recommended features, nearly one-quarter already are being required for certification by the Certification Commission for Health IT, an HHS-sponsored organization that reviews EMR products to determine whether their functionality, interoperability and security meet certain standards.

…..( see the URL above for full article )

The report – which is available at www.dhhs.gov/healthit - is well worth a review. It shows how ONCHIT, CCHIT and commerce are working together to get incremental improvement in the systems used by American Clinicians – again a useful idea for OZ!

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Highly Recommended.

All in all not a bad lot to start the week!

More next week.

David.