Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
AHRQ to Study Barriers to Indiana HIE
June 10, 2008
The Agency for Healthcare Research and Quality plans to study the barriers to participating in a health care information exchange in the state of Indiana. The Washington-based organization published a notice June 10 in the Federal Register requesting comments on the initiative.
Indianapolis-based Regenstrief Institute is the prime contractor for the AHRQ study. The organization will develop and implement a questionnaire and survey process to identify barriers throughout the state of Indiana to participation in the Indiana Network of Patient Care. Seven-year-old INPC is a local HIE comprising five major health systems, Indiana Medicaid and the electronic prescribing network RxHub. The Regenstrief Institute created and operates the INPC and serves as custodian of its data.
More here:
http://www.healthdatamanagement.com/news/HIE_survey26445-1.html
This is an important study because the Regenstrief Institute is one of the organisations that is well along in developing really effective Health Information Exchange. The final report will be a useful document.
Second we have:
Andrew Bracey - Friday, 13 June 2008
THE government is being urged to consider funding Medicare rebates for online consultations, as part of the solution to the growing workforce crisis.
Calling for Medicare reforms at a recent Gold Coast conference, health economist Dr Paul Gross (PhD) said rebates for such consultations would enable patients with non-urgent conditions to email GPs, which could prove a boon for time-poor doctors.
“Payments for online consultations have to be looked at [as] GPs are not working after 5pm and they are not taking on new patients,” Dr Gross told MO.
Representatives from Sydney-based online consultation service Ozdocsonline recently met with the RACGP to discuss endorsement of the introduction of an MBS rebate covering email consultations between GPs and patients.
Service founders drafted an MBS item descriptor last year, which Ozdocsonline confirmed the college was considering.
More here (for registered readers):
http://www.medicalobserver.com.au/medical-observer/News/Article.aspx/Push-for-e-consult-rebate-for-GPs-
I must say I think that this is an idea whose time has come. The main issue is to get the appropriate policy settings in place that make it easy for patients and doctors to communicate electronically while at the same time addressing issues of privacy, security and record preservation and medico legal liabilities.
Third we have:
Innovative restructuring of data architecture earns global gong for NSW Health.
Andrew Hendry 13/06/2008 08:00:48
The data collection and reporting branch of New South Wales' Department of Health was recently named a laureate of the 21st Century Achievement awards for improving the performance of its critical healthcare information system and data warehouse.
The awards, presented by the Computerworld Honours Program in the US, feature organisations that have used information technology to benefit society.
The Demand and Performance Evaluation Branch (DPEB) of NSW Health is responsible for collecting and maintaining large critical data collections, such as daily hospital events, births and medical waiting lists, for the nearly 7 million people that NSW Health services.
The DPEB also produces a wide range of reports on issues like patient demographics, emergency department performance, and also for external, government or planning purposes. The ultimate goal of the branch is to improve patient health and quality of service by providing accurate information and reporting quickly.
The DPEB was named a laureate of the awards for implementing a solution that revitalized and extended the life of its existing data warehouse with minimal hardware expenditure, improving its performance and providing much needed breathing space for a new data warehouse to be designed over the next few years.
More here:
http://www.computerworld.com.au/index.php?id=1891043707&eid=-255
The full details of the award can be found here:
http://www.cwhonors.org/viewCaseStudy2008.asp?NominationID=309
This is good to see but, when reading the details, what has been achieved seems to be what most would have expected to be in place for decades. Surely the collection of basic operational information in the NSW Hospital system should have been sorted out decades ago.
Fourthly we have:
Identity laws good enough.
Darren Pauli 11/06/2008 16:24:07
Deployment of a national access card will be a job for private industry, not government, according to the federal Human Services Minister, Joe Ludwig.
The government launched scathing criticism at the Howard government's plans for a national identity card, but has remained open at the philosophy behind the initiative.
Speaking at the 2008 Australian Smart Cards Summit in Sydney today, Ludwig said the government does not reject the idea of a national identity card, but will not deploy it without private investment.
"The Access Card structure tangled everything into one big complex project, which risked delays, cost blow-outs, and restricted the former government's ability to steer the project over the long term," Ludwig said.
"Labor was opposed to the previous government's Access Card, but we have no in-principle objection to smart cards. The Access Card was an Identity Card by stealth.
More here:
http://www.computerworld.com.au/index.php?id=1845873234&eid=-255
and:
Karen Dearne | June 11, 2008
THE Rudd Government would not embark on any large-scale smart card projects, Human Services Minister Joe Ludwig has told the industry Smart Cards Summit in Sydney.
Instead, the Government "may well continue to use the cheaper traditional magnetic swipe card" and the existing EFTPOS network for the welfare payments scheme announced in the recent budget.
"Put simply, we could not afford to wait to solve the difficulties for small business in the Northern Territory involving manual processing and stored value cards," he said. "We needed a solution this year, and a smartcard was not going to be an option.
"The Income Management Card will use EFTPOS to deliver income-managed payments to about 20,000 Centrelink customers in NT communities, and the trial for people referred by child welfare agencies in areas of Western Australia,"Senator Ludwig said.
More here:
http://www.australianit.news.com.au/story/0,24897,23847150-5013044,00.html
On the basis of these two reports it seems there is significant policy confusion in the Human Services department about how best to manage access to services electronically. I wonder how long the lack of a Smartcard deployment strategy is going to be allowed to persist and for how long these efforts are not going to be integrated with NEHTA’s identification plans.
Fifth we have:
Natasha Wallace Health Reporter
June 11, 2008
A NATIONAL report says the method of measuring access to elective surgery by waiting times and waiting lists is not meaningful and makes state-by-state comparisons meaningless.
The report released today by the Australian Institute of Health and Welfare, the national agency for health and welfare statistics and information, also provides a more accurate measure.
It says the current measures include only public surgery despite private surgery comprising 61 per cent of all elective surgery, do not account for patients yet to go on a waiting list and do not include the total waiting time. There was also differences between the states on what was considered urgent surgery.
The report, Elective Surgery In Australia: New Measures Of Access, says measurements focusing on the length of waiting lists or how long patients waited, including the proportion who were seen "on time", "are not meaningful".
The report disputes what the NSW Health Minister, Reba Meagher, has repeatedly claimed - that a significant increase in recent years in the number of patients being treated "on time" demonstrated effective access to elective surgery.
Using a new formula, the report showed the median waiting time across Australia was 29 days for 2004-05. The new method uses supply-related measures, such as rates of surgery in both public and private hospitals, as well as demand-related measures such as diagnosis, rather than just relying on urgency categories.
More here:
http://www.smh.com.au/news/national/waiting-lists-a-bad-measure-health-report/2008/06/10/1212863646329.html
The report cited can be found here:
http://www.aihw.gov.au/publications/index.cfm/title/10596
This is important stuff. With all the political heat being applied to the public hospital systems around the country it is vital we can measure just how well the system is performing in comparable and credible ways.
Sixth we have:
http://news.smh.com.au/technology/patient-web-sites-used-for-news-support-in-crisis-20080609-2noz.html
June 9, 2008 - 4:28AM
When he was diagnosed with kidney cancer last year, Dave deBronkart needed an easy way to keep his far-flung friends and family updated. So did the president of the American Medical Association when he fell ill months ago. And so did the mother of a soldier wounded in Iraq who later suffered brain damage.
They all turned to the Internet, setting up individual Web sites to give progress reports. In return, they get posted notes of encouragement and support _ all without having to repeat the details in emotional and exhausting phone calls.
"I had already been burning myself out with phone calls" telling people, said deBronkart, of Nashua, N.H.
DeBronkart, like others, used free online services like CaringBridge and CarePages and their user-friendly formats to quickly set up a Web site to share the news _ good and bad. Patients themselves or family members write about treatment and recovery from illnesses, accidents or other medical crises, such as a premature births.
Sarah Doyle first used CarePages to prepare her for the arrival of her now year-old son Aidan. She learned during her pregnancy that Aidan would be born with his liver and intestines exposed. She read about the experiences of other families who had dealt with similar birth defects.
"I got a good idea what to expect. It wasn't such a shock," said Doyle, of Bellingham, Mass.
She has used her own page to chronicle Aidan's 11 months in a Boston hospital, his multiple surgeries and his arrival home in March. She recently reported that Aidan said his first word: mama.
"We really use it as a tool to say: We've been through some of the worst and now we're doing fine," said Doyle, who's expecting a second child in September.
Both online services were born out of medical emergencies, and have been used by tens of thousands since.
More here
http://news.smh.com.au/technology/patient-web-sites-used-for-news-support-in-crisis-20080609-2noz.html
The two sites referred to are as follows:
http://www.CaringBridge.org
http://www.CarePages.com
This is another side of e-Health that has a value that should not be ignored. A lot of such sites now exist and seem to help many people in their moments of difficulty. The risk, of course, is that wrong and dangerous advice can be posted. One hopes the effect of the common sense of the group will rapidly filter such material out.
Last we have:
Difficult decisions and paths not taken -- here are the 15 pivotal moments that have shaped today's high-tech landscape
Neil McAllister (InfoWorld) 10/06/2008 10:52:22
Imagine how different the computing world would be if IBM had used proprietary chips in the original PC, rather than off-the-shelf components. The PC clone market would never have happened, and IBM, rather than Microsoft, might have emerged as the leading company of the computer revolution.
Or if Steve Jobs had never taken his fateful tour of Xerox PARC? Had he not seen PARC's GUI in action he might never have created the Macintosh. And then where would Windows be today?
In every industry there are key milestones that mark a change in the course of history, and the fast-moving technology field has more than its share. Presented here are 15 turning points that shaped the computing world as we know it today, including some that still continue to influence its direction for years to come.
Continue reading here:
http://www.computerworld.com.au/index.php?id=2006850715&eid=-6787
This is a fun list to wrap up the week. Well worth a browse to see if you agree.
More next week.
David.
