There are two vital links that follow from the Australian Story.
1. Communiqué from Health Ministers Meeting (December 5, 2008)
See:
http://www.health.gov.au/internet/main/publishing.nsf/Content/mr-yr08-dept-dept051208.htm
2. Booze and Co E- Health Report.
See:
http://www.nhhrc.org.au/internet/nhhrc/publishing.nsf/Content/discussion-papers
Direct link:
Happy reading!
David.
Sounds good at first blush – the devil will be in the detail!
Siobhain Ryan | December 06, 2008
Article from: The Australian
HEALTH ministers have finally agreed on a national plan to share patients' electronic records, on the same day a new study slammed scattergun spending of almost $1.3 billion on state-based e-health schemes.
At a meeting in Brisbane yesterday, they gave the tick to the strategy commissioned in April amid controversy over delays, cost blowouts and resignations in e-health projects and bodies across the country.
Electronic records for patients are currently held separately, if at all, across GP surgeries, hospitals, government agencies and other health centres, allowing only patchy sharing of information.
The gaps have resulted in duplicate consultations, tests and treatments and prescribing mistakes, with past studies calculating the net benefits of better electronic record-keeping at up to $8.7 billion over the first 10 years.
More here:
http://www.theaustralian.news.com.au/story/0,25197,24758462-23289,00.html
David.
As this is now important I thought what it known of its purpose, so far, would be useful.
Here is the announcement release:
13 May 2008
The Australian Government will establish a $10 billion Health and Hospitals Fund to support strategic investments in health as part of the Government’s reform agenda to equip Australia’s health and hospital system for the future.
The Health and Hospitals Fund will be the single biggest investment in health infrastructure ever made by an Australian Government.
The Health and Hospitals Fund will support future health infrastructure priorities, including investments in:
The Government will invest $10 billion in the Health and Hospitals Fund, drawn from the 2007-08 and 2008-09 surpluses. A proportion of future surpluses may be allocated to the Fund as appropriate.
Expenditure from the Health and Hospitals Fund will be subject to consideration through the Budget process each year.
The establishment of the Health and Hospitals Fund means the Government will not proceed with the establishment of the previous Government’s Health and Medical Infrastructure Fund.
In addition to our other commitments to health and hospitals, including an additional $1 billion for hospitals this year; up to $600 million to clear elective surgery waiting lists; $780 million for dental health; and $275 million for GP Super Clinics, the establishment of the Health and Hospitals Fund demonstrates the Government’s commitment, in partnership with State and Territory Governments, to equipping Australia’s health and hospital system for the future.
The Health and Hospitals Fund will be established by 1 January 2009.
The announcement is found here
http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr08-nr-nr078.htm
Mr Bill Ferris AC has been appointed as Chair of the new Health and Hospitals Fund Advisory Board.
We will have to see if “medical technology and equipment” covers e-health!
David.
The ABC News has just confirmed Australian Health Ministers are meeting tomorrow.
This means we will soon know if e-Health gets a serious boost in 2008 or we have to wait till who knows when to see some action.
It seems very unlikely, with the silly season upon us, we will see much happen after this meeting for the year.
As they say! – Stay Tuned!
David.
Again there has been just a heap of stuff arrive this week.
First we have:
By Frank D. Roylance
November 21, 2008
You're all achy, coughing and feverish. Work is out of the question, but you're not sick enough to see a doctor. How nice it would be if someone checked in to ask how you're feeling.
The Maryland Department of Health and Mental Hygiene won't send over a pot of chicken soup. But state epidemiologists have a first-in-the-nation, Web-based project to ask thousands of residents whether they've been laid low by flu symptoms.
The Maryland Resident Influenza Tracking Survey is designed to augment reports from the doctors, hospitals and medical laboratories traditionally used to gather data on the geography and intensity of the flu season. The health department sends a weekly e-mail to people who sign up, asking them such questions as whether they've had a fever or a sore throat.
"We're looking at ways to fill in the gaps of our existing surveillance system," said Rene Najera, an epidemiologist at the health department. "We're trying to get at people who don't go to the hospital or do not see physicians. When those people do not seek care, they don't get reported to us."
More here:
http://www.baltimoresun.com/technology/bal-te.md.flu21nov21,0,5604173,print.story
Also we have:
By Kevin Sullivan
Washington Post Foreign Service
Monday, November 24, 2008; A08
WINGHAM, England -- Geese honked happily outside as Pat Swinfen sat in the study of her 16th-century farmhouse, cozy and warm amid thick Oriental carpets and a glowing wood fire.
Pure English countryside idyll -- except for the critically ill pregnant woman in Iraq desperately in need of a neurologist.
Swinfen, a retired nurse in her early 70s, sat at her computer and tapped out an e-mail, trying to connect doctors in Basra working on the woman, who had suffered a brain hemorrhage, with a renowned neurologist from Northern Ireland trekking in Nepal.
She soon had an e-mail response from the neurologist, who told Swinfen to forward details of the case.
The Swinfens run the Swinfen Charitable Trust, a telemedicine charity that uses e-mail to link sick people in poor, remote or dangerous parts of the world with hundreds of medical specialists in some of the world's finest hospitals.
Doctors in about 140 hospitals and clinics in 39 nations use the organization to seek help for patients requiring specialized care beyond their capabilities. Through the trust, they can be put in e-mail contact -- often within hours -- with one or more of the 400 specialists who work without pay as part of the trust's network.
More here
http://www.washingtonpost.com/wp-dyn/content/article/2008/11/23/AR2008112302629.html
Seems there is a lot of news on how e-mail can make a difference! Good stuff.
Second we have:
Balancing Privacy with Progress
Health care IT continues with the struggle between access and security.
One of the primary roadblocks in the advancement of health information technology (IT) is the ongoing debate about the privacy and security of personal health information. Many maintain that the timely exchange of patient information among the various entities in the health care process - which is essentially the backbone of effective health care IT - increases the risk of that very personal data falling into the wrong hands. These claims have gained resonance in recent years with the all-too-frequent reports of cybercrimes and high-profile security breaches involving the medical records of various celebrities.
Privacy and security concerns are by all means legitimate. But are they significant enough to warrant slowing the vast improvements to health care quality, safety and affordability that technology can generate? Indeed, the greatest potential danger to the health care system may not be the misuse of personal health information, but the non use of it.
Right now, valuable clinical data sits idle in various places throughout the health care system when we could be deploying it through electronic health records (EHRs) to improve the system and perhaps even save lives. Delivering a greater breadth and depth of actionable information to the point of care furnishes clinicians with a much more thorough and complete picture of a patient and his or her medical history. The EHR fills in important blanks; it essentially makes known to a physician that which is otherwise unknown. As a result, doctors can make faster and more accurate decisions, which can snowball into a wealth of related benefits: better outcomes, increased operational efficiencies, less waste, lower costs and so on.
Given these almost certain benefits, one must consider whether we're approaching the point in the privacy debate where fear of the misuse of information needs to be overcome in order to prevent the nonuse of information, and whether the somewhat misdirected fear of potential security breaches is really worth stifling health IT progress and all it has to offer - especially at a time when the country is grappling in earnest for solutions to the high cost of quality health care.
Much more here:
http://health-care-it.advanceweb.com/Article/Balancing-Privacy-with-Progress.aspx
This is a very useful view and the full article is worth a read!
Third we have:
20 Nov 2008
German health insurer, Gmünder ErsatzKasse (GEK), has signed a five-year deal with Atos World line, to implement and operate the new German electronic health card (EHC) on its behalf.
During 2009, GEK plans to issue 30,000 cards per day in order to provide its 1.7million members in Germany with the new e-health card.
Due to be rolled-out nationally in 2009, the electronic health card is one of Germany’s most important public sector IT projects. The card is designed to guarantee the secure exchange of data between insured parties, doctors, pharmacists and health insurance companies and will serve to validate patient’s identity, rather than hold their electronic medical record.
The introduction of the new electronic health card is intended to help connect citizens, pharmacists, doctors, hospitals as well as the private and statutory health insurance companies. Use of the card will help simplify and accelerate information exchanges, reducing and in some cases eliminating current paperwork.
Atos Worldline, a division of Atos Origin, has been selected by GEK to implement and operate the issuing and management of e-health cards. Services include the implementation of the health insurance data, the running of the card application and management system.
Atos will provide its card application management system for the electronic health card ‘Worldline eGK KAMS’.
Atos says its Public Key Infrastructure ensures that patient data is securely stored. The keys for the e-health card Atos Origin will supply are approved as trusted services by Gematik (Gesellschaft für Telematikanwendungen der Gesundheitskarte mbH), the national body overseeing the German e-health card project.
More here:
http://www.ehealtheurope.net/news/4344/germany%E2%80%99s_gek_picks_atos_for_e-health_card
It is important to understand just how the Germans are proceeding on e-Health. Here is a useful article to get started.
Fourth we have:
The Defense and Veterans Affairs departments will migrate their respective electronic health record systems to a service-oriented architecture to enhance the interoperability of outpatient clinical data.
Stephen Jones, principal deputy assistant secretary of Defense for health affairs, made the announcement at a Pentagon press conference this morning.
SOA means that the systems will rely on Web services that connect loosely coupled, reusable components.
A study by Booz Allen Hamilton recommended the use of SOA, and officials accepted that recommendation, Jones said.
The decision came on the heels of speculation that DOD might ditch its EHR — AHLTA — in favor of VA’s Veterans Health Information Systems and Technology Architecture or another alternative.
“The Booz Allen study looked at three different options: building on the current approach, replacing AHLTA with VistA and replacing both with another commercial off-the-shelf solution,” Jones said.
Booz Allen recommended the first option, which would allow DOD and VA to “move forward with information sharing in a compatible way,” Jones said. He added that he could not provide cost or schedule information because the implementation effort is just beginning.
More here
http://www.govhealthit.com/online/news/350692-1.html
Interesting where these large organisations think SOA fits.
Last for this week we have:
Posted: November 20, 2008 - 3:30 pm EDT
The Joint Commission released a white paper urging the healthcare industry to consider specific actions within five core areas of hospital development.
In its paper, Health Care at the Crossroads: Guiding Principles for the Development of the Hospital of the Future, the commission maps out steps hospitals should take in the areas of economic vitality, technology adoption, patient-centered care, staffing and design to better meet the needs of patients. “The importance of hospital-based care will not diminish in the future, but hospitals will have to meet the high expectations of the public and all stakeholders in an increasingly challenging environment,” said Mark Chassin, a physician who is president of the commission, in a written statement. Aramark Healthcare supported the development of the white paper.
Full article here:
http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20081120/REG/311209972/-1/TODAYSNEWS
This is a useful study – and shows where technology can help future hospital developments.
David.
The following release appeared a few days ago.
November 12, 2008 (Toronto, ON) - Canada Health Infoway (Infoway) today unveiled plans for a new certification service to help emerging consumer health solutions complement and leverage Canada's investments in e-health solutions.
"As Canada's health informatics industry evolves, it is essential that emerging solutions leverage the investments and progress made in every province and territory that are implementing electronic health records," said Richard Alvarez, president and CEO, Canada Health Infoway. "The launch of our new certification service will help the vendor community to develop new products accordingly, and provide buyers and users of those systems with some assurances the solutions are of high quality."
The new service will provide developers with greater market access, improve the quality of products they develop and enhance testing efficiencies.
Organizations investing in certified solutions can expect a higher degree of confidence that the products they purchase are reliable, interoperable, private and secure.
"We are pleased Infoway is moving forward with certification of health information technology solutions," said Elaine McKnight, Assistant Deputy Minister, Health Sector IM/IT Division, B.C. Ministry of Health. "Having an offering of certified solutions to choose from will help speed implementation and adoption of private, secure and interoperable EHR technologies."
Infoway will formally launch the certification service in early 2009, at which point it will accept applications for certification from developers of consumer health platforms.
"Canadians want electronic access to their personal health information, which is an important part of managing chronic illness and preventing its onset," added Alvarez. "As health IT vendors develop solutions to address this demand, it is essential that they are reliable, safeguard patient privacy and can interoperate with the core elements of the electronic health record infostructure that provinces and territories are implementing in collaboration with Infoway throughout Canada."
Canada Health Infoway is an independent, not-for-profit organization funded by the federal government. Infoway jointly invests with every province and territory to accelerate the development and adoption of electronic health record projects in Canada. Fully respecting patient confidentiality, these secure systems will provide clinicians and patients with the information they need to better support safe care decisions and manage their own health. Accessing this vital information quickly will help foster a more modern and sustainable health care system for all Canadians.
The complete release is found here:
http://www.infoway-inforoute.ca/en/News-Events/InTheNews_long.aspx?UID=346
This is an important initiative as it encourages interoperation between the various sectors and actors within the Canadian Health System. Canada has, of course, a published set of standards, architectures and selected products for their EHR initiatives and this additional work will nicely complement work undertaken to date.
In Australia NEHTA has been talking about both enterprise architecture and certification for a couple of years – but to date not much seems to have actually been progressed to implementation. An example of suggestions of the need for the work is here:
Karen Dearne | October 30, 2007
THE National E-Health Transition Authority (NEHTA) will usher in a "more transparent and consultative approach" over the coming year, the organisation's chair Uschi Schreiber said.
Ms Schreiber said the current review of NEHTA's progress will assist the board in "framing more precisely the future evolution of e-health in Australia".
....
"Steps towards a national SEHR include improving the ability for healthcare providers to electronically send discharge summaries and referrals, prescriptions, pathology requests and reports," NEHTA said in its report.
"Work in these areas now form the focus of our 2007-08 program, which will also see the presentation of the business case for the SEHR to the Council of Australian Governments in early 2008.
"During the next 12 months we will progress NEHTA's approach to certification, conformance and accreditation - an important element in ensuring NEHTA's specifications and recommendations are adopted."
While there had been some employee turnover in the past year, the organisation's growing work program had seen a concerted focus on recruiting IT specialists and health professionals.
Full article here
http://www.australianit.news.com.au/story/0,24897,22672420-15306,00.html
A quick look at this article, from just over a year ago, shows just how glacial things have actually been with both the SEHR (now IEHR for some as yet unexplained reason) and other goals (messaging etc) running very late indeed.
Certification of both messaging interoperability and software quality and interoperability really matter – we should not still be waiting.
David.
