International News Extras For the Week (22/01/2009).

Again there has been just a heap of stuff arrive this week.

First we have:

Take TB Meds, Get Mobile Minutes

A program to boost TB drug compliance rewards patients with cell-phone minutes.

By Emily Singer

A new program that combines cheap, paper-based diagnostics with text-messaging technology could improve tuberculosis (TB) treatment in poor countries. The program, which is the brainchild of engineers, economists, and entrepreneurs at the Innovations in International Health (IIH) project at MIT, rewards patients who adhere to the lengthy TB drug regimens with cell-phone minutes. Called XoutTB, the diagnostics have proved successful in a pilot field test in Nicaragua; a larger trial will begin this month in Pakistan.

TB strikes millions of people across the globe: 9.2 million new cases were diagnosed in 2006, and 1.7 million people died from the disease, according to the World Health Organization. The infection can be effectively treated with antibiotics, but patients need to keep taking the drugs daily for six months or more to completely wipe it out. However, because the drugs can trigger nausea and other side effects, some patients stop taking them when their TB symptoms subside, often one to two months into treatment. "In Pakistan and other countries, low compliance rates are fueling the emergence of drug-resistance strains," says Rachel Glennerster, executive director of the Poverty Action Lab at MIT.

More here:

http://www.technologyreview.com/biomedicine/21945/?nlid=1644

I just love the simplicity and ease of implementation of the idea!

Second we have:

Top 10 Trends and Events Shaping Medtech in 2009 From Aaron Dickson of Millennium Research Group

Written by Mark Taylor

Thursday, 08 January 2009

Here are the 10 leading trends affecting the medical technology industry for 2009, according to a webinar hosted by Aaron Dickson, co-president of the Toronto-based Millennium Research Group, a strategic research and intelligence firm in the medical technology and pharmaceutical market sectors.

1. Impact of the economic downturn in the medtech industry. Mr. Dickson says first with the initial credit crisis squeezing facility spending and later with the drop of consumer confidence, most publicly-traded healthcare firms suffered share price declines and some experienced layoffs. Mr. Dickson says the economic downturn, the biggest story of the year, will affect medtech firms different, depending upon their reliance on hospital spending and elective procedures. Companies producing items requiring large capital outlays will be hurt more. He predicts cardiovascular markets will be less affected because of the nature of cardiovascular conditions and the critical necessity of most cardiovascular devices. But emerging interventional devices could be hit. And companies — dependant upon elective procedures — could also suffer. As the prospect of people losing their jobs increases, they will become more concerned about taking time off, he says.

2. Pres. Obama’s health plan. Mr. Dickson says healthcare reform comprised an important part of Sen. Obama’s election platform. “It may have to be adjusted, given the current economic situation, with some components delayed or revisited,” he says. “But Mr. Obama recently reiterated his pushing to change healthcare, saying it can’t be put off because we’re in an emergency, it is part of the emergency.” He says forcing employers to provide healthcare coverage will likely be postponed, but his plan to invest in healthcare technology, expand children’s health insurance coverage and subsidize and support state Medicaid programs stand a better chance of passage.

3. Medical devices increasingly treating diseases traditionally treated by drugs. Mr. Dickson says that while devices to date have made small inroads into drug-dominated diseases, the market for devices to treat arthritis, depressive disorders and chronic migraines will continue to grow as neural stimulators, already used in treating Parkinson’s Disease, and other devices, improve. “There are real opportunities for growth,” he predicts.

More here:

http://www.hospitalreviewmagazine.com/news-and-analysis/business-and-financial/top-10-trends-and-events-shaping-medtech-in-2009-from-aaron-dickson-of-millennium-research-group.html

This is an interesting 10 item list – well worth a browse!

Third we have:

Obama's big idea: Digital health records

President-elect wants to computerize the nation's health care records in five years. But the plan comes with a hefty price tag, and specialized labor is scarce.

By David Goldman, CNNMoney.com staff writer

January 12, 2009: 4:05 AM ET

NEW YORK (CNNMoney.com) -- President-elect Barack Obama, as part of the effort to revive the economy, has proposed a massive effort to modernize health care by making all health records standardized and electronic.

Here's the audacious plan: Computerize all health records within five years. The quality of health care for all Americans gets a big boost, and costs decline.

Sounds good. But it won't be easy.

In fact, many hurdles stand in the way. Only about 8% of the nation's 5,000 hospitals and 17% of its 800,000 physicians currently use the kind of common computerized record-keeping systems that Obama envisions for the whole nation. And some experts say that serious concerns about patient privacy must be addressed first. Finally, the country suffers a dearth of skilled workers necessary to build and implement the necessary technology.

"The hard part of this is that we can't just drop a computer on every doctor's desk," said Dr. David Brailer, former National Coordinator for Health Information Technology, who served as President Bush's health information czar from 2004 to 2006. "Getting electronic records up and running is a very technical task."

It also won't come cheap. Independent studies from Harvard, RAND and the Commonwealth Fund have shown that such a plan could cost at least $75 billion to $100 billion over the ten years they think the hospitals would need to implement program.

That's a huge amount of money -- since the total cost of the stimulus plan is estimated to cost about $800 billion, the health care initiative would be one of the priciest parts to the plan.

The biggest cost will be paying and training the labor force needed to create the network. Luis Castillo, senior vice president of Siemens Healthcare, a company that designs health care technology, said the laborers will have the extremely difficult task of designing a a system that "thinks like a physician."

"Doctors cannot spend hours and hours learning a new system," said Castillo. "It needs to be a ubiquitous, 'anytime, anywhere' solution that has easily accessible data in a simple-to-use Web-based application."

But highly skilled health information technology professionals are as rare as they come, and many IT workers will need to be trained as health technology experts.

Much more here:

http://money.cnn.com/2009/01/12/technology/stimulus_health_care/index.htm

This is a much more detailed and useful article on the plan than usual – especially the discussion of the need for training!

Fourth we have:

National eHealth collaborative launched

Former American Health Information Community brings together public-private sector members to achieve nationwide electronic health information network

Published: 01/08

WASHINGTON, DC., USA - (HealthTech Wire / News) - The National eHealth Collaborative, formerly AHIC Successor, Inc., was officially launched today in Washington, D.C. The National eHealth Collaborative is a public-private partnership dedicated to the creation of a secure, interoperable, nationwide health information network that will advance the American public’s interest in health and improve the quality, safety, efficiency and accessibility of healthcare. The Collaborative builds on the accomplishments of the American Health Information Community (AHIC), a federal advisory committee established in 2005, and AHIC Successor, Inc., founded in 2008 to transition AHIC’s accomplishments into a new non-profit membership organization, now known as the National eHealth Collaborative (NeHC).Much more here:

http://www.healthtechwire.com/The-Industry-s-News-unb.146+M5ab2291f0a8.0.html

This is an important step for the US and provides the top level governance needed to progress the Obama vision for Health IT.

Heaps more here:

http://nationalehealth.org/

Fifth we have:

Estonian E-health information system is stuck

Marge Tubalkain-Trell

marge.tubalkain-trellatchararipaev.ee

12.01.2009 14:19

Although the work of medical institutions should’ve been transferred into E-health information system this year, most of the hospitals haven’t joined the system yet, Postimees reports.

E-health is an information system that joins digital health record, pictures and registration. Both, doctors and patients should be able to make many necessary things through the system and it would save time and money.

.....

The rest of the medical institutions wait for permit from Data Protection Inspectorate to take the system to use.

More here:

http://balticbusinessnews.com/Default2.aspx?ArticleID=e3e8d80e-f1dc-429f-851b-ccdb42f83428

Love the headline – sounds a little like some place closer to home with a few bureaucratic problems!

Sixth we have:

Surgeon general updates health-history Web tool

By Joseph Conn / HITS staff writer

Posted: January 13, 2009 - 5:59 am EDT

HHS and the Surgeon General's Office reintroduced what they described as an updated and improved version of a Web-based tool for individuals and families to create their own health histories while HHS also announced the launch of its Medicare personal health-record pilot for Medicare beneficiaries in Arizona and Utah.

The surgeon general first developed the family history tool, called My Family Health Portrait, in 2004 with help from Indian Health Service, according to a news release.

Individuals can choose from a list of ailments and diseases and can forward copies of the history to various family members for verification and additions. The tool allows individuals and families to graph their “family tree” that includes the diagnoses of each family member.

While the software that compiles the history is hosted at the National Cancer Institute and the history itself is created online, the final work can be downloaded to an individual’s own computer. The government says it does not retain copies of the health histories. The source code for the tool is openly available for others to adopt and customize and can be downloaded here.

More here:

http://www.modernhealthcare.com/article/20090113/REG/301139996/1153

This looks like a very useful initiative I must say.

More is found here:

http://www.washingtonpost.com/wp-dyn/content/article/2009/01/12/AR2009011201850.html

Seventh we have:

Study: Spending on health IT would generate 212,105 jobs

• By Nancy Ferris
• Jan 07, 2009

A $10 billion investment in health information technology as part of a planned economic recovery package would create or retain 212,105 jobs in one year, a Washington think tank has determined.

The Information Technology and Innovation Foundation (ITIF) endorsed health IT spending, along with spending on broadband networks and a smart power grid, as components of a larger economic stimulus package Congress is expected to introduce soon.

ITIF President Robert Atkinson said the organization does not necessarily advocate the amounts of spending that it analyzed — $10 billion for each IT component or a total of $30 billion. He said the analysis of the job-creation effects could be extrapolated to a larger or smaller amount of spending.

“I think this is a once-in-a-generation opportunity for our country” to position itself for greater competitiveness in a future global economy in which IT will be a major element, Atkinson said.

More here:

http://govhealthit.com/articles/2009/01/07/spending-on-health-it-would-generate-212105-jobs.aspx?s=GHIT_130109

Another reason for Mr Rudd and Ms Roxon to consider e-Health seriously!

Eighth we have:

Health Evolution Partners Launches 21CM

Partnership with Top Health System Leaders to Target Practice-Changing Innovations

SAN FRANCISCO--(BUSINESS WIRE)--David J. Brailer, MD, PhD, Chairman of Health Evolution Partners, a manager of health care investment funds that seeks out companies that will be the leading brands of a new health care system, announced today a partnership with leaders of America's top health care systems. 21CM (21st Century Medicine) is a collaboration between Health Evolution Partners and select health care leaders that will identify innovations which change how medicine is practiced. Health Evolution Partners will work with 21CM leaders to bring these innovations into widespread use.

"It is a privilege to work to improve care delivery with individuals who are leading change every day on behalf of their patients and physicians,” said Brailer. "Our collaboration with these outstanding leaders accelerates our efforts to identify and support the companies that can change our health care system."

More here:

http://www.businesswire.com/portal/site/google/?ndmViewId=news_view&newsId=20090112005355&newsLang=en

I must say I like the sound of this!

Ninth we have:

Microsoft: Don't just throw money at health care

Posted by Ina Fried

In stark contrast to the many businesses beating a path to Washington to beg for money, Microsoft is urging caution as the government looks to spend billions on digitizing health care.

Peter Neupert, the former Drugstore.com CEO, who now heads Microsoft's health care unit, said investment is a "necessary, but not sufficient" condition for improvement and said that spending money on computer technology may not even be the right first step.

"I'm trying to transform the discussion just a little bit," he said in an interview on Wednesday. "Don't focus on spending money on tech per se. Focus on what outcomes do we want."

Neupert, who is due to testify before a congressional committee on Thursday, likens it to when the government set out to put a man on the moon.

"When we decided to go to the moon, we didn't say let's build a great...rocket," Neupert said. "We said let's go to the moon...I feel a little bit of the conversation is lets build a great rocket and hope we get to the moon."

The hearing, to be chaired by Senator Barbara A. Mikulski (D-Md.) is titled "Investing in Health IT: A Stimulus for a Healthier America." Even the title suggests that the spending itself is a main priority, although background information also talks about the need to reduce medical errors and give health care providers quicker access to patient data.

Full article here:

http://news.cnet.com/8301-13860_3-10142627-56.html?tag=nl.e433

I really think this cautionary approach is vital when talking of a project of this scale. Well done MS

Last for this week we have:

Report: Healthcare reform could save money

January 09, 2009 | Bernie Monegain, Editor

NEW YORK – It's possible to provide health insurance for uninsured Americans and also save healthcare costs, asserts a report released Friday by the Commonwealth Fund.

Technology would have to play a key role in streamlining administration and purchasing, the report suggests.

Authored by Sara R. Collins, Jennifer L. Nicholson and Sheila D. Rustgileading, the report analyzes health insurance bills put forth by members of the 110th Congress and President-elect Barack Obama. The authors conclude that several proposals could substantially reduce the number of uninsured Americans and would either reduce healthcare spending or add only modestly to annual healthcare expenditures.

More here:

http://www.healthcareitnews.com/news/report-healthcare-reform-could-save-money

The good news just keep coming!

Enough for the week even!

David.

Report Watch – Week of 12 January, 2009

Just an occasional post when I come upon a few interesting reports that are worth a download. Already we have had the Booze Allen report which I noted here:

http://aushealthit.blogspot.com/2009/01/booze-allen-suggests-sophisticated.html

Two others also dropped into my view this week.

First we have:

Report Covers E-Script Issues

January 13, 2009

A new report examines ways for provider organizations, pharmacies and insurers to cooperate to ease adoption of electronic prescribing systems and integrate them with other information systems.

The report is from I.T. vendor and consulting firm Computer Sciences Corp. in Falls Church, Va. It discusses what e-prescribing is and its major functions, incentives to encourage adoption, best practices, and barriers.

.....

To access the complete report, click here.

--Joseph Goedert

Access the full article here:

http://www.healthdatamanagement.com/news/e-prescribing27546-1.html?ET=healthdatamanagement:e735:100325a:&st=email&channel=medication_management

The second was:

ONC Commissioned Medical Identity Theft Assessment

In May 2008, the Office of the National Coordinator for Health Information Technology (ONC) awarded an approximately $450,000 contract to Booz Allen Hamilton to assess and evaluate the scope of the medical identity theft problem in the U.S.

Medical Identity Theft

Medical identity theft is a specific type of identity theft which occurs when a person uses someone else's personal health identifiable information, such as insurance information, Social Security Number, health care file, or medical records, without the individual's knowledge or consent to obtain medical goods or services, or to submit false claims for medical services. There is limited information available about the scope, depth, and breadth of medical identity theft.

Dr. Robert Kolodner, National Coordinator for Health Information Technology, has noted that medical identity theft stories are being documented at an increasing rate, bringing to light serious financial, fraud, and patient care issues. ONC recognizes that health IT is an important tool to combat the threat of medical identity theft. We are seeking input from the public and other government agencies to better understand how health IT can be utilized to prevent and detect medical identity theft as well as build consumer trust in electronic health information exchange. ONC believes it is imperative to obtain a more comprehensive understanding of this issue from a variety of perspectives, and to create an open forum for dialogue to work proactively to address medical identity theft.

An Assessment in Three Phases

Three specific deliverables corresponding with each of the three phases resulted from the assessment.

I. A comprehensive Environmental Scan Report of the medical identity theft problem in the U.S particularly focusing on the intersection of Health IT was completed October 15, 2008 and released at the ONC Medical Identity Theft Town Hall meeting.

A literature review and documentary research in addition to interviews was conducted to explore the scope and trends of medical identity theft. This report will:

1. Identified a comprehensive list of stakeholders who are affected by medical identity theft and summarize their activities;
2. Identified issues of medical identity theft, quantify its impact on the health care industry, and identify gaps where there are no reliable measures; and
3. The Environmental Scan Report serves as a baseline for developing recommendations for the prevention, detection, and remediation of medical identity theft.

II. A one-day Town Hall meeting was held, October 15, 2008, in Washington, D.C. sponsored by the U.S. Department of Health and Human Services, Office of the National Coordinator for Health Information Technology on Medical Identity Theft. The written transcript and audio file from the event are now available. Access the written transcript and audio file.

The Town Hall enabled health care experts to share knowledge and experience of medical identity theft and how health IT can be utilized to prevent and detect medical identity theft.

ONC Medical Identity Theft Town Hall Speakers and Topics

Welcoming Remarks by Robert Kolodner, MD, U.S. Department of Health & Human Services, National Coordinator for Health Information Technology

Opening Remarks by Jodi Daniel, JD, MPH, Director, Office of Policy and Research, Office of the National Coordinator for Health Information Technology

Panel 1: Understanding the Scope of the Problem

Moderator: Jodi Daniel

Panel:
Department of Justice, Kirk Ogrosky
Federal Trade Commission, Betsy Broder
Healthcare Information and Management Systems Society, Lisa Gallagher
Identity Theft Resource Center, Linda Foley
Massachusetts General Hospital, Shanda Brown
Victim of Medical Identity Theft, Nicole Robinson
World Privacy Forum, Pam Dixon

Panel 2: Laws, Policies and Procedures

Moderator: Jodi Daniel

Panel:
American Health Information Management Association, Harry Rhodes
Centers for Medicare and Medicaid Services, Stephanie Kaisler
HHS Office of Inspector General, Gary Cantrell
Hogan & Hartson LLP, Marcy Wilder
Massachusetts General Hospital, Shanda Brown
Social Security Administration, Jonathan Cantor

Panel 3: The Role of Health Information Technology (HIT)

Moderator: John Loonsk, MD, Director, Office of Interoperability and Standards, Office of the National Coordinator for Health Information Technology

Panel:

American Health Information Management Association, Harry Rhodes
BlueCross BlueShield Association, Calvin Sneed
CareSpark, Liesa Jenkins
Good Health Network, Lory Wood
Healthcare Information and Management Systems Society, Lisa Gallagher
Indiana Health Information Exchange, Debbie Banik

Panel 4: The Path Forward

Moderators: Morris Landau, JD, MHA, LLM, Policy Analyst, Office of the National Coordinator for Health Information Technology Denise Tauriello, Senior Associate, Booz Allen Hamilton

Panel:

American Health Information Management Association, Harry Rhodes
CareSpark, Liesa Jenkins
Federal Trade Commission, Betsy Broder
Healthcare Information and Management Systems Society, Lisa Gallagher
Massachusetts General Hospital, Shanda Brown
World Privacy Forum, Pam Dixon

III. A final report and roadmap.

The report and roadmap summarizing health IT and medical identity theft issues raised at the town hall will be released in Winter 2008 - 2009 and will set forth possible next steps for the Federal government and other stakeholders in order to work toward prevention, detection, and remediation of medical identify theft.

The web page is found here:

http://www.hhs.gov/healthit/privacy/theft.html

Both reports and associated materials are worth a close look.

David.

The NEHTA Rumour for the Week (or maybe more).

From totally unreliable sources I have been told.

1. NeHTA have put the case to the powers that be to be restructured into the Australian E-health Agency (or whatever) thereby getting rid of the nonsensical charade that they are a Pty Ltd organisation.

(This would be in line with the Deloittes Strategy and would do wonders for accountability and governance of the whole endeavour)

2. That this may happen this side of March 2009.

If it is not true, it is a great rumour. If it is true it suggests some real work is underway to begin implementation of the National E-Health Strategy.

That would have to be a very good thing indeed in my view! Frankly, I reckon if this rumour is not true it should be!

Can any of the blogs ‘anonymous’ correspondents confirm / deny this great little piece of scuttlebutt?

David.

Computerised Physician Order Entry (CPOE) – Wrinkles, Trials and Tribulations

The following excellent lead article appeared in Health Date Management for January 2009.

CPOE: It Don't Come Easy

Howard J. Anderson, Executive Editor
Health Data Management, January 1, 2009

Focusing on the need to dramatically reduce medical errors, many patient safety advocates have urged hospitals to implement computerized physician order entry systems.

By shifting from paper-based or verbal orders to electronic ordering, advocates say, hospitals can eliminate errors caused by illegible handwriting or ambiguous voice messages. In addition, CPOE systems include decision support functions that steer physicians to making appropriate decisions based on medical evidence. And they provide alerts that warn physicians about orders for drugs or procedures that have the potential to harm their patients.

But so far, only about 8% of U.S. hospitals have implemented CPOE, the Leapfrog Group estimates. And a recent study by the Washington-based employer consortium found that hospitals that have adopted the technology are facing some serious challenges.

Some 100 hospitals recently used Leapfrog's CPOE Evaluation Tool, which offers scenarios for testing certain order entry functions. And the results were disappointing, says Leah Binder, Leapfrog's CEO.

For example, although the vast majority of drug allergies were caught by the systems, some were not. Also, some hospitals' CPOE systems failed to offer an alert that a drug should be taken with food. And a few hospitals' systems even failed to prevent a potentially fatal medication order in the simulation.

"It's extremely complicated to set up these systems properly," Binder says. "They have to be updated continually. There are always going to be bugs that hospitals need to address on an ongoing basis."

Hospitals face the challenge of customizing the off-the-shelf software to meet their specific needs, Binder adds. "These are not plug-and-play systems," she stresses.

Many experts also warn that hospitals must take extraordinary steps to avoid "alert fatigue" caused by vendors' systems that are pre-programmed to display so many alerts that physicians begin to ignore most of them. Moreover, successful deployment of CPOE requires time-consuming re-engineering of care processes, they stress.

The key to using CPOE to consistently prevent medical errors, Binder argues, is to continually test the technology and refine it. All 33 hospitals that were top scorers in the Leapfrog Group's annual quality survey used the CPOE evaluation tool to help them qualify for the recognition (see sidebar, page 22).

"Many institutions have no idea of how they are doing on providing decision support," says David Bates, M.D., chief of the general medicine division at Brigham and Women's Hospital, Boston. "The CPOE evaluation tool helps leadership to measure where they are with decision support."

Refining The Tool

Bates helped Leapfrog Group refine the tool, providing feedback that the initial version was far too difficult to use and did not focus on the most common orders that affect patient safety. By using the revamped tool, hospitals can more precisely target their efforts to refine decision support in their CPOE systems, the physician says.

"We have a long list of things that we want to add that we haven't gotten around to yet," he says. "The tool helped us refocus our efforts."

But another physician whose organization used the tool says the test focused far too heavily on the triggering of alerts and not enough on testing the logic embedded in decision support.

"We need to test the actual functioning of the order sets," says Charles Ross, M.D., chief medical information officer for Summa Health System, which owns six hospitals in Ohio. The key to a successful CPOE deployment, Ross stresses, is building logic into the order sets that, rather than triggering an alert, steers the doctor to the right decision.

For example, a well-designed CPOE system would prevent doctors from ordering certain drugs to treat pneumonia, rather than displaying various alerts about the inappropriate drugs that could be ignored.

"If you met all the requirements of the Leapfrog tool, it would lead to some over-alerting of physicians," contends Lori Idemeto, pharmacy informatics specialist at Virginia Mason Medical Center, Seattle.

She observed, however, that the tool helped the organization identify some areas for improvement. For example, the hospital tweaked its order sets to provide more guidance on single and cumulative drug dose limits.

Vastly more here:

http://www.healthdatamanagement.com/issues/2008_60/27494-1.html

A full layout version of the article is available here:

http://digital.healthdatamanagement.com/healthdatamanagement/200901/?u1=texterity

There is a great deal of good advice and understanding about how to get CPOE right from the ground up in this article and it is strongly recommended for careful reading – especially for those involved in planning such implementations in Australia. Taking notice of the lessons here can make the difference between success and failure (which with CPOE is a real risk!).

David.

Pulse+IT Website Updated and Adds New Services.

I had the following e-mail today letting me know of some updates at Pulse+IT – the only Health IT Magazine serving the Australian e-Health Community.

-----

Dear David,

Some of your readers may be interested in the following upgrades to the Pulse+IT website...

Firstly, I've established a new RSS feed to serve up our latest news pieces.

The actually news portal interface on the website is still being refined, but the feed is active and available at:

http://www.pulsemagazine.com.au/index.php?option=com_bca-rss-syndicator&feed_id=4

Secondly, for those that would prefer to receive news updates via email, we are now offering a free eNews alert service that will bundle up and send out introductions and links to all news pieces published on the website within the last week. The sign-up form can be found here:

http://www.pulsemagazine.com.au/index.php?option=com_content&view=article&id=335

Links to both services can be found on the left hand side of the Pulse+IT home page (http://www.pulsemagazine.com.au).

Both services are free and unrestricted, so I encourage all to get on board.

Kind regards,

Simon.

-----

There is no reason not to browse the site and sign up if interested. I hope people enjoy!

David.

Booze Allen Suggests a Sophisticated Approach to e-Health that Recognises the Complexity and Difficulties.

The following release appeared last week.

http://www.boozallen.com/publications/article/40808278?lpid=38218798&gko=50ac0

Toward Health Information Liquidity: Realization of Better, More Efficient Care From the Free Flow of Health Information

How health information and communications technology (health IT) can accelerate progress towards health reform and a genuinely patient-centered health care system.

Recognizing the challenges presented by the current state of our economy and national discussions about healthcare reform, Booz Allen Hamilton and the Federation of American Hospitals have collaborated to examine the ways that health information technology, in combination with communications technology (hereafter referred to simply as health IT), can accelerate progress toward the goal of a patient-centered healthcare system.

We engaged thought leaders from across the different segments of the healthcare industry to discuss ways to accelerate progress toward the free flow of essential electronic health information. This group of invested stakeholders from the provider community, academia, the technology industry, and government concluded that consumers, clinicians, and providers all derive greater benefits when health information flows faster and more freely, or becomes more “liquid.” Growing evidence indicates that liquid health information can facilitate improvements in healthcare access, quality, safety, efficiency, convenience, and outcomes. At the same time, it can open the door to innovation and provide a foundation for a new standard of patient-centered care through enhanced use of healthcare teams and informatics.

We conducted a series of interviews with these thought leaders and convened them to discuss the benefits of liquid electronic health information, as well as the barriers that inhibit the conversion from paper-based record systems to robust electronic health information and that discourage the sharing of appropriate data that is already electronic. Published reports, white papers, websites, policy blogs, trade newsletters, and other sources of information on early adopters of electronic health information informed the results of the discussions and our conclusions.

Health IT alone will not dramatically improve care and reduce costs. Even when information is electronic, it is not automatically shared outside of organizational or network firewalls, or across organizational boundaries. In the course of our inquiry, two accelerators emerged that combine policy and market changes to change healthcare delivery and improve the flow of information. First, focus on enhancing the flow of health information and communications among patients and providers, rather than focusing only on adoption of electronic health records (EHR). Second, take bold new steps toward realizing a consumer-centered healthcare system.

Booz Allen's Susan Penfield, Kristine Martin Anderson, Margo Edmund, and Mark Belanger are the authors of "Toward Health Information Liquidity: Realization of Better, More Efficient Care From the Free Flow of Health Information."

study posted January 12, 2009

Comment.

This study makes interesting reading and I do not disagree with the findings. However it is not really as simple as it seems. Booze Allen clearly recognise this I believe as they point out, among the key things needed are both a Health Information Exchange Architecture and Knowledge Management Framework as well as interoperation and communication standards (Section 1.3 to 1.6).

Under Accelerator 1 – Intensify the Focus on Information Flow and Communication we read

“1.3 Define and implement a national health information exchange and knowledge management architecture – make sure critical history data, such as pharmacy, lab and imaging date flow securely across organisational boundaries.

1.4 Create and maintain standards for information exchange: the Certification Commission for Health IT (CCHIT) could certify any system’s ability to meet health information exchange requirements.

1.5 Fast-track implementation of a national e-prescribing network with decision support at the time and place of care.

1.6. Assure availability of pharmacy, lab and imaging histories at the point of care and increase reliable and valid reporting for quality and safety.”

This is all going to require very serious work and planning! It is not at all easy or quick to get these things right.

There is a bit of a ‘cargo cult’ around in Australia that seems to think all you need to do is connect clinicians and it will all sort itself out. This is utter rubbish – Booze Allen know it – but some DoHA staff and some academics do not. They need to read the detail to see what is needed and just how hard it will actually be.

David.

Useful and Interesting Health IT Links from the Last Week – 18/01/2009.

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

First we have from the NEHTA site.

NSW Health Providing Online and Integrated Health Records

Medical consultations are happening all the time in a variety of circumstances. Any time a patient consults a healthcare practitioner a large amount of information is generated. Managing that information is central to a smoothly functioning health system. Where once that information was recorded in hard copy on paper and needed to be physically transported, we now live in the digital age and that information can exist and be managed in a digital and online form.

These electronic health records form the basis of what is known as e-health and NEHTA is putting into place the structures that will allow e-health to become part of the Australian health scene on a national scale. However, on a state-based level in Australia independent and successful pilot projects are underway such as the Healthelink project in NSW.

Healthelink

he Healthelink Electronic Health Record (EHR) pilot is the beginning of NSW Health’s strategy to provide an online and integrated electronic record of an individual’s health care provided across public and private health settings. The project began planning in 2004 and by March 2006 the Maitland Hospital began contributing data to Healthelink followed by The Children’s Hospital at Westmead in September that year.

Currently almost 45,000 people have been enrolled and have a Healthelink electronic health record. There are seven hospitals and nine community health centres directly involved in the pilot and there are over 150 general practitioners participating. The pilot phase of Healthelink includes a potential patient population of 170,000 people in the greater western Sydney and Maitland areas.

Already there are well over 200 healthcare providers who have access to their patient’s Healthelink records. These providers work in hospital emergency departments, community health and in general practice.

.....

Progress report
Early feedback indicates that the Healthelink pilot has been a success in terms of its ability to transfer information between multiple providers and provide ready access for clinicians and consumers. The technological capability driving this project is a major achievement given the complexity of sharing information in the healthcare environment. Based on their experiences in the pilot, the overwhelming majority of healthcare providers surveyed were positive about the benefits the EHR can achieve and the potential it can have in effectively delivering healthcare.

The Healthelink EHR pilot will continue to operate until June 2009. Subject to the approval of a business case, a state-wide rollout could commence in 2009-10.

More here:

http://www.nehta.gov.au/case-studies/401-nsw-healthelink

What I don’t follow is why NEHTA is pushing this trial as a success when even the summary report issued a few weeks ago – just before Christmas of course – made it clear there was a long way to go before this system would make any real difference to care and actually get used consistently by patients and clinicians.

They really should know there is no way this is the foundation for any form of national system – if that is what we are to have – without a total re-design!

See the following URL for my comments on the Evaluation Report (Summary).

http://aushealthit.blogspot.com/2008/12/nsw-healthelink-evaluation-devil-is-in.html

Second we have:

IBM makes MRI scans 100 million times better

January 14, 2009 - 8:35AM

IBM on Tuesday said it has enhanced magnetic resonance imaging (MRI) technology 100-million-fold, paving the way to one day see what is going on at molecular levels in people's bodies.

IBM researchers working with the Center for Probing the Nanoscale at Stanford University in California have created a microscope that, with further development, could give 3D images of proteins.

"This technology stands to revolutionize the way we look at viruses, bacteria, proteins, and other biological elements," said Mark Dean, vice president of strategy and operations for IBM Research.

The microscope takes advantage of "magnetic resonance force microscopy" (MRFM) that detects miniscule amounts of magnetism.

More here:

http://news.smh.com.au/breaking-news-technology/ibm-makes-mri-scans-100-million-times-better-20090114-7gdu.html

If this is even 10% true this is amazing news. Getting 3D images of proteins could be a major step in improvement of our capacity to develop all sorts of important medicines and treatments.

More details here:

http://www.technologyreview.com/biomedicine/21950/?nlid=1650

Third we have:

Internet stimulates elderly

Xanthe Kleinig | January 13, 2009

SEARCHING the web may be more beneficial for the brain than reading a book, scientists say.

Researchers at the University of California at Los Angeles measured a two-fold increase in brain activity among the websavvy compared with internet novices in a study of the elderly.

Team leader Dr Gary Small said the results encouraged the idea that computerised technologies may have benefits for middleaged and older adults.

‘‘Our most striking finding was that internet searching appears to engage a greater extent of neural circuitry that is not activated during reading - but only in those with prior internet experience,’’ Dr Small said.

‘‘A simple, everyday task like searching the web appears to enhance brain circuitry in older adults, demonstrating that our brains are sensitive and can continue to learn as we grow older.’’

The UCLA researchers tested 24 neurologically normal research volunteers between the ages of 55 and 76. Half had experience searching the internet.

The study participants searched the web and read books while undergoing MRI scans.

More here:

http://www.australianit.news.com.au/story/0,24897,24905688-15306,00.html

This should be good news to all readers of the blog..as they are all definitely web savy!

Fourth we have:

Rift over mouth rinse and cancer

Angus Hohenboken | January 12, 2009

Article from: The Australian

DENTAL health experts have locked horns over evidence of a link between mouthwash and oral cancer, with one academic saying it is more likely to prevent the disease.

Results of a review published in the Australian Dental Journal found there was "sufficient evidence" that "alcohol-containing mouthwashes contributed to the increased risk of development of oral cancer".

Lead author of the review Michael McCullough called for mouthwashes containing alcohol to be removed from supermarket shelves and reclassified as "prescription only".

But the head of the University of Queensland's School of Dentistry, Laurence Walsh, said yesterday that mouthwash was more likely to help prevent cancer than bring it on.

"There is a whole range of reasons why some mouth rinses would actually reduce the chance of the cancer because they impair the production of molecules that do have cancer-causing effects like acetaldehyde," Professor Walsh said.

"There is literature which is now recommending that mouth rinses be used to reduce bacteria which produce acetaldehyde and there is a fairly strong consensus internationally that mouth rinses containing alcohol aren't linked to cancer."

More here:

http://www.theaustralian.news.com.au/story/0,25197,24899327-23289,00.html

I really could not resist a comment on this – as an example of what has to be a bad example of a hysterical press ‘beat up’ of a not all that important paper in a pretty minor journal.

Facts are that Listerine has been in use by millions since about 1914 according to Wikipedia. If the stuff was at all dangerous don’t you think we would have noticed by now?

For a proper review of what was known as of 2003 go here:

http://jada.ada.org/cgi/content/full/134/8/1079

The full article can be read here:

http://www3.interscience.wiley.com/cgi-bin/fulltext/121540201/PDFSTART

What the article crucially lacks is any estimate of the scale and level of impact of the use of alcoholic mouthwashes – with the key study they cite pointing to risk stating that they did not note the alcohol content of the mouthwashes they were reporting on.

It is possible there is a risk – but this sort of publication does not really help much. Clearly the journal editors were pretty unconcerned, regarding the level of risk, as they accepted the paper in March and did not publish it until December!

Put all this down to a slow news month – and maybe we do a properly designed study to sort out the issue one and for all!

Fifth we have:

Industry peers slam govt file sharing filter

Clean feed bit torrent a pain for business.

Darren Pauli 12/01/2009 15:18:00

A federal government move to stamp-out illegal file sharing via the national Internet content filtering scheme will be impossible, experts say, without blanket ban on peer-to-peer traffic.

Communications minister Stephen Conroy issued the furtive announcement last month in a government blog that ISPs may be required to block illegal file sharing in peer-to-peer networks — used by the likes of LimeWire, Kazaa and BitTorrent clients.

“Technology that filters peer-to-peer and BitTorrent traffic does exist and it is anticipated that the effectiveness of this will be tested in the live pilot trial,” Conroy wrote in the blog.

The Internet routes around damage. People will get around [the filters] - Neal Wise, penetration tester

The national clean feed Internet scheme, part of the government's $128 million Plan for Cyber Safety, will impose national content filtering for all Internet connections and will block Web pages detailed in two blacklists operated by the Australian Communications and Media Authority (ACMA).

Penetration testing firm Assurance.com.au director Neal Wise said blocking illegal content over peer-to-peer traffic is too resource-intensive and detrimental to legitimate traffic to be feasible.

“It is one thing to use a proxy server to ban a list of Web sites, but other application protocols are a whole other thing — many peer-to-peer [networks] are particularly cunning and get around firewalls and packet filters,” Wise said.

“[Both filters] can be easily defeated. The Internet routes around damage and people will get around it if it becomes mandatory... the hackers always win.

More here:

http://www.computerworld.com.au/article/272715/industry_peers_slam_govt_file_sharing_filter?eid=-6787

I wonder how long it will be before all this just gets quietly dropped? The level of technical feasibility seems pretty low – to say nothing of the performance and reliability implications on the Internet – on which we hope to base future e-Health. The coalitions that are forming to oppose this move seem to be growing weekly.

Sixth we have:

Standing to reason

January 17, 2009

We've surrendered the right to knowledge for promises of prosperity and safekeeping, writes Robert Laughlin, and even the air we breathe may end up patented as a result.

When young, we learn that knowledge is a beautiful, logical thing that anyone can use as she or he likes - provided, of course, they have the patience to read and think. This idea partly comes from parents, who never tire of inventing reasons for us to study more, excel in exams, and so forth, but it's also something we usually conclude on our own. Most of us decide in young adulthood that the ability to reason and understand is natural, human, and rightfully ours.

Unfortunately this conclusion is erroneous. While some information is indeed available free and even forced upon us in school, most economically valuable knowledge is private property and secret.

We have entered the Information Age, a time when access to understanding has become more important, in many instances, than access to physical means. The growing efforts of governments, corporations and individuals to prevent competitors from knowing certain things that they themselves know has led to a stunning expansion of intellectual property rights and the strengthening of state classification powers.

Much more here:

http://www.smh.com.au/news/national/standing-to-reason/2009/01/16/1231608986636.html

This is an article about the patenting of obvious clinical IT ideas and nature (e.g. genes etc). My view is that people, like the Pharmacy Guild and their associates, who try to patent e-health business processes and ideas are behaving immorally and should be condemned. Trying to make money from, and obstructing progress in, developing approaches to improve health services I fund simply repugnant.

Last a slightly more technical article:

Windows 7: "Vista That Works"

Although hardly revolutionary, Microsoft's next operating system repairs some of Vista's flaws.

By Erica Naone

One week after Microsoft began offering preview downloads of Windows 7 at the Consumer Electronics Show (CES) in Las Vegas, experts are generally optimistic about what they're seeing. The full release of the new operating system isn't planned until 2010. But the software giant seems to be hoping that the preview release will allay the concerns of Windows users who were unwilling to switch from Windows XP to its troubled successor, Vista.

Vista, which was released in late 2006, met with some bad reviews and sluggish adoption in the business world. Forrester Research reports that by June 2008, only about 9 percent of its clients had switched to Vista. Microsoft went on selling XP months longer than it had planned. Now, the company is promoting Windows 7 as a response to user feedback.

Windows 7 features a few changes to Microsoft's familiar user interface. Buttons for open windows no longer appear along the bottom of the screen. In their place are larger icons representing active and frequently used (or user selected) programs. When a user hovers the cursor over the icon for an active program, preview thumbnails of the open windows pop up, and the user selects the one that she wants. Certain cursor movements also trigger common changes to windows. Dragging a window to the top of the screen maximizes it, dragging a window to the side snaps it in place so that it takes up half the screen, and dragging the cursor down to the right-hand corner of the screen makes all the open windows transparent so that the user can see down to the desktop. Microsoft also says that it has made it easier for users to create home networks, and that Windows 7 makes better use of resources than Vista did. The system requirements are similar to those for Vista Home Premium, but early reports say that Windows 7 manages memory better and runs faster.

Much more here:

http://www.technologyreview.com/computing/21965/?nlid=1690&a=f

I wanted to mention this to just say I have now had an opportunity to try the beta and it seems to be pretty good for a product that is six months or so from being finalised. The 64 bit version even installed painlessly and seems to run the basics very well indeed.

More next week.

David.

International News Extras For the Week (15/01/2009).

Again there has been just a heap of stuff arrive this week.

First we have:

Report: EMR market to grow 14% through 2012, spurred by PHRs

Written by Editorial Staff

Tue, Jan 06 2009

As EMR adoption gains in U.S. healthcare, internet-based personal health records (PHRs) will influence the healthcare industry, according to a new report from healthcare market research firm Kalorama Information.

Patients can obtain information, such as laboratory results, radiology reports, medication lists and culture test results with the click of a mouse. Kalorama’s report, “U.S. Markets for EMR Technology,” examined how the focus of ownership of medical records is shifting from one that is distributed among various healthcare providers to one that is shared and controlled by both the patient and the provider.

Patients’ and physicians’ interest in viewing records online has increased, since giving patients online access to their own charts is expected to enhance the doctor-patient relationship and reduce healthcare costs, according to the report.

“The driver for EMR sales has always been hospital-side, as in ‘this can reduce your costs,’” said Bruce Carlson, publisher of Kalorama. “That’s still true, but with PHRs, the driver is also on the consumer side, as in ‘this can make your organization seem friendly and modern to healthcare consumers.’”
More here:

http://www.healthimaging.com/index.php?option=com_articles&view=article&id=15708

It is good to see something is growing in these dismal economic times!

Second we have:

HIMSS acquires Government Health IT magazine

• Jan 05, 2009

The Healthcare Information and Management Systems Society has acquired Government Health IT magazine, its Web site and annual conference from 1105 Media Inc., the organization announced Jan. 5.

The purchase expands HIMSS’ access to federal health care technology and policy planners and is a logical next step for the education and advocacy organization, said Stephen Lieber, president and chief executive officer of HIMSS.

“The federal sector is a major player in health care — not only in setting policy but also as the largest payer and one of the largest providers of health care,” Lieber said.

“By expanding our publishing and educational efforts with this suite of Government Health IT media products, HIMSS and our members will have a direct line of communication with this very important sector,” he added.

More here:

http://govhealthit.com/articles/2009/01/05/himss-acquires-government-health-it-magazine.aspx?s=GHIT_060109

This move can only improve reporting and discussion of the Health IT Sector in the US.

Third we have:

Kramer to head eHealth Ontario

By: Dave Carey - CIO Canada (05 Jan 2009)

"What we have lacked up until now is a province-wide eHealth strategy to implement," says the health care IT veteran. What's on the eHealth Ontario agenda

Longtime health care IT executive Sarah Kramer, no stranger to large and complex challenges, now faces the biggest challenge of her career as she assumes the post of president and CEO of eHealth Ontario, an agency created recently to harness information and technology to improve patient care in Ontario.

Kramer has served as vice-president and CIO with Cancer Care Ontario, and her work as lead for the initiative to reduce patient wait times in Ontario was the subject of a CIO Canada cover story in March 2007.

“There is no shortage of eHealth talent in this province. What we have lacked up until now is a province-wide eHealth strategy to implement and a single organization focused on executing that strategy,” said Kramer in a speech given at the annual Ontario Hospital Association (OHA) conference, soon after she assumed her new post.

The key priorities of eHealth Ontario include: creating a diabetes registry that will ensure people are receiving the best possible care; establishing an e-prescribing system to eliminate hand-written prescriptions and reduce medication errors; and developing an e-health portal which will allow healthcare providers and patients to easily and securely access the health information they need to deliver and receive better care.

More here:

Reads like a sensible list of initiatives to get things making a difference in Ontario.

Fourth we have:

Industry Predictions: Consumer Demands Will Help Shape Health IT in 2009

by Jane Sarasohn-Kahn

While there are uncertainties in forecasting what health IT will look like in 2009, one force is already undeniably influencing the health IT market: American consumers.

Health IT has gone mainstream and in 2009, consumers will help decide where exactly it fits in the stream. President-elect Barack Obama has said health IT will be part of a stimulus package to help revive the country's ailing economy. But even without the government's help, 2009 will be a crossroads kind of year for health IT.

In the second half of my annual iHealthBeat end-of-one-year, beginning-of-another look at health IT, we'll examine the consumer drivers shaping the industry.

Health Financing and Medical Banking

In this era of economic downturn, employers continuing to sponsor health insurance for workers are looking for ways to manage costs. This past year saw growth in health savings accounts coupled with high-deductible health plans. These are tools that help employers compel workers to put more financial skin in the game of health coverage. And the consumers who opt into these plans have, in aggregate, serious monies to manage in the funds.

In 2008, HSAs amounted to about $6 billion in the second quarter of 2008, according to Information Strategies. We'll see expansion in medical banking functions that manage this business. Besides UnitedHealth (OptumHealth Bank), WellPoint (Arcus Bank), and the BlueCross and BlueShield Association (Blue Healthcare Bank), other plans will create banks that will be FDIC-insured to manage the HSA balances.

These funds, along with other consumer-facing health monies, will add up to at least $40 billion by 2013.

Telehealth Takes Off

The growth of broadband to the home, consumers' comfort with IT and health providers' need to extend caregiver resources beyond their institutional walls will converge in 2009 for telehealth applications to move into the home. Here's an instance where recession will be the mother of innovation for patient self-care and home care.

Hospitals need to staff even more efficiently during this economic-conservation era. Institutions can add volume without adding significant cost by adopting telehealth approaches to help patients with chronic illnesses avoid entering the hospital.

FDA's approval in 2007 of Intel's health device, the Health Guide, is another market signal that technology is available to provide real-time telemetry from the home to the provider by a major trusted market player. With aligned incentives between provider, payer and patient, the home could begin to become a central node for chronic care in 2009.

Much more here:

http://www.ihealthbeat.org/Perspectives/2009/Industry-Predictions-Consumer-Demands-Will-Help-Shape-Health-IT-in-2009.aspx

Well worth a browse and some useful links.

Fifth we have:

Study: Telehealth boosts veterans' management of chronic care

By Molly Merrill, Associate Editor 01/06/09

According to a new study, veterans with chronic conditions who are provided with home health technology from the Department of Veterans Affairs are better able to manage their health and avoid hospitalization.

The study appears in the current issue of the journal (italics) Telemedicine and e-Health (end italics) and was authored by VA national telehealth staff members.

It looks at health outcomes from 17,025 VA home telehealth patients.

Patients who used home telehealth were able to reduce the average number of days hospitalized by 25 percent and reduce hospitalization by 19 percent, the study found. The data also showed that the cost of telehealth services averaged $1,600 per patient a year - much lower than in-home clinician care costs, authors say.

"The study showed that home telehealth makes healthcare more effective because it improves patients' access to care and is easy to use," said Secretary of Veterans Affairs James B. Peake. "A real plus is that this approach to care can be sustained because it's so cost-effective and more veteran-centric. Patients in rural areas are increasingly finding that telehealth improves their access to healthcare and promotes their ongoing relationship with our healthcare system."

VA's home telehealth program cares for 35,000 patients and is reportedly the largest of its kind in the world.

Adam Darkins, chief consultant in VA's care coordination program and the study's lead author, said clinicians and managers in healthcare systems, as well as information technology professionals, have been awaiting the results of the telehealth study.

More here:

http://www.healthcareitnews.com/story.cms?id=10673

Again we have evidence that e-health works – as is also shown in the item below!

Sixth we have:

Federal healthcare spending report shows e-Rx can save money

By Diana Manos, Senior Editor 01/06/09

National health spending in 2007 was at its lowest rate of overall growth since 1998, according to a new report from the Centers for Medicare & Medicaid Services.

CMS researchers said slower prescription drug spending contributed to the slowed healthcare spending.

Pharmaceutical Care Management Association President and CEO Mark Merritt said the report shows how pharmacy benefit management tools, such as electronic prescribing, can lower costs while expanding access to medications.

"Pharmacy benefit managers could provide even greater savings and access if policymakers work to accelerate physician adoption of electronic prescribing, support greater use of mail-service pharmacies in federal programs and empower the FDA to approve follow-on biologics and process applications for traditional generics in a timely manner," he said.

Still, despite the slowed overall spending, health spending growth outpaced a slowing economy and increased as a share of the gross domestic product, according to Micah Hartman, Anne Martin, Patricia McDonnell and Aaron Catlin of the CMS National Health Expenditure Accounts Team, who authored the report.

With the exception of prescription drugs, most other healthcare services grew at about the same rate as or faster than in 2006, the team said. Spending growth from private sources accelerated in 2007 as public spending slowed.

More here:

http://www.healthcareitnews.com/story.cms?id=10675

The good news just keeps coming!

Seventh we have:

Germany’s e-health smartcard scaled back

07 Jan 2009

Key clinical components of Germany’s flagship national e-health smartcard programme look set to be dropped or delayed because of problems encountered in the first seven pilot sites.

Electronic prescriptions, electronic emergency data sets, and electronic medication safety applications are all likely to be suspended. Instead, the priority will be electronic referral letters and electronic insurance claims.

National health IT organisation Gematik confirmed the planned changes after the publication of an interim report that summarises the results of the smartcard tests in the seven German test regions.

The report clearly shows the two offline applications that have been tested so far - the electronic emergency data set and the electronic prescription with the smartcard as data medium - have not worked so far.

The Gematik report identifies two key problems. The first relates to problems with PIN numbers. For the creation of the emergency data set, or emergency record, German legislation requires a PIN code to be entered by the patient. But the early studies from the test regions found that up to 70% of cases had forgotten their PIN.

The second reason for the failure was the need for digital signatures, upon which services like electronic prescriptions depend. Doctors say the signature process takes far too long. In addition, technical fixes promised by Gematik a year ago have still not been implemented.

More here:

http://www.ehealtheurope.net/news/4458/germany%E2%80%99s_e-health_smartcard_scaled_back

Only to be reminded – as this article does – that it is important to check out the little things before roll out! Need to have people remember their PIN – or adopt a different approach!

Eighth we have:

Global resource for free ehealth education

7 January 2009

Health Sciences Online has launched a website where anyone can access more than 50,000 courses, references, guidelines, and other expert-reviewed, high-quality, current, cost-free, and ad-free health sciences resources.

The up-to-date, authoritative information is aimed primarily at health care practitioners and public health providers, enabling their training, continuing education, and delivery of effective treatments to patients.

The information is delivered by powerful search technology from Vivisimo, Inc., which allows users to easily see comprehensive search results and quickly find the answers they need with an intuitively navigated graphic interface. Through integration with Google Translator, users can search and read materials in 22 languages.

Dr Jeff Koplan, Former Director of the US Centers for Disease Control and Prevention (CDC), calls Health Sciences Online (HSO) "a visionary undertaking" and the World Bank heralds it as "globally democratising health science knowledge." The World Health Organization (WHO) expects HSO "to make a considerable contribution to the advancement of elearning worldwide."

More here:

http://www.bjhcim.co.uk/news/2009/n901007.htm

Access Health Sciences Online at www.hso.info

Well worth a browse and bookmark!

Ninth we have:

HL7 OK’s Pediatric Record Standard

January 9, 2009

Health Level Seven has approved a standard for the basic functional requirements for pediatric documentation in an electronic health records system.

The Child Health Functional Profile is designed to define the general pediatric functions for electronic records used in the care of children in the United States. It addresses immunization management, growth tracking, medication dosing, data norms and privacy.

.....

More information is available at hl7.org

Full article here:

http://www.healthdatamanagement.com/news/Pediatric27528-1.html?ET=healthdatamanagement:e731:100325a:&st=email&channel=electronic_health_records

Last for this week we have:

NHS anti-obesity drive goes online

05 Jan 2009

The government has kicked off 2009 with the launch of a three-year anti-obesity initiative with a high profile multi-channel advertising campaign that will span TV, print, billboards and the Internet.

Launched on Friday the campaign, called ‘Change4Life’, begins with £8m worth of television advertisements and a range of initiatives to get people to eat better and exercise more.

Dawn Primarolo, the public health minister, said the aim was “a lifestyle revolution” on a scale not attempted before, to tackle projections that 90 per cent of today’s children would grow up to become overweight adults.

NHS Choices, the official NHS web portal is championing the most ambitious social marketing campaign. The site is leading the health service’s online effort with dedicated resources, tools and a call to action for individuals to change their lifestyles: “Don't just make a New Year resolution, make a Change4Life for you and your family”.

More here:

http://www.ehealtheurope.net/news/4449/nhs_anti-obesity_drive_goes_online

The website is here:

http://www.nhs.uk/change4life/Pages/default.aspx

Good luck to them – I hope it can help!

David.

For those who can access the Wall St Journal the following site is valuable:

What's New (Or Improved) In Health Sites

· By LAURA LANDRO

A new crop of online tools is making it easier to be healthier in 2009.

The Internet has long drawn people seeking information about health care. Last year, health Web sites drew about 72 million unique visitors, up 14% from a year earlier, according to comScore Inc., an online-marketing research firm that tracks some 200 such sites. Such strong growth comes as sites increasingly focus on some of today's leading consumer health concerns, including prescription-drug safety, quality of care, and the ability to network with other patients facing similar health problems.

Health-care information providers have seen big changes over the past year or so. Two of the most popular sites, Revolution Health and EveryDayHealth, merged to surpass longtime leader WebMD Health Corp. as the largest health site as measured by unique visitors. Google Inc. and Microsoft Corp. launched competing ventures that allow patients to store their medical records online. And HealthCentral Network sold a minority investment to Barry Diller's IAC/Interactive Corp. and the two companies set up a partnership to sell advertising to pharmaceutical companies.

Much more here (subscription required):

http://online.wsj.com/article/SB123128697040459161.html?mod=djemHL

D.