Quote Of The Year

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

or

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

Thursday, December 03, 2009

Weekly Overseas Health IT Links 01-12-2009

Here are a few I have come across this week.

http://www.thestar.com/comment/article/730885

Forging ahead with electronic health records

November 26, 2009

Tom Closson

The digital exchange of health information (often called electronic health records or EHRs) is essential to transforming Canada's health-care system. Unfortunately, it appears that governments may be quietly re-examining their commitment to creating EHRs as they look for ways to reduce public spending in the wake of large, recession-fuelled deficits. Our advice is that we must continue to move forward.

Jurisdictions that have created EHRs know that the benefits are not hypothetical. Better information exchange between providers is reducing medication errors, improving patient referrals and follow-ups, and empowering patients to be more involved in their own care. These are areas where Ontario woefully underperforms today. With the help of EHRs, we can improve Ontario's health system performance.

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http://www.e-health-insider.com/news/5415/procurements_for_south_complete_by_april

Procurements for South complete by April

25 Nov 2009

The Department of Health’s chief information officer, Christine Connelly, has said she wants the formal procurement process for systems in the South to begin in January and to be complete by the beginning of April 2010.

According to multiple sources, Connelly announced the timescales in a speech at the Additional Supply Capability and Capacity (ASCC) market awareness event held by the DH in Westminster yesterday.

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http://www.e-health-insider.com/news/5422/bury_formally_accepts_lorenzo_r1.9

Bury formally accepts Lorenzo R1.9

27 Nov 2009

NHS Bury has accepted iSoft’s electronic patient record system, three weeks after becoming the first NHS organisation to go-live with Lorenzo Regional Care Release 1.9.

Last week, E-Health Insider revealed that NHS Bury had set its own ‘local criteria’ to determine whether the implementation had been a success.

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http://www.enisa.europa.eu/media/press-releases/position-paper-security-risks-online-banking-and-eid-cards

Position Paper: security risks, online banking and eID cards

ENISA launches new Position Paper on security risks in online banking through European eID cards

The EU’s ‘cyber security’ Agency, ENISA (the European Network and Information Security Agency) today presents its new Position Paper. The paper is focusing on authentication risks with European eID Cards. It analyses 7 vulnerabilities, identifies 15 threats and gives security recommendations.

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http://www.financialexpress.com/news/Nilekani-likely-to-create-database-for-e-health-card/546710/

Nilekani likely to create database for e-health card

fe Bureaus

Posted: Friday, Nov 27, 2009 at 0000 hrs IST

Updated: Friday, Nov 27, 2009 at 0000 hrs IST

New Delhi: The health ministry has sought the Unique Identification Number Authority of India project head Nandan Nilekani’s assistance in creating a database of children from humble background who could be allotted electronic health cards. The cards would be handed over to parents and guardians of the children who would form part of the database. This would enable them access to free medical treatment in all the state-owned hospitals including primary healthcare centres. The decision was formalised on Wednesday at a meeting between Nilekani and minister of state for health and family welfare Dinesh Trivedi.

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http://www.ehealthnews.eu/content/view/1829/26/

Microsoft and Stakeholders Look at eHealth, Standards and Interoperability

Wednesday, 25 November 2009

Interoperability and eHealth might at first glance appear as very different concepts - but the actual relationship between the two is extremely important. Microsoft recently hosted a session on interoperability and standards in eHealth as part of its overall interoperability series.

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http://www.ehiprimarycare.com/news/5418/qmh_goes_it_alone_with_isoft

QMH goes it alone with iSoft

26 Nov 2009

ISoft has signed a £1m deal with NHS Wandsworth to provide the latest version of its CliniCom Patient Administration System to Queen Mary’s Hospital, Roehampton.

The contract will see Queen Mary’s Hospital split from its joint iSoft PAS, which is currently hosted by Kingston Hospitals NHS Trust, after Kingston goes-live with Cerner Millennium as part of its commitment to the National Programme for IT in the NHS.

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http://www.baltimoresun.com/health/sns-dc-fda-rxmining,0,5167082.story

States, Consumer Advocates Challenge Rx Data Mining

Andrew Zajac

Washington

November 24, 2009

Washington Bureau

When your doctors writes you a prescription, that's just between you, your doctor, and maybe your health insurance company--right?

Wrong. As things stand now, the pharmaceutical companies that make those prescription drugs are also looking over the doctor's shoulder, keeping track of how many prescriptions for whose drugs the individual physician is writing.

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http://www.nytimes.com/2009/11/24/health/24vioxx.html?_r=2&scp=1&sq=public%20database%20is%20urged%20to%20monitor%20durg%20safety&st=cse

November 24, 2009

Public Database Is Urged to Monitor Drug Safety

By NATASHA SINGER

What could be done to prevent another Vioxx? This pain medication for arthritis became a blockbuster after its introduction in 1999, only to be taken off the market in 2004 when a study linked the drug to an increased risk of heart attack and strokes.

A new study published Monday in Archives of Internal Medicine offers an ambitious proposal to determine a drug’s risks sooner than they might otherwise become evident. The authors propose a system to examine widely prescribed drugs through safety analyses that would pool data as they emerge from various clinical trials of a medication and aggregate the information for a fuller picture of a drug’s harms and benefits.

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http://www.signonsandiego.com/news/2009/nov/25/va-kaiser-plan-link-electronic-medical-records/

VA, Kaiser plan to link electronic medical records

Wednesday, November 25, 2009 at 1:11 a.m.

— A pilot program linking two of the largest electronic medical record systems in the country will be launched in San Diego County in mid-December by Kaiser Permanente and the federal Department of Veterans Affairs.

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http://www.theglobeandmail.com/report-on-business/digitizing-the-health-of-a-nation/article1375193/

November 24, 2009

Digitizing the health of a nation

By MARLENE HABIB

Special to The Globe and Mail

Electronic health records will improve the quality and accessibility of health care while reducing wait times and saving taxpayers money

Getting Canada on track to make electronic health and medical records more efficient has had its ups and downs, but to date, there are nearly 300 projects under way, which have already helped save money, speed up some processes and improve care.

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http://www.ehiprimarycare.com/news/5411/discharge_summary_target_%27to_be_missed%27

Discharge summary target 'to be missed'

24 Nov 2009

The vast majority of NHS hospitals look set to miss the government’s target for delivering discharge summaries to GP practices within 24 hours from next April.

Dr Mike Dixon, chair of the NHS Alliance, predicts that less than 50% of hospitals will hit the target. Other industry observers have suggested that as few as 20% could be delivering discharge summaries within 24 hours by 1 April 2010, despite a contractual obligation to do so.

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http://www.govhealthit.com/newsitem.aspx?nid=72450

Health IT panel to heed calls for simpler EHR standards

By Mary Mosquera
Thursday, November 19, 2009

A panel advising the Office of the National Coordinator of Health IT (ONC) said it will heed the overwhelming consensus it has received in recent public comments to develop the simplest possible certification standards for accelerating health IT adoption.

The Health IT Standards Committee’s implementation workgroup reported today that it distilled the testimony of industry organizations within and outside healthcare, as well as contributors to its public blog. The participants provided details of their experiences with adopting standards.

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http://www.who.int/goe/ehir/2009/24_november_2009/en/index.html

24 November 2009

eHealth Worldwide

:: UK - Mobile mHealth Center Launched (Healthcare IT News - 11 November 2009)

An m-Health Innovation Centre is being established in Manchester, England, to act as a focus point for mobile health in the United Kingdom. The University of Manchester is partnering on the initiative with the GSM Association, an group of mobile operators and related companies, to foster innovative mobile applications and services that promote healthier lifestyles and early intervention.

Many articles follow.

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http://www.ihealthbeat.org/features/2009/once-ahead-of-curve-medical-informatics-now-at-center-of-change.aspx

Tuesday, November 24, 2009

Once Ahead of Curve, Medical Informatics at Center of Change

For a couple of decades now, the American Medical Informatics Association has been ahead of the cultural curve in recognizing the potential for IT to change the way health care is delivered.

Culture -- led by lawmakers, policy wonks and even the general public -- is catching up, and informatics experts are glad to have company.

"This is our time," Ted Shortliffe, president and CEO of AMIA, said during the organization's annual symposium on biomedical and health informatics last week in San Francisco. He added, "We've been working on these things for years and years and not making a lot of headway some of the time. But now things have changed. We are in the midst of an historic shift, and this organization is right in the middle of it."

MORE ON THE WEB

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http://www.healthdatamanagement.com/news/RHIO-39400-1.html?ET=healthdatamanagement:e1094:100325a:&st=email

RHIO: 100,000 Give Consent

HDM Breaking News, November 23, 2009

The Rochester RHIO in New York has announced that more than 100,000 patients have consented to their physicians viewing their health information via the RHIO.

Rochester RHIO started a pilot in 2007 with five practices and 27 physicians. Today, it serves more than 1,500 authorized providers including 500 physicians. Data exchanged via the RHIO includes lab reports, radiology images and reports, medication histories, and hospital discharge summaries. By January, the service will include emergency medical treatment data and information on health and human services for senior citizens.

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http://www.healthdatamanagement.com/news/ONC_stimulus_blog_meaningful_use-39405-1.html?ET=healthdatamanagement:e1094:100325a:&st=email

ONC Gets a Blog

HDM Breaking News, November 24, 2009

The Office of the National Coordinator for Health Information Technology has launched a blog to provide an industry wide forum on health I.T. issues.

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http://www.huffingtonpost.com/2009/11/24/switch-to-electronic-reco_n_368994.html

Switch To Electronic Records Getting Mixed Reviews At Hospitals, Clinics

Huffington Post Investigative Fund and American University's Investigative Reporting Workshop | Fred Schulte

More than five years ago, one of California's leading hospitals decided to leap into the future of medical care by digitizing its patients' health records. Despite a $50 million investment and countless hours trying to overcome persistent technical headaches, the system is still not fully up and running.

This summer, the University of California San Francisco Medical Center quietly wrote off more than a third of the money it has spent, terminated its contractor and prepared to start part of the project from scratch.

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http://www.eurekalert.org/pub_releases/2009-11/plos-eeh112009.php

Evaluating eHealth: How to make evaluation more methodologically robust

eHealth—the organisation and delivery of health services and information using information technology (IT) systems—is playing an increasingly important role in shaping health care systems. This week PLoS Medicine publishes the third in a series of articles evaluating eHealth. Richard Lilford and colleagues consider the evaluation of health IT systems as they are employed following pre-implementation testing.

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http://www.kaiserhealthnews.org/Daily-Reports/2009/November/23/Digital-Divide.aspx

Digital Divide Appears Between Hospitals That Treat The Rich And Poor

"Hospitals that disproportionately care for poor patients are less likely than other hospitals to have adopted health information technology," according to an October study published in Health Affairs, American Medical News reports. The economic stimulus legislation in February directed $19 billion in federal investments to help all types of hospitals adopt electronic records, but some researchers are concerned the money may not close that divide.

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http://www.informationweek.com/news/healthcare/mobile-wireless/showArticle.jhtml?articleID=221900388

Medicine Bottles Get Net Connection

A new pill bottle cap with a wireless Internet connection flashes when it's time to take a pill and even calls forgetful patients with reminders.

By Mitch Wagner

InformationWeek

n Internet-connected pill bottle cap sounds a bit over the top, but its creator says the device can generate real health improvements, cost savings, and even revenue for insurance and pharmaceutical companies.

Called GlowCap, the bottle cap reminds patients to take their pills and keeps track of whether they're taking them when they should. The caps are built into lids that fit on prescription bottles. They contain chips that communicate wirelessly with a home server that's about the size of a nightlight and plugs into an electrical socket. The server contains a cell modem that connects to theAT&T (NYSE: T) network and to a service that runs in the cloud and connects to Google (NSDQ: GOOG) Health, Microsoft (NSDQ: MSFT) HealthVault, and standard electronic healthcare systems.

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http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=210820

Strengthening Hospital/Physician Communication

Web portals can strengthen communication between a hospital, its staff and the community it serves.

By Asim Masood, MD

The relationship between a hospital, its physicians, staff and the communities it serves can be strengthened through greater communication and education, which Web portals are uniquely positioned to provide. For example, physicians, always short on time and often facing complex -- sometimes life-or-death -- decisions, can benefit greatly from a portal that unifies clinical data from myriad disparate systems into a single, intuitive view.

The ability to securely access all of a patient's medical information, regardless of the physician's current location, the time of day, or the number of venues in which the patient receives care, is invaluable to patient safety and outcomes. This is the power of Web portals -- providing a singular view of all information and a means to communicate that is easily accessible when, where and how the target audience needs and wants it.

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http://www.modernhealthcare.com/article/20091123/MODERNPHYSICIAN/311239964

Indiana exchange debuts data-monitoring service

By Joseph Conn

Posted: November 23, 2009 - 8:00 am EDT

The Indiana Health Information Exchange is debuting its year-old quality improvement and patient data-monitoring service for the first time outside of the greater Indianapolis area, the exchange announced.

The Indianapolis-based regional health information organization calls the service Quality Health First.

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http://www.healthdatamanagement.com/news/meaningful_use-39399-1.html?ET=healthdatamanagement:e1092:100325a:&st=email

MGMA to Feds: Pilot Meaningful Use

HDM Breaking News, November 23, 2009

The federal government should conduct a small pilot project with a number of vendors and a variety of physician practices before incentive programs for meaningful use of electronic health records start, the Medical Group Management Association recommends.

The pilot would ensure that the process of demonstrating meaningful use is achievable and practical, the Englewood, Colo.-based association said in a recent letter to David Blumenthal, M.D., national coordinator for health information technology. "This pilot could assist in determining potential roadblocks to program success and identify solutions to those roadblocks."

.....

Text of MGMA's letter to Blumenthal is available at mgma.com/WorkArea/DownloadAsset.aspx?id=31758.

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http://www.modernhealthcare.com/article/20091123/FREE/311239947

MGMA warns that IT stimulus money could be wasted

By Joseph Conn / HITS staff writer

Posted: November 23, 2009 - 10:45 am EDT

The Medical Group Management Association, in a sharply worded, five-page letter to David Blumenthal, head of HHS' Office of the National Coordinator for Health Information Technology, warns of potential dire consequences if the government overreaches in setting up the health IT subsidy program created under the American Recovery and Reinvestment Act of 2009.

The letter, dated Nov. 22 and released publicly today, was signed by MGMA President and CEO William Jessee.

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http://www.nextgov.com/nextgov/ng_20091120_8634.php?oref=rss?zone=NGtoday

Electronic health records could be a deadly target during a cyberwar

By Bob Brewin

Most health officials worry about hackers stealing sensitive information such as an AIDS diagnosis from someone's electronic medical record, but a technology manager for a health care system in the Pacific Northwest said it's just as likely the digital files could be a target of terrorists or a nation state during war.

Countries have invested millions of dollars in computer systems to conduct a cyberwar against the United States "and the best way to do that is to destabilize the population," said Chad Skidmore, director of network services for Inland Northwest Health Services, a network of 34 hospitals in Spokane, Wash. To do that, hackers could infiltrate health systems to change patient records so misinformation will lead to deadly consequences.

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http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/11NOV2009/0911HHN_Coverstory&domain=HHNMAG

Comparative Effectiveness (Why Does It Matter to You?)
By Geri Aston

The federal government has earmarked $1.1 billion to create a process for comparing medications, devices and treatments. The goal: research focusing on "real people" in the "real world."

The $1.1 billion in new federal funding for comparative effectiveness research presents a host of opportunities but also some challenges for hospitals.

Both the Institute of Medicine and the Federal Coordinating Council for Comparative Effectiveness Research in June issued reports on their priorities as required by the American Recovery and Reinvestment Act of 2009, which authorized the new funding. The documents make it clear that the organizations see a major role for hospitals in conducting the research and ensuring that the findings make their way into clinical practice.

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http://www.govhealthit.com/newsitem.aspx?nid=72468

CMS pushes for uptake of transaction standards

By Brian Robinson
Monday, November 23, 2009

The Center for Medicare & Medicaid Services is pushing ahead on both its internal and external priorities to ensure it meets fast-approaching deadlines for putting new electronic transaction and billing standards in place, its e-health leader said last week.

The agency’s systems staff is on schedule to make the necessary changes in order to start testing for compliance of the new 5010 version of the X12 standards for HIPAA transactions in January 2011, according to Tony Trenkle, director of the Office of e-Health Standards and Services at CMS.

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http://www.businessweek.com/investor/content/nov2009/pi20091120_238900.htm

Stocks: Three Overstuffed Turkeys

Amazon.com, Cerner, and Intuitive Surgical may be profitable and innovative, but their stock valuations are likely too rich for most investors' tastes

Sometimes a stock looks so enticing that investors just can't help themselves.

The market appetite is such that the stock rockets higher, leaving behind most reasonable measures of the company's worth. To commemorate this week's Thanksgiving feasts, BusinessWeek went hunting for stocks that have arguably inspired feeding frenzies over the past year.

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http://www.newvision.co.ug/D/8/459/701979

E-health technology can improve medical services

Sunday, 22nd November, 2009

By Ivan Kahangire

The Ministry of Information Communication Technology recently embarked on Phase Two of the $106m (sh212b) on the nation backbone infrastructure IT project. Government’s noble intention is to extend 2,130km of fibre optic cable to the countryside, so as to provide high speed bandwidth for faster communication, data and information flow.

While this is being done, it is hoped that other ministries are planning and laying strategies to put this fiber optic cable to the best use to improve service delivery to the common man. Only then will this truly translate into “bridging the digital divide”.

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Enjoy!

David.

Wednesday, December 02, 2009

What Did NEHTA Promise the Senate To Deliver by December 2009? – The Official List.

Now it is December it seems like a good time to assess how NEHTA is going against its June 2009 promises in the ‘Year of Delivery’. Here is what was expected:

Senate Community Affairs Committee

ANSWERS TO ESTIMATES QUESTIONS ON NOTICE

HEALTH AND AGEING PORTFOLIO

Budget Estimates 2009-2010, 4 June 2009

Topic: e-HEALTH – NEHTA WORK DUE BY END OF 2009

Hansard Page: CA 70

Senator Boyce asked:

Provide an indication of what work NEHTA is due to complete and to implement this (calendar) year.

Answer:

The work that National E-health Transition Authority (NEHTA) is expected to complete and implement for the remainder of this calendar year includes:

NEHTA outcomes expected to be completed and implemented between 4 June 2009 and 31 December 2009

Month: June

Initiative

Clinical terminology

Explanation: (Standardising key Clinical information)

Outcome

Australian Medicines Terminology (AMT) will contain 99% of Therapeutic Goods Administration (TGA) registrable products including all medicines, dressings, nutritional supplements and diagnostic agents listed under the Pharmaceutical Benefits Scheme.

Month: July

Initiative

Discharge summaries

Explanation: (Electronic exchange of patient reports between hospitals and the primary care sector)

Outcome

A nationally endorsed electronic discharge summary will be released.

Month: July

Initiative

Conformance, compliance and accreditation

Explanation: (Ensuring that software complies with Australian Standards and NEHTA specifications)

Outcome

A document describing how a national certification authority for eHealth related software will function will be completed during July.

Month: November

Initiative

Clinical terminology

Explanation: (Standardising key Clinical information)

Outcome

First consolidated version of SNOMED CT for Australia will be completed during November. It will incorporate an Australian Language Reference Set, allowing development of Australian preferred terms.

Month: December

Initiative

Secure messaging

Explanation: (World standard secure transfer of health information)

Outcome

A lead implementation project with the Northern Territory Department of Health and Families will use NEHTA secure messaging specifications to develop a Web Services Messaging Application platform for the transfer of clinical information from participating healthcare providers. This will use selected medical software to eHealthNT’s existing Shared Electronic Health Record (SEHR) repository.

Month: December

Initiative

Unique healthcare identification (UHI)

Explanation: (Unique identification of any healthcare provider, organisation or consumer)

Outcome

The individual healthcare identifier (IHI) and healthcare provider identifiers for individuals and organisations will be designed, developed and delivered as per the contract arrangement with Medicare Australia. (noting that legislation is expected in mid 2010 to allow IHIs to be issued)

Month: December

Initiative

Supply chain

Explanation: (Unique identification of healthcare products such as medicines and medical devices through a national product catalogue)

Outcome

Fifty leading health product vendors will have their products on NEHTA’s National Product Catalogue.

Month: December

Initiative

Referrals

Explanation: (Exchange of relevant patient healthcare information between healthcare providers)

Outcome

First release of a nationally endorsed electronic GP referral.

Month: December

Initiative

Electronic transfer of prescriptions

Explanation: (Electronic Medication Management)

Outcome

Release of specifications to support the trial exchange of electronic prescriptions between GPs and community pharmacies.

Month: December

Initiative

E-health engagement and communications

Explanation: (Stakeholder Engagement)

Outcome

Launch of the first national e-health web portal.

Month: December

Clinical terminology

Explanation: (Standardising key Clinical information)

Outcome

Release of a live technical demonstration to show the healthcare community the benefits of SNOMED CT and Australian Medicines Terminology (AMT).

---- End Answer.

Unless I have missed a lot of announcements it seems that December will indeed be very busy.

I leave it as an exercise for the reader to assess just how much of this has actually happened. For one the compliance and conformance documentation due in July, seems to be missing in action – but of course I could have missed it. I am sure someone will let me know if that is the case.

I wonder what the national e-Health web portal will do?

David.

Tuesday, December 01, 2009

Don't Forget to Vote in Survey

Only 2-3 days to go - so register your opinion on NEHTA.

New Questionnaire starts in a few days.

David.

A Draft Letter to Send / E-mail to Your Local Federal MP.

I am increasing convinced we need to apply some pressure to the polity to reign in and externally review NEHTA and its profligate and increasingly failed activities.

I am hearing informally that there is increasing internal concern that the flagship Identifier Projects are becoming less and less likely to be successfully delivered, if for no other reason that planning for how what NEHTA is developing will actually interface with the existing health system remains both vague and incompletely worked through. The deadlines for delivery of anything useful, if at all, appear to be increasingly extended.

Below is a possible form of words to assist in formulating an e-mail or letter.

Contact details for all MPs and Senators can be found here:

http://www.aph.gov.au/whoswho/index.htm

-----

Dear (Local Member’s Name)

Re: An Impending Very Expensive and Wasteful Failure of a Government Funded Entity.

The National E-Health Transition Authority (NEHTA) was established just on five years ago (as a company limited by guarantee with each State and Federal Jurisdiction as Shareholders) to improve the operation of the National Healthcare System through the use of information technology.

Despite the expenditure of now of over $125M dollars very little has been achieved to improve the health services received by the Australian Community.

Evidence is increasingly accumulating of deep organisational malaise within NEHTA which is being manifested by high staff turnover levels and a worsening culture of organisational threat and disempowerment as it becomes increasingly clear most of the organisations objectives are unlikely to be met without a dramatic relocation of the goalposts.

Health informatics experts with which I am in touch are increasingly sceptical of NEHTA’s capacity to deliver and it is important as little good money as possible is thrown after that already spent

As would be expected vested interests in the Commonwealth Department of Health, who have publicly supported NEHTA at forums such as Senate Estimates Hearings, have a strong desire to prevent any review that may suggest they have been less that fully frank about the current chances of the overall success of NEHTA’s objectives. This makes the need for such a review even more urgent.

What I am suggesting is that you ask the Federal Health Minister to ask the Auditor General to undertake a financial, performance and value for money review of NEHTA so that I and the public at large can be assured our hard earned tax dollars are not being wasted.

Whether you are from either Government or Opposition you clearly have an interest in having a very small percentage of the funds expended so far to ensure the money has been well and usefully spent.

Yours sincerely.

Joe Citizen.

-----

Maybe now the e-mail regarding climate change have settled we can have some impact in getting NEHTA back on some useful rails.

I really hope so.

David.

Struth A Real E-Health Failure Now Leads the Liberals!

It seems that Tony Abbott, former federal Health Minister is now Leader of the Opposition.

He apparently said he wanted to clean the slate and apologise for past wrongs. Well his e-Health performance is certainly one of those!

See here:

http://aushealthit.blogspot.com/2006/11/questions-for-minister-abbott-to-ask.html

And here:

http://aushealthit.blogspot.com/2007/08/minister-abbotts-e-health-report-card.html

and here:

http://aushealthit.blogspot.com/2007/03/open-letter-to-minister-tony-abbott.html

and here:

http://aushealthit.blogspot.com/2007/06/minister-abbot-responds-to-open-letter.html

Miss Gillard – from Opposition sure had his measure:

http://aushealthit.blogspot.com/2006/12/oh-joy-australian-politician-who.html

More history available by using the new improved search down the side menu for “abbott”.

Remember this is the man who gave us NEHTA -and did not set the processes running to fix it late in 2007 just before the election having had the Boston Consulting Review in October, 2007.

Oh dear, oh dear!

David.

Monday, November 30, 2009

Weekly Australian Health IT Links - 30-11-2009

Here are a few I have come across this week.

http://www.australiandoctor.com.au/articles/16/0c065e16.asp

Patient records Bill stymied

27-Nov-2009

CONTROVERSIAL legislation giving Medicare the ability to seize patient records has been stopped in its tracks by the ongoing debacle over cataract rebates.

Yesterday, the Federal Government was forced to halt debate on the Health Insurance Amendment (Compliance) Bill 2009 until next year, because both sides of Parliament could not agree on amendments.

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http://www.smh.com.au/national/health-department-accused-of-censorship-20091127-jwwm.html

Health department accused of censorship

NATASHA WALLACE HEALTH

November 28, 2009

THE University of Sydney removed from its website an extremely critical essay about a new multimillion-dollar emergency department IT system after pressure from the NSW Health Department. .

Doctors, nurses and administrators at four area health services heavily criticised the system - which tracks patients - as posing an ''unacceptably high risk'' to patient safety because it was so slow, cumbersome and inefficient.

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http://www.zdnet.com.au/news/software/soa/Academic-claims-NSW-Health-censorship/0,130061733,339299731,00.htm

Academic claims NSW Health censorship

By Suzanne Tindal, ZDNet.com.au
27 November 2009 02:26 PM

A professor at the University of Sydney who wrote a scathing essay about NSW Health's implementation of a Cerner system within emergency departments has accused the government of pressuring his institution to take the essay down, which it did, if only temporarily.

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http://www.computerworld.com.au/article/327889/adobe_outlines_nbn_vision?eid=-6787

Adobe outlines NBN vision

e-Health providers may resell superfast broadband connectivity with their health services

Tim Lohman 27 November, 2009 11:59

Adobe has released its vision for the services it believes will be delivered over the NBN in a new whitepaper, The National Broadband Network: Unleashing Australia’s Digital Potential.

The paper seeks to provides a simple, practical overview of how superfast broadband access will address areas such communication, education, entertainment, high definition video and photography, social networking and business efficiency.

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http://www.abnnewswire.net/press/en/61827/iSOFT_Group_Limited_%28ASX:ISF%29_Boosts_Patient_Safety_Solution_Offering_Through_Acquisition_Of_PSI.html

iSOFT Group Limited (ASX:ISF) Boosts Patient Safety Solution Offering Through Acquisition Of PSI

Sydney, Nov 26, 2009 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) Australia's largest listed health information technology company today announced it acquired Patient Safety International Pty Ltd. (PSI) in a deal worth up to A$5 million as part of the company's strategy of boosting its portfolio of innovative solutions through bolt-on acquisitions.

The acquisition provides iSOFT with state-of-the-art patient safety software that enables healthcare organizations to record, monitor and take relevant management action to minimize future adverse medical events. South Australia based PSI's AIMS solution uses an ontology that comprises a comprehensive set of some 25,000 terms developed by the Australian Patient Safety Foundation.

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http://www.computerworld.com.au/article/327812/victorian_auditor-general_slams_public_sector_privacy?eid=-6787

Victorian Auditor-General slams public sector privacy

Information security policy, standards and guidance for the sector are incomplete and too "narrowly focused" on ICT security

Tim Lohman 26 November, 2009 13:26

The confidentiality of personal information collected and used by the public sector can be, and has been, easily compromised, a Victorian Auditor-General report has found.

The Maintaining the Integrity and Confidentiality of Personal Information report, which examined information security in three Victorian government departments, found that the ability to penetrate databases, the consistency of its findings and the lack of effective oversight and coordination of information security practices strongly indicate that this phenomenon is widespread.

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http://www.theaustralian.com.au/australian-it/ag-slams-vic-data-security/story-e6frgakx-1225804098869

AG slams Vic data security

  • Melissa Jenkins
  • From: AAP
  • November 25, 2009 8:00PM

THE Victorian government is failing to put safeguards in place to prevent public servants snooping on our personal details.

Auditor-General Des Pearson is scathing in a report over the lack of effective and co-ordinated measures to protect personal information used by the public service.

He has particularly directed criticism at Premier John Brumby's own department and Treasury, but says his findings suggest lax information security throughout the entire public service.

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http://www.pharmacynews.com.au/article/study-to-look-at-near-miss-dispensing-errors/506610.aspx

Study to look at 'near miss' dispensing errors

25 November 2009

The Pharmacy Guild has urged pharmacy staff to take part in a study that will aim to discover the reasons behind 'near miss' dispensing errors.

Researchers from Monash University, University of Sydney and University of South Australia have teamed up to identify the nature of and reasons behind 'near misses' – dispensing errors that are detected before they reach the patient.

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http://www.theaustralian.com.au/australian-it/exec-tech/health-in-second-place-as-wii-fit-goes-for-games/story-e6frgazf-1225796008503?referrer=email&source=AIT_email_nl

Health in second place as Wii Fit goes for games

  • Mahesh Sharma
  • From: Australian IT
  • November 10, 2009 10:10AM

NINTENDO'S exercise game controller has caught its second wind with Wii Fit Plus's launch.

The Wii Fit balance board, released last year, was designed to get gamers off the couch and on to their feet.

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http://www.6minutes.com.au/articles/z1/view.asp?id=506474

Medicare's new powers curbed

by Jared Reed

New privacy safeguards have been agreed to in the Senate in the contentious draft legislation which gives Medicare the right to seize patient documents when questioning payments.

The amendments mean that Medicare will not be able to “develop a reasonable concern” as to the clinical relevance of a service under investigation.

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http://www.theaustralian.com.au/australian-it/improved-medical-message-system-improves-patient-safety/story-e6frgakx-1225802579737

Improved medical message system improves patient safety

QUEENSLAND'S Mater Health Services is running electronic medical records for 1.4 million patients across its seven hospitals, off the back of InterSystems' Ensemble integration engine that links more than 95 separate clinical systems.

Mater chief information officer Malcolm Thatcher says the e-patient record (EPR) system now holds more than 10 million pathology results and 12.5 million events, as well as demographic information.

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http://news.smh.com.au/breaking-news-national/bca-calls-for-national-ehealth-strategy-20091123-iudk.html

BCA calls for national e-health strategy

November 23, 2009 - 2:29PM

AAP

A national e-health strategy would bring benefits of nearly $28 billion in its first eight years, a leading business lobby group says.

In a letter sent to Prime Minister Kevin Rudd last month and released on Monday, the Business Council of Australia (BCA) says using communication technology to improve the flow of health information is key to a more efficient health system.

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http://www.computerworld.com.au/article/327322/open_source_no_panacea_e-health

Open source no panacea for e-health

Leading CIO says open source should not be seen as a panacea for addressing the interoperability challenges in healthcare

Kathryn Edwards 23 November, 2009 16:56

Open source software could provide a model for better e-health collaboration, but should not be seen as a panacea for addressing the interoperability challenges in healthcare, according to a leading healthcare industry CIO.

Malcolm Thatcher, CIO of Queensland-based Mater Hospital, said there are two issues to consider around the need for interoperability amongst Australian healthcare providers.

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http://www.thesheet.com/nl06_news_selected.php?act=2&selkey=9185&stream=1

Easyclaim too hard for doctors

20 November 2009 6:45am

There were 76 million patient-claimed Medicare rebates in the year ending June 30, representing the total potential market for the reverse Eftpos Easyclaim system.

However, most of these rebates are still being paid in cash at Medicare offices while a slowly growing number are being paid online.

As at October 2009, Medicare says 2763 practices had signed up to EasyClaim, while 4795 had signed up to Medicare Online.

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http://www.abnnewswire.net/press/en/61794/iSOFT_Business_Solutions_%28ASX:ISF%29_Wins_New_Deals_Worth_A10_Million.html

iSOFT Business Solutions (ASX:ISF) Wins New Deals Worth A$10 Million

Sydney, Nov 23, 2009 (ABN Newswire) - iSOFT Business Solutions (ASX:ISF) Australia's largest listed health information technology company today announced that iSOFT Business Solutions won new business totalling about A$10 million in October. The new deals include two contracts worth GBP2 million each (A$7.2 million).

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http://www.smh.com.au/national/nsw-health-to-review-privacy-policy-for-insurers-lawyers-20091124-jhep.html

NSW Health to review privacy policy for insurers' lawyers

JOEL GIBSON LEGAL AFFAIRS

November 25, 2009

THE NSW Health department is likely to review its privacy policies after a number of complaints about solicitors for insurers seeking irrelevant medical records from claimants, a source familiar with the department's privacy policy said.

A review of the department's privacy manual will address the issue amid fears that the forms can lead to the incorrect provision of information by doctors, the source said.

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http://www.smh.com.au/national/crash-victim-says-insurer-adds-insult-to-injury-20091122-isvi.html

Crash victim says insurer adds insult to injury

JOEL GIBSON LEGAL AFFAIRS

November 23, 2009

A RANDWICK woman knocked off her bicycle and thrown across a roundabout by a car has spent five years fighting a big insurance company that wants access to all her medical records, including ''irrelevant'' ones, before it will assess her claim.

The woman, who has asked to remain anonymous, says the catch-all request could capture highly personal information such as psychologists' notes about a previous sexual assault.

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http://www.abc.net.au/news/stories/2009/11/23/2750118.htm

Swift treatment for heart attack victims

ACT paramedics treating heart attack victims will be able to send vital patient information to doctors at the Canberra hospital whilst enroute. (ABC News)

The vital signs of heart attack patients can now be sent electronically to the Canberra Hospital before the ambulance even arrives.

A picture of the electrocardiogram [E.C.G.] can be emailed to specialists at the Hospital via a blackberry while the patient is enroute.

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http://www.smh.com.au/technology/biz-tech/tech-tools-of-the-trade-20091117-ijls.html

Tech tools of the trade

November 17, 2009

It pays to know how your business can benefit from the latest technical advances, writes Julia Talevski.

Still using old software and back-up tapes in your company? As new technologies become available in the market, it can be hard to determine what they do and how they can benefit your business. Here is a list of technologies to help you grasp the latest on the market.

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http://www.theaustralian.com.au/telstras-dismemberment-may-be-put-on-hold/story-e6frg8zx-1225801836376

Telstra's dismemberment may be put on hold

THE legislative dismemberment of Telstra could be delayed indefinitely unless the Senate can speed through debates on the party-dividing emissions trading scheme that comes before parliament this week.

The historic telecommunication regulatory reforms, which are aimed at providing a level playing field ahead of construction of the government's $43 billion national broadband network (NBN), are due to be debated this week.

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http://www.cio.com.au/article/326918/cio_guide_nbn?eid=-601

A CIO's Guide to the NBN

Australia's $43 billion National Broadband Network will usher in a new era of connectivity and business innovation. Here’s what CIOs need to know. . .

Darren Horrigan 19 November, 2009 07:51:00

Forests have been felled and new server rooms built to carry the torrent of words written about broadband Internet access in Australia. Some of the country’s most brilliant technical, business and social minds have joined what has become at times little more than a cacophony of claims, counter-claims and lies.

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http://www.computerworld.com.au/article/327842/nbn_senate_select_committee_report_reveals_massive_split?eid=-255

NBN Senate Select Committee report reveals massive split

Report recommends cost-benefit analysis, interim implementation study report by end of year

Trevor Clarke 26 November, 2009 21:05

The Senate Select Committee into the National Broadband Network (NBN) has called for a rigorous cost-benefit analysis, an interim implementation study report, a skills audit and that legislation be brought forward to provide the funding and governance framework for NBN Co.

In its third report, the coalition-heavy committee's call for a cost-benefit analysis follows a similar call from the OECD, which said the Federal Government should conduct a more rigorous and systematic analysis of planned infrastructure projects, including the NBN.

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Enjoy!

David.

Sunday, November 29, 2009

NSW Health, Cerner and Professor Patrick. Where To From Here?

It is now clear that there is an issue with the implementation of Cerner FirstNet in at least some NSW Hospitals and that at least some of those using the system are pretty unhappy with the present state of play.

The following article rehearses the present state of play.

Health department accused of censorship

NATASHA WALLACE HEALTH

November 28, 2009

THE University of Sydney removed from its website an extremely critical essay about a new multimillion-dollar emergency department IT system after pressure from the NSW Health Department. .

Doctors, nurses and administrators at four area health services heavily criticised the system - which tracks patients - as posing an ''unacceptably high risk'' to patient safety because it was so slow, cumbersome and inefficient.

Some hospitals have boycotted Cerner FirstNet and reverted to paper to record clinical notes because it is too difficult and too time-consuming to retrieve critical patient information from the system, the essay said.

''In a number of cases we know senior clinicians have shut down the use of FirstNet within a few days of it coming online,'' it said.

This flies in the face of the recommendation last year from Peter Garling's inquiry into public hospitals for full electronic medical records to improve efficiency and patient safety.

The essay, by a medical IT professor, Jon Patrick, said several hospitals also reported it ''doubled the delay'' before emergency patients were first seen by a clinician.

He also said the Cerner contract proposal suggested it was giving a ''cheap price'' on the proviso of a ''speedy finalisation of the contract'' which left NSW Health with such an ''incredibly tight schedule'' it stymied proper clinical consultation.

The essay was published late last month but NSW Health asked that it be removed, Professor Patrick said on his website. The university then published it again two weeks later.

More here:

http://www.smh.com.au/national/health-department-accused-of-censorship-20091127-jwwm.html

There is also very comprehensive in depth coverage of the issue here:

Academic claims NSW Health censorship

By Suzanne Tindal, ZDNet.com.au
27 November 2009 02:26 PM

A professor at the University of Sydney who wrote a scathing essay about NSW Health's implementation of a Cerner system within emergency departments has accused the government of pressuring his institution to take the essay down, which it did, if only temporarily.

“One would have thought that Cerner was aware of the failure of the contract to specify the necessary reporting module and so it appears to be a form of gazumping.”

Professor Jon Patrick

"Version 4 of this essay was temporarily withdrawn on Friday, 23rd October by the university following a complaint from NSW Health," Professor Jon Patrick said on the Health Information Technologies Research Laboratory website. He believed the university was correct to investigate the complaint and didn't consider it at the time as an act of censorship.

Much more here:

http://www.zdnet.com.au/news/software/soa/Academic-claims-NSW-Health-censorship/0,130061733,339299731,00.htm

The most recent version of the paper / essay on the issue (all 23 pages of it) is found liked from here:

http://aushealthit.blogspot.com/2009/11/new-release-of-jon-patrick-essay-on.html

To me the issue around all this is not what has gone on to – date, but what must be done to now ‘pull the fat from the fire’.

First a few disclaimers:

1. I have known Jon Patrick for a number of years, have had many discussions with him on informatics matters and have no reason to believe he has anything other the most principled and honest reasons for raising this issue – despite one or two rather nasty assertions made in the comments sections on the blog (Anonymously not surprisingly!)

2. I have known the Cerner Corporation and many people who work for it (up to and including the CEO Neal Patterson) for a period that now extends over 20 years. I have also (not recently) done paid work for Cerner in Australia and reviewed Cerner implementations many years for NSW Health many years ago.

3. I have done paid work for some Cerner competitors over the years.

4. I worked in NSW Health for almost 20 years as a clinician and so on.

A few basic facts are:

1. Cerner is a highly successful global provider of Health Information Software company who – as their web site says:

“Working together with more than 8,000 clients worldwide, Cerner is solving healthcare's many challenges by making sure the right people have the right information at the right time. Building on our clinical expertise, we are finding new and innovative ways to deliver value to our clients.”

The basic facts are here:

http://www.cerner.com/public/Cerner_3.asp?id=27165

2. Cerner seems to have met difficulties at least in NSW, Victoria and the UK when instances of their software have been customised for a large number of organisations. This has not as often been the case when they have worked with single organisations both in Qld and the UK and of course in the US.

3. The possibilities for the cause of the present set of complaints are legion (could be NSW Health issues, Cerner issues, internationalisation of software issues, local workflow or cultural issues, technology provisioning issues and a range of other possibilities - or a bit of each!)

The only thing that is crystal clear to me is that there is much more darkness than light both about how things are going, what the root causes of any issues are and how they can be addressed.

Looking as an outsider it seems to me what is needed is the input of a genuinely dis-interested expert in Hospital Information Systems (preferably with a good knowledge of a variety of HIS implementation from around the globe) to review (with no options ruled out) the NSW process and plans and consult with all stakeholders to define a way forward and have NSW Health implement what is recommended.

Sadly NSW Health does not have a great track record of undertaking such introspection and then actioning what is needed but we can all hope.

There are a lot of reputations on the line here – as well as the credibility of the NSW Health eMR agenda, and indeed the national e-Health Agenda, to get this right – and it needs to be done properly, transparently and openly. All involved could learn from what might be discovered.

We are well beyond the time when ED staff should need to bring their own laptops to work to manage data entry because the systems provided are so bad!

I wonder will anyone listen?

David.