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."

Tuesday, January 26, 2010

Weekly Australian Health IT Links - 25-01-2010

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

General Comment:

It seems we have a run of quite bizarre press releases from NEHTA. This sudden rush to the media suggest to me that there is a rising tide of panic as it is recognised that it is only a few months until it becomes clear to all that NEHTA has over-promised and under-delivered.

The issue all of those who actually hope e-Health can be a genuine enabler of a higher quality, safer and more sustainable health system in OZ is how we can get from where we are now to where we need to be. NEHTA is a failed experiment and we need a new approach – perhaps as suggested in the Deloittes National E-Health Strategy.

Suggestions welcome!

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Since writing this a day or so ago there have been some discussions in some private technical groups about the future for NEHTA. I was interested to note that among some I recognise as more than technically and clinically competent there is a rising feeling that we are watching an inevitable train-wreck and the time to really put an end to all this is fast approaching.

I really wonder what can be done, as it is now clear that NEHTA is actually hindering e-Health progress in a whole range of domains. It is producing products and services that are probably not fit for purpose and whose use seems unlikely. It is also likely, with the election looming, to have its deeply flawed HI Service legislation delayed – if not canned – and lastly is failing at even the basic role of achieving basic compliance with already agreed standards (HL7 V2 etc).

I wonder how long it will be before we see that staff bailing out as they recognise the ship they have joined has some serious leaks?

Sadly I guess the only response to the issues raised will be another deceptive press release!

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http://www.medicalobserver.com.au/News/0,1734,5803,22201001.aspx

Patient e-identifier a legal risk for GPs

Elizabeth McIntosh - Friday, 22 January 2010

GPs risk falling foul of strict new e-health regulations and face hefty fines and jail terms, say doctors’ groups who are seeking a review of proposed legislation governing the use of unique healthcare identifier (UHI) numbers.

Released late last year, the draft Healthcare Identifiers Bill 2010 outlines proposed regulations around access to and use of UHIs, which will eventually be allocated to every Australian.

The 16-digit UHIs are intended to enable secure electronic transfer of patient information between health professionals, and misuse of the numbers could see health professionals slapped with fines of up to $13,200 or two years’ imprisonment.

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e-Health news sparks more criticism

Health identifiers to be assigned this year

A release promoting extra safeguards for national e-health identifier by its governing body has been labelled ‘chaff’ from a long-term industry advocate.

The Healthcare Identifiers Bill 2010 proposes that unique healthcare identifiers be in operation within 10 years, spearheaded by Medicare. Each Australian will have a unique record held in a single national database that can be accessed by different health professionals.

Pundits and analysts say e-health identifiers can improve communication between pharmacies and doctors and introduce transparency into patient medical histories, but many are concerned that the government is not paying dues to privacy concerns or addressing governance issues.

More and Associates consultant, Dr David More, said the governing National E-Health Transition Authority (NEHTA) has not provided enough information on record content and access and how health providers will be authenticated.

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http://topnews.us/content/210065-ihis-protect-identity-oz

IHIs to protect identity in OZ

To keep records of well-known personalities people in OZ will soon be given fake identities. A 16-digit health ID number will be assigned to everyone to serve this purpose.

The federal agency responsible for the rollout yesterday stated that this identity would lessen the risks of exposure to someone’s information.

"There was a "need to provide special protection for vulnerable people such as well-known personalities and victims of domestic violence. Pseudonymisation is not intended to be a generally available option," a spokesperson for NEHTA said.

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http://topnews.net.nz/content/21787-national-e-health-plan-plagued-privacy-concerns

National E-Health Plan Plagued by Privacy Concerns

Submitted by Ketan Mukherjee on Tue, 01/19/2010 - 09:54

The Rudd Government has not been able to calm the fears and concerns that are currently plaguing people with regards to the patient privacy and data security risks which could be related to the planned Healthcare Identifiers routine. Consumer and industry groups are now warning that the draft Bill is very "flawed".

Concerns are that the proposed identifier system will end up allowing the linkage of "personally identifiable information across multiple networks", the proposed routine is based on an old technology and has been designed in order to support a countrywide e-health records system that might never be built.

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http://www.news.com.au/couriermail/story/0,1,26610127-952,00.html

Health ID cover-up for some exposes risks

By Renee Viellaris

January 20, 2010 12:00am

THE same people who claim a new national health identity system will be safe from fraud will be able to get fake ID to keep their own records secret.

While every Australian will soon be assigned a 16-digit health ID number, politicians and other "well-known personalities" will be able to take advantage of false identities to stop their records falling into the wrong hands.

The 16-digit health number is a "building block" towards national electronic health records, which will be eventually shared among health professionals.

The federal agency responsible for the rollout yesterday conceded the safeguards would be built into the system to "mitigate against the potential risks of exposure to this information". But access to the extra level of protection offered by the false IDs, known by the federally funded National E-Health Transaction Authority as "pseudonymisation", will not be widespread.

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http://www.theage.com.au/national/hospitals-resort-to-virtual-wards-20100119-mj3v.html

Hospitals 'resort to virtual wards'

JULIA MEDEW

January 20, 2010

VICTORIAN hospital staff are being run off their feet as they try to keep up with soaring demand, and hospitals are manipulating their data to make it look like they are performing better than they are, a junior doctor says.

Candice Simpson said her employer, Geelong Hospital, had been under extreme pressure in recent weeks and that hospitals were ''resorting to data manipulation and 'virtual wards' to make their numbers look good for the Government''.

''This situation isn't limited to Geelong Hospital only, it's endemic within the healthcare system, all hospitals around the state are doing the same thing. The problem lies with inadequate funding,'' she wrote in a letter published in the Geelong Advertiser on Friday.

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http://www.smh.com.au/world/science/dead-man-winking-discovery-offers-hope-to-paralysis-victims-20100119-mj78.html

Dead man winking: discovery offers hope to paralysis victims

NICKY PHILLIPS

January 20, 2010

SCIENTISTS have made the eyes of a dead person blink, in a world-first use of artificial muscle that could eventually benefit people with facial paralysis after a stroke or injury.

Researchers from the US used artificial muscles made from silicon that can expand and contract when activated by an electrical impulse, the same process that allows muscles to move in the body. The technology is known as electroactive polymer artificial muscle.

The researchers were able to make the eye blink by inserting a bundle of muscle fibres from another part of the face above the eye of a cadaver. The ends of the fibres were then connected to the artificial muscle which is powered by a battery and contracts and releases, moving the eyelid.

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http://www.computerworld.com.au/article/332968/government_called_step_up_leadership_over_e-health/

Government called on to step up leadership over e-health

Concerns over e-health issues arise as government pushes ahead with reforms

The Rudd Government needs to boost its leadership and learn from other countries implementing e-health strategies, according to a leading healthcare industry CIO.

Malcolm Thatcher, CIO of Queensland-based Mater Hospital, said the government needs to recognise and implement enablers for e-health, including the management of health identifiers, secure messaging, common terminologies, patient privacy and industry incentives and recognise that e-health is a complex challenge.

Thatcher also stressed the need for closer alignment among the state health bodies.

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19 January 2010

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr010.htm?OpenDocument

E Health to Deliver a Better, More Efficient System

18 January 2010

Patient care will be improved and inefficiency in the health system will be cut by new e-health legislation soon to be introduced by the Rudd Government.

Today I visited Medicare Australia to see first hand how the secure e-health system currently being developed will work for patients and health care professionals.

The demonstration clearly showed how useful tools like electronic health records, medications-management systems and electronic clinical messaging (discharge, referrals, pathology, and prescriptions) will help improve delivery of health care – particularly when patients are being cared for by multiple providers.

The first step in creating an e-health system will come into effect in the middle of the year when unique healthcare identifiers are assigned to all health consumers as well as to health professionals and the organisations that provide health care in Australia.

Note: This is the official press release.

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http://www.news.com.au/adelaidenow/story/0,22606,26604444-5006301,00.html

Expert claims health records can't be kept secret

TORY SHEPHERD

January 19, 2010 12:01am

PRIVACY fears over Federal Government plans to put personal medical details in a national health database have been ignored and personal information put at risk.

An ex-employee of the National E-Health Transition Authority says he quit in disgust after his concerns about the system were ignored.

A privacy expert says hackers will target the "honeypot" of information and the Australian Privacy Foundation warns the draft legislation contains "defects" and ignores important privacy concerns.

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http://www.news.com.au/adelaidenow/comments/0,22638,26604444-5006301,00.html

Readers' Comments

Health records 'won't be secret'

TORY SHEPHERD

January 19, 2010 12:01am

PRIVACY fears over Federal Government plans to put personal medical details in a national health database have been ignored and personal information put at risk.

An ex-employee of the National E-Health Transition Authority says he quit in disgust after his concerns about the system were ignored.

A privacy expert says hackers will target the "honeypot" of information and the Australian Privacy Foundation warns the draft legislation contains "defects" and ignores important privacy concerns.

Note: A huge number of comments follow!

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http://www.theaustralian.com.au/australian-it/privacy-concerns-persist-on-national-e-health-plan/story-e6frgakx-1225820990882

Privacy concerns persist on national e-health plan

THE Rudd government has failed to calm fears over patient privacy and data security risks related to its proposed Healthcare Identifiers regime, with consumer and industry groups warning the draft Bill is flawed.

They say the proposed identifier system will enable linkage of personally identifiable information across multiple networks, it is based on old technology, and designed to support a nationwide e-health records system that may never be built.

Meanwhile, concerns about the cost of integrating new ID numbers into medical IT systems and the wisdom of excluding health funds -- which now offer members a range of better-health programs -- have emerged in responses to a tight consultation period over the holiday period.

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http://www.theaustralian.com.au/australian-it/e-scripts-to-be-subsidised/story-e6frgakx-1225820971735

E-scripts to be subsidised

PHARMACISTS will be funded 15 cents per script completed electronically - up to $36 million annually - while pharmacy software vendors will be compensated to incorporate e-prescribing features into dispensing systems.

The deal is part of the Fifth Community Pharmacy Agreement, just negotiated between the Rudd Government and the Pharmacy Guild.

Doctors issue around 240 million scripts for patients each year.

No funding or upgrade subsidies have been announced for GPs and other medical practitioners who originate electronic scripts on their desktop systems.

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http://www.heraldsun.com.au/news/commuters-using-fake-names-to-register-for-myki-transport-smartcard/story-e6frf7jo-1225821393917

Commuters using fake names to register for myki transport smartcard

  • Ashley Gardiner
  • From: Herald Sun
  • January 20, 2010 12:00AM

COMMUTERS are using fake names to register for myki.

One wit sent a myki card to the Herald Sun registered with the name Useless Mongrel.

It came with a letter from Transport Ticketing Authority chief executive Gary Thwaites that began: "Dear Useless, welcome to myki."

A card was also issued for Santos L Halper, a reference to The Simpsons episode when Bart applies for a credit card under the name of his dog, Santa's Little Helper.

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http://www.smh.com.au/national/privacy-fears-growing-as-police-tighten-national-grip-20100117-mecr.html

Privacy fears growing as police tighten national grip

GEESCHE JACOBSEN CRIME EDITOR

January 18, 2010

PRIVATE details of more and more people are finding their way on to databases used by the nation's police.

Information about licensed drivers and car owners are to be added to a network that already holds nearly 9 million police records.

Police say it makes their job faster and safer, but critics warn of the potential for the misuse of such mountains of information.

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http://www.theaustralian.com.au/australian-it/bypassing-telstra-proposed-to-cut-nbn-costs/story-e6frgakx-1225820992223

Bypassing Telstra proposed to cut NBN costs

WHILE Telstra and the government continue discussions on the possible sale of the telco's passive network assets into the $43 billion national broadband network, a British fibre-optic deployment specialist says it has the expertise to bypass the incumbent's network and deliver fibre for a fraction of the cost.

The government has been desperate to strike an agreement with Telstra on the telco's role in its ambitious broadband plans, but so far has only secured tentative terms that could result in it moving traffic from its copper network to the NBN.

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http://ces.cnet.com/8301-31045_1-10434346-269.html

CES: CNET's 3D TV FAQ

by David Katzmaier

The recent flood of news about new 3D TVs, itself spurred by the hype surrounding the 3D release of Avatar, has raised a few questions. At CNET, one of our main jobs is to explain "new" technology, so this article, arranged in the tried-but-true manner of "Frequently Asked Questions," attempts to answer them as well as we can at this early stage.

We polled the six major TV makers who announced new 3D models--LG, Panasonic, Samsung, Sony, Toshiba, and Vizio--to help with some answers. Although many of the questions came back "we'll get back to you on that," we did learn something. With asking the manufacturers, and some judicious trolling of Web resources (special thanks to AVS forum and the friendly folks at EngadgetHD), we came up with the following. It will be updated and expanded as--inevitably--parts are proven wrong or we're actually given some hard information; however, in the meantime feel free to leave a comment. Or at least vote in the poll.

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The next gadget to spend too much money on? I wonder what the e-Health applications might be? Remote surgery? As I understand it the current ‘surgical robots’ already use 3D techniques.

Enjoy!

David.

Monday, January 25, 2010

It Seems We Have Another Blogger Interested in E-Health in OZ!

I noticed the following post a day or so ago from the beautiful north coast of NSW.

Sunday, 24 January 2010

Australian Health Minister Nicola Roxon is not telling the truth about the Medicare e-card

Remember over the course of 2009 the Federal Health Minister Nicola Roxon assuring everyone within hearing that the new Medicare smart card would contain data and, give access to a database, which could be checked for accuracy by individual patients and that information would only be given out if the individual patient agreed to participate in the e-health scheme?

This is what the Minister was putting about at the time:

Eventually, the plan is for each person to have an individual e-health record, which holds their personal details; a summary health profile that can be shared with the person's permission between treating doctors; event summaries such as hospital discharge reports, care plans and test results, and a self-care management record where people can add their own material. and Ms Roxon has said participation in e-health records schemes would be voluntary and yet again All Australian residents will be allocated an Individual Healthcare Identifier (IHI) to support better communication between healthcare providers involved in patient treatment – but no patient will be forced to use it to access any health service.

Believed her did you?

Well, she told whoppers - barefaced and knowingly.

The proof is in the draft Healthcare Identifiers Bill 2010 which contains no precise provisions along those lines.

Much more here:

http://northcoastvoices.blogspot.com/2010/01/australian-health-minister-nicola-roxon.html

I have to say I am much attracted by the quotation provided in the side bar of the blog.

The Universal Declaration of Human Rights

Article 19

Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers. [Adopted and proclaimed by United Nations General Assembly resolution 217 A (III) of 10 December 1948]”

I had not realised blogging has such high level support and encouragement!

The rest of the blog is worth a browse to see what you think, but as I read it I think I am reading a blogger who is pretty unhappy about how the Rudd Government in general and Ms Roxon in particular are going about the e-Health task.

It is worth a mention that today’s articles describing Mr Rudd’s concerns about how the overall health sector is to be sustained and funded seem to even give e-Health the briefest comment.

See here:

http://www.theaustralian.com.au/news/kevin-rudd-in-alert-on-health-spend/story-e6frg6n6-1225823075398

Kevin Rudd in alert on health spend

  • Samantha Maiden, Online political editor
  • From: The Australian
  • January 25, 2010 12:00AM

KEVIN Rudd has declared 2010 a year of "major health reform", warning that health spending alone will outstrip state tax revenues within two decades.

In the latest in a series of speeches in the lead-up to Australia Day, the Prime Minister yesterday warned that Australia faced the choice of cutting pensions, health services and aged care; running massive deficits; or, his preferred option, boosting productivity as the population aged to help lift tax revenues.

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And here:

http://www.theage.com.au/national/states-face-health-cost-avalanche-20100124-msl7.html

States face health cost avalanche

MICHELLE GRATTAN AND LORNA EDWARDS

January 25, 2010

FEDERAL Government spending per person on health will rise in real terms from $2290 today to $7210 in 2050, with state governments at risk of being overwhelmed by rising costs, Prime Minister Kevin Rudd has said.

Treasury projects that, on present trends, the total health spending of all states will exceed all of their tax revenues, excluding the GST, by 2045-46, and possibly earlier in some states.

This year the Australian Government is spending the equivalent of 4 per cent of GDP on health, but the third Intergenerational Report, prepared by Treasury with projections to 2050, forecasts this will increase to 7.1 per cent in 2050.

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This is all a bit of a worry as e-Health is certainly seen around the world as one of the enablers of health system sustainability long term. Not with Rudd and Roxon it seems.

David.

Sunday, January 24, 2010

The NEHTA Spin Machine Pops A Gasket – And Tells Porkpies – With Its Latest Effort.

The following release dropped into view via the NEHTA RSS feed a day or so ago.

The original seems to have come from the Royal Australian College of General Practitioners.

Health Records Security Top Priority

22 January 2010

A general practice at the heart of the Black Saturday bushfires, awarded the Royal Australian College of General Practitioners (RACGP) 2009 Victoria General Practice of the Year Award, has worked tirelessly to get the practice back on its feet a year on from the fires.

One of the painfully slow after-effects of the Black Saturday bushfires has been to rebuild all of the vital community information that was lost, including the medical records of all the patients at the Marysville Medical Clinic, now located in Buxton.

When the Marysville Clinic burnt to the ground that day, along with it went all the files, paper records and patient history of many families and individuals living in the area.

Dr Lachlan Fraser, the solo rural GP in Marysville, had back-ups of the data, but the copies saved off-site were burned when his secretary lost her home and nearly her life in the township.

Thankfully they also had an old back up version that was kept in, Alexandra, half an hour north, an area that was also threatened with fire. But the clinic had still lost the past year and half of data, so along with the task of setting up and working from a temporary building, they has also had to re-establish vital medical data for patients.

“We perhaps had half of the information we would have liked and in particular it meant that we lost our recent records that involved patient pathology results or x-rays that we needed to follow up. It has meant that we needed to reconstruct patient histories which is a huge process and extra work during this difficult time for everyone,” said Dr Fraser.

Peter Fleming, CEO of the National E-Health Transition Authority (NEHTA) said that in the future, the difficult situation of starting to build patient files again will be one less thing that GPs have to worry about following a bushfire or natural disaster.

NEHTA is the lead organisation supporting the national vision for e-health in Australia.

“E-health is the electronic collection, management, use, storage and sharing of healthcare information instead of using paper records. A national e-health system will ensure that health information is safely and securely stored at all times.

“This means that the medical treatment for any person affected by a tragedy such as Black Saturday will never again have to be delayed while waiting for all information to be updated or assessed,” he said.

For this reason, the RACGP, which is the largest representative body for Australia's urban and rural general practitioners, is determined that GPs such as Dr Lachlan Fraser be a leader in the adoption of e-health in Australia.

“We are currently developing the next edition of the RACGP Standards for General Practices (4 th edition) and are working with NEHTA to make sure that the Standards are now fully integrated with e-health so that our RACGP members can deliver the highest standard of care to their patients,” said Dr Chris Mitchell, RACGP President and GP in northern New South Wales.

“The new RACGP Standards for General Practices will ensure that what the Marysville Medical Clinic and also GPs in flood affected areas of Australia have gone through will never have to be repeated.

“Trauma and grief counselling are high on the list of immediate services provided in these circumstances. However, maintaining high quality health services such as diabetes management and access to pathology results is very important, particularly for our patients with chronic diseases. The quick re-establishment of high quality general practice services can help high risk patients who lost everything back to health,” he said.

Dr Fraser agreed and added that electronic records would be a far better way to safeguard patient records which could then be accessed by healthcare providers anywhere in Australia and so helpful for those who did not re-settle in the same location.

Publication Date: 22 January 2010

Authorised By: Media

The release is found here:

http://www.racgp.org.au/media2010/35858

The release is also found here (complete with RACGP Logo)

http://www.nehta.gov.au/media-centre/nehta-news/590-bushfire-release

and it has appeared overseas here:

http://www.medicalnewstoday.com/articles/176861.php

With the title:

Health Records Security Top Priority, Australia

What just amazes me here is the arrant nonsense spouting from the mouth of NEHTA CEO.

Peter Fleming, CEO of the National E-Health Transition Authority (NEHTA) said that in the future, the difficult situation of starting to build patient files again will be one less thing that GPs have to worry about following a bushfire or natural disaster.

NEHTA is the lead organisation supporting the national vision for e-health in Australia.

“E-health is the electronic collection, management, use, storage and sharing of healthcare information instead of using paper records. A national e-health system will ensure that health information is safely and securely stored at all times.

“This means that the medical treatment for any person affected by a tragedy such as Black Saturday will never again have to be delayed while waiting for all information to be updated or assessed,” he said.”

This is just wrong, most especially the paragraph I have bolded. A severe fire anytime in the present, or next few fire seasons, would lead to the same outcomes and NEHTA knows it!

Now I, like all Australians, was greatly saddened, and horrified, by the awful loss of life and property in the Black Friday fires a little over a year ago.

This said there is just no excuse for this release. Nowhere in any NEHTA plan is the provision of off-site GP record archiving that has even been mooted let alone costed and funded, which is what is being suggested here.

An off-site summary record may be a twinkle in NEHTA’s eye, but after a year of trying they have not had that funded, let alone a more comprehensive provider record.

What is also undeniable is that if we sadly have another event like Black Friday in the next few years there is a high likelihood that there will be exactly the same outcome for the local GPs data – as there is nothing NEHTA has yet done or even planned, or will do in the foreseeable future, which would make the least bit of difference.

A different release from the College pointing out that natural disasters do happen, using this sad case as an example, and alerting GPs to think about secure cloud based encrypted backup over the internet would be much more sensible – as might be a review of possible providers of such services the College could endorse. Maybe such a suggestion for the next set of RACGP Standards?

The College should withdraw this present ill-conceived release in my view. I am sure many of those with serious e-Health knowledge and experience within the College, and there are many, would find this release rather opportunistic if not just offensive.

NEHTA should also apologise for making claims there is no way they can justify. I bet this release was not initiated by the College, but, of course, I am always open to surprises!

David.

Saturday, January 23, 2010

AusHealthIT Man Poll Number 6 – Results 23 January, 2010

The question was:

Does the Current Federal Health Minster Understand the Potential Importance and Value of E-Health?

Results:

Totally

- 2 (2%)

Pretty Well

- 8 (11%)

Marginally

- 32 (47%)

Not at All

- 25 (37%)

Votes: 67

Comment:

84 % it seems are not sure she ‘gets it’!

It seems there is a deep scepticism among readers that Ms Roxon has her head around e-Health in any useful way. Maybe that is part of the reason why we are having such difficulties.

Someone needs to provide her with a decent E-Health 101!

Thanks again to all who voted.

David.

Friday, January 22, 2010

An Uninformed Blog Takes a Shot at AusHITMan.

This dropped into view today.

Friday, January 22, 2010

'es mad about e health.

I got emailed an article in Computerworld this week, which seem

This article seems to be based on the rants of one individual who is blogging his way into retirement. The fact that one of the main objectives of this person's blog is to "provide commentary on what seems to have become the lamentable state of e-Health in Australia" and "to foster improvement" is hilarious. Obviously there will be a negative perspective of a topic irrespective of any merits of benefits there might be.

The blogger seems to be aiming target at NeHTA, as he has failed to recognise the challenges of being handed a poisoned chalice. Having been involved a little at NeHTA, it was easy to see that while every effort is being made to define pragmatic Australian standards for e-health information systems, numerous other parties will directly influence the likelihood of success. One instance that springs to mind was NeHTA had developed a simple directory service to identify nodes on the network. It was put forward as an Australian standard, but one vendor who had a hugely complex and excessively featured commercial non-standard product, vetoed the standard, forcing the market place to use it.

Lots more here:

http://rowlyemmett.blogspot.com/2010/01/es-mad-about-e-health.html

What to make of this?

Does he mention all the educational stuff I post?

Does he mention all the positive suggestions I make for improved leadership and governance etc.

Does he actually understand that lack of key stakeholder involvement is a death blow?

What ‘poisoned chalice’ cannot be sorted out after an organisation has been operational for 5+ years with competent management?

Has he actually read an understood more than the most recent 20 posts and the heading?

Anyone have a clue what this actually means?

“Dr More also seems unaware that as well as defining technical implementations, operational standards are also being defined to ensure the technical implementations are not compromised by poor work practices. Certainly, some areas in NeHTA (although I can't speak for all) recognise that no matter how well the system is designed, if the configuration, operational practices, support processes and policies are weak, the technical systems will be vulnerable.”

I sure don’t. Sounds to me like a consultant trying to sell something..but what would I know? (A very great deal as it happens is the answer).

When his has a blog with 50 sensible e-health posts I am sure we will all take him more seriously!

A worthy rant. I suggest readers make up their own mind if the “Procrastinator” has a clue. He has been on Blogger since 2002 and has never posted on e-Health and has only averaged 7 or 8 posts a year. Clearly travel to Fiji, testing stuff and not e-Health is the passion here!

And to the much broader point. Does this blogger think we are (in OZ) doing OK in e-Health and what is he doing to improve it – given he says I am doing nothing?

We all await a decent and coherent response!

David.

Note: The first paragraph of the post is messed up..not sure why.

D.

Thursday, January 21, 2010

It Seems The Professional Experts Agree with AusHITMan.

The following appeared yesterday.

Ovum: Australia needs to get national e-health act together

Research firm tips a big year for healthcare technology but Australia in danger of missing out on e-health opportunities

Spandas Lui 20 January, 2010 14:41:00

The global electronic health record (EHR) industry is set to blossom this year but Australia’s muddled national e-health strategy may stymie local growth, according to research firm, Ovum.

In its 2010 Trends to Watch: Healthcare Technology report, Ovum claims 2010 will be a pivotal year for EHR adoption. It credits worldwide government e-health initiatives and the recovering economy with spurring IT uptake by healthcare providers.

However, Ovum claims Australia risks sluggish EHR growth as the Federal Government fails to ratify a detailed direction for e-health. This will only be resolved when the National E-Health Strategy pushed by the Rudd government back in 2008 to standardise health record formats and integrating public and private health data is formalised.

While the country is already advanced in terms of healthcare and related IT systems, the e-health agenda has made little progress, Ovum research director, Steve Hodgkinson, said.

“[It’s] a lot of talk and not much action,” Hodgkinson, said. “Action is happening at a local and regional level with individual health organisations and hospitals implementing health record solutions but the issue is how they integrate together, which is the preoccupation of the strategy.

Hodgkinson said the Government was in the lurch as these kinds of issues required agreement amongst the various political parties. But without clear national directions the E-Health strategy has become an obstacle in healthcare technology investments.

“It is a two-edged sword,” he said. “The Government can speed things up if it makes effective and decisive decisions and funds are allocated to get things moving.

“I think it’s fair to say many people in the industry are frustrated by the time everything is taking and the lack of clarity of directions and people are holding off investment to wait and see what happens.”

More here:

http://www.arnnet.com.au/article/333166/ovum_australia_needs_get_national_e-health_act_together

Seems like the lack of leadership at the national level has been noticed. Ovum are a global firm and these comments read pretty clearly to me.

It seems to be a very sad situation when we find that assessed globally we are “sluggish!”.

Needless to say I strongly endorse their view!

David.

Weekly Overseas Health IT Links 20-01-2010

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

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http://www.nytimes.com/2010/01/12/health/12denmark.html?scp=2&sq=Denmark&st=cse

Denmark Leads the Way in Digital Care

By SINDYA N. BHANOO

COPENHAGEN — Jens Danstrup, a 77-year-old retired architect, used to bike all around town. But years of smoking have weakened his lungs, and these days he finds it difficult to walk down his front steps and hail a taxi for a doctor’s appointment.

Now, however, he can go to the doctor without leaving home, using some simple medical devices and a notebook computer with a Web camera. He takes his own weekly medical readings, which are sent to his doctor via a Bluetooth connection and automatically logged into an electronic record.

“You see how easy it is for me?” Mr. Danstrup said, sitting at his desk while video chatting with his nurse at Frederiksberg University Hospital, a mile away. “Instead of wasting the day at the hospital?”

He clipped an electronic pulse reader to his finger. It logged his reading and sent it to his doctor. Mr. Danstrup can also look up his personal health record online. His prescriptions are paperless — his doctors enters them electronically, and any pharmacy in the country can pull them up. Any time he wants to get in touch with his primary care doctor, he sends an e-mail message.

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http://www.guardian.co.uk/society/2010/jan/13/online-health-records-saving-lives

Online health records can save lives

The crisis-hit £12.7bn NHS IT programme is under attack from the Tories, but it is working well in Scotland

Few tears were shed when the chancellor, Alistair Darling, appeared to sound the death knell last month for the hugely costly NHS national programme for IT. Yet it turned out to be a premature obituary for the £12.7bn scheme, which, instead of being scrapped, will have £600m – less than 5% – cut from its costs.

The programme, one of the most ambitious IT projects in the world, is designed ultimately to provide staff in hospitals and GP surgeries with potentially life-saving electronic health records on every­one in England. But it has been beset by problems since its inception in 2002. As a result, parts of it – including the core patient record project – are years behind schedule, it is costing several billion pounds more to implement than initially forecast, and has become mired in controversy over privacy issues.

Parts of the programme are running successfully, notably the computerised Choose and Book appointment booking service, the NHS N3 broadband network, and the electronic picture archiving and communications service (Pacs), which allows medical staff to quickly call up scans on a computer. As of March 2009, £4.5bn had been spent on these projects and other work.

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http://www.healthdatamanagement.com/news/meaningful_use_stimulus_arra_ehr-39634-1.html?ET=healthdatamanagement:e1132:100325a:&st=email

CIO Lays Out Incentive Game Plan

HDM Breaking News, January 12, 2010

Hospitals may well wish to hire a consultant to help them wade through the meaningful use rules and formulate a strategy for compliance. But John Halamka, M.D., gave the industry a 25-point cheat sheet for that strategy via a Jan. 3 posting on his Web blog, http://geekdoctor.blogspot.com/.

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http://www.healthdatamanagement.com/news/connectathon_interoperability_hie_vendors_ehr-39632-1.html?ET=healthdatamanagement:e1132:100325a:&st=email

Vendors Test Interoperability in Chicago

HDM Breaking News, January 11, 2010

Some 104 organizations including 95 software vendors are participating in the 11th Annual IHE North American Connectathon this week in Chicago, testing the ability of their products to transmit patient data to disparate information systems.

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http://www.healthcareitnews.com/news/brailer-proposed-meaningful-use-criteria-feel-right

Brailer: Proposed meaningful use criteria 'feel right'

January 11, 2010 | Patty Enrado, Special Projects Editor

SAN FRANCISCO – The "hand of thoughtful policy" created the proposed criteria for meaningful use, according to David J. Brailer, MD, former healthcare IT czar for the Office of the National Coordinator.

"It would have been easy to be symbolic rather than meaningful," the founder and chairman of the San Francisco-based healthcare investor firm Health Evolution Partners said. He expected the criteria to "be looser, less meaningful." Instead, he said, "I'm pretty impressed."

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http://fcw.com/articles/2010/01/13/hhs-electronic-health-records-ehrs-physician-notes.aspx

Key ingredient missing from e-health records, advisers say

A federal advisory panel says EHR regulations should include doctors' narrative notes

The Health and Human Services Department might have missed an opportunity to include a requirement for physician progress notes to be collected within subsidized electronic health records (EHRs) in its recent proposed regulation, according to members of a federal advisory committee that met today.

HHS’ Health Information Technology Policy Committee convened to discuss possible missed opportunities, areas needing clarification and other gaps in the proposed rule, which was released on Dec. 30, 2009.

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http://health-care-it.advanceweb.com/Editorial/Content/Editorial.aspx?CC=213723

The Future of Health Care Information Security

Health IT executives can determine the future of information security with the decisions they make today.

By Bryan Cline, PhD

Why do information security at all?

It's an interesting question.and one that's simple to answer. We "secure" or protect information that has value. Often-cited examples include national security information, battlefield intelligence and trade secrets. In the health care industry, patients and their families entrust us with their personal information along with their personal health and safety. A violation of this trust can have consequences ranging from personal embarrassment to medical identity theft.

For more than a decade, however, we've had another reason to protect personal information -- regulatory compliance. In 1996, the U.S. Congress passed the Health Information Portability and Accountability Act (HIPAA). A portion of HIPAA -- the Privacy Rule -- requires the protection of specific personally identifiable health information, referred to as protected health information (PHI). This caused an initial flurry of activity in the industry and was a driving force behind the creation of executive-level compliance and privacy offices in many health care institutions. Unfortunately, it had little impact on how PHI was protected once it became digital.

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http://www.modernhealthcare.com/article/20100113/REG/301139950

Computer medical records stolen from Kaiser

By Associated Press

Posted: January 13, 2010 - 11:00 am ET

Kaiser Permanente says a computer drive containing thousands of patient records was stolen from an employee's car.

Hospital officials said Tuesday the external drive stolen Dec. 1, 2009, held data on as many as 15,500 patients throughout Northern California, including the patient's name and Kaiser medical records number.

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http://www.modernhealthcare.com/article/20100114/REG/301149956

Stolen Tenn. BlueCross hard drives affect 220,000

By the Associated Press

Posted: January 14, 2010 - 9:15 am ET

Computer hard drives stolen from a BlueCross BlueShield of Tennessee closet in Chattanooga contain personal information on 220,000 members, and that count could more than double, an ongoing investigation shows.

A Wednesday statement from the state's largest health insurer shows that as many as 500,000 members, including some in other states, could eventually be identified as facing a risk of identity theft.

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http://www.modernhealthcare.com/article/20100115/REG/301159985

HIMSS program takes ‘HIT to the Streets'

By Andis Robeznieks / HITS staff writer

Posted: January 15, 2010 - 11:00 am ET

Implementation of health information technology is a means if not an end, with the end being healthcare reform, and with reform being defined as improved patient and public health outcomes and improved healthcare delivery, according to Judy Murphy, vice president of information services at Milwaukee-based Aurora Health Care.

"It's not about IT implementation, it's about practice change," Murphy said at the opening of a program held in Rosemont, Ill., titled "Takin' HIT to the Streets" sponsored by the Healthcare Information and Management Systems Society.

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http://fcw.com/articles/2010/01/12/hhs-health-it-strategic-plan-update.aspx

HHS panel to give fresh spin to federal health IT strategy

The update will address how health IT will be used to reduce errors and improve the quality of care

By Alice Lipowicz

Jan 12, 2010

A federal advisory panel to the Health and Human Services Department began considering a framework today to update the Federal Health Information Technology Strategic Plan guiding adoption of electronic health records. The updated plan is expected to be released by October.

HHS initially created a strategic plan for health IT in June 2008 to cover the period through 2012. Under the economic stimulus law, HHS’ Office of the National Coordinator for Health IT must update that plan.

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http://www.nextgov.com/nextgov/ng_20100111_6160.php

FDA nationwide electronic network will track safety of drugs and medical devices

By Aliya Sternstein 01/11/2010

The Food and Drug Administration is constructing a nationwide electronic system to continuously track the safety of drugs and medical devices using anonymous patient data, but federal officials and health care specialists say its usefulness might be limited without more personal information.

The Sentinel initiative, launched in May 2008, will complement existing systems that monitor side effects and other adverse changes in health linked to FDA-regulated products. The system will tie together information from various registries, including electronic health record systems and insurance claims databases, allowing FDA workers to query an issue quickly.

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http://healthplans.hcpro.com/content.cfm?topic=HEP&content_id=244916

CT AG's Office Suing Health Net for Member Data Breach

Les Masterson, for HealthLeaders Media, January 13, 2010

Connecticut Attorney General Richard Blumenthal is suing Health Net of Connecticut, Inc., after the insurer reportedly failed to secure private medical records and financial information of 446,000 Connecticut members and then did not promptly notify them of the possible security breach for six months.

According to the AG's office, the insurer learned that a portable computer disk drive disappeared from the company's Shelton office about May 14, 2009. The insurer contends that it was misplaced, but the AG's office says that it was stolen. The disk contained protected health information, social security numbers, and bank account numbers, according to the AG's office.

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http://www.modernhealthcare.com/article/20100113/REG/301139951

WorldVistA meeting set to begin Thursday

By Joseph Conn / HITS staff writer

Posted: January 13, 2010 - 11:00 am ET

Physicians, programmers and vendors interested in leveraging the public investment by the Veterans Affairs Department in health information technology will meet on the campus of Arizona State University this week for the 20th VistA Community Meeting. The four-day gathering begins Thursday.

Presenters and agenda items include:

Ignacio Valdes, a psychiatrist and developer of the new Astronaut family of tools to install enable clinicians to install and use open-source versions of the VA's Veterans Health Information System and Technology Architecture clinical information system, including a “cloud”-based instance of VistA.

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http://www.govhealthit.com/newsitem.aspx?nid=72911

Meaningful use panel ponders rule changes

By Mary Mosquera

Monday, January 11, 2010

A Health & Human Services Department advisory panel Friday explored potential clarifications and tweaks of its proposed meaningful use rules, the set of requirements healthcare providers must meet in order to qualify for thousands of dollars in federal health IT incentive payments.

It its first session on Jan. 8 following the release of the proposal, the meaningful use workgroup of HHS’s Health IT Policy Committee signaled it might revisit aspects of the plan, including the number of quality measures it requires and the effect on physicians trying to apply them.

But the panel said it would concentrate on “philosophical” comments instead of specific changes. “Clearly, clinical quality reporting and quality measures tied to outcome improvement is one of those big topics,” said Paul Tang, the workgroup co-chairman and chief medical information officer at the Palo Alto Medical Foundation.

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http://www.healthleadersmedia.com/content/TEC-244791/How-Ready-Are-Hospitals-for-Meaningful-Use.html

How Ready Are Hospitals for Meaningful Use?

Carrie Vaughan, for HealthLeaders Media, January 12, 2010

Every hospital leader that I have spoken with in the past six months or so has been confident that his or her organization is in a position to qualify for meaningful use and capture all of the incentive payments from the HITECH Act. Yet, both hospital and physician organizations have recently expressed concern about providers' abilities to meet the requirements of meaningful use defined by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator.

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http://www.e-health-insider.com/Features/item.cfm?&docId=323

Intelligent response

The Pre-Budget Report put some numbers on the scale of efficiency savings that the NHS will be expected to find over the next few years. Another reason for the NHS to get a grip on its data, says Daloni Carlisle.

The Pre-Budget Report in December 2009 threw a number of challenges to the NHS in general and to its chief executives, directors of finance and IT managers in particular.

Squirreled away beneath the hoo-ha over whether the National Programme for IT in the NHS was to be axed or trimmed by £600m or £500m, the PBR called for interim savings of £10 billion a year by 2012-13 through value for money initiatives.

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http://www.fierceemr.com/story/vista-powerful-it-adaptable/2010-01-14?utm_medium=nl&utm_source=internal

VistA is powerful, but is it adaptable?

January 14, 2010 — 11:36am ET | By Neil Versel

The lead in a Federal Computer Week story pretty well sums up the conundrum: "Is VistA a diva in disguise?" The open-source EMR at the heart of the Department of Veterans Affairs' health IT strategy "is the best health information system in the world, bar none," says Ed Meagher, a former VA deputy assistant secretary of information and technology, but, he adds, it's also an old system that's difficult to manage and very high-maintenance.

Meagher, now a private consultant, has been hired by VA CIO Roger Baker to lead a workgroup that will make recommendations on how to modernize VistA and make it more adaptable to the private sector. "VistA is very old technology. That does not mean it does not work or is not useful. It is not a perfect answer, but I think there are potential uses for it," explains Dr. David Kibbe, a health IT consultant to the American Academy of Family Physicians. "This is a very good trend that is occurring."

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http://www.ehiprimarycare.com/news/5532/cameron:_don%E2%80%99t_believe_google_scare

Cameron: Don’t believe Google scare

12 Jan 2010

David Cameron has said people should not believe “scare stories” about patients’ medical records being handed over to companies such as Google and Microsoft, if the Conservatives are elected.

In response to a question from E-Health Insider about how the party would deliver on its manifesto pledge to give people online health records, Cameron said: “Some of the scare stories you will have read in the papers that it will all be handed over to Google or some other company, don’t believe that.”

The Conservatives launched the first section of their draft manifesto last week. It dealt with the party’s pledges for the NHS, and said that patients would be able to check their health records as easily as their bank accounts and choose who to share them with.

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http://www.modernhealthcare.com/article/20100111/REG/301119980

Certification details for ‘meaningful' EHRs still unknown

By Joseph Conn / HITS staff writer

Posted: January 11, 2010 - 11:00 am ET

The massive new federal rule issued by the CMS on Dec. 30, 2009, has been getting most of the attention, but a smaller, companion rule by the Office of the National Coordinator at HHS also will affect providers and developers of electronic health-record systems.

The American Recovery and Reinvestment Act of 2009, also known as the stimulus law, requires the ONC to “keep or recognize a program or programs for the voluntary certification of health IT as being in compliance with applicable certification criteria adopted” by HHS.

And, according to ONC rule writers, HHS is obliged under the stimulus law to adopt standards, implementation specifications and certification criteria that will “enhance the interoperability, functionality, utility and security of health information technology.”

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http://www.ihealthbeat.org/features/2010/california-health-it-sphere-in-flux-in-wake-of-calrhio-shake-up.aspx

Thursday, January 07, 2010

California Health IT Sphere in Flux in Wake of CalRHIO Shake-Up

by George Lauer, iHealthBeat Features Editor

CalRHIO, one of the country's first organizations designed to oversee the exchange of digital health information, has been thrown into a state of flux after failing to win designation as California's lead health IT agency. Leaders and employees have left. Some of CalRHIO's board members may still be active in negotiations with the state, but the future of the organization is unclear.

The upheaval at the California Regional Health Information Organization leaves the recently reorganized California eHealth Collaborative as the front-runner in the race to win the state's nod to oversee billions of federal stimulus dollars for health IT projects. The first wave of federal money -- about $40 million -- is expected to begin flowing into California early this year. The state-designated agency could end up disbursing billions of dollars through a variety of federal programs over the next several years.

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http://www.healthdatamanagement.com/news/prescription_history_PHR_consumer_HealthVault_Walgreens-39624-1.html?ET=healthdatamanagement:e1131:100325a:&st=email

Walgreens Links to HealthVault

HDM Breaking News, January 7, 2010

Drug store chain Walgreens now enables its pharmacy patients to download their prescription history from the Walgreens.com Web site to a personal health record on the Microsoft HealthVault platform.

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http://www.nursingtimes.net/nursing-practice-clinical-research/acute-care/implementing-online-tools-and-resources-to-help-nurses-apply-evidence-based-care/5010233.article

Implementing online tools and resources to help nurses apply evidence based care

A global resource can enable nurses to translate healthcare evidence into practice at a local level. A project looked at how it was implemented and evaluated

Authors

Penny Bond, MSc, BSC, RN, is professional practice development officer; Jill French, MPH, BSc, MCSP, is project lead; both at NHS Quality Improvement Scotland.

Abstract

Bond P, French J (2009) Implementing online tools and resources to help nurses apply evidence based care. Nursing Times; 106: 1, early online publication.

While nurses may be aware of tools and resources for quality improvement, this does not necessarily mean they are used in practice. An alliance between NHS Quality Improvement Scotland and The Joanna Briggs Institute in Australia has been set up to promote and facilitate the use of online tools and resources designed to support the development of practice and ultimately to enhance care. This article summarises the tools available and discusses the implementation and evaluation of this project.

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http://www.healthcareitnews.com/news/stimulus-deals-great-start-healthcare

Stimulus deals off to 'great start' in healthcare

January 08, 2010 | Bernie Monegain, Editor

MINNEAPOLIS – Recent stimulus-induced EHR deals show sooner-than-expected adoption, especially in the hospital sector, according to investment firm Piper Jaffrey.

The second half of 2010 and all of 2011 are likely to show a large number of EHR deals, Piper Jaffrey analyst Sean Wieland wrote in his analysis Friday.

Wieland noted a growing trend of hospitals buying or subsidizing EHRs for physician practices.

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http://www.modernhealthcare.com/article/20100111/REG/301119979

Ambulatory survey shows slight uptick in EHR use

By Andis Robeznieks / HITS staff writer

Posted: January 11, 2010 - 11:00 am ET

A government survey indicates there was an 18.7% increase in the use of electronic health-record systems in physician offices to 41.5% in 2008 from 34% in 2007, but preliminary results for 2009 show only a slight increase up to 43.9%.

Doctors were asked, “Does this practice use electronic medical records or electronic health records (not including billing records)?” with options for answering “all electronic,” “part paper and part electronic,” “no” or “don't know.”

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http://www.bizjournals.com/sanjose/stories/2010/01/11/daily8.html?s=industry&i=health_care

Monday, January 11, 2010, 7:08am PST

NetApp, Stanford build gastric cancer registry

Silicon Valley / San Jose Business Journal

NetApp Inc. and the Stanford Genome Technology Center are building the country's first comprehensive gastric cancer registry, the company said Monday.

Sunnyvale-based NetApp (NASDAQ:NTAP) said the registry is powered by its storage technology, and the company donated more than $600,000 in hardware, software and services.

The Gastric Cancer Fund is working with the Stanford Comprehensive Cancer Center and Stanford Genome Technology Center to aggregate clinical and genetic data on gastric cancer patients and serve as a resource in developing strategies for this cancer's detection, treatment, and prevention.

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http://www.ehealtheurope.net/news/5511/tech_vital_to_medication_adherence

Tech vital to medication adherence

04 Jan 2010

Information technology has a vital role to lay in cutting medication-related errors and improving medication adherence among older people, suggests a recent report.

The report says that of the 3 billion medication prescriptions issued each year in the US, 12% are never picked up by the patient and 40% are not taken correctly.

Published by the US Centre for Technology and Aging in Oakland, California, the report says "widespread use" of technology aimed at older people has the potential to save thousands of lives and billions of dollars.

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http://www.e-health-insider.com/news/5529/stockport_becomes_seventh_lorenzo_site

Stockport becomes seventh Lorenzo site

11 Jan 2010

NHS Stockport has become the seventh site to implement iSoft’s Lorenzo electronic patient record system.

The primary care trust has gone live with Lorenzo Regional Care Release One (LRC 1) clinical documentation model.

This is being used by a community rehabilitation therapy team, following an implementation from local service provider, CSC, under The National Programme for IT in the NHS.

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http://www.who.int/goe/ehir/2010/12_january_2010/en/index.html

12 January 2010

eHealth Worldwide

Lots of interesting links.

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http://www.ihealthbeat.org/features/2010/no-shortage-of-material-for-satirical-health-it-web-sites.aspx

Wednesday, January 13, 2010

No Shortage of Material for Satirical Health IT Web Sites

by George Lauer, iHealthBeat Features Editor

After a fall vacation in the Caribbean, a restful holiday at home and a toast to the new year, the visionaries from SEEDIE and Extormity say they're ready to help usher in the digital age of U.S. health care.

If you're not already familiar with the work of these two health IT organizations, you should probably check out SEEDIE.org and Extormity.com before proceeding much further with this feature. What you're about to read will make a lot more sense, or at least you'll be better armed to appreciate the non-sense, after a visit to these sites.

SEEDIE is the Society for Exorbitantly Expensive and Difficult to Implement EHRs. Extormity is explained online like this: "At the confluence of extortion and conformity lies Extormity, the electronic health records mega-corporation dedicated to offering highly proprietary, difficult to customize and prohibitively expensive health care IT solutions."

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Enjoy!

David.