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."

Friday, February 05, 2010

Weekly Overseas Health IT Links 03-02-2010.

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://content.nejm.org/cgi/content/full/362/3/192

Accelerating the Use of Electronic Health Records in Physician Practices

Steven Shea, M.D., and George Hripcsak, M.D.

North Shore Hospital System on Long Island in New York recently announced that it will pay an incentive of up to $40,000 to each physician in its network who adopts its electronic health record (EHR) — paying 50% of the cost to physicians who install an EHR that communicates with the hospital and 85% of the cost if the physician also shares de-identified data on the quality of care.1 This payment would apparently come on top of the $44,000 incentive that the American Recovery and Reinvestment Act of 2009 (ARRA) has authorized Medicare to pay each eligible health care professional who uses certified EHRs in a meaningful manner. "Meaningful use" is still being defined, but the overarching goal is to improve the population's health through a transformed health care delivery system with the use of EHRs to improve local processes, foster quality measurement, and increase communication. North Shore's announcement is a sign of the continuing acceleration of EHR adoption by physicians' offices2 and hospitals.3 Support for information systems is exempted from the Stark amendment to the Omnibus Budget Reconciliation Act of 1989, which prohibits hospitals from offering physicians incentives for providing referrals or admissions. The exemption for information technology acknowledges that the likelihood of additional referrals may be part of the motivation for hospitals to form closer links with community physicians through EHRs. Another benefit to hospitals from supporting the use of EHRs by physicians who are linked to them by geography, academic appointment, or practice pattern is the enhanced ability to manage the quality and outcomes of care. For example, if financial penalties and incentives are to be imposed on the basis of rates of readmission, then the more closely aligned a hospital is with the physicians who provide its patients' postdischarge care, the greater the benefits it will reap.

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http://www.healthleadersmedia.com/print/TEC-245673/Will-the-iPad-Revolutionize-Healthcare

Will the iPad Revolutionize Healthcare?

Cheryl Clark, for HealthLeaders Media, January 29, 2010

Apple's announcement of the iPad has been big news this week. The new technology has had health officials wondering: How will the iPad be used in a physician's practice, clinic or acute care setting? Could it really revolutionize care? Will it allow patients to communicate better with their providers through user-friendly pictures easily visible on the screen?

We asked health leaders to weigh in on the iPad, based on the rumor and the hype, and what is known about the device so far. Their consensus? Many things are possible, but maybe not just yet.

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http://www.healthdatamanagement.com/news/registry_als_cdc_research_gehrig-39715-1.html?ET=healthdatamanagement:e1149:100325a:&st=email

CDC Readies ALS Registry

HDM Breaking News, January 28, 2010

The Centers for Disease Control and Prevention has published a notice outlining steps to register individuals for listing in the new Amyotrophic Lateral Sclerosis Registry, authorized under legislation signed in 2008. The motor neuron disorder also is known as ALS and Lou Gehrig's Disease.

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http://govhealthit.com/newsitem.aspx?nid=73061

HHS takes Hippocratic oath on health IT stimulus

By Mary Mosquera

Thursday, January 28, 2010

The Health & Human Services Department will set up a panel of experts to identify and fix any “potentially harmful unintended consequences” of its push to get physicians and hospitals equipped with electronic health records over the next several years.

In announcing a contract to set up the group, HHS acknowledged the plan to offer providers financial incentives to adopt health IT was meant to “enormously improve the quality and efficiency of health.”

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Most Hospitals Increasing IT Spending

Government regulatory issues and financial incentives were named as the top drivers in a survey of hospital IT executives.

By Marianne Kolbasuk McGee, InformationWeek

Jan. 27, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=222500180

Three quarters of small to mid-sized hospitals in the U.S. plan to increase their IT budgets this year, with clinical point-of-care systems being the top IT priority, says a new survey.

The U.S. government's health IT stimulus programs are apparently driving many of these hospitals' IT plans.

Government regulatory matters, followed by financial incentives, were named as the top issues driving healthcare over the next two years, said the respondents to a survey conducted by the Healthcare Information and Management Systems Society (HIMSS) last October and released Wednesday.

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http://www.healthcareitnews.com/news/state-union-speech-omits-mention-healthcare-it

State of the Union speech omits mention of healthcare IT

January 28, 2010 | Diana Manos, Senior Editor

WASHINGTON – Healthcare IT has been highlighted over the past four years in State of the Union speeches, though President Barack Obama made no mention of it in his Wednesday night speech. Some stakeholders defend the Administration's support of health IT, while others question it.

Bruce Merlin Fried, a partner at Sonnenschein, Nath and Rosenthal, LLP in Washington, DC, said while there was no mention of healthcare IT, it remains the one fundamental structure for healthcare reform that has been passed and been funded.

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http://www.e-health-insider.com/news/5594/king%27s_showcases_e-prescribing_roll-out

King's showcases e-prescribing roll-out

28 Jan 2010

King’s College Hospital NHS Foundation Trust has started rolling out its iSoft e-prescribing system trust-wide.

The system enables prescribers to order their patient’s medication electronically and view scheduled and administered medications on an electronic drug chart via the iSoft Clinical Manager electronic patient record system.

The trust is one of the first to use the functionality, which is also in use in Salford and was piloted at Epsom and St Helier.

Ben Fidler, senior clinical analyst at King’s, told E-Health Insider: “Orders are placed in the same way as a diagnostic test in the native functionality of iCM, so it has been fairly straightforward for staff to pick up.

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http://ehealtheurope.net/news/5599/first_european_deal_for_healthvault

First European deal for HealthVault

28 Jan 2010

Microsoft and Siemens have signed an agreement to licence Microsoft’s personal health record platform, HealthVault, in Germany.

Siemens will host all the stored health data in what the two companies describe as “security enhanced” data centres in Germany. Data will be transmitted over an encrypted connection over the Internet.

Microsoft launched HealthVault in the US in October 2007. It has promoted HealthVault as an online platform that will allow individuals to store their personal health data, import information from various medical devices, and decide who to share it with.

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http://www.healthdatamanagement.com/news/standards_onc_stimulus_hitsp-39683-1.html?ET=healthdatamanagement:e1146:100325a:&st=email

Halamka: HITSP Still in Business

HDM Breaking News, January 26, 2010

The Healthcare Information Technology Standards Panel will not disband at the end of this week when its current federal government contract expires, contrary to at least two published reports on Jan. 26.

That's the word from John Halamka, M.D., chair of HITSP and CIO at Beth Israel Deaconess Medical Center and Harvard Medical School.

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http://www.e-health-insider.com/news/5583/pennine_care_delays_lorenzo_r1.9

Pennine Care delays Lorenzo R1.9

27 Jan 2010

Pennine Care NHS Foundation Trust has delayed its implementation of Lorenzo Regional Care Release 1.9 until the summer, E-Health Insider has learned.

Last May, NHS Bury’s informatics plan revealed that both the primary care trust and the mental health services trust would be working to implement Lorenzo R 1.9 in 2009, under the National Programme for IT in the NHS.

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http://www.isria.com/pages/27_January_2010_67.php

Slovenia - Minister Pavlinič Krebs: “e-Health Project provides answers to contemporary health challenges"

"The e-Health Project is one of the priority development programmes and among the largest national IT projects. Partly co-financed by the European Social Fund, substantial funds have been earmarked for its implementation." The Minister of Public Administration, Irma Pavlinič-Krebs, addressed these words to participants in her opening remarks to the introductory part of the international e-Health seminar held at Center Evropa in Ljubljana.

http://www.forbes.com/2010/01/25/digital-privacy-ponemon-technology-cio-network-healthcare.html?boxes=Homepagechannels

E-Health

The Next Health Care Debate: Digital Privacy

Andy Greenberg, 01.25.10, 6:05 PM ET

As President Obama has learned over the last year, Americans tend to get angry when you try to fix the country’s dysfunctional health care system. But even as the national debate over universal coverage drags on, there's another sticky issue ahead for health reform: digital privacy.

In a study released Monday by the privacy-focused Ponemon Institute, Americans registered a deep distrust of anyone in either the federal government or private industry who might store digital health records like those that the Obama administration has encouraged hospitals to create. Of the 868 Americans surveyed about their views on digitizing and storing health records, only 27% said they would trust a federal agency to store or access the data--the same percentage as those who would trust a technology firm like Google, Microsoft or General Electric.

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http://www.ethiopianreview.com/health/28673

Spain will promote the new Transplant Directive and “e-Health”

ethiopianreview.com | January 27th, 2010 at 3:43 am |

The new European Directive on organ donation and transplants and the promotion of “e-Health” will be two of the strategic topics of the Spanish Presidency of the EU, according to the presentation by the Minister of Health and Social Policy, Trinidad Jiménez, before the Health Commission of the European Parliament.

Trinidad Jiménez also stated that the Spanish Presidency of the EU will try to drive forward a “very ambitious” proposal on cross-border medical care that “respects the basic principles of patient safety and quality”, given that health is “a public good, not just another market commodity”.

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http://www.ehiprimarycare.com/news/5568/first_welsh_practice_live_with_ihr

First Welsh practice live with IHR

21 Jan 2010

The first GP practice and out-of-hours service in Wales has gone live with Informing Healthcare’s new Individual Health Record solution.

The biggest GP practice in Wales, the Argyle Medical Group in Pembroke Dock, which has 27,000 patients, has become the first practice to use the IHR solution from GP system supplier INPS.

The pilot will link the practice with the Pembrokeshire and Ceredigion out-of-hours service.

Informing Healthcare announced last September that it was changing its approach to the deliver of the IHR in Wales, by signing agreements with GP system suppliers to deliver proprietary versions.

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http://www.govhealthit.com/GuestColumnist.aspx?id=73002

Plain speaking on health data access

By Denny Porter

Wednesday, January 20, 2010

For years a crisis has been brewing for many people who have become tangled up in a cyber-age web where healthcare records are being generated and maintained across an ever-broadening spectrum of healthcare delivery systems.

Two particular categories of patient are at the forefront of this crisis: those that have been diagnosed and told they have a terminal disease; and our country's severely wounded military service members who are forced to transition from the Department of Defense to the Department of Veterans Affairs and out into the civilian healthcare system.

Both sets of patients face a similar, urgent and daunting task. They are literally fighting for their lives while being forced to get their hands on every shred and electron of their medical histories. By searching the Internet you can see that all across the country, patients and families are caught up in this crisis. By the time these patients are at this stage of treatment, every minute, hour and day counts.

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http://www.govhealthit.com/newsitem.aspx?nid=73030

Connect upgrades patient search, authentication

By Mary Mosquera

Friday, January 22, 2010

The Health & Human Services Department has updated the government’s Connect software to incorporate the ability to query for a patient and to assure the identity of sender and recipient in the exchange of health data.

Connect is the federally developed software that lets agencies and healthcare organizations share health data by using the protocols, agreements and core services that comprise the nationwide health information network (NHIN).

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http://www.govhealthit.com/newsitem.aspx?nid=73003

Military Health System lays out five-year IT plan

By Peter Buxbaum

Wednesday, January 20, 2010

For the first time in over a decade, the Military Health System last week finalized a strategic plan for information management and technology.

The five-year plan emphasizes collaboration among the armed services, Tricare the services’ health plan organization, the Joint Chiefs of Staff, the MHS chief information officer, and other Department of Defense health-related offices.

It is MHS's first formally adopted IM/IT plan since 1999, according to MHS CIO Chuck Campbell.

The plan places heavy emphasis on two goals: redesigning the MHS IT architecture and delivering a robust electronic health record.

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http://www.healthleadersmedia.com/content/TEC-245517/Health-IT-Panel-Use-Technology-Now-to-Help-Transform-Healthcare.html

Health IT Panel: Use Technology Now to Help Transform Healthcare

Carrie Vaughan, for HealthLeaders Media, January 26, 2010

Healthcare transformation is long overdue—especially as it relates to technology, according to a panel of technology executives who spoke at a Nashville Health Care Council luncheon last week about the future and current state of healthcare information technology.

Panelists included Steve Ballmer, Microsoft's CEO; Harry Greenspun, MD, chief medical officer of Plano, TX-based Dell Perot Systems; George Lazenby, CEO of Nashville, TN-based Emdeon; and Glen Tullman, CEO of Chicago-based Allscripts Healthcare Solutions Inc.

Greenspun says healthcare IT is about a decade behind other industries, and he is amazed that healthcare consumers have tolerated it given the fact that you can make dinner reservations online but not necessarily doctor appointments. "On my iPhone I can get a custom-made burrito at the nearest Chipotle," he says. "But if I get hit by a truck, I can't find, with that same iPhone, a qualified orthopedic surgeon who takes my insurance."

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http://www.ihealthbeat.org/perspectives/2010/political-earthquakes-health-care-reform-and-health-it.aspx

Tuesday, January 26, 2010

Political Earthquakes, Health Care Reform and Health IT

by Bruce Merlin Fried, Esq.

Sitting in my K Street office in Washington, D.C., I can see the dust settling after the political earthquake that followed the election of Republican Scott Brown to the Senate from Massachusetts. "Turmoil" would be a fair way to describe the behavior of policymakers, stakeholders and journalists in the wake of this electoral seismic event.

Let me hasten to say that I am not analogizing the political turn of events in Washington, D.C., to the profound tragedy that has befallen Haiti and its people. The two are incomparable. But in a real sense, Brown's election has disrupted the order of things in Washington in ways that were unpredicted (or at least unexpected) and with lingering consequences that may not be felt for some time.

What we all know is that the Democratic majority in the Senate has been reduced to 59. With that, the ability of the majority party to overcome minority party filibusters has been lost (unless, of course, a Republican senator can be coaxed to the other side). And with that loss, the prospects for enactment of comprehensive health care reform, such as the bills passed by the House and Senate, are enormously diminished, if not extinguished.

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http://www.e-health-insider.com/news/5578/scottish_pms_deal_may_go_national

Scottish PMS deal may go national

26 Jan 2010

NHS National Services Scotland is to make a decision on whether the recently announced Patient Management System contract should be widened to become a national system to cover all NHS boards in Scotland.

NHS NSS, which procures IT software on behalf on Scotland’s 14 health boards and eight special health boards, selected InterSystems as its preferred bidder in November 2009.

The decision means that InterSystems will provide its TrakCare product to five health boards including NHS Greater Glasgow and Clyde, NHS Ayrshire and Arran, NHS Lanarkshire, NHS Borders and NHS Grampian.

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http://www.kansascity.com/105/story/1707370.html

Race to share your medical info is on

By DIANE STAFFORD

The Kansas City Star

No matter what happens with health care reform, an electronic network to share your medical records is being stitched together.

Health practitioners, information tech experts, lawyers, ethicists and government officials are racing to implement a national system by 2014.

“We don’t want to just have the equipment in place. We want to have a meaningful use of electronic health records that will help consumers and health care providers,” said Helen Connors, director of the University of Kansas Center for Health Informatics.

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http://www.govhealthit.com/newsitem.aspx?nid=73038

HITSP to expire as standards group; successor sought

By Mary Mosquera

Monday, January 25, 2010

HITSP, an organization that did much to sort through and harmonize health IT standards and whose work provided an early foundation for “meaningful use,” will cease to exist in its current form after this week.

Dr. John Halamka, the face of the technical body since its inception in 2005, said the Health IT Standards Panel would disband on Jan. 31, when its contract expired.

HITSP was set up in 2005 as a partnership among public and private sector organizations to help pursue President Bush’s vision of establishing a nationwide system of electronic health record sharing by 2014.

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http://www.who.int/goe/ehir/2010/26_january_2010/en/index.html

26 January 2010

eHealth Worldwide

:: Canada: E-health Leads Nova Scotia's Healthcare Transformation (December 2009 - Healthcare Quarterly)

Nova Scotia's healthcare policy direction seems well-defined and well-established for the foreseeable future. This is the case, despite the recent electoral transition from a Progressive Conservative to a New Democratic Party government for the first time in the province's history; and despite the threat of the province's net direct debt increasing through 2012, after eight years of declining net direct debt as a percentage of the province's gross domestic product. As well, little public consideration is being given to disrupting the current regional healthcare organizational structure by further consolidating the province's nine district health authorities (DHA), as occurred last year in Alberta and New Brunswick. Moreover, the Health Information Technology Services Program of Nova Scotia (HITS-NS), the province's shared IT services or provincial service delivery organization, is steadily expanding the inventory of clinical, financial, and administrative software applications hosted for eight DHAs on a common Meditech Client-Server platform, as well as some applications for Capital Health DHA 9 (CDHA) and IWK Health Centre (IWK), the province's consolidated women's and children's hospital located in Halifax.

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http://www.modernhealthcare.com/article/20100125/NEWS/301259967

Leavitt: CCHIT has proven it can meet federal laws

By Joseph Conn / HITS staff writer

Posted: January 25, 2010 - 7:30 am ET

Part two of a two-part series (Access part one):

The Certification Commission for Health Information Technology announced last week it was taking applications beginning Feb. 12 from vendors for its new, upgraded electronic health-record testing and certification program. The new CCHIT testing criteria have been tailored to conform with new federal rules on certification and meaningful use.

At present, CCHIT has not be "recognized" as an EHR testing and certification body by the Office of the National Coordinator for Health Information Technology at HHS, and therefore, EHRs against the new CCHIT criteria won't qualify, at least for now, as being "certified" and eligible for use by providers seeking federal EHR subsidies under the American Recovery and Reinvestment Act of 2009, also known as the stimulus act.

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http://www.modernhealthcare.com/article/20100125/MODERNPHYSICIAN/301259995

Med students not ready to use EHRs: study

By Linda Wilson

Posted: January 25, 2010 - 7:00 am ET

Does the medical-school curriculum adequately prepare students to diagnose and treat patients using an electronic health record?

That's the question educators at the University of Illinois at Chicago College of Medicine set out to answer this year. The preliminary conclusion: probably not. As a result, the school may add course work to teach students how to incorporate the EHR into an encounter with a patient.

To test the EHR-savvy of nearly 190 fourth-year medical students who haven't participated in a formal class, the school set up a mock patient encounter in the summer and fall of 2009.

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http://www.healthdatamanagement.com/news/ehr_hospitals_himss_analytics_stage_7-39673-1.html?ET=healthdatamanagement:e1144:100325a:&st=email

Three More Hospitals Reach Stage 7

HDM Breaking News, January 25, 2010

HIMSS Analytics, the Chicago-based research and consulting unit of the Healthcare Information and Management Systems Society, has announced three additional hospitals have reached Stage 7 of its 0-7 scale for adoption of electronic health records. That brings the total number of Stage 7 hospitals to 38.

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http://www.healthcareitnews.com/news/healthpartners-use-emr-highlight-cancer-concerns

HealthPartners to use EMR to highlight cancer concerns

January 22, 2010 | Kyle Hardy, Community Editor

MINNEAPOLIS – The HealthPartners Medical Group is using an electronic medical record and race information to raise awareness of colorectal cancer among African American patients.

The Minneapolis-based medical group launched the program in an attempt to save lives by providing more timely colorectal cancer screening for African American patients. Organizations such as the American College of Gastroenterology recommend that regular colorectal cancer screening for African Americans should begin at age 45, compared to age 50 for other races.

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http://www.healthcareitnews.com/news/interoperability-king-ihe-connectathon

Interoperability is king at IHE Connectathon

January 22, 2010 | Bernie Monegain, Editor

CHICAGO – Healthcare data is rendered meaningless unless it can be shared, industry experts say. The Integrating the Healthcare Enterprise (IHE) North America Connectathon, now in its 11th year, recently showed how to get interoperability done right.

Focused on electronic health record system connectivity and interoperable exchange of patient health data with standards-based systems, the IHE 2010 North America Connectathon, held Jan. 11-15 in Chicago, brought together 498 system engineers, who were testing more than 150 health IT systems from 104 participating companies and organizations.

IHE is a global initiative that creates the framework for passing vital health information seamlessly – from application to application, system to system and setting to setting – across multiple healthcare enterprises.

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http://www.healthcareitnews.com/news/healthcare-investment-outpaces-it-investment-first-time%E2%80%A8

Healthcare investment outpaces IT investment for the first time

January 22, 2010 | Mike Miliard, Managing Editor

NEW YORK – Venture capital investment in healthcare has exceeded that for information technology for the first time, according to new statistics released Friday.

Dow Jones VentureSource reported that the healthcare industry in 2009 was the beneficiary of more VC cash than the IT sector, raking in $7.7 billion. While that represents a 14 percent decrease from the previous year, it’s far less than the 35 percent decline in IT investment, which totaled just $6.1 billion in 2009 – the lowest showing in 13 years, and the first year on record that IT was not the venture industry’s most favored sector.

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http://www.fiercehealthit.com/story/healthcare-may-help-it-industry-reverse-job-losses/2010-01-25?utm_medium=nl&utm_source=internal

Healthcare may help IT industry reverse job losses

January 25, 2010 — 1:10pm ET | By Neil Versel

The IT industry has been reeling, having cut a net 175,000 jobs in 2009, or about 13.2 percent of all announced U.S. job cuts across all industries last year. The decline is more than 12 percent greater than the 155,000 tech jobs shed in 2008. But there are some bright spots. Forrester Research recently forecast that U.S. IT spending would grow by 6.6 percent in 2010, reversing an 8.2 percent reduction last year. And then there is the health IT sector.

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http://www.ama-assn.org/amednews/2010/01/25/bil20125.htm

Phishing schemes are becoming sneakier in targeting doctors

A new round of e-mail scams looks like legitimate messages from trusted sources. How can physicians avoid becoming victims?

By Pamela Lewis Dolan, amednews staff. Posted Jan. 25, 2010.

A faculty physician at the University of California, San Francisco, Medical Center received an e-mail last fall appearing to be from the hospital's information technology staff. The e-mail requested the doctor's login information in order to perform routine security upgrades to the system. Because it seemed like an ordinary request, the physician sent the information.

But that e-mail wasn't from his hospital's IT administrators. It was from a scammer, and by responding, the physician had unwittingly exposed the personal information of more than 600 of his patients.

This type of scam has become so common it's earned its own nickname: "spearphishing." Like phishing, this scam is carried out via a fictitious e-mail that looks legitimate. But unlike phishing, in which missives are sent to as many e-mail accounts as possible, spearphishing targets a specific population by posing as someone with whom the e-mail recipient routinely conducts business and exchanges information.

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http://www.auntminnie.com/index.asp?Sec=sup&Sub=ris&Pag=dis&ItemId=89206&wf=3548

Structured reporting is coming; the devil's in the details

By Cynthia E. Keen

AuntMinnie.com staff writer

How much structure is enough for structured radiology reports? That was the question asked at an RSNA meeting session, where a panel of technology evangelists and session attendees agreed that while more user-friendly structured reporting software would stimulate adoption, the technology behind it doesn't exist yet.

However, the question of whether structured reporting will be adopted by radiologists is a question of "when," not "if." Just as the use of speech recognition technology has been replacing medical transcriptionists over the past decade in many private practices and radiology departments, reports prepared in a consistent format amenable to data mining and using some form of standardized terminology will displace the preparation of entirely free-text reports.

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http://www.auntminnie.com/index.asp?Sec=sup&Sub=ris&Pag=dis&ItemId=89021&wf=3548

Healthcare IT pays off, but don't hold your breath

By Cynthia E. Keen

AuntMinnie.com staff writer

January 7, 2010

Investing in healthcare IT projects such as electronic health records (EHR) and e-prescription systems produces significant socioeconomic benefits, but it can take nearly 10 years to see the first positive returns, according to a new study from Europe.

The EHR IMPACT study, the final report of a multiyear study initiated by the European Commission to evaluate the economic impact of utilizing healthcare IT in Europe, concluded that healthcare IT can produce annual socioeconomic returns of up to 400%.

However, it takes at least four -- and more typically nine -- years before EHR and e-prescription initiatives produce their first positive annual socioeconomic return, and it takes between six and 11 years to achieve a cumulative net financial benefit, according to the EHR IMPACT study.

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http://www.nation.com.pk/pakistan-news-newspaper-daily-english-online/Karachi/24-Jan-2010/Intl-moot-on-ehealth-begins

Int'l moot on e-health begins

Published: January 24, 2010

KARACHI - E-health is still an elusive concept in Pakistan, but it surely has a deeper concern and relevance to our local environment. Interestingly, very few healthcare professionals are now involved in promoting e-health in our country.

he first e-health conference began at AKUH, on Saturday morning, with the titled ‘Better Health for all through E-Health’.

Shariq Khoja, general secretary E-Health Association of Pakistan and representing AKUH at the platform, said, “No doubt that e-health was first developed in the western countries, focusing on the needs and standards that were supposed to be met according to their lifestyle, but e-health is need of the hour as far as Pakistan is concerned.

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Enjoy!

David.

Thursday, February 04, 2010

What A Giggle – Making Money from the Mess in E-Health in OZ!


The following turned up today. A very interesting report if you want to pay.

A bit rich for this poor blogger!

Report Available

National eHealth strategy progress in Australia

PDF Format

Published : January 2010

No.of Pages : 26

For more than a decade Australia has been looking to establishing a national eHealth system. After many reviews, reports and an estimated A$5 billion expended on various eHealth initiatives, the country is no closer to realisation of a national approach to eHealth. Vendors selling into this market are advised to remain focused on local and regional opportunities rather than waiting for a mythical national eHealth gravy train to leave the station.

Table of Contents :

Overview

In a nutshell

Executive overview

It is a challenge to see the wood for the trees

The size of the Australian health sector

National-level eHealth governance bodies

eHealth strategy documents are on the table

Two schools of thought on the health record

Progress, though slow, on individual healthcare identifiers

Disappointment at COAG

The national broadband network is unlikely to accelerate eHealth in the near term

eHealth therefore remains a local and regional game in Australia for the foreseeable future

The Australian health sector structure

Health sector structure

Expenditure and funding

Health sector by the numbers

Governance mechanisms

Government policy and eHealth

National eHealth strategy

National Health and Hospitals Reform Commission recommendations relating to eHealth

NEHTA and its role in the eHealth strategy agenda

NEHTA’s proposed role

The road to implementation

Funding the eHealth agenda

NHHRC costings

Deloitte eHealth strategy costings:

An instructive example: the case of NSW Health

Electronic health records

Two schools of thought on the health record

The health-practitioner-controlled record

The person-controlled health record

The need for a unique identifier

Council of Australian Governments meeting

eHealth and the National Broadband Network

Acknowledgements

Sources

List of Tables :

Table 1: Numbers employed in health occupations in Australia, 2006

Table 2: Cost estimates – foundations work stream

Table 3: Cost estimates – solutions work stream

Table 4: Cost estimates - change and adoption work stream

Table 5: Cost estimates - governance work stream

Table 6: Proposed priority eHealth solutions

Here is the link to the report.

http://www.bharatbook.com/detail.asp?id=130804&rt=National-eHealth-strategy-progress-in-Australia.html

It costs $US1495.00!

26 pages – we all know all this and what can one say? – Hardly value for money,

Not in a fit would I pay for this – not that it would not be fun to read.

The summary does certainly suggest they do, however, know – like OVUM (or is this their report at extra cost?) – what a mess we are in!

See here:

http://aushealthit.blogspot.com/2010/01/it-seems-professional-experts-agree.html

And does anyone think NEHTA and DoHA have any responsibility for any of this negative reporting on poor old OZ? Well, I sure do!

David.

Weekly Australian Health IT Links - 02-02-2010

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:

Clearly the biggest news of the week was the focus the Prime Minister was bringing to bear on the health sector with his early January speeches.

Also pretty big was the suggestion that there might be a major injection of funds for e-Health via the COAG process sometime in the next few months.

See here:

http://aushealthit.blogspot.com/2010/01/another-false-dawn.html

What seems to be missing in all this is the making of the link between e-Health and supporting the sustainability of the health system. Other countries get it but somehow it does not seem to have got through to those of our political elite. Blowed if I know why?

Interestingly the Defence Department seems to get it – see article below – and is funding a new e-Health system for our service people!

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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.

That is an increase of more than $200 billion by then. Forty years ago, federal spending on health was only 1.2 per cent of GDP.

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http://www.smh.com.au/national/health-spending-to-swamp-budgets-20100124-msls.html

Health spending to swamp budgets

JONATHAN PEARLMAN AND LINTON BESSER

January 25, 2010

KEVIN RUDD has warned that the states are being ''overwhelmed'' by rising health costs as he gears up for an election fight over an overhaul of hospital funding.

Citing figures from the coming third intergenerational report, the Prime Minister said yesterday health spending was set to swamp the public purse and he sought to pave the way for a battle with the states over control of funding.

He singled out NSW, where the Treasury estimates spending will more than double over 22 years to 55 per cent of the budget.

''Rapidly rising health costs create a real risk - absent [of] major policy change - state governments will be overwhelmed by their rising health spending obligations,'' he said in a speech in Sydney. ''Without reform, states' ability to provide the services they currently provide will be significantly strained. That is why 2010 must be and will be a year of major health reform.''

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http://www.smh.com.au/opinion/politics/rudds-options-on-health-costs-are-alarmist-and-misleading-20100126-mw8a.html

Rudd's options on health costs are alarmist and misleading

January 27, 2010

Welcome to another year of media manipulation by our political leaders. Don't you love it? The Rudd Government is sitting on two major economic reports - from the Henry review on tax reform and Treasury's third intergenerational report - and some day soon it will let us see them. Meanwhile, it's leaking to journalists or dropping into speeches bits and pieces from them.

In the week leading up to Australia Day, Kevin Rudd gave a series of speeches in each capital city purporting to outline the findings of the intergenerational report on the implications of our ageing population. His version was both debatable and - I think we'll find - quite misleading.

In ''sounding the alarm bells'' on the effects of ageing, his first point was that it will lead to much slower growth in our material standard of living. Whereas average real income per person grew by 1.9 per cent a year over the past 40 years, Treasury's projections show it growing by only 1.5 per cent a year over the next 40.

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http://www.psnews.com.au/Page_psn2017.html

Defence battles health problems

New medical services that improve the treatment of wounded servicemen and women in the Australian Defence Force have been announced by the Minister for Defence Personnel, Greg Combet.

Mr Combet said the health and wellbeing of Defence personnel was a top priority for the Government.

“That is why we are putting considerable funding into new and improved Defence health initiatives,” he said.

.....

“We will continue to provide our personnel with world class health care, that is why we are also funding a comprehensive e-health system to improve the maintenance of ADF health records,” he said.

http://www.smh.com.au/technology/enterprise/computers-under-constant-attack-20100128-n1s0.html

Computers under constant attack

CONRAD WALTERS

January 29, 2010

THIRTY per cent of computer systems for the nation's essential services such as banks, government and utilities are repeatedly attacked by hackers every month, according to an international report released today. More than half of those targets are hit multiple times a week or even multiple times a day, and the situation could get worse.

Forty per cent of the Australian experts surveyed for the report believed the nation would sustain a ''major cyber incident'' against its key services in the next 12 months. Given a two-year timeframe, the figure jumped to 53 per cent, and 76 per cent expected a major digital strike against the nation's critical infrastructure within five years.

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http://www.pharmacynews.com.au/article/nps-drug-information-hotline-shelved/510137.aspx

NPS drug information hotline shelved

28 January 2010 | by Mark Gertskis

A drug information telephone hotline used by pharmacists will be shut down in the middle of the year because of rising costs and limited reach.

The National Prescribing Service (NPS) has confirmed that it would stop funding the Therapeutic Advice and Information Service (TAIS) on 30 June.

Staffed by specialist pharmacists, the service provides information on new drugs, side effects and drug interactions.

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http://www.6minutes.com.au/articles/z1/view.asp?id=510128

GPs lack email for discharge summaries

by Jared Reed

A fax is the GP’s preferred method of receiving a hospital discharge summary because many practices do not have an email address, despite high levels of computerisation.

In a study that pitted fax, email, post and patient hand delivery against each other, fax and email were found to be the most reliable method of a GP receiving their patient’s discharge summary, in randomised controlled trial of 196 geriatric patients at a Sydney teaching hospital.

The researchers found that most practices stored their information electronically, and almost 90% used medical prescribing software - but most still preferred to receive information by fax, meaning staff would need to manually scan documents to the patient’s file.

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http://www.computerworld.com.au/article/334165/gaming_tech_spurs_development_hyperfast_medical_imaging_systems/?eid=-255

Gaming tech spurs development of hyperfast medical imaging systems

University, hospital team to build tools to boost medical image processing by 1,000 times.

University and hospital researchers have taken a cue from the gaming industry by using 3D video graphics chips to develop a parallel software platform that can speed the processing times, in this case for medical digital imaging, by 10 to 1,000 times.

Northeastern University in Boston and Massachusetts General Hospital (MGH) were jointly awarded a $1.3 million grant from the National Science Foundation in December to develop the technology and use it to enhance several biomedical imaging applications, including software designed for breast and brain imaging.

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http://www.psnews.com.au/Page_psn20116.html

Agencies plug into eHealth systems

The Minister for Health, Nicola Roxon, has visited the offices of Medicare Australia in Canberra to see for herself how a new, secure eHealth system would work for health care patients and professionals.

Ms Roxon said her visit showed how useful tools such as electronic health records, medications-management systems and electronic discharge, referrals and prescriptions would be. She said the new e-health system would improve patient care and efficiency.

She said unique healthcare identifiers would be assigned to all health consumers and professionals by the middle of the year, following the passage of the Healthcare Identifiers Bill 2010 and would be provided in addition to Medicare numbers to ensure security.

Ms Roxon said the Government was “committed to continuing implementation of eHealth to support a more effective health system.”

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http://www.thefreelibrary.com/A+new+era+in+clinical+communications:+a+report+on+the+past+year%27s...-a0216961585

A new era in clinical communications: a report on the past year's work at NEHTA.

Introduction

The development of a national electronic health system for Australia goes hand in hand with consultation and collaboration with government, industry and health sector stakeholders. Meeting the needs of the Australian public and ensuring that e-health systems meet consumer expectations of safety, quality and security is paramount to the success of e-health for Australia. To this end, the National E-Health Transition Authority (NEHTA NEHTA National E-Health Transition Authority (Australia) ) has spent the past year interacting with stakeholders and understanding both technical and social requirements to advance the e-health agenda. Following on from an independent review conducted by the Boston Consulting Group late in 2008, NEHTA launched an Action Plan for Adoption Success (1) to further develop our collaboration and engagement with industry, the healthcare sector, consumers and the state, territory and federal governments. The Action Plan flows directly from NEHTA's acceptance of all the recommendations in the review and resulted in a multifaceted program of stakeholder engagement. This took the form of NEHTA-hosted events, seminars and consultation forums; external conferences and presentations; informal briefings; face-to-face meetings; and NEHTA produced publications.

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http://www.computerworld.com.au/article/334035/telstra_separation_bill_delayed_again/?eid=-6787

Telstra separation bill delayed again

Federal Government's efforts to force separation upon the telco will be sidelined due to "more pressing considerations"

The Federal Government's proposed legislation for the separation of Telstra (ASX:TLS) has been delayed again thanks to big ticket items to be discussed in the Senate hearings starting on February 2.

A spokesperson for Communications Minister Stephen Conroy said the senator plans to have the bill heard "this year" but could not make the next sitting in the first week of February because of "more pressing considerations".

The spokesperson would not provide any further details on the situation.

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http://www.theaustralian.com.au/australian-it/windows-70-upgrade-closes-off-an-upgrade-option/story-e6frgakx-1225823429974

Windows 7.0 upgrade closes off an upgrade option

A LONG-TIME Microsoft user is furious at the loss of basic back-up functions after upgrading to Windows 7 Family Pack.

But Microsoft says users should visit its website and research products before buying.

Former Australian Computer Society president Philip Argy had PCs at home running various versions of Windows: XP Professional 32-bit, Vista Ultimate 64-bit, and Windows 7 Home Premium.

He had never had any problem manually backing up files to a Linksys external storage system, and late last year Microsoft began offering a "family version" of Windows 7, which allows upgrades to three PCs for the single price of about $280.

Mr Argy bought the family edition, on which the packaging states that all editions of Windows XP and Windows Vista can upgrade to Windows 7.

On the back of the box is a statement that automatic backup is possible for Professional and Ultimate versions, but not Home Premium. It says: "Recover your data easily with an automatic backup to your home or business network".

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http://news.smh.com.au/breaking-news-world/nasa-ends-effort-to-free-rover-spirit-20100127-mwt4.html

NASA ends effort to free rover Spirit

January 27, 2010 - 8:09AM

AFP

NASA says efforts to free the Spirit rover bogged down by Martian sand are over and instead the plucky robot is hunkering down to brave the harsh Mars winter.

"Spirit is not dead; it has just entered another phase of its long life," said Doug McCuistion, director of the Mars Exploration Program at NASA headquarters in Washington.

"It looks like Spirit's current location on Mars will be its final resting place," he said on Tuesday

Earlier this month NASA, celebrated Spirit's bountiful, six-year stint on the Red Planet, much longer than the three months it was forecast to last.

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Pretty sad after such a great effort!

Enjoy!

David.

Wednesday, February 03, 2010

NEHTA is Leaking Like A Sieve – A Symptom The Organisation is in Deep Trouble I Suspect.

The following just dropped over the fence into my lap today.

Document Title.

Unique Health Indicator Project

Project Health Check

National eHealth Transition Authority

Date: 13 March 2009

The authors of the document are SMS Management and Technology – a listed technology consulting firm.

I think quoting from the Executive Summary says all that is needed.

Executive Summary

Review Approach

This report details the results of a project health check undertaken of the Unique Health Identifier (UHI) project at nehta. The project review was undertaken over 10 days and involved in-depth interviews of project team members, suppliers and senior managers and a review of key project artefacts. The report assesses the UHI project’s health in 14 key elements, notes any exceptions to these findings and makes recommendations for improving the health of the project. Annex A outlines the approach to interviews and questionnaires used in the review.

Using the intelligence gathered through the project health check (scored in Annex B), an assessment has been made of the project’s ability to deliver. Overall, the Unique Health Identifier project is rated as RED. Unless significant changes are implemented, this project will not deliver agreed scope within timeline or quality tolerances. There are critical issues and concerns that exist within the project that require management intervention by the project sponsor, programme management and other senior management.

Summary of Key Findings

There is a lack of organisational project management and delivery competencies

Dysfunctional Project team environment

o UHI team communication is intermittent, piecemeal, reactive and selective

o UHI team lacks clarity as to team and individual deliverables

o No clear critical path or project plan and supporting roadmap for the Pilot

o Management of scope definition and scope creep has been a major cause of project delay

UHI team members are confused as to the role and accountabilities of the UHI team and nehta

. There is confusion between the following roles:

o governance oversight

o policy concept development

o delivery and design

o stakeholder marketer or advocate

Medicare team members also have some confusion as to nehta’s role in relation to the project

Lack of clarity on all aspects of the Pilot

o There is no documented description of the deliverable, no critical path, no comprehensive allocation of responsibilities for team members, or current risks and issues log

o There may be contractual changes required to enable delivery and operation of the December Pilot

o Some team members lack confidence in the team’s ability to deliver to the December 2009 deadline

· Medicare working relationship at the non-executive level is fractured

· Project governance structure is not clear and has been ineffective

· Lack of effective private sector stakeholder engagement

Summary of Key Recommendations

H.1. Immediate focus on scoping and planning for the December 2009 pilot

H.2. Lock down scope to ensure no more scope creep

H.3. Invest in addressing the UHI team’s morale issues

H.4. Improve team communications on the critical path and team accountabilities

H.5. Establish a streamlined governance structure for December 2009 delivery

H.6. More actively manage risks and issues at all levels within the UHI project

H.7. Maintain joint Medicare and nehta executive sponsorship with a focus on improving the working relationship between nehta and Medicare

H.8. Engage key internal and external stakeholders on the December 2009 Pilot

H.9. Build organisational project management competencies

H.10. Implement a structured project methodology immediately

----- End Extract.

That less than 12 months ago the HI project was in this state reflects pretty badly on all concerned – one can only hope it is much, much better now!

At a broader level it seems to me that so much arriving in just a day or so just shows how dysfunctional NEHTA has become and how a much broader review of all that is going on is really warranted.

I am sure there is enough information here for an FOI request for the full document to have the desired effect now we are told NEHTA is subject to FOI. See here for details.

Peter West (in a comment found here)

http://aushealthit.blogspot.com/2010/01/has-time-come-to-just-ignore-nehta-and.html

told us:

Where does this idea that NEHTA is not subject to FOI come from?

I have an email from Jim Claremont, Department of the Prime Minister and Cabinet to the effect that NEHTA has been identified as an agency for the purposes of the Freedom of Information Act 1982 (Cth).

FOI requests for NEHTA documents can be lodged with
Department of Health and Ageing
GPO Box 9848
CANBERRA ACT 2601
FOI Contact Officer is on 02 6289 1718.

Go for it!

----- End Comment.

I am also told there have been a large number of staff also leaving in the last few months and that this is, in part, due to the rather poor organisational culture. Looking today NEHTA has 17 jobs advertised which seems high for an organisation with of the order of 150 people.

The sooner a formal review is undertaken the better in my humble opinion.

David.

Request to Take Files Off Line

I have just had a call from NEHTA. They claim the documents are draft and so may mislead. On that basis I will agree to remove them.

NEHTA has agreed, with me, to make the finalised document public - so we will see if that happens.

Sorry to all those who are curious but were not quick enough.

David.

Tuesday, February 02, 2010

What Fun - NEHTA Lets its Health Identifier Communications Strategy Out!

All of us who did not fall down in the last day or two are aware of the media management and spin NEHTA is prone to.

Well, for the first time we are now able to provide interested readers with the ‘communications strategies’ (read spin crib sheets) NEHTA is planning to use to sell the Health Identifier Service to consumers and health care providers.

The documents are very current – being dated 29 Jan, 2010

There is little doubt that there is a substantial ‘spin’ component when we read.

“Communication Objectives

The objectives of this strategy is to:

· Increase the national awareness of e-health and its associated benefits to all Australians – this is in conjunction with specific campaigns focused on the introduction of healthcare identifiers to the Australian public.

· Foreground the introduction identifiers as a fundamental component to enabling e-health.

· Articulate strategies and tactics to manage media issues and unfavourable and inaccurate messages about the HI Service and e-health.

· Shape public ‘consumer’ opinion to support and embrace the concept of e-health and the introduction of identifiers to the Australian public.”

The talk for shaping opinion says it all.

We learn of all sorts of things we are going to be subjected to.

First and most amusingly we read that your inoffensive blogger is to have paid for competition!

“E-health Blog

NEHTA is sponsoring an e-health blog that is being established and managed by blogger Charles Wright. The purpose of the blog is to give consumers with an interest in technology factual information about e-health and the HI Service and to combat other sources of misinformation.”

Could that be little old me?

Next a new website is about to be launched in a few days.

“e-health website

www.ehealthinfo.gov.au is a jurisdiction (federal and state health departments) owned website to serve as the primary internet gateway to e-health information and knowledge. This website will be the focal point for sharing the combined activities and knowledge of e-health stakeholders, delivering information and knowledge to healthcare managers and providers, as well as providing healthcare consumers with an authoritative information source.

The site will serve to raise awareness of e-health and provide general information in addition to information that’s specific to particular industry audiences.

This site will have a soft launch on February 5th with a large public launch by the end of February.”

Third we are going to muck about with Google to get more attention.

“Search Engine Optimisation

Google Searches/ Search Engine Optimization – leveraging key word searches and tactics to place targeted content online. An online and search engine strategy is being developed to drive traffic to the blog and ehealthinfo.gov.au including other online material we need to highlight.”

Fourth there seems to might be a bit of secret influence peddling going on.

“RACGP Co sponsorship

NEHTA and the RACGP have entered into an agreement whereby NEHTA will assist the RACGP as they prepare the next version of the RACGP Standards for General Practices which is the foundation for Practice Accreditation. NEHTA will also be the major sponsor of the RACGP National Conference in 2010. As part of this sponsorship, 12 topics that relate to the Standards will be developed as topics to promote e-health to consumers. One topic is being developed each month and a news release is being distributed to media outlets with a view to them picking up the story. This is mainly a mainstream print media campaign.”

I wonder how the membership would see this? An assault on College independence maybe? I sure would.

Fifth it seems there are some really expensive heavy spinners involved.

“E-health Promotion

To increase the national awareness of e-health and its associated benefits to all Australians, in conjunction with specific campaigns focused on the introduction of identifiers, we have engaged integrated marketing and communications agency The Campaign Palace.

The Campaign Palace will leverage our communications messages around wellness, personal empowerment, health, positive lifestyle experiences and preventive care in a variety of online and offline media.

To counterpoint the work of the Campaign Palace, international public relations firm Hill and Knowlton will implement a mainstream media campaign that involves engaging e-health champions to be the expert and trusted “voice” to present credibility of our messages to the Australian public.”

The experts who they seem to indicate they may use are a diverse bunch from Delta Goodrem to Professor Kerryn Phelps and Ita Buttrose. I wonder have they all agreed?

We are also to be Issues Managed.

“Issues Management

To manage media issues and unfavourable and inaccurate messages about the HI Service and e-health we have employed the services of specialist Canberra public relations firm McManus, Skotnicki and Associates to assist with proactive and reactive issues. Principals Gerard McManus and Tom Skotnicki have strong connections with the Canberra press gallery and Canberra political media and understand the process of government. They have notable experience in issues management and dealing with contentious media issues.

Issues are managed proactively and potential issues that may negatively impact on the progress of e-health are responded to quickly.”

Last we are to be subjected to paid articles in the medical press – advertorials!

“Advertorial

This is a paid form of editorial and provides an effective means of conveying information in a controlled and strategic manner. NEHTA will explore opportunities to promote key developments through advertorial in specialist publications such as Australian Doctor and Medical Observer. Consideration will have to be given to MCGC processes if this is undertaken.”

Enough – read the gory details for yourself!

The files can be downloaded here:

Removed at NEHTA Request

and here:

Removed At NEHTA Request

Enjoy reading and as they say forewarned is forearmed!

I will note in passing – as free advice to NEHTA – their case for fostering provider adoption looks flimsy at best.

David.

Monday, February 01, 2010

Treasury Releases the 2010 Intergenerational Report.

Just a short post to note the report has been released.

The report can be downloaded from this page.

http://treasury.gov.au/igr/igr2010/

I have to say this report is quite pathetic in my view. It is alarmist – describing us as ‘hot, crowded, ailing and ageing’.

The modelling seems to me to have been done on assumptions that are not really explicit and while the negative impact of technology on costs is mentioned the beneficial effects on productivity and so on are just ignored.

Sure it will cost a bit more to care for our population as we all age, but where is the modelling of the offsets and the positive things we might do to make things less difficult for all of us.

As for mentioning e-health in assisting health sector not anywhere to be found.

Hopeless, technically inadequate and hysterical while offering no list of offsets that might be possible. A purely political document in my view.

David.

Some Amazing Figures from the eRx E-Prescribing System’s Operators.

A very interesting article appeared in Pharmacy Daily in mid January. Two paragraphs especially caught my attention.

Pharmacy Daily Monday 18th January 2010

eRx welcomes funds

.....

eRx has also confirmed that it will continue to provide a free e-prescription service to eRx users via the current Guild funding for 10.6 million transactions and AFSPA funding for 500,000 membership transactions.

More than 3700 pharmacies, general practitioners and medical specialists have registered to use eRx since its Apr 09 launch, with 7.5 million electronic prescriptions already sent to the exchange, of which 1.7m have been dispensed.

.....

The full issue is downloadable from here:

http://www.pharmacydaily.com.au/getattachment/cca1def7-f248-4816-aee0-474ac25c7625/1-18-2010-12-00-00-AM.aspx

A few things struck me.

The first thing that struck me was that the penetration of registration for the service has clearly reached a real ‘critical mass’

The second was that the ‘free use’ of the system was soon going to run out.

I was also rather confused by the huge number of prescriptions that had been sent to the exchange (7.5M) and that only 23% of those had been dispensed.

What on earth is going on here? Surely more than that proportion or patients actually go and get their medicine from the chemist?

Is it that people are turning up to pharmacies who are not connected to eRx?

Or is it that the meaning of the barcode on the prescription is not being recognised and used for what it is.

I think it would be very interesting to know what is actually happening that these figures are reached. It would be also interesting to know what happens after the prescriptions expire. Right now seems a lot of unloved prescriptions are sloshing around eRx.

Clearly we will need to get the linkage between prescriber, pharmacist and patient working better than this at some point in the future!

David.