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."

Sunday, March 21, 2010

Weekly Australian Health IT Links - 21-03-2010.

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. Note also that full access to some links may require site registration or payment.

General Comment:

The early part of the week was clearly dominated by the Health Identifiers Bill Inquiry and the report that was produced and tabled in what must have been in near record time. It looks like debate in the Senate will happen in early May – during the Budget Session. It is not clear how it will all work out at this point.

Now that we have seen the outcome of the Tasmanian and SA elections it does seem Mr Rudd’s proposals are going to meet continuing scrutiny. It also seems the COAG meeting, due on April 11, might also be delayed a little.

Also this week we see continuing issues with just how the NBN and Telstra will work together (or not). No doubt we would all like to see this just sorted out so that the infrastructure is in place for e-Health applications to use when they are ready.

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http://www.infosecurity-us.com/view/8179/iso-issues-new-guidelines-for-safeguarding-electronic-medical-data-/

ISO issues new guidelines for safeguarding electronic medical data

18 March 2010

ISO has published two new documents outlining principles and guidelines for secure archiving of electronic medical record data.

The Switzerland-based International Organization for Standardization, more commonly known as ISO, has just released two new briefs that address the complex nature of securing electronic medical record data. The organization concluded that documents outlining both data protection principles and guidelines were necessary to provide harmonized international standards for this industry, where information is quite sensitive and regulations regarding data transfer and storage abound.

Although the use of electronic medical records has proliferated throughout the globe as of late, its use is “exacerbating issues such as confidentiality, integrity, availability, and accountability” of the data, according to the Pekka Ruotsalainen, who led the project to develop the standards.

Ruotsalainen’s group produced two documents: Health Informatics – Security requirements for archiving of electronic health records – Principles, and Health Informatics – Security requirements for archiving of electronic health records — Guidelines. Each is available for purchase from the ISO website.

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http://www.theaustralian.com.au/news/health-science/medical-dividend-from-biosecurity-network/story-e6frg8y6-1225842567635

Medical dividend from biosecurity network

Leigh Dayton, Science writer

From: The Australian

March 20, 2010 12:00AM

THIS week's launch of the Australian Biosecurity Intelligence Network promises spin-offs for public health as well as improved preparedness for biological threats to plants and animals.

Based in Canberra and headed by geneticist, immunologist and counter-terrorism expert Joanne Banyer, the network will provide secured communications and information technology infrastructure to enable experts and officials to tackle emerging biosecurity threats.

"We think of it as providing the collaboration infrastructure," explains Stephen Prowse, an expert in immunology, infectious diseases and diagnostics with the University of Queensland and an ABIN board member.

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http://www.medicalobserver.com.au/index.php/news/nehta-set-to-miss-deadline-for-identifier-numbers?hash=0f4c9790d7a85b5ee7acc95ba1b597bd-41f78717d591531fca1ca679682ca2f3

NEHTA set to miss deadline for identifier numbers

19th Mar 2010

Shannon McKenzie

THE National e-Health Transition Authority is almost certain to miss its 1 July deadline to begin the national rollout of its healthcare identifier numbers, after the necessary legislation was delayed in Federal Parliament.

Senate debate on the Healthcare Identifiers Bill 2010 has now been pushed back to 11 May. However, given this is scheduled to be a short parliamentary session ahead of the federal Budget, there is no guarantee the legislation will be passed on this date.

National e-Health Transition Authority (NEHTA) clinical lead Dr Mukesh Haikerwal said this would “absolutely cause a delay” in the program, but one that could present opportunities.

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http://www.geelongadvertiser.com.au/article/2010/03/20/156531_news.html

Top doc praises our e-health uptake

Joel Cresswell

March 20th, 2010

GEELONG is a leader in Australia's movement to electronic health, according to one of the nation's top GP's.

The clinical head of the National E-Health Transition Authority, Mukesh Haikerwal, said Geelong's hospital and GP network had embraced electronic data collection and communication, well ahead of the remainder of the technologically "backward" sector.

He said the changes had streamlined drug prescriptions, diagnosis and reduced double handling between the hospital and GPs.

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http://www.healthtechwire.com/The-Industry-s-News-unb.146+M570d0560a7c.0.html

Chronic disease and demographic development to drive eHealth adoption

BARCELONA, SPAIN - (HealthTech Wire / News) – At The World of Health IT, iSoft, one of the largest eHealth companies in the world with more than 13,000 customers, launched its Health Information Exchange (HIE) platform, which connects all stakeholders in healthcare – including the patient. Andrea Fiumicelli, Chief Operating Officer at iSoft, spoke to HealthTech Wire about the factors that will drive eHealth adoption in Europe and how his company is advancing ICT in healthcare.

According to Fiumicelli, the major challenges in European eHealth are the actual processes.

“The industry has been ready to establish a single European eHealth market for the past 5 to 8 years. The technology is no longer a limiting factor. However, the processes are and we would welcome a simplification, e.g. with regards to reimbursement,” Fiumicelli said. This would ease innovations and lead to more efficient research and development.

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http://www.medicalobserver.com.au/index.php/news/software-vendors-urge-ehealth-subsidies-for-gps

Software vendors urge e-health subsidies for GPs

19th Mar 2010

SOFTWARE vendors have argued that GPs should be subsidised to upgrade computer software that will enable the rollout of a national e-health system.

Shannon McKenzie

SOFTWARE vendors have argued that GPs should be subsidised to upgrade computer software that will enable the rollout of a national e-health system.

Addressing a Senate inquiry into proposed legislation that will enable the rollout of the unique health identifiers (UHI) scheme, Dr Vincent McCauley, treasurer of the Medical Software Industry Association, said while GPs would be required to invest in new software, they would not necessarily reap the benefits.

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http://www.theaustralian.com.au/australian-it/health-identifier-bill-delayed/story-e6frgakx-1225841967151

Health identifier bill delayed

  • Karen Dearne
  • From: Australian IT
  • March 17, 2010 4:25PM

SENATE consideration of the Rudd Government's controversial Healthcare Identifiers Bill will not take place until budget day on May 11.

This follows a tumultuous week of testimony and a rushed report recommending adoption despite Coalition concerns and calls for amendments.

The Healthcare Identifier service, to be run initially by Medicare Australia, is due to commence on July 1.

Medical software specialists, privacy advocates and the e-health community had been seeking more details on how the scheme would work.

Late last Friday, Health Minister Nicola Roxon finally released draft regulations underlying the proposed legislation, and invited public comments by April 9.

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http://www.smh.com.au/technology/this-brainless-patient-is-no-dummy-20100320-qn7n.html

This brainless patient is no dummy

RACHEL BROWNE

March 21, 2010

MEET the new high-tech robot suffering from a multitude of health problems helping to save lives around Australia.

SimMan 3G might look like a dummy but he is surprisingly smart. He talks, cries and bleeds as well as replicates conditions ranging from anaphylaxis to cardiac arrest.

Costing $100,000, the wireless robot is being used by hospitals, universities, the Defence Force and ambulance services.

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http://www.theage.com.au/victoria/hospitals-caught-out-on-data-says-doctor-20100318-qicu.html

Hospitals caught out on data, says doctor

JULIA MEDEW

March 19, 2010

VICTORIANS should expect the performances reported by most hospitals to drop this year as a result of a crackdown on data rorting, a Melborne doctor says.

Dr Peter Lazzari - who was dropped by Angliss Hospital last year after he spoke about waiting-list manipulation - said that if hospitals reported waiting times honestly this year, their performance on paper could look much worse.

Last year, Victoria's Auditor-General Des Pearson found that at least three Victorian hospitals inappropriately removed patients from waiting lists and one had ''admitted'' them to fictitious wards.

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http://www.6minutes.com.au/articles/z1/view.asp?id=513539

Senate wary of health identity numbers

by Michael Woodhead

Concerns about privacy and 'function creep' have dominated Senate discussions over the introduction of unique health identifier numbers for all Australians.

Last week’s Senate hearings into the proposed July introduction of health identifiers saw Senators asking pointed questions about whether Medicare and other agencies could guarantee privacy of patients’ medical records under such a scheme.

Medicare representatives rejected media claims that Medicare staff were routinely gaining unauthorised access to on personal medical files, saying that compliance programs had reduced the instances of snooping from 270 in the first year of e-health programs to just 16 the last six months.

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Crikey, March 16, 2010

http://www.crikey.com.au/2010/03/16/health-id-cards-unleash-scary-little-brothers/

17. Health ID cards unleash 'scary' Little Brothers

Stilgherrian writes:

AUSTRALIAN HEALTH CARE, ID CARDS, IDENTITY THEFT, NATIONAL IDENTITY CARD

Comparing the proposed Healthcare Identifier to the doomed 1980s Australia Card is a cliche, I know, but it’s spot on. The Healthcare Identifiers Bill introduced last Wednesday is sketchy at best, and health minister Nicola Roxon has already been forced into releasing an equally sketchy draft of the accompanying regulations on Friday.

The legislation authorises Medicare to issue a new 16-digit healthcare ID number, central to the government’s eHealth strategy, to every Australian and every healthcare provider from July 1. But that’s about all it does. It fails to address in any real detail what protections will be implemented when this one identifier provides the key to everything from an appointment with your masseur or your dentist to your s-xual or mental health records.

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http://www.smh.com.au/national/gps-angry-about-bypass-program-on-web-20100315-q9og.html

GPs angry about 'bypass' program on web

KATE BENSON HEALTH

March 16, 2010

AUSTRALIAN researchers have developed a world-first program that allows people to bypass GPs and be assessed, diagnosed and treated by psychologists over the internet.

About 1000 people have already been treated for anxiety disorders, including obsessive compulsive disorder and agoraphobia, and developers, from Swinburne University in Melbourne, want to start treating depressives, bulimics and gamblers next month.

The program, designed to tackle the nation's crippling shortage of mental health services, has drawn the ire of doctors, concerned that patients could be dangerously misdiagnosed.

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http://www.theaustralian.com.au/australian-it/medicare-data-breaches-increase-privacy-fears/story-e6frgakx-1225841101367

Medicare data breaches increase privacy fears

MEDICARE Australia dealt with 234 serious data privacy breaches by employees in 2007-08, but 160 of these resulted in only an emailed warning or counselling.

In the three years from November 2006 until December last year, 569 staff were identified as having "unauthorised access" to client records held by the agency.

Contrary to recent Medicare claims that most of the unauthorised access related to staff accessing their own records, only 171 out of the 569 investigated were in that category.

Medicare was yesterday forced to produce data breach statistics and details of sanctions to a senate inquiry, after disputing revelations in The Australian of staff snooping.

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http://www.theaustralian.com.au/australian-it/heath-identifier-function-creep-threatens-data-privacy-says-coalition/story-e6frgakx-1225841103224

Heath identifier function creep threatens data privacy says Coalition

Karen Dearne

From: The Australian

March 16, 2010 12:00AM

THE Senate Community Affairs committee has recommended passage of the controversial Healthcare Identifiers Bill, despite the minority Coalition members calling for amendments to ensure patient privacy and prevent personal identifiers being turned into a national identity regime.

Last night, the committee recommended developing a plan to introduce the scheme over the next two years, opening it to public comment before finalisation.

"The National E-Health Transition Authority in partnership with the Health Department and Medicare should more effectively engage all stakeholders in establishing the HI service," it said.

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http://www.theaustralian.com.au/australian-it/reject-e-health-identifier-bill-says-law-professor/story-e6frgakx-1225841104102

Reject e-health identifier bill, says law professor

THE Healthcare Identifiers Bill should be rejected until the Rudd government provides the full suite of legislation intended to support new national electronic health initiatives, a Senate inquiry has been told.

Law professor Graham Greenleaf, co-director of the Cyberspace Law and Policy Centre at the University of NSW, said the fundamental problem was that the bill was incomplete, covering only a "small but central element of a much broader health identification and surveillance system", including future personal e-health records.

"When seen in its entirety, this system shares a very large number of common elements with the discredited and rejected Australia Card (in 1986-87) and the Access Card (2006-07) proposals put forward by governments from both parties," he said.

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http://www.zdnet.com.au/blogs/patch-monday/soa/Can-privacy-and-health-identifiers-mix-/0,2001107879,339301777,00.htm

Can privacy and health identifiers mix?

Posted by Stilgherrian @ 17:32

A new 16-digit healthcare identifier for all Australians is a centrepiece of the Rudd Government's e-health strategy. The numbers are scheduled to be issued from 1 July, but have the privacy issues been properly thought out?

The Healthcare Identifiers Bill (PDF) is currently making its way through parliament, but many key details have been left to be defined in regulations. After pressure in a Senate committee, Health Minister Nicola Roxon was forced to release draft regulations (PDF) on Friday, but they're still short on details.

http://media.cnetnetworks.com.au/audio/musiccentre/patch_monday/patch_monday_ep34_01.mp3

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http://www.zdnet.com.au/news/software/soa/Senators-split-over-e-health-Bill/0,130061733,339301800,00.htm

Senators split over e-health Bill

By Ben Grubb, ZDNet.com.au
16 March 2010 03:14 PM

Senators looking into the Federal Government's Health Identifier Bill as part of a Senate inquiry have not been able to reach a consensus over whether they recommend the new law be passed.

The Bill — due for debate as the third item on the Senate's orders of the day on 11 May — is required to be passed in order for Australians to be issued a 16-digit national healthcare identifier. The Federal Government intends to have the Bill passed before 1 July, when the roll-out is due to begin.

Health Minister Nicola Roxon referred the Bill to a Senate Committee late February due to high levels of community interest. The report from the committee's inquiry has shown in its corresponding report that Coalition and Labor senators are split over privacy concerns and evidence raised in submissions.

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http://www.e-health-insider.com/news/5737/isoft_makes_move_on_consumer_healthcare

ISoft makes move on consumer healthcare

16 Mar 2010

ISoft has formed a partnership with Switzerland-based telehealth device company Medic4all. The two companies are showcasing integrated telehealth products at the World of Health IT conference in Barcelona.

These include a monitoring operations centre that manages patient data and a home care platform that allows healthcare professionals to remotely monitor, diagnose and care for patients.

According to iSoft, one of key differentiators between its "end to end" solution and what other companies are offering is the look and appeal of each of the devices.

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http://www.computerworld.com.au/article/339598/isoft_reaffirms_revenue_guidance/?eid=-255

iSoft reaffirms revenue guidance

Says work under the UK’s National Programme for IT (NPfIT) remains on track

iSoft (ASX:ISF) has moved to reassure investors that its FY10 financial guidance and work on the UK’s National Programme for IT (NPfIT) remains on track.

In an ASX statement today the e-health provider said it was on track to achieving the agreed data for the roll out of its Lorenzo application at Cumbria's University Hospitals of Morecambe Bay NHS Trust under the NPfIT. This was contrary to recent speculation in media reports.

“iSoft expects the milestone at Morecambe Bay to be met according to the timetable agreed between its partner Computer Sciences Corporation [CSC] and the National Health Service [NHS], and expects this achievement to trigger a cash payment to the company,” the statement said.

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http://abnnewswire.net/press/en/62442/iSOFT_Group_Limited_%28ASX:ISF%29_Reaffirms_FY10_Guidance_and_Says_NPfIT_Commitments_on_Track.html

iSOFT Group Limited (ASX:ISF) Reaffirms FY10 Guidance and Says NPfIT Commitments on Track

Sydney, Mar 15, 2010 (ABN Newswire) - iSOFT Group Limited, Australia's largest listed health information technology company, today reaffirmed its guidance for fiscal 2010 and said it is on track to achieve the agreed date for the rollout of Lorenzo at University Hospitals of Morecambe Bay NHS Trust under the UK's National Programme for IT (NPfIT).

Morecambe Bay "go-live"

iSOFT remains on track for the "go-live" of Lorenzo Regional Healthcare Release 1.9 at Morecambe Bay in accordance with the agreed schedule, contrary to recent speculation in media reports. iSOFT expects the milestone at Morecambe Bay to be met according to the timetable agreed between its partner Computer Sciences Corporation (CSC) and the NHS, and expects this achievement to trigger a cash payment to the company.

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http://www.e-health-insider.com/news/5741/isoft_says_it_is_%27on_track%27_at_morecambe

iSoft says it is 'on track' at Morecambe

16 Mar 2010

Australian health IT firm iSoft yesterday said it was “on track” to implement Lorenzo across University Hospitals of Morecambe Bay NHS Trust by the end of March.

In a statement to the Australian Stock Exchange, the company said it would meet its promised revenues and added: “iSoft remains on track for the ‘go-live’ of Lorenzo Regional Healthcare Release 1.9 at Morecambe Bay in accordance with the agreed schedule, contrary to recent speculation in media reports.”

Last week, E-Health Insider reported that local service provider CSC and iSoft look set to miss the 31 March deadline for the go-live across the trust.

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http://www.theaustralian.com.au/news/opinion/broadband-network-will-be-43bn-white-elephant/story-e6frg6zo-1225841083908

Broadband network will be $43bn white elephant

Malcolm Colless

From: The Australian

March 16, 2010 12:00AM

THE present federal budget describes the Rudd government's $43 billion national broadband network as the single largest building infrastructure project in Australian history.

But it could end up as one of Australia's biggest and costliest infrastructure debacles. And that's saying something when you look at the financial disaster that has engulfed the home insulation program and the amount of taxpayers' money wasted on the mismanagement of the primary school building revolution.

What has emerged from these multi-billion-dollar spending splurges is an absence of good governance. Political rhetoric and spin have taken precedence over economic common sense.

The NBN is no exception. It is just that the financial cost of failure is so much higher. The project's operating body, NBN Co, is flying by the seat of its pants on a mission from Kevin Rudd to deliver a national high-speed fibre-optic broadband network at the cutting-edge of world standards.

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http://www.theaustralian.com.au/australian-it/conroy-set-for-clash-over-nbn/story-e6frgakx-1225841689131

Conroy set for clash over NBN

Mitchell Bingemann

From: The Australian

March 17, 2010 12:00AM

THE Rudd government will today defy a Senate order by not releasing the study into the costs, structure and financial viability of the $43 billion national broadband network.

Last week, Greens senator Scott Ludlam lodged a Senate order for Communications Minister Stephen Conroy to release the $25 million KPMG and McKinsey study by 10am today.

It is understood the government will ignore the request.

"It's extremely politically dangerous for the government to not table the study because they have been referring all the unanswered questions about the information vacuum surrounding the NBN to this particular study," Senator Ludlam said.

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http://news.smh.com.au/breaking-news-national/broadband-network-hangs-in-balance-20100318-qg66.html

Broadband network hangs in balance

March 18, 2010 - 7:59AM

AAP

The federal government has until 10am (AEDT) on Thursday to produce a report that might determine whether the Senate approves Labor's planned national broadband network strategy.

But the Australian Greens, who are threatening to withdraw their support for key legislation paving the way for the break-up of Telstra, are not holding out much hope the government will agree to the upper house demand.

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http://www.smh.com.au/technology/enterprise/word-excel-powerpoint--free-on-the-web-20100315-q7g7.html

Word, Excel, Powerpoint - free on the web

LIA TIMSON

March 15, 2010 - 3:43PM

Microsoft is rising to the challenge of Google Docs, offering free Office applications on the web as it releases Office 2010.

New paid versions of the ubiquitous office suite will be available to businesses in May and consumers in June, but its Office Web Apps component is already available in beta through Microsoft Office Live.

Anyone with a Windows Live account can create, modify or share Word, Excel and PowerPoint documents for free. They do not need Microsoft software installed on their machines.

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Enjoy!

David.

Saturday, March 20, 2010

A Couple of Interesting White Papers from CSC’s Healthcare Group.

The following appeared a few days ago.

Insights

Technology Cornerstones Supporting Tomorrow's Healthcare

Author:

Michael Garzone, Fran Turisco, Jared Rhoads

Summary:

New technologies are helping to deliver critical health information to authorized end users regardless of time, place or device. These technologies are broadening the reach of health information across care settings as they improve data access and data interoperability, enable personalized interactions, and provide ubiquitous computing. Care communities, patients, care givers and consumers need to develop a vision of how care delivery practices and processes should fit together, which data are shared and how, and which are the most suitable supporting infrastructure technologies. In this paper, we discuss the technology cornerstones that support the healthcare system of tomorrow. We identify the cornerstones and discuss what new technologies are available to fill those needs.

Download "Technology Cornerstones Supporting Tomorrow's Healthcare"

Contact Details are here:

http://www.csc.com/health_services/insights/40262-technology_cornerstones_supporting_tomorrow_s_healthcare

This paper was published in February, 2010 and builds on this paper from late last year.

Insights

Tomorrow's Healthcare System Using Today's Technology

Author:

Fran Turisco, Erica Drazen

Summary:

Tomorrow's healthcare system can be achieved with today's technologies. Patient-Centric care, directed by a team of professional care givers and family members, supported by commonly-used IT technologies and integrated medical devices, improves medication, care plan and health goals adherence and allows patients to remain independent longer. By removing the current barriers of health reforms and reimbursement issues, and lack of widespread connectivity and EHR adoption, this paper allows the reader to imagine a truly efficient and effective healthcare system from the perspectives of a patient, nurse, physician and care mentor/coach.

The proliferation of today's communication and Internet-based technologies, plug-and-play medical devices for the home, and a growing number of health and wellness applications provide the infrastructure to bring tomorrow's healthcare system within reach.

Download "Tomorrow's Healthcare System Using Today's Technology"

Again the contact information is here:

http://www.csc.com/health_services/insights/36297-tomorrow_s_healthcare_system_using_today_s_technology

Both are worth a download and read. The vision of what is more than possible today is great fun.

David.

Friday, March 19, 2010

Weekly Overseas Health IT Links 18-03-2010.

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. Note also that full access to some links may require site registration or payment.

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Down To Business: Electronic Healthcare Won't Be Denied

Obstacles abound, no doubt. But three huge constituents will demand it: government, large providers -- and the customers who will benefit.

By Rob Preston, InformationWeek

March 9, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=223300167

What we're witnessing is "the single fastest transformation of an industry in the history of the United States." The commentator: Glen Tullman, CEO of Allscripts. The industry: healthcare, where system vendors like Tullman's are at the center of driving that digital transformation.

Is this just hyperbole from an industry player? Consider that the federal government is spending upwards of $20 billion to get healthcare providers to digitize their records and processes, and that 70% of that money must be spent over the next three years. For an industry still mired in 20th century practices, an electronic overhaul in just a few years would indeed be historic.

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http://www.leaderpost.com/health/health+records+radar/2678700/story.html

E-health records on radar

By Pamela Cowan, Leader-PostMarch 13, 2010

Government officials are being tightlipped about the upcoming provincial budget, but money for electronic health records could be on the radar.

When Health Minister Don McMorris was recently asked by the Leader-Post if the March 24 budget would include funding for electronic health records, he said that area has been a priority in the province and "it would be just foolhardy to stop right now." "It was a Patient First recommendation and we can see the efficiencies that it creates for patients and as well as for physicians that are involved, so we need to keep moving on that front," McMorris said. "But all those decisions will be read on (budget day)." The total cost for the province's electronic health record is estimated to be $600 million, which includes $285 million spent from 1997 to the end of 2010. Canada Health Infoway -- an independent, federally funded organization that is tasked with accelerating the development of electronic health records across Canada -- contributed $40 million of the money spent so far.

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http://huffpostfund.org/stories/2010/03/stimulus-push-electronic-health-records-could-widen-digital-divide

Stimulus To Push Electronic Health Records Could Widen 'Digital Divide'

By Fred Schulte
Huffington Post Investigative Fund

Created 2010-03-08 13:43

Federal Plan May Leave Behind Small Hospitals and Rural Doctors

A year after Congress agreed to spend billions of dollars to encourage a national switch to electronic health records, many doctors and hospitals have grown skeptical of the pace and details of the plan.

Medical societies, both large and small, say that federal officials are pushing doctors to phase out paper charts too quickly. Some rural health organizations fear the program could exacerbate a “digital divide” by concentrating the funding in elite hospitals that already computerize their records. Even some of the elite hospital systems aren’t satisfied, seeking help from lawmakers to plead their case for more money.

“I don’t think any of the recipients are happy,” said Robert Tennant, a senior policy advisor with the Medical Group Management Association, which represents medical practices with nearly 275,000 doctors.

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http://www.healthcareitnews.com/news/consumers-weigh-top-10-meaningful-use-arguments

Consumers weigh in on top 10 meaningful use arguments

March 08, 2010 | Molly Merrill, Associate Editor

WASHINGTON – A Washington-based advocacy group has collected consumer and employer perspectives on the top 10 arguments concerning meaningful use. And with only a week left before the public comment period on meaningful use comes to a close, the Office of the National Coordinator for Health Information Technology is urging the public to weigh in with their own thoughts.

While the healthcare provider community's concerns with the government's proposed definition of "meaningful use" of healthcare IT are well-documented in the media, less attention has been paid to the consumer and employer perspectives, said officials of the Consumer Partnership for eHealth or CPeH, a coalition led by the National Partnership for Women and Families.

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RSA: Google, PayPal, Equifax, Others Form Open Identity Exchange

The companies have created a non-profit to manage the process of certifying identity providers.

By Thomas Claburn, InformationWeek

March 3, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=223101402

Google, PayPal, Equifax, VeriSign, Verizon, CA, and Booz Allen Hamilton on Wednesday at the RSA Conference announced that they have formed a non-profit organization to oversee the exchange of online identity credentials on public and private sector Web sites.

The organization, The Open Identity Exchange (OIX), will serve as a trust framework provider. A trust framework is a certification program that allows organizations and individuals to exchange digital credentials and to trust the identity, security, and privacy assertions associated with those credentials.

With help from the OpenID Foundation and the Information Card Foundation, OIX has been authorized to serve as a trust framework for the U.S. government. It will certify identity management providers to make sure they meet federal standards.

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http://www.google.com/hostednews/ap/article/ALeqM5g9LcUIAg-72ZFn6tDkvVdKaKirogD9EBUTG82

CDC uses shopper-card data to trace salmonella

By DAVID MERCER (AP) – 2 days ago

CHAMPAIGN, Ill. — As they scrambled recently to trace the source of a salmonella outbreak that has sickened hundreds around the country, investigators from the Centers for Disease Control and Prevention successfully used a new tool for the first time — the shopper cards that millions of Americans swipe every time they buy groceries.

With permission from the patients, investigators followed the trail of grocery purchases to a Rhode Island company that makes salami, then zeroed in on the pepper used to season the meat.

Never before had the CDC successfully mined the mountain of data that supermarket chains compile.

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http://www.govhealthit.com/newsitem.aspx?nid=73277

VA working on ‘Aviva’ -- next generation of VistA

By Mary Mosquera

Wednesday, March 10, 2010

The Veterans Affairs Department is at work on the next-generation of VistA, its 20-plus year-old electronic medical record system, which is often praised by users but considered a headache to planners working to bring VA health systems fully into the Internet age.

The new system – dubbed Aviva – is designed to be Web-enabled, modular in design and capable of easily exchanging health records with other EMRs and organizations using standards built for the Nationwide Health Information Network (NHIN).

In contrast, the current version of VistA resides on tens of thousands of computers, is difficult to upgrade and presents obstacles to VA plans to share information with other agencies and heath organizations, according to its chief technology officer.

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http://www.govhealthit.com/newsitem.aspx?nid=73290

CMS extends Medicare-Tricare PHR test

By Peter Buxbaum

Thursday, March 11, 2010

A personal health record pilot in South Carolina, which incorporates both Medicare and military Tricare claims data, has been extended through Sept. 30, 2010.

The Internet-based My Personal Health Record-South Carolina (MyPHRSC), a Medicare project, provides its 4,500 participants 24 months of Medicare A and B claims history and 24 months of Tricare pharmacy data upon request.

The pilot went live in April 2008 and began incorporating Tricare data in January 2009. In July, 2009 a calendar reminder feature, and a Health Tracker tool were added to the PHR.

"The Health Tracker allows users to track their blood pressure, cholesterol, hemoglobin A1C, and weight in a graph or table format," said Chris Gayhead, a project officer at the Centers for Medicare and Medicaid Services (CMS).

The number of participants "exceeded our expectations," said Gayhead. Six-hundred sixty thousand South Carolina Medicare beneficiaries are eligible to participate in MyPHRSC. Tricare beneficiaries who are Medicare eligible can authorize to have their Tricare data incorporated in the PHR.

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http://www.healthcareitnews.com/news/healthcare-industry-one-most-mobile

Healthcare industry one of the most mobile

March 11, 2010 | Mike Miliard, Managing Editor

BLUE BELL, PA – Healthcare IT workers are among the biggest users of smart phones and other mobile technology, but addressing the security needs of such devices remains a critical concern, according to a survey released today.

Forrester Consulting conducted the study on behalf of Fiberlink, the Blue Bell, Pa.-based developer of cloud-based "Mobility as a Service" (MaaS) solutions.

The study, titled "Managing and Securing Mobile Healthcare Data and Devices," found that 95 percent of healthcare enterprises relying on smartphones for work, making the industry one of the most mobile across all verticals.

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http://ehr.healthcareitnews.com/blog/study-shows-risks-sharing-data

Study shows risks of sharing data

By Jeff Rowe, Editor

There’s been no shortage of stories recently about the increase in attempts by hackers to get access to digitized health information, but a recent Canadian study shows that many healthcare providers may unwittingly be giving the hackers a helping hand.

Published recently in the Journal of the American Medical Informatics Association, the study is reportedly“ the first of its kind to empirically estimate the extent to which personal health information is disclosed through file-sharing application.”

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http://healthcare.zdnet.com/?p=3427

Google Health is not at all well

Posted by Dana Blankenhorn @ 6:18 am

During HIMSS there was the usual crowd at the Google booth.

The show giveaways — plastic tape measures (shown) and zip-pouches with emergency supplies (band-aids and aspirin) that can be clipped to a backpack — were welcome and very popular. That’s why they had to be kept in these huge plastic tubs. The tubs were refilled regularly.

But there was nothing shown at the Google booth that wasn’t available in 2007. There were screens showing Google Health, and screens showing Google enterprise services. That was all.

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http://www.e-health-insider.com/news/5716/bma_says_%27suspend_scr_roll-out%27

BMA says 'suspend SCR roll-out'

10 Mar 2010

The British Medical Association has written to the government calling for the roll-out of the Summary Care Record to be suspended.

In a letter to health minister Mike O’Brien, the doctors’ union claims the roll-out of the SCR has been accelerated before sufficient independent evaluation of the pilot areas has taken place.

It calls on the Department of Health to consider halting implementation in areas where Public Information Programmes have not yet started.

Dr Hamish Meldrum, BMA Council chairman, said: “The break-neck speed with which this programme is being implemented is of huge concern. Patients’ right to opt-out is crucial and it is extremely alarming that records are apparently being created without them being aware of it.

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http://ehealtheurope.net/comment_and_analysis/570/oh_vienna

Oh, Vienna

11 Mar 2010

What are the key trends in PACS/RIS technology and management? Linda Davidson asked some of the participants at the vast European Congress of Radiology in Vienna last week.

What are the next steps for the information systems used in digital medical imaging? For Derek Danois, Accenture’s newly-appointed managing director for medical imaging services, the emphasis has to be on helping healthcare organisations to “build value in their investments and deliver value over a long period of time.”

“It’s not about refreshing that existing infrastructure but [about] how you take advantage of that infrastructure,” he said. One of the areas in which he sees advances in prospect is the use of analytics from digital medical images and their associated reports to monitor and improve the quality of care.

For example, he explained, analytics can be used to understand the effectiveness and quality of different radiological protocols laid down by bodies such as the UK’s Royal College of Radiologists. Reports can show whether protocols are being followed, while tracking deviations from protocols could indicate that an investigation or intervention is needed.

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http://www.ehealtheurope.net/news/5710/healthcare_mistrusts_cloud_security

Healthcare mistrusts cloud security

08 Mar 2010

A new survey has indicated that healthcare organisations have yet to be convinced of the merits of cloud computing.

Only 33% of healthcare organisations said they planned to adopt a cloud storage strategy for any data over the next 12-24 months.

An overwhelming majority of respondents - more than 80% - reported that the most significant barrier is concern about security and availability of data.

Respondents also cited cost and a lack of conviction that cloud storage offers significant benefits when compared to local media.

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http://www.e-health-insider.com/Features/item.cfm?&docId=329

All part of the plan

Systems integration is back on the agenda following the Department of Health’s instruction to shift from a “replace all” to a “connect all” philosophy. Daloni Carlisle looks at the challenges ahead.

In December 2009, the Department of Health announced a shift in emphasis for healthcare IT. The Informatics Planning guidance for the coming financial year said it should move from a “replace all” philosophy to “connect all”.

It is a change that is welcomed by many, but which comes with its own challenges. David Rivett is head of systems integration and chief technical operating officer of Hytec and has spent the last 20 years connecting systems.

“In a sense this takes us back to the days before NPfIT,” he says. The trouble is that in the intervening years, a multitude of different interim solutions have sprung up that now need integrating.”

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http://www.e-health-insider.com/Features/item.cfm?&docId=330

Interoperability Tookit update

The NHS has been promised an interoperability toolkit to get good, local ideas working with existing and national programme systems. Daloni Carlisle gets an update on its progress.

In April last year, Christine Connelly, the NHS’ director general of informatics, promised that an ‘app store’ style toolkit would be developed for the health service.

Connelly said that while the “core aims” of the National Programme for IT in the NHS would be retained, the toolkit was needed to “allow new products to be developed locally, accredited centrally and linked to existing deployments of information systems such as Cerner and Lorenzo.”

In other words, the toolkit was to provide more local flexibility, and to encourage trusts to learn from and spread innovation between each other.

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http://www.modernhealthcare.com/article/20100310/NEWS/303109960

Clinical informatics moves toward certification

By Joseph Conn / HITS staff writer

Posted: March 10, 2010 - 11:00 am ET

The role of medical informatics in healthcare is rapidly expanding, as is the use of information technology itself. What is not moving rapidly—at least to an outside observer—is an already 5-year-old effort by institutional medicine that has perhaps another three years to go before creating a program of subspecialty board certification in clinical informatics.

To insider Don Detmer, however, what would appear to some as a glacial pace is actually “moving amazingly fast, as far as these things go” given that medical boards and medical education organizations “move very, very slowly.”

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http://govhealthit.com/newsitem.aspx?nid=73261

Chopra cites fed projects as health IT catalysts

By Mary Mosquera

Tuesday, March 09, 2010

A National Cancer Institute registry service that will allow patients, federal health researchers and healthcare providers to access its data is just the first of a slew of examples that the Obama administration hopes will spur meaningful use of health IT.

“We’re looking for success stories and where we can help to accelerate adoption,” said Aneesh Chopra, the White House chief technology officer. “The standards for meaningful use are not new – some organizations have been engaging in meaningful use for some time.”

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http://www.healthcareitnews.com/news/survey-shows-nurses-spend-most-their-time-paperwork

Survey shows nurses spend most of their time on paperwork

March 09, 2010 | Bernie Monegain, Editor

ALPHARETTA, GA – A new survey of hospital nurses found that they estimate spending one quarter of their 12-hour shift on indirect patient care, with paperwork taking up much of the rest of their time.

In the survey, conducted by Alpharetta, Ga.-based Jackson Healthcare, nurses reported having to document patient care information in multiple locations, in addition to having to complete logs, checklists and other redundant paperwork that prevented them from having more time with their patients. Beyond these paperwork redundancies, nurses reported significant time being wasted trying to secure needed equipment and supplies.

When asked for solutions to these challenges, nurses recommended a combination of ancillary staff support, hospital-wide communications technology and reductions in redundant regulatory requirements.

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http://health-care-it.advanceweb.com/Editorial/Content/Editorial.aspx?CC=217363

Meaningful Health Information Exchange

It's about connecting people, not just systems.

By Brad Hawkins

We live in an age of instant information. As a culture, we use our computers, our phones and our handheld devices to stay in touch with one another and with the world at large. For most of us, online banking has been a way of life for more than a decade. We shop, connect with high school classmates, watch TV programs virtually commercial-free, and book travel plans all online. On any given day, 25 percent of Americans say they have watched a short video on their phones [Deloitte 2009 Survey of Health Care Consumers; May 2009].

While other industries have set high expectations for electronic interaction with consumers, the health care industry lags. Technology has certainly advanced health care, but the progress ends where recordkeeping and communication begin. Many health care organizations continue to maintain paper-based systems to schedule appointments, track patient interaction, and for the most part, handle billing. Those organizations that have made the transition to electronic systems have found that system integration is a critical issue.

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http://www.ehealtheurope.net/news/5719/ge_launches_ehealth_platform

GE launches ehealth platform

10 Mar 2010

GE Healthcare has launched its next-generation e-Health Solutions platform – which includes expanded services for health information exchange, a clinical portal and a patient health management system.

The new platform is designed for international as well as domestic GE Healthcare customers and is said to be adaptable for regional markets in either hosted or deployed models.

“Healthcare professionals around the world recognize that connecting the healthcare IT ecosystem has enormous potential to improve the quality of health outcomes and to reduce costs,” said Vishal Wanchoo, president and CEO of GE Healthcare IT.

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http://www.who.int/goe/ehir/2010/9_march_2010/en/index.html

9 March 2010

eHealth Worldwide

:: Canada - No More Dithering On e-Health (2 March 2010 - Medical News Today)

Canada is lagging behind many countries in the use of electronic health records and it is critical that the country's medical and political leaders set targets for universal adoption, states an editorial in CMAJ (Canadian Medical Association Journal). While Canada has invested more than $1.6 billion in federal funds to develop integrated electronic health records, only 37% of general practitioners use electronic records compared with 97% in New Zealand and 95% in Australia.

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http://www.ehiprimarycare.com/news/5713/no_boundaries_plan_needs_shared_records

No boundaries plan needs shared records

09 Mar 2010

The abolition of GP practice boundaries will increase the importance of shared medical records, according to the Department of Health.

The DH has launched a consultation on its plans to scrap GP practice boundaries which it argues will meet demand from a “significant minority” of patients to move to a different practice.

The consultation looks at the implications of enabling patients to register with any practice of their choice including the impact on home visits, urgent care, co-ordination of care, access to secondary care, resource allocation and IT and access to patients’ medical records.

The consultation says “the need for a more accessible clinical record will increase” if patients are able to register with a GP practice some distance from their home and rely on a local service for urgent care and home visits.

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http://www.ehiprimarycare.com/news/5715/letter_errors_fuel_scr_roll-out_row

Letter errors fuel SCR roll-out row

09 Mar 2010

The British Medical Association is to write to health minister Mike O’Brien as the row over the roll-out of the Summary Care Record escalates.

Local medical committees have reported that their attempts to include opt-out forms in information sent to patients has been blocked.

Meanwhile, a glitch at a mailing house used by NHS Connecting for Health has led to patients receiving information packs addressed to other patients.

The BMA’s General Practitioner Committee has also issued guidance to GPs on the roll-out, which says it is “deeply concerned by this sudden acceleration in the roll-out and feel that it being rushed.”

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http://www.modernhealthcare.com/article/20100309/NEWS/303099986

EHR regulations may discourage IT adoption: AHA

By Joe Carlson / HITS staff writer

Posted: March 9, 2010 - 11:00 am ET

The American Hospital Association says the regulations proposed by federal administrators to use stimulus payments to encourage widespread adoption of electronic health-record systems may actually discourage many providers from even trying to use the technology.

The government's proposed list of 23 measures to demonstrate so-called “meaningful use” of EHR systems is so daunting that even hospitals that already have long-established systems may not qualify for stimulus payments because regulators have proposed hospitals meet every criteria before they become eligible to receive the federal grants, according to the AHA.

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http://www.modernhealthcare.com/article/20100309/NEWS/303099999

HIMSS attendees urged to focus on patient care

By Andis Robeznieks / HITS staff writer

Posted: March 9, 2010 - 11:00 am ET

Though some tried to change the subject, “meaningful use” of health information technology—and the billions of dollars in federal stimulus-law subsidies that are attached to that term—dominated discussions at the Healthcare Information and Management Systems Society annual conference and exhibition March 1-4 in Atlanta.

Original estimates of the amount of money the federal government would dish out to help subsidize healthcare provider investments in IT ranged between $14.1 billion and $27.3 billion. However, during a conference presentation, John Halamka, a physician who is chief information officer at 621-bed Beth Israel Deaconess Medical Center, Boston, and Harvard Medical School, said the current best thinking was that the government would be paying between $22 billion and $23 billion to those who met its meaningful-use requirements for health IT subsidies.

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http://www.healthleadersmedia.com/content/TEC-247709/More-to-HIMSS-than-EHRs-Four-Technologies-for-Patients-and-Providers.html

More to HIMSS than EHRs: Four Technologies for Patients and Providers

Gienna Shaw, for HealthLeaders Media, March 9, 2010

Amidst all the buzz about clinical data sharing and the accompanying alphabet soup of acronyms (EHRs, EMRs, PHRs, RHIOs and HIEs, not to mention ARRA and HITECH), it's easy to forget that the annual HIMSS conference is also a showcase for technology of the hardware variety—physical products and gadgets you can see, feel, and, in some cases, hold in one hand.

Keep in mind that there were about 900 vendors with booths in two exhibit halls so large you measure them not in square feet but in acres.

According to my pedometer, I walked about 26 miles over the course of six days—a literal marathon of keynotes, sessions, and tours of vendor booths. So with apologies to the other 896 vendors at the show, here are four products that impressed me. I have only one complaint about three of the technologies—along with many others at the show—but I'll get to that later.

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http://www.ngrguardiannews.com/focus_record/article01/indexn2_html?pdate=090310&ptitle=E-Medicine:%20A%20pilot%20success%20in%20Nigeria

E-Medicine: A pilot success in Nigeria

G overnment officials and private sector stakeholders gathered recently in Ibadan to review the progress of the pilot e-medicine scheme undertaken in the six geographical zones of the country. Buoyed by the success of the field trial, they are calling for nationwide implementation of the revolutionary healthcare service delivery, reports WOLE OYEBADE.

LOLA did not register formally for the revolutionary workshop held recently in Ibadan, Oyo State. She sneaked into the hall where stakeholders were discussing the introduction of telemedicine in Nigeria.

After three hours of listening to experts talking about 'medicine of the future", she exclaimed: "If these people (discussants) had introduced this scheme before now, my aunt's only son would not have died in our village. The doctor attending to the boy could not get expert advice quick enough hence the only child of my aunt died. Two years after, my aunt has not recovered from the shock. The nation needs to move with the times".

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http://www.ihealthbeat.org/features/2010/stimulus-programs-aim-at-current-future-health-it-problems.aspx

Tuesday, March 09, 2010

Stimulus Programs Aim at Health IT Problems

by Helen Pfister and Karyn Bell, Manatt Health Solutions

With a nod toward averting future problems as well as educating the public about current ones, the federal government's campaign to move the health care industry into the digital age spawned a couple of offshoots over the past two months.

HHS announced it will award a contract to develop ways to identify "undesirable and potentially harmful" unintended consequences of programs funded and administered by the Office of the National Coordinator for Health IT. That effort includes consideration of the electronic health record "meaningful use" incentive program. The public comment period for CMS' proposed meaningful use rule ends March 15.

In addition, HHS will engage a contractor to support a comprehensive two-year public education campaign that fulfills the HITECH mandate to educate the public about privacy and security of protected health information. The campaign will be jointly led by ONC and the HHS Office for Civil Rights.

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http://www.healthleadersmedia.com/content/TEC-247566/Health-IT-Design-That-Keeps-EndUsers-in-Mind.html

Health IT Design That Keeps End-Users in Mind

Heather Comak, for HealthLeaders Media, March 5, 2010

This is part two in a two-part series on human factors engineering and its impact on patient safety. Go here to read part one.

Human Factors Engineering (HFE) principles are often being applied to the design of healthcare information technology (HIT).

HFE is defined by the Human Factors and Ergonomics Society as the "scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data, and other methods to design in order to optimize human well-being and overall system performance."

As HIT increasingly becomes a part of clinicians' everyday jobs, it's important to consider their design. If HIT is not designed with the end-user or end-facility in mind, it may fail at facilitating patient safety.

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http://www.healthleadersmedia.com/print/TEC-247595/Blumenthal-ONC-Shifting-From-HIT-Policy-to-Implementation

Blumenthal: ONC Shifting From HIT Policy to Implementation

Gienna Shaw, for HealthLeaders Media, March 8, 2010

In the near future, electronic health records and other health information technology will be as accessible and important as the stethoscope, the operating room, or the exam table. And there's no question that that the federal government will be required to support the acquisition of health technology, added National Coordinator for Health Information Technology David Blumenthal, MD, at the HIMSS convention in Atlanta last week.

"It will be assumed as a professional attribute," he said.

Blumenthal did talk about the meaningful use of EHRs—no question the hot topic at this year's conference—saying that the HITECH provisions are an "ambitious" and "evolving vision."

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http://www.healthleadersmedia.com/content/TEC-247575/Five-Ways-Health-IT-Leaders-Can-Fight-Medicare-Fraud.html

Five Ways Health IT Leaders Can Fight Medicare Fraud

Gienna Shaw, for HealthLeaders Media, March 5, 2010

Fair warning to health IT professionals: Harry Markopolos, the man who infamously warned the government that Bernie Madoff was up to something fishy, is setting his sights on Medicare fraud. And the first place he'll look for evidence is in your system's e-mails, documentation, and databases.

When Markopolos, who now works full-time investigating fraud, looks into a case, he always starts with the IT department. What does he look for? Bills submitted to Medicare by dead patients or from dead doctors, up-coding or billing for procedures that were not performed, and other fraudulent billing practices. He'll check your books for evidence of kickbacks, slush funds, and sudden inexplicable increases in revenue.

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http://www.miamiherald.com/2010/03/07/1518101/coral-gables-couple-accused-again.html

Coral Gables couple again accused of stealing, selling patient records

A Coral Gables couple are indicted a second time on charges of stealing the private records of patients to sell to lawyers for personal-injury claims.

BY JAY WEAVER

jweaver@MiamiHerald.com

Last year, they were charged with running a racket to pilfer patient records from Jackson Memorial Hospital to sell to lawyers for personal-injury claims.

Now Ruben E. Rodriguez and wife Maria Victoria Suarez have been indicted again for paying an ambulance-company employee to steal information on patients transported to Miami-Dade hospitals and healthcare clinics. That theft scheme dates all the way back to 1995, according to an indictment filed last week.

In both federal cases, the Coral Gables couple are accused of brokering the stolen computer records of patients' names, addresses, telephone numbers and medical diagnoses to several attorneys in exchange for kickback payments. The lawyers paid them hundreds of thousands of dollars for the referrals after settling injury claims, authorities say.

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http://www.modernhealthcare.com/article/20100308/NEWS/303089988

CCHIT has jump on EHR certification competition

By Joseph Conn / HITS staff writer

Posted: March 8, 2010 - 11:00 am ET

One of many potential beneficiaries of last week's release of a proposed federal rule outlining the process by which HHS will authorize organizations to test and certify electronic health-record systems is the not-for-profit organization formed in 2004 to do those very tasks.

The Certification Commission for Health Information Technology has a first-mover advantage under the new rule announced by David Blumenthal, head of HHS' Office of the National Coordinator for Health Information Technology, during the Healthcare Information and Management Systems Society convention held last week in Atlanta.

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http://www.modernhealthcare.com/article/20100308/NEWS/303089939

Hospitals' patient-safety data systems fall short: HHS

By Andis Robeznieks / HITS staff writer

Posted: March 8, 2010 - 11:00 am ET

Billing data may not be a reliable source of hospital adverse event information and voluntary hospital incident reporting systems may be an unreliable source of information for patient safety organizations, according to Adverse Events in Hospitals: Methods for Identifying Events, a new report released by the HHS Inspector General's office.

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http://govhealthit.com/newsitem.aspx?nid=73211

ONC top doc says he does not use e-prescribing

By Paul McCloskey

Monday, March 01, 2010

ATLANTA -- Dr. David Hunt, the Office of the National Coordinator’s chief medical officer, told a crowd of physicians here yesterday that as a practicing surgeon he does not use electronic prescribing.

The reason, he said at the Health Information and Management Systems Society annual conference, is to avoid the impractical – and potentially unsafe – consequences of working around a federal ban on the e-prescribing of controlled substances.

The ban, imposed by the Justice Department, has had the effect of suppressing e-prescribing, widely considered a prime example of meaningful use and a potentially heavy driver of health IT adoption.

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Iatric Introduces Health Data Tool

The patient portal provides online access to electronic health records and can be integrated with Google Health and Microsoft Healthvault.

By Antone Gonsalves, InformationWeek

March 5, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=223101704

Iatric Systems has introduced for hospitals a patient portal that provides online access to personal health information and the ability to pay bills.

PtAccess is available to hospitals that have implemented electronic health records. The Web-based portal can provide patients with discharge instructions, visit history, clinical results, provider contract information, and medication order history.

Patients can also input information useful to healthcare providers, such as home medication inventory, surgical and medical history, and allergies. Patients can also view and pay hospital bills.

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http://www.healthdatamanagement.com/news/coding_automated_hospital-39899-1.html

Computer-Assisted Coding Gives a Boost

HDM Breaking News, March 3, 2010

A computer-assisted coding project underway in a Maine health system is showing early returns, including reduced expenses and improved cash flow. Mandy Reid, coding manager at Eastern Maine Medical Center, discussed the technology at the HIMSS 2010 Conference & Exhibition, noting that the 7-hospital rural delivery system had reduced FTEs and improved accounts receivable during the project's first phase.

Serving as a pilot site for coding software vendor 3M Health System, Eastern Maine began the project on the inpatient side, where it logs some 21,000 annual patient visits.

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http://www.ihealthbeat.org/perspectives/2010/health-care-is-local-in-search-of-meaning-at-himss-10.aspx

Monday, March 08, 2010

Health Care Is Local: In Search of Meaning at HIMSS '10

by Jane Sarasohn-Kahn

It's been a year since the American Recovery and Reinvestment Act and the HITECH Act got the president's signature. Since then, there have been countless meetings of standards-setters, CIO experts and medical informatics pros, all opining on the meaning of "meaningful use," the criteria for certifying electronic health records and the vision for a Nationwide Health Information Network.

As they asked in "Seasons of Love" from Rent, "565,600 minutes … how do you measure a year?" The chorus's response: "In cups of coffee, in inches, in miles, in laughter, in strife." And 525,000 journeys to plan.

That's about the number of physicians who will be affected by the 2009 federal economic stimulus plan, and based on what I heard among those clinicians who haven't yet adopted an EHR, they're barely willing to Rent, let alone Buy, an EHR based on their latest understanding about what's involved with the process of adopting what seems to be a still-evolving set of rules.

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http://www.fiercehealthit.com/story/himss10-ibm-marches-hie-after-closing-initiate-deal/2010-03-08?utm_medium=nl&utm_source=internal

HIMSS10: IBM marches into HIE after closing Initiate deal

March 8, 2010 — 2:44pm ET | By Neil Versel

It may have been a coincidence that IBM closed on its acquisition of Initiate Systems just as HIMSS10 got underway in Atlanta last week. We're certain that it was no coincidence that IBM introduced a product called Initiate Exchange on the very same day it announced the closing of the Initiate deal. "The acquisition was driven by IBM's desire to enhance its ability to help healthcare clients draw on data from hospitals, doctors' offices and payers to create a single, trusted shareable view of millions individual patient records," an IBM press release read.

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http://www.computerworld.com/s/article/347329/IT_Scurries_to_Meet_E_health_Records_Deadline

IT scurries to meet e-health records deadline

Health care providers must start EHR projects before the feds finish writing the rules. By Lucas Mearian

Lucas Mearian

March 8, 2010 (Computerworld) U.S. hospitals and physicians have four years to deploy comprehensive electronic health records (EHR) systems if they hope to snag some of the billions of dollars the federal government has earmarked to reimburse them for the work.

However, although health care companies must begin such efforts soon if they want to meet the reimbursement deadlines, the federal government has yet to finalize technology and product specifications for e-health systems, causing concern among health care IT officials.

"I think we have nontechnology people making decisions about technology," said Gregg Veltri, CIO at the Denver Health and Hospital Authority.

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Enjoy!

David.

Thursday, March 18, 2010

Just So You Know - A Rumour About Extra NEHTA Funding

I have now heard from two sources there is to be $400M given to NEHTA as part of the selling the Roxon / Rudd Health Reform Plan to the Council of Australian Governments.

It could all be the most made up bit of nonsense ever, but if true one really hopes this time there will be some clear conditions on just how the funds are spent, on what and what is delivered for the funds.

Rumours of extra funding for e-Health certainly must have some basis, given that this area is to be subject of an additional announcement at some point - according to the initial plan that was released a week or two ago.

We shall all see - but if true, you heard it here first. Anonymous tips welcome!

David.

And You Think NEHTA has Improved Do You? I am Not So Sure!

With all the excitement of the HI Service we have maybe let our attention on other areas NEHTA is meant to be addressing slip.

I was brought back to earth when I found these recent entries in the new publications area.

IHTSDO Update October 2009 10/03/2010

Medicare OTS Information Sheet 04/03/2010

Doctors in Training Dinner- 13th February 2010- Victoria- Sean Holmes 03/03/2010

Connecting Healthcare- 9-10 February 2010- Sydney- Mukesh Haikerwal 03/03/2010

The top one is a three page report on the meetings held by 5 NEHTA staff members for 5 days in Bethesda, Maryland, USA. Not that the location is mentioned as far as I can see. I hear Maryland is a very nice spot to visit for 5 days in early Autumn!

What is worse the meeting was held October 3-9, 2009 and we get a brief report all of at least six months later. Just pathetic. Hardly the level of communication we should see from a publicly funded organisation.

Grab the 3 pages from here:

http://www.nehta.gov.au/component/docman/doc_download/953-ihtsdo-update-october-2009

More amazing is the last presentation from Dr Haikerwal – The NEHTA Clinical Lead.

This is the explanation of the Personal EHR in a few slides:

Extract Begins – Sorry the Format is Hard to Read.

PEHR Explanation: 1

Smart use of data is at the core of a self-improving system

Key: nationally consistent standards

Data:

•Should drive Clinical decision-making

•Measure and improve health outcomes

•Measure and improve performance

•Transparent reporting

•Inform Planning

PEHR Explanation: 2

All ‘users’ -consumers, health professionals, managers, funders and governments have a part and will benefit

Access record: generate an audit trail to inform us when and by who record viewed

Patient does not hold the infra-structure

•They will not be using a USB key

•They do control the access to the data

This does not change GP/local/hospital records, use or ownership

PEHR Explanation: 3

CORE COMPONENT: HEALTH SUMMARY RECORD: like RACGP’s Maintained at the Patient’s choice of ‘Health Care Home’: Generally by the GP in the Practice setting (or other authorised source).All Providers are part of the System which will provide data that is:

•Technologically current

•secure

•standards driven

•quality assured

Being able to link data:

Consistently

Confidence of users (Providers & Consumers)

Consent and Confidentiality

PEHR Explanation:4

System FOR the patient / citizen at the centre of the information tree

The PEHR is a driver of the change: bold and clear expectations (from the health eco-system)

Our PEHR:

We citizens drive:

What is on it

Who we permit to access it and write to it.

Control access to our own health information

(what information shared and with whom including which health practitioners –trusted source); (add information: self carer alternative self-management (e.g. monitoring BP DM) (respected source)

Where and how health record stored, backed-up retrieved

Integrity of the data and provenance (who wrote the entry) is core

Can base decisions on this with PROVENANCE.

An entry can be added to or removed “in toto” from share not altered

PEHR Explanation:5

Understand and inform that our care is better co-ordinated

•within practices

•between providers

Outcomes and satisfaction enhanced if information about care:

•available at the point of care

•up to date historical information

•timely new interaction information

•accurate

Enabled greater e-Health environment: added functionality indexed allowing exchange of information from various data repositories.

PEHR Explanation:6

Patients controlling access to their own health information may be confronting: can be liberating!

Patients chose to access different practitioners at points in their life may choose not to reveal all the details of their health and health care.

This is regrettable and hampers their care and hinders the efforts of those treating them.

PEHR Explanation:7

A person-controlled electronic health record part of the broader e-health environment

Health performance metrics measurement and data enhance :

Health research and planning

Recognise, plan for and combat disease

Need ongoing development of e-Health records by health services

Must join up and integrate information across the care continuum.

General Practice consults: encounter remains on the practice/primary care organisation’s system.

PEHR Explanation:8

Add to the PEHR summary record (from the GPs, hospitals or other trusted sources) at the push of a button (with patient request)

Patient requests information to be stored on their PEHR

Copy resides on PEHR and in the Practice.

Accessed with patient permission by authenticated users

Enhance care co-ordination which is more complex

PEHR Explanation:9

PEHR full and comprehensive summary of patient history e.g. :

- Medications

- Allergies

- encounters with medical and other specialists

- pathology and radiology results and

possible access to images can be through it being used as a portal but it may not be complete if patients so desire.

Health professionals are aware that even today all records may not be complete.

PEHR Explanation:10

For best health care and outcomes available records on PEHR, should be:

- Comprehensive

- accurate and the concept of accurately recording

- up to date (requires data cleaning)

- PROVENANCE of entries is crucial

The veracity of the record as a trusted source must be assured to allow it to be a source of data when making clinical decisions.

The patient area for documentation by the individual, their carer or other authorised representative / advocate is a respected source and clearly annotated as such. It is a vital part of the record providing information to guide care.

End Extract.

I can’t imagine why Dr Haikerwal was provided with such confusing and vague material to present.

I have read this through many times and am still not sure what is being proposed. If interested I suggest a download of the whole presentation.

You can grab it from here:

Connecting Healthcare- 9-10 February 2010- Sydney- Mukesh Haikerwal

It is really time NEHTA came clean and explained just what it is they are on about and just what the plans if any are.

If they are proposing some form of centralised shared record – the blood sport going on between the British Medical Association and the Department of Health should provide some real pause for thought!

See here for links:

http://www.bma.org.uk/about_bma/BMAinthenews.jsp

Summary Care Record
The BMA’s press release outlining concerns with the rollout of the Summary Care Record stimulated significant interest and was covered by The Guardian, The Telegraph, The Times, The Daily Express, The Daily Mail, Sky News and BBC Online. Hamish Meldrum also appeared on Radio 4’s Today programme to discuss the issue further. The BMA and/or its representatives were quoted, mentioned, or interviewed in over 30 other broadcasts across the country regarding this issue.

Lots of excitement and worry.

David.