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, April 11, 2010

Weekly Australian Health IT Links - 12-04-2010.

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:

It seems that the Federal Health Team are pushing with all their weight to get their version of health reform through. We have another announcement today – this time on Emergency Departments.

http://www.smh.com.au/national/rudd-promises-to-halve-waiting-times-20100410-rzs2.html

Rudd promises to halve waiting times

STEPHANIE PEATLING POLITICAL CORRESPONDENT

April 11, 2010

AUSTRALIANS would wait no more than four hours for medical attention in hospital emergency departments in an ambitious bid by the federal government to halve existing waiting periods.

Prime Minister Kevin Rudd will today announce a $500 million injection for emergency departments but only if the states sign up to his health reform plan.

And in a boost for Queensland the government announced yesterday it would spend $22 million on clinical training to entice graduates to take up jobs in the cities and towns in which they have studied.

Under the new target, public hospitals will be required to ensure people are admitted to hospital, referred for follow-up treatment or treated and discharged within four hours.

---- End extract.

Three things occur to me about all this.

The first is to ask the question just why is it that the vague, partially defined plan put up by the Commonwealth is to brook no discussion, debate or fine tuning? Compare this with what happened in the US where there was a full on public and political debate with lots of tweaking of the final package that made it to the President’s desk. I thought we lived in a democracy where the best ideas should be accepted. Not much sign of this here. ‘My way or the highway’ seems to be the mantra.

Second just why do we have to be drip fed the plans? Being made up on the run feels about right to me!

Third, you won’t fix emergency department treatment times until you fix the hospitals that they are the front door for.

I really do not like how this is being done at all, and I suspect people who think like me are rising in number. The results of the recent poll make this clear.

See here:

http://aushealthit.blogspot.com/2010/04/aushealthit-man-poll-number-14-results.html

Can I also say I don’t much like these ‘behind closed door’ discussions that seem to be going on. Just what is it that the Government is offering that the public can’t know about?

See here:

http://www.smh.com.au/national/emergency-funding-welcome-but-extra-hospital-beds-key-doctors-20100411-s0gd.html


Emergency funding welcome, but extra hospital beds key: doctors

April 11, 2010 - 1:28PM

Doctors say federal Labor's promise of an extra $500 million to cut waiting times in emergency departments will only work if there is also a boost in hospital beds.

In order to receive the extra cash public hospitals will have to treat and discharge emergency patients, refer them for follow-up care or admit them, within four hours.

"The funding will assist emergency departments to deal more efficiently with patients who are treated and discharged and those who are referred for follow-up treatment," Australian Medical Association president Andrew Pesce said in a statement.

"(But) there will need to be additional reforms to ensure that patients who must be admitted to hospital have a bed to go to in a safe and appropriate timeframe."

---- End extract.

And as a last point, watch the tricks that go on to ensure patients are treated etc in the 4 hour window. Put a bucket of money in front of any Health Bureaucrat and watch them meet the target 100% - statistical fudging will be rife I suspect – just as it is now!

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http://www.theaustralian.com.au/australian-it/data-breach-costs-2m-per-incident/story-e6frgakx-1225851401246

Data breach costs $2m per incident

  • Karen Dearne
  • From: Australian IT
  • April 08, 2010 1:19PM

ONE of the first comprehensive local surveys of data breach costs shows organisations sustained financial losses of almost $2 million on average per incident, with an average $123 spent to deal with each compromised record.

The 2009 Australian Cost of a Data Breach study, conducted by US-based Ponemon Institute on behalf of data encryption specialist PGP, examined the actual financial losses incurred by 16 organisations from different industry sectors following a data loss, with breaches ranging from around 3300 to 65,000 lost or stolen records.

In the most expensive incident, one organisation spent more than $4m to resolve a single event.

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http://www.australiandoctor.com.au/articles/80/0c068880.asp

Mind the glitch

8-Apr-2010

COMPUTERS: Software problems could result in a medicolegal disaster for GPs. By Noel Stewart

ACCURATE clinical records -- preferably electronic -- and robust recall management systems can go a long way in protecting GPs and their medical clinics from adverse legal actions.

Yet inaccurate or incomplete clinical notes can at times result from a glitch in the software system. I have heard many horror stories of clinical data being lost, often during software upgrades or in the migration process. Sometimes these issues were slow to be resolved.

So who is at fault if a doctor is sued for negligence based on a glitch in the computer system?

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http://www.computerworld.com.au/article/342392/casa_upgrade_medical_records_system/?eid=-6787

CASA to upgrade medical records system

Will streramline business processes at the aviation safety agency

The Civil Aviation Safety Authority (CASA) is to overhaul its medical records system (MRS) in a bid to streamline the government agency’s business processes.

The current MRS supports the processing of regular medical examinations required to be undertaken by pilots, flight crew and air traffic controllers to obtain and keep their licences, according to CASA documents.

As a result of overhauling the MRS, CASA expects that it will realise significant efficiencies by improving the user environment and avoiding unnecessary multiplication of effort, and improve safety effectiveness by having a single, robust system with consistent data.

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http://www.futuregov.net/articles/2010/mar/30/australian-healthcare-provider-migrates-clinical-s/

Australian healthcare provider migrates clinical system online

St Vincent’s & Mater Health Sydney implemented a web-based clinical support system which reduced cost without compromising user experience. Chief Information Officer David Roffe tells FutureGov the benefits of migrating its clinical system online.

The application development tool used to develop the previous system at St Vincent & Mather Health (SV&MHS) went out of support in 2000. Although the system was still usable, it was difficult and expensive to find programmers who are skilled in such an outdated computer programme. Roffe needed to decide whether to buy a new system off-the-shelf or redevelop the current system in-house, and what technology to use.

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http://www.e-health-insider.com/news/5810/cohen:_morecambe_bay_go-live_%27early_may%27

Cohen: Morecambe Bay go-live 'early May'

08 Apr 2010

Gary Cohen has predicted that the latest version of Lorenzo will go live at University Hopsitals of Morecambe Bay NHS Trust in May 2010.

The executive chairman and chief executive of iSoft told the Financial Times "we are confident that we have a go-live in early May."

He made his comments the day after NHS chief information officer Christine Connelly confirmed that the trust had not gone live with Lorenzo Regional Care Release 1.9 by the 31 March deadline she set last year.

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http://www.couriermail.com.au/news/queensland/bosses-held-party-while-queensland-health-staff-went-without-pay/story-e6freoof-1225852012703

Bosses held party while Queensland Health staff went without pay

THE introduction of Queensland Health's payroll system was celebrated with a roof-top party while thousands of staff went without their fortnightly pay.

Senior executives and bureaucrats involved in the $40 million project were treated to beers, cheese platters and a barbecue just days after the troubled payroll system went live.

The Tuesday afternoon shindig was held on March 30 on the roof of the Department of Public Works in George St, with guests enticed by an invitation featuring a cheesy play on the poem Click Go The Shears.

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http://www.theaustralian.com.au/australian-it/medibank-private-acquires-mckesson-asia-pacific/story-e6frgakx-1225851849432

Medibank Private acquires McKesson Asia-Pacific

  • Correspondents in Melbourne
  • From: AAP
  • April 09, 2010 1:47PM

PRIVATE health insurer Medibank Private has agreed to acquire phone and web-based healthcare services provider McKesson Asia-Pacific from McKesson Corp for an undisclosed sum.

McKesson Asia-Pacific, McKesson New Zealand and Fitness2live will become a part of Medibank.

Medibank Private managing director George Savvides said McKesson delivered healthcare services and programs to state and national governments, area health services, corporations and health insurers, including Medibank Private.

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http://www.theaustralian.com.au/in-depth/aboriginal-australia/gps-to-ask-all-patients-if-theyre-aboriginal/story-e6frgd9f-1225851120249

GPs to ask all patients if they're Aboriginal

DOCTORS and health workers will be expected to ask all their patients if they are of Aboriginal origin regardless of their appearance or country of birth as part of the push to lift standards in indigenous health.

New guidelines issued by the Australian Institute of Health and Welfare today say all patients in hospitals, clinics and GP surgeries should be asked whether they are "of Aboriginal or Torres Strait Islander origin" even if staff already know the patient or the family background.

The move is intended to provide a more accurate measure of indigenous health disadvantage by counting people whose status has previously been unrecorded -- in some cases because they were not asked.

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http://www.computerworld.com.au/article/342180/pirate_party_philip_nitschke_teach_seniors_hack_filter/?eid=-255

Pirate Party and Philip Nitschke teach seniors to hack filter

Newcastle techie preaches proxies to the grey army

Pro-euthanasia group Exit International is holding national hacking crash-courses in how to bypass the Federal Government's planned ISP-level Internet content filter with help from the Australian Pirate Party.

The first of eight “Hacking Masterclasses” was held in Chatswood NSW on Thursday last week, and drew about 50 elderly people — some bearing laptops. Exit International director and controversial Australian physician, Philip Nitschke, created the class to help the elderly access euthanasia-assistance material online, following fears that the Internet filter will block access to the information.

A leaked copy of the filter blacklist revealed Exit International websites, the UK publisher of the Peaceful Pill eHandbook, and three YouTube videos were on the list of banned materials.

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http://www.smh.com.au/business/telstra-on-brink-of-deal-or-no-deal-20100408-rv85.html

Telstra on brink of deal or no deal

LUCY BATTERSBY

April 9, 2010

AN END to the tussle between the government and Telstra on the value of Telstra's telecommunications infrastructure is in sight, with Communications Minister Stephen Conroy saying the parties will soon reach a conclusion or break off negotiations.

''It won't be long before there will be either a deal or no deal in the discussion between the government and Telstra,'' Senator Conroy told 3AW yesterday.

''I can assure Telstra shareholders that David Thodey and Catherine Livingstone have been representing their interests,'' he said, referring to Telstra's chief executive and chairman.

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http://www.theaustralian.com.au/business/industry-sectors/optus-sides-with-telstra-in-national-broadband-controversy/story-e6frg9hx-1225851118825

Optus sides with Telstra in national broadband controversy

OPTUS has joined Telstra in baulking at a deal with the government over the national broadband network, with the No 2 carrier saying drastic changes were needed to draft legislation before it will sign up to the $43 billion project.

In its submission to the senate select committee on the national broadband network, Optus warned that the project could be sunk unless clauses that allowed the government-owned network to compete in retail markets -- specifically in the supply of telco services to government agencies -- were removed from the draft legislation.

Optus, until now, has been happy to negotiate with the government about its involvement in the NBN and had even gone so far as to consider selling its east-coast hybrid fibre-coaxial (HFC) cable network into the project.

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http://www.theaustralian.com.au/australian-it/medicare-extends-its-long-standing-contract-with-ibm-for-another-year/story-e6frgakx-1225850070857

Medicare extends its long-standing contract with IBM for another year

MEDICARE Australia will pay IBM $189 million for a one-year extension to its longstanding technology infrastructure services contract, along with a disengagement arrangement for up to 24 months.

This disengagement period will begin on January 1, three months before the services contract is due to end, on March 31 next year.

It covers provision of business-as-usual services including computing hardware and software in midrange, mainframe and data warehouse environments, desktops, a gateway and cross-platform services.

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http://www.theaustralian.com.au/australian-it/medicare-pours-8m-into-advertising-blitz-for-online-claims/story-e6frgakx-1225850080813

Medicare pours $8m into advertising blitz for online claims

MEDICARE spent $8 million spruiking the benefits of electronic claiming in doctors' offices in a two-month advertising blitz last May and June, on top of $42m in financial incentives and $6m to fix a "design flaw" inhibiting uptake of the troubled Easyclaim system.

The media campaign promoted the use of Easyclaim, Medicare Online and (in-hospital claiming service) Eclipse in a bid to reduce attendance at Medicare offices for cash rebates.

A direct mailout to 7.2 million Medicare cardholders cost $4.1m, $2m was spent on print and radio advertisements, while $1.8m was spent on creative and market research consultants", public relations firms and "champion" events.

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http://www.smh.com.au/nsw/nsw-health-admits-its-patient-satisfaction-figures-are-rubbery-20100404-rlsd.html

NSW Health admits its patient satisfaction figures are rubbery

JULIE ROBOTHAM HEALTH EDITOR

April 5, 2010

NSW Health has overstated the proportion of patients satisfied with how long they have to wait for an operation, after an error compiling the statistics, the department has admitted.

In its latest patient survey, released in November, it claimed 85 per cent of patients thought their operation had been scheduled within a reasonable period. But the actual figure was 80 per cent, a departmental spokesman confirmed to the Herald.

The original satisfaction figure was compiled from the responses of the 59 per cent of patients who had undergone medical tests before admission, while other patients' answers were not included.

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And from a year ago.

http://www.computerworld.com.au/article/301824/nsw_health_spend_100m_electronic_medical_records/

NSW Health to spend $100m on electronic medical records

Patient information to be shared between health facilities

After many promises and trials, NSW Health has committed $100 million over the next two years to replace existing paper-based health records in public hospitals with a state-wide electronic system aimed at improving patient care.

NSW Health anticipates the new electronic medical record (eMR) technology will make it easier for doctors and nurses to track the condition of patients through the health system as hospital information will be linked between facilities electronically.

Minister for Health, John Della Bosca, said the $100 million project will be rolled out to 188 hospitals across the state by the end of 2010.

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I wonder how this project is going. We do now have a new Health Minister in NSW.

It looks like there has been some progress in the West of the state.

http://www.health.nsw.gov.au/news/2009/20091028_00.html

28 October 2009

Electronic Medical Record providing safer care in our public hospitals

The Deputy Premier and Minister for Health, Carmel Tebbutt, today announced that hospitals in the Greater Western Area Health Service (AHS) were preparing to roll out an Electronic Medical Record (eMR) system to assist clinicians and provide safer care for patients.

"There are many advantages in the switch to electronic records," Ms Tebbutt said.

"An eMR system will allow clinicians fast access to patient information, notify them of alerts and whether a patient has an allergy and will reduce paperwork to give nurses and doctors more time with patients.

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And for a serious sense of déjà vu!

http://www.misaustralia.com/viewer.aspx?EDP://1270767702634&section=news&xmlSource=/news/feed.xml&title=Gershon+reforms+too+slow%2c+say+IT+companies

Gershon reforms too slow, say IT companies

Showdown talks with senior information technology industry executives will kick off a review of the federal government's implementation of plans to reduce IT spending by $1 billion over four years.

The former head of the National E-Health Transition Authority, Ian Reinecke, was appointed by the Finance Minister, Lindsay Tanner, last month to conduct an independent review of the ICT Reform Program embarked upon following the Gershon Review of 2008.

And also in the AFR:

Review of IT cuts begins with talks

09 Apr 2010

Ian Reinecke will meet senior representatives of the information technology industry next week as part of a review of the federal government’s plans to wipe $1 billion from IT spending over four years.

Oh dear, oh dear!

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Enjoy!

David.

Saturday, April 10, 2010

Crikey’s Health Blog Finds a Great Little Story! Spin Alert On!

The following appeared a few days ago.

Come in spinner…DOHA needs you

April 7, 2010 – 9:53 pm, by Croakey
The Department of Health and Ageing has put out a tender for “media liaison and issues management services”. It’s worth reading because it says quite a lot about how the Department views this role.
I saw no emphasis on or even mention of concepts like promoting greater transparency or fostering a more open and informed health debate. But of course it was probably naive to even search for such a thing; this job is all about keeping the lid on. Control, control, control – isn’t that what “issues management” is all about?
It could be fun to have a go at re-writing the evaluation criteria – what if DOHA asked for feedback from journalists or those who have been promoting more open government? We could provide comment on not only the consultant’s performance but related processes and the broader departmental culture around media engagement. Or perhaps even on the writing of the tender document…
Presumably the contract – due to commence on October 6, just a day after the final date for its awarding – will be worth a small fortune as it involves masses of work, including being the first point of contact for all media enquiries, handling media inquiries referred by the Ministers’/Parliamentary Secretary’s offices, supporting the Secretary and Departmental Executive, and serving as the Chief Medical Officer’s primary media adviser.
The full blog and some responses can be browsed here:
A quick visit to the DoHA site finds the following:

Provision of media liaison and issues management services.

Reference Number

RFT 277/0910

Title

Provision of media liaison and issues management services.

Description

The Department of Health and Ageing is seeking tenders from capable and experienced individuals or organisations to provide media management including critical issues across a range of matters for the Department. The successful tenderer will be the first point of contact for all media enquiries and issues for the Department. Tendering organisations will need to provide evidence of previous experience in journalism and management of sensitive media issues; and an understanding and appreciation of, and experience with, health, ageing, and sport (in the context of sport and health) media issues.
Full specification is found here:
So here we have the DoHA tender for help in ‘issues management’ – read spin and public disinformation service.
Of course they will have to work very hard to do better than the equivalent team at NEHTA!
I hope some enterprising soul with an ABN Registration will download a copy and send it along. I would love to browse the detail of the requirements!
David.

Friday, April 09, 2010

Weekly Overseas Health IT Links 07-04-2010.

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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http://www.healthcareitnews.com/news/obama-maine-tout-health-reform-governor-calls-it-critical

Obama in Maine to tout health reform, governor calls IT critical

April 01, 2010 | Mike Miliard, Managing Editor

PORTLAND, ME – President Barack Obama roused an enthusiastic crowd in support of his landmark health reform in Maine on Thursday, touting a new course that will "build on the system of private health insurance that we already have," making coverage "more secure and more affordable" for those who already have it, and allowing those who don't have coverage to "finally be able to get it."

As it does, he pledged, "costs will come down for families, businesses, and the federal government, reducing our deficit by more than $1 trillion over the next two decades."

The president's speech was primarily about the tax breaks that will allow small businesses to provide coverage to their employees (see more at Healthcare Finance News), and the new regulations that will set rules for who insurance companies must allow onto their rolls.

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http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=218327

HIE Connection Promotes Quality Care, Community Focus

Collaborative data-sharing among physician practices and Doylestown Hospital advances patient care.

By Richard D. Lang, EdD, and Rita Moran

A strong community connection has been evident at Doylestown Hospital in Doylestown, Pa., since its founding in 1923 by a local women's civic organization. Today, that organization is the only women's club in the nation to own and operate a community hospital.

Located near Philadelphia, Doylestown Hospital, a 208-bed facility, is on the leading edge of community benefit and involvement through the creation of the Doylestown Clinical Network (DCN). DCN is a health information exchange (HIE) that seeks to advance patient care through collaborative data-sharing among area physician practices and our hospital.

Our path down this road began in the late 1990s, when community physicians approached the hospital for help after realizing that billing systems for its practices could not make the Y2K transition. We decided to set up a separate applications services provider (ASP) organization, through which our medical staff could purchase a new practice management (PM) system at cost(should we say at "fair market value")?

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NHIN Direct Focus Is Health Data Exchange Specs

Nationwide Health Information Network (NHIN) Direct aims to develop interoperability specs, but not to replace statewide and regional health information exchanges.

By Marianne Kolbasuk McGee, InformationWeek

March 30, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224200787

The Nationwide Health Information Network (NHIN) Direct project unveiled last month will coexist with and not replace the federal government's ongoing vision for a robust, secure, and comprehensive national health data exchange, said a top government official.

NHIN Direct aims to develop interoperability specifications for simple, direct one-on-one data exchange between healthcare providers.

Earlier this month, the U.S. Department of Health and Human Services' Office of National Coordinator (ONC) for Health IT unveiled the NHIN Direct Project, an initiative to develop specifications and easy processes for local healthcare providers to exchange health data directly with other providers -- such as labs exchanging data with a doctor's office, or a primary care physician electronically sending a patient referral to a specialist.

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http://www.modernhealthcare.com/article/20100402/NEWS/304029993

Most HITS readers would consider open-source EHR

By Joseph Conn / HITS staff writer

Posted: April 2, 2010 - 11:00 am ET

Nearly two thirds of Health IT Strategist readers responding to our latest poll indicate they are keeping an open mind when it comes to open-source software.

Asked: “Would you consider using an open-source electronic health-record system in your hospital or physician office?” 93 of the 139 poll takers, or almost 67%, indicated “yes,” while 47 (not quite 34%) responded, “no.” (The percentages don't add up to 100 because of rounding.)

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http://www.e-health-insider.com/news/5784/st_george%E2%80%99s_gets_cerner_for_easter

St George’s gets Cerner for Easter

29 Mar 2010

St George’s Healthcare NHS Trust has gone live with Cerner Millennium, the strategic electronic patient record system provided by London's local service provider, BT.

In a statement, chief operating officer Patrick Mitchell said: “The first phase of the Cerner Millennium deployment at St George’s Healthcare NHS Trust went live as planned on Monday 29 March.

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http://www.healthdatamanagement.com/news/hie-state-plan-onc-hitech-40059-1.html?ET=healthdatamanagement:e1228:100325a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_033110

New Mexico First with HIE Plan

HDM Breaking News, April 1, 2010

The Office of the National Coordinator for Health Information Technology has approved New Mexico's strategic plan for health information exchange, making it the first state to get such approval.

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http://www.fierceemr.com/story/federal-panel-wants-national-reporting-emr-software-data-errors/2010-04-01?utm_medium=nl&utm_source=internal

Federal panel wants national reporting on EMR software, data errors

April 1, 2010 — 12:18pm ET | By Neil Versel

The Adoption/Certification Workgroup of the federal Health IT Policy Committee wants to require hospitals and physicians to report "hazards and near-misses" as a result of software malfunctions, beginning in 2013. Reporting would become part of demonstrating "meaningful use" of EMRs and thus a condition for receiving Medicare and Medicaid bonus payments.

While some would like to see a database on EMR and data glitches up and running sooner than that, some patient-safety advocates believe 2013 is unrealistic. "I think it will take a while to do this right," UCSF physician Dr. Robert M. Wachter tells the Huffington Post Investigative Fund. "The problem here is that there are potentially dangerous systems and we have no mechanism to figure out what they are or to force them to improve," he adds.

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http://www.healthdatamanagement.com/issues/18_4/regulation-ehr-contract_hospital-congress-fda-40004-1.html?ET=healthdatamanagement:e1225:100325a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_033010

Is 'Speak No Evil' a Contract Clause?

Sen. Charles Grassley frets that vendors use contractual clauses to hide software flaws - but he might not be getting the full story.

By Joseph Goedert

Health Data Management Magazine, 04/01/2010

Are electronic health records flawed and dangerous products sold by vendors that use onerous contractual provisions to absolve themselves of responsibility and muzzle user complaints? Or is an influential United States Senator barking up the wrong tree?

Sen. Charles Grassley (R-Iowa), ranking member of the Finance Committee, is investigating reports he has received that EHRs and computerized physician order entry systems are plagued with flaws that can result in patient or financial harm. The investigations is being conducted as federal officials implement provisions of the American Recovery and Reinvestment Act that will make tens of billions of dollars available to providers to significantly increase the adoption and use of EHRs.

That investigation took a sharp turn in late February when Grassley sent signals (see sidebar, page 30) that he might be considering Food and Drug Administration regulation of clinical information systems. Grassley, in letters sent to Health and Human Services Secretary Kathleen Sebelius, and the influential Healthcare Information and Management Systems Society trade association, asked for their views on a 1997 position paper that called for voluntary industry oversight of the integrity of clinical systems rather than regulation (see sidebar, page 30). The paper was published in the Journal of the AmericanMedical Informatics Association. The FDA, which started considering regulation in 1996, ultimately declined to do so amid industry opposition.

Grassley's also concerned with contractual "hold harmless" provisions that absolve vendors of responsibility for harm, and "gag orders" more commonly known as confidentiality or nondisclosure provisions that prohibit providers from publicly disclosing problems with their software. It should be noted that various types of confidentiality and hold harmless clauses are in virtually all I.T. contracts in all industries, consultants and attorneys who negotiate these contracts say. Grassley, however, wants to know if these clauses can be worded in a way that potentially could jeopardize patient safety.

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http://www.modernhealthcare.com/article/20100331/NEWS/303319993

‘High touch' tops tech with preventive care: study

By Andis Robeznieks / HITS staff writer

Posted: March 31, 2010 - 11:00 am ET

Primary-care practices who rely more on “high touch” principles such as patients seeing the same doctor and scheduling a “well visit” are likely to deliver more preventive services than those that rely on “high tech” principles such as using clinical decision-support tools and performing continuous quality improvement, according to a study in the Annals of Family Medicine journal of the American Academy of Family Physicians.

Researchers examined the records of 568 patients at 24 New Jersey primary-care practices participating in a study on improving colorectal cancer screening and concluded that the “relationship-centered aspects” of the medical home model “are more highly correlated with preventive service delivery” than were “information technology capabilities.” Of the practices in the study, 46% used electronic health records, though it's unknown what functions were used and how long the systems were in place.

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http://www.medscape.com/viewarticle/717818?src=mp&spon=18&uac=17738FT

The 2009 EHR User Satisfaction Survey: Responses from 2,012 Family Physicians

Robert L. Edsall; Kenneth G. Adler, MD, MMM

Posted: 03/19/2010; Family Practice Management. 2009;16(9):10 © 2009 American Academy of Family Physicians

Abstract and Introduction

Abstract

If you're shopping for an EHR system, you might appreciate this advice from a couple of thousand colleagues.

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http://govhealthit.com/newsitem.aspx?nid=73411

HHS awards PR firm $26M for health IT campaign

By Mary Mosquera

Monday, March 29, 2010

The Health & Human Services Department awarded public relations firm Ketchum Inc. a contract for $26 million to create a publicity campaign to educate the public about the privacy and security of their personal information contained in or managed by health IT systems.

The HITECH Act called for public education efforts to help drive the adoption and meaningful use of electronic health records. .

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http://www.healthcareitnews.com/news/study-names-100-top-performing-hospitals

Study names 100 top-performing hospitals

March 29, 2010 | Bernie Monegain, Editor

ANN ARBOR, MI – On Monday, Thomson Reuters released its annual study identifying the 100 top U.S. hospitals based on their overall organizational performance. The 10 areas measured, such as adherence to clinical standards and patient safety, are boosted by the use of information technology.

The Thomson Reuters 100 Top Hospital: National Benchmarks study evaluates performance in 10 areas: mortality, medical complications, patient safety, average length of stay, expenses, profitability, patient satisfaction, adherence to clinical standards of care, and post-discharge mortality and readmission rates for acute myocardial infarction, heart failure, and pneumonia. The study has been conducted annually since 1993.

"This year's study magnified the value that 100 Top Hospital award winners provide to their communities," said Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals programs at Thomson Reuters. "Even during the economic downturn, the 100 Top Hospitals maintained a profit from operations while raising the bar for clinical quality and patient satisfaction. The insistence of these hospitals' leaders – their boards, executive teams and medical staffs – on overall excellence makes the difference."

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Accenture Exec: EMR Targets Unlikely To Be Met

Today, only six percent of U.S. office-based physicians use a fully functioning electronic medical record system.

By Nicole Lewis, InformationWeek

March 29, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224200662

The government's goal to provide every citizen with an electronic medical record by 2014 is not likely to be met, according to Dr. Kip Webb, who leads Accenture's clinical transformation practice.

In an interview with InformationWeek, Webb noted that based on a recent survey, a substantial number of physician practices with 10 or fewer employees have said they will not embark on a program to adopt electronic medical records.

Asked if he felt the government's EMR goals were achievable, he replied, "I don't."

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http://www.e-health-insider.com/news/5793/bt_may_win_new_cerner_%E2%80%98greenfield%E2%80%99_deal

BT may win new Cerner ‘greenfield’ deal

31 Mar 2010

BT could be on the verge of being awarded a lucrative deal to install Cerner Millennium at three new hospital trusts in the south of England.

E-Health Insider understands a new deal is currently with Treasury pending approval, and the completion of the local service provider contract resets.

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http://www.ehealtheurope.net/news/5772/icn_and_ihtsdo_team_up

ICN and IHTSDO team up

25 Mar 2010

The International Council of Nurses has teamed up with the International Healthcare Terminology Standards Development Organisation to advance the use of standardised terminology and interoperability in healthcare IT.

The collaboration will see ICN actively work with the IHTSDO to facilitate involvement of the nursing community through the IHTSDO Nursing Special Interest Group.

David Benton, chief executive of ICN said: “ICN will embrace this collaboration as an important means of supporting nurses in providing quality care.

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http://www.ehiprimarycare.com/news/5783/choose_and_book_reaches_20m_referrals

Choose and Book reaches 20m referrals

30 Mar 2010

NHS Connecting for Health has announced that 20m referrals have now been made through Choose and Book.

The Department of Health’s IT agency said the achievement was a "key milestone" for the e-booking system, which was launched in 2004.

However, the figures also show that the system is currently used for around 50% of first outpatient appointments; well short of the 90% target originally set by the DH.

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http://www.healthleadersmedia.com/content/TEC-248742/DEA-Proposes-Allowing-Biometrics-to-Identify-EPrescribing-User

DEA Proposes Allowing Biometrics to Identify E-Prescribing User

Janice Simmons, for HealthLeaders Media, March 30, 2010

The Drug Enforcement Agency (DEA) is posting in the Federal Register on Wednesday an interim final rule that would permit hospitals, healthcare providers, and pharmacies to use electronic prescriptions in the dispensing of controlled drugs. Comments on the rule will be open for 60 days.

The rule is similar to a regulation proposed by DEA in June 2008 for e-prescribing. That provision ran into trouble when federal healthcare providers told DEA that the approach proposed for the private sector was inconsistent with their existing practices and did not meet the security requirements for federal systems.

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http://www.courant.com/business/hc-griffin0330.artmar30,0,1191216.story

Griffin Hospital Reports Breach Of 957 Patients' Records

By Matthew Sturdevant

msturdevant@courant.com

March 30, 2010

Medical information for 957 patients at Griffin Hospital in Derby was breached by a radiologist who broke into a computer archive system over a period of several weeks after he was terminated in February.

The hospital announced the security breach Monday on its website.

The doctor worked for a radiology group contracted by Griffin Hospital. His job ended Feb. 3, although it's not clear if he was fired.

His archive password was revoked when he lost his job, but he continued to access the system using passwords of other employees without their knowledge between Feb. 4 and March 5, the hospital said.

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http://www.modernhealthcare.com/article/20100330/NEWS/303309994

NHIN won't funnel information to CIA: Blumenthal

By Joseph Conn / HITS staff writer

Posted: March 30, 2010 - 11:00 am ET

Part one of a two-part series:

David Blumenthal, head of HHS' Office of the National Coordinator for Health Information Technology, has denied allegations that a framework for selecting data transmission standards for the proposed national health information network would configure the system to afford federal control over patient data and funnel that information to federal agencies, including the CIA, Justice Department and National Security Agency.

Blumenthal's remarks came more than three hours into the March 25 meeting of the Health IT Standards Committee. The committee is a federal panel created under the American Recovery and Reinvestment Act of 2009, also known as the stimulus law, to advise the ONC on matters concerning health IT standards.

Just before Blumenthal spoke, ONC staffer Doug Fridsma completed two lengthy presentations, followed by group discussions. One talk was on NHIN Direct, an ONC open-development project that had its startup meeting the day before.

NHIN Direct aims to develop specifications for simple information exchange tasks to afford less technologically advanced healthcare practitioners the means to perform basic clinical information-sharing required under a federal electronic health-record subsidy program, part of the meaningful-use criteria of the stimulus law.

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http://www.modernhealthcare.com/article/20100330/NEWS/303309993

Health IT group stresses patient-safety reporting

By Maureen McKinney / HITS staff writer

Posted: March 30, 2010 - 11:00 am ET

In its latest set of draft recommendations, the Certification/Adoption Workgroup of HHS' Health IT Policy Committee stressed the need for a standardized, transparent system for reporting patient-safety issues. During a March 29 meeting, the group also discussed the creation of a national patient-safety organization, which would serve as a clearinghouse for safety concerns from providers, vendors and patients.

“We believe patient safety is going to be more and more of an issue with the increasing use of health IT,” said Marc Probst, chief information officer of Intermountain Healthcare, Salt Lake City, and co-chairman of the work group. “We also think it's very important to create a safe, nondisciplinary environment so people don't try to hide errors.”

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http://www.healthleadersmedia.com/content/TEC-248583/Health-Reform-Brings-Changes-More-Work-for-HIM.html

Health Reform Brings Changes, More Work for HIM

Andrea Kraynak, for HealthLeaders Media, March 25, 2010

After an eventful week on Capitol Hill, HIM directors are likely wondering how health reform will affect them. Understanding what is in the bill is an important first step to figuring out what is on the horizon. Only then can HIM directors begin to figure out how to manage those changes.

"It will be awhile until all of this is flushed out and there is a clearer picture for the impact on HIM or other healthcare professionals," says Darice Grzybowski, MA, RHIA, FAHIMA, president of HIMentors, LLC, in Westchester, IL. After all, many of the provisions don't go into effect until several years in the future.

While a few details are still being worked out regarding EHR-related legislation, Congress took care of most of that in ARRA's HITECH Act. However, new healthcare reform legislation does address the topic briefly.

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http://www.healthleadersmedia.com/content/TEC-248746/Can-Broadband-Really-Save-Healthcare.html##

Can Broadband Really Save Healthcare?

Gienna Shaw, for HealthLeaders Media, March 30, 2010

The government is super stoked about the potential of greater broadband access to improve the U.S. healthcare system. Part of the 376-page National Broadband Plan report released by the Federal Communications Commission (FCC) last week gushes about health IT, e-health, m-health, telehealth, and electronic medical records (EMRs).

Can broadband really save healthcare? Well, technology is part of the solution for some of the industry's problems, such as physician and specialist shortages and disparities in access to care. But it's only part of the solution. And it comes with problems of its own. (Read more about wireless health, telehealth, and more in the March HealthLeaders magazine cover story, Medical Breakthroughs That Will Change Healthcare.)

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http://www.ihealthbeat.org/features/2010/blumenthal-discusses-federal-health-it-strategy-timeline.aspx

Tuesday, March 30, 2010

Blumenthal Discusses Federal Health IT Strategy, Timeline

In a recent interview with iHealthBeat, National Coordinator for Health IT David Blumenthal discussed the timeline for issuing final rules on "meaningful use," standards and certification criteria and the certification process, as well as "NHIN Direct," the health IT work force and the likelihood of the country meeting President Obama's goal of providing all Americans with an EHR by 2014.

Blumenthal said that CMS has received more than 2,000 comments on the notice of proposed rulemaking describing how health care providers can demonstrate meaningful use of certified electronic health records to qualify for incentive payments under the 2009 federal economic stimulus package and that the Office of the National Coordinator for Health IT has received more than 300 comments on the interim final rule describing required certification standards for EHR technology.

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http://www.healthdatamanagement.com/news/cms-administrator-berwick-nominate-40035-1.html?ET=healthdatamanagement:e1223:100325a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_032610

Reports: Berwick to Lead CMS

HDM Breaking News, March 29, 2010

President Obama will nominate Donald Berwick, M.D., president and CEO at the Institute for Healthcare Improvement, as administrator of the Centers for Medicare and Medicaid Services, according to numerous published reports over the weekend. Charlene Frizzera, COO of CMS and acting administrator since January 2009, will remain COO once Berwick becomes administrator, according to a spokesperson.

Based in Cambridge, Mass., the Institute for Healthcare Improvement is an independent, not-for-profit organization that brings together stakeholders to share lessons, and identify gaps in quality and best practices.

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EMR Data Theft Booming

Fraud resulting from exposure of electronic medical records has risen from 3% in 2008 to 7% in 2009, a 112% increase, researcher says.

By Nicole Lewis, InformationWeek

March 26, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224200494

Acceleration in the use of electronic medical records may lead to an increase in personal health information theft, according to a new study that shows there were more than 275,000 cases of medical information theft in the U.S. last year.

Unlike stealing a driver's license or a credit card, data gleaned from personal health records provides a wealth of information that helps criminals commit multiple crimes, according to Javelin Strategy & Research, a Pleasanton, California-based market research firm.

Information such as social security numbers, addresses, medical insurance numbers, past illnesses, and sometimes credit card numbers, can help criminals commit several types of fraud. These may include: making payments from stolen credit card numbers and ordering and reselling medical equipment by using stolen medical insurance numbers.

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http://www.govhealthit.com/newsitem.aspx?nid=73370

Healthcare reform legislation awash in IT

By John Moore

Wednesday, March 24, 2010

The healthcare reform legislative package signed into law yesterday by President Obama hinges on information technology for some of its most far-reaching changes.

The President yesterday signed the Patient Protection and Affordable Health Care Act, which includes IT-dependent projects that run the gamut from proposals to build state-run insurance “exchanges” to modern long-term care facilities.

Health IT is likely to play a key role in all these efforts. For example, the new law tasks the Department of Health and Human Services with creating a Web portal through which a resident in any state will be able to locate “affordable health insurance coverage options.”

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http://fcw.com/articles/2010/03/25/hhs-panel-considers-central-authority-for-health-it-vocabulary.aspx

HHS panel considers central authority for health IT vocabulary

Advisers examine who will decide the vocabulary and resolve disputes

A federal advisory task force is considering whether a central authority is needed to define and enforce medical vocabulary terms to be used in health care messaging, records and data exchange.

The Health and Human Services Department’s Vocabulary Task Force heard testimony from the National Library of Medicine, Centers for Disease Control and Prevention, National Cancer Institute, Joint Commission, and several other organizations March 23. The goal was to review options for creating and updating a common vocabulary for health information systems.

Experts say free and standardized terminology is needed for interoperability between health record systems. Currently, there are vocabularies for clinicians who identify patient problems, for medication terms and for lab orders, among others. Issues that haven't been resolved include governance, such as who decides what goes into the vocabularies, and how disputes are resolved.

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http://www.eweek.com/c/a/Health-Care-IT/Job-Demand-for-Health-Care-IT-Expanding-in-2010-and-Beyond-405743/

Job Demand for Health Care IT Expanding in 2010 and Beyond

Hospitals, medical clinics, doctor's offices and other health care organizations are facing government-mandated deadlines in a host of areas such as electronic medical records, clinical systems and new privacy and medical-coding standards. IT is expected to reap some of the benefits of this health care growth spurt. Evidence from a couple of new reports from health care IT industry organizations shows demand for health care-related technology jobs is on the rise.

It's not uncommon to hear about the high demand of medical-related jobs such as nursing. With an aging Baby Boomer population, the expectation for growing demand in health care jobs is real, according to the Department of Labor's Bureau of Labor statistics, which predicted "3.2 million new wage and salary jobs between 2008 and 2018, more than any other industry, largely in response to rapid growth in the elderly population" in an updated February report. IT is expected to reap some of the benefits of this health care growth spurt. Evidence from a couple of new reports from health care IT industry organizations shows demand for health care-related technology jobs is on the rise.

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Enjoy!

David.

Thursday, April 08, 2010

Victoria Makes A Counter Offer to The Commonwealth on Health Reform. Lots of E-Health!

The following was released today.

VICTORIA’S HEALTH PLAN PUTTING PATIENTS FIRST

From the Premier

Thursday, 08 April 2010

The Premier, John Brumby, today released Victoria’s health proposal - Putting Patients First – which outlines Victoria’s plan to drive an efficient, effective and accountable health system that delivers the best possible health care to patients, now and into the future.

Mr Brumby said Putting Patients First provided practical reforms that would continue to drive important improvements in the healthcare we deliver today and in the years to come.

“Our government understands how important it is for Victorian families to access the very best health services, regardless of where they live,” Mr Brumby said.

“That’s why we have increased funding to our health services by more than 130 per cent over the past 10 years to create Australia’s best and most responsive health system.

“However, the challenges of an ageing, growing population and the rise of chronic disease demand improvements to our health system now.

“Our health system needs more support from the Commonwealth Government now, in services and resources so we can treat more patients, sooner.

“With additional support from the Commonwealth now, we can ensure our local hospitals and health services remain flexible and responsive to the needs of their local communities.”

Key features of the Putting Patients First plan include:

  • Transparent and accountable financing – including an increase in the Commonwealth effort to match the states – a real 50-50 funding partnership for our hospitals. This would deliver an extra $1.2 billion for Victorian patients next year, which could be used to treat patients faster in emergency departments and operating theatres;
  • Real accountability – making sure Victorians know exactly who is responsible for the planning and delivery of health services - the Victorian Government;
  • Taking action to keep people well and out of hospital - investing in prevention programs such as the successful WorkHealth initiative to help people stay healthy, and avoid chronic illnesses which can result in unnecessary hospitalisation;
  • Investing in primary and aged care – for patients who would receive more appropriate care in a non-hospital setting such as a GP clinic or a residential aged care service, reducing pressure on public hospitals;
  • Improvements to the building blocks of our health care system – including improvements to the workforce, buildings and equipments, and innovation.

Mr Brumby said the plan outlined an alternative funding model to the one proposed by the Commonwealth – a 50-50 partnership starting today that would significantly increase access to services and deliver better healthcare for everyone.

Lots more follows:

The full release is here:

http://www.premier.vic.gov.au/newsroom/9991.html

The full report is available here:

http://www.premier.vic.gov.au/images/stories/media/Putting_Patients_First.pdf

The E-Health component is a real 'curate's egg' (Page 29)

New technology

Victoria supports the rollout of the National E-health Strategy and action to deliver individual electronic health records

To provide world-leading health care, Australia must put the patient at the centre of its services. The 21st century offers us new technologies that can be used to coordinate, integrate and improve the quality of health care, instead of treating people’s one-off health complaints. That’s why Victoria strongly supports the introduction of e-health, and in particular individual electronic health records (IEHR).

E-health means that when a person visits a doctor, hospital or other health care provider, vital information such as test results, prescriptions, hospital discharges, vaccinations and medical treatment can be electronically recorded and compiled into an IEHR. With the patient’s consent, this information can be shared between health care providers ensuring all relevant health professionals can access an accurate and up-to-date picture of the person’s needs, improving clinical decision-making, timeliness and patient outcomes.

E-health will result in:

· Improved access to services for patients living in rural and remote locations, and additional support for providers located in these regions;

· Increased safety through reducing avoidable medical errors and deterioration of chronic conditions caused by a lack of patient information; and

· Increased patient involvement by supporting self-management and informed decision-making.

A business case for IEHRs for every Australian is ready for consideration by COAG. Victoria strongly supports COAG endorsing the business case as part of the overall health reform package, and the Commonwealth funding it from the Health and Hospitals Fund, with additional support from States. Victoria strongly supports the rollout of the National E-Health Strategy and the adoption of IEHR, and is confident that the appropriate privacy measures are in place.

The really good bit is support for the National E-Health Strategy.

The really bad bit is giving an unreformed and unaccountable NEHTA a single extra cent.

I hope the good part is actually done – as that demands major NEHTA reform and that the E-Health Strategy approach is followed. IEHR’s are a very late idea in this – to follow sorting out all sorts of other things first.

I wonder do the Victorians really understand what they are asking for here?

Also a pity we still don’t know what the Rudd / Roxon team plan in this area.

David.