Quote Of The Year

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

or

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

Friday, April 16, 2010

Weekly Overseas Health IT Links 14-04-2010.

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.

-----

http://www.healthleadersmedia.com/content/TEC-249046/Many-Health-Professionals-Buying-iPad-But-its-Affect-on-Healthcare-Still-in-Question

Many Health Professionals Buying iPad, But its Effect on Healthcare Still in Question

Cheryl Clark, for HealthLeaders Media, April 5, 2010

By random and unscientific measure, about one in 10 people in line to buy an iPad at a San Diego Apple Store Saturday were health providers hoping to use it for patient care.

Kevin Kaloha, an intern at nearby UCSD School of Medicine, said he was in line on orders from his Radiology Department chiefs. "They told me to come down here and buy one," he said. "I think they want to test it and try it out to see how we can use it for imaging."

-----

http://www.fiercehealthcare.com/story/alarm-fatigue-death-shines-light-national-safety-issue/2010-04-06?utm_medium=nl&utm_source=internal

'Alarm fatigue' death shines light on national safety issue

April 6, 2010 — 1:03pm ET | By Debra Beaulieu

According to patient safety experts, the recently released report of the death of a heart patient at Boston's Massachusetts General Hospital in January shines a light on a national problem known as "alarm fatigue." Although intended to enhance patient safety, the typical cacophony of beeps and buzzes linked to patient monitoring devices in hospitals can lead healthcare workers to ultimately tune the noise out or even off, both of which investigators say occurred in the MGH case, reports the Boston Globe.

According to the report, 10 nurses could not recall hearing the beeps at the central nurses' station or seeing scrolling tickertape messages on three hallway signs that would have warned them as a patient's heart rate fell and finally stopped over a 20-minute span, reports the Globe. A separate bedside monitor was also turned off inadvertently.

-----

http://www.ehiprimarycare.com/news/5799/gps%27_future_should_include_it_incentives

GPs' future should include IT incentives

06 Apr 2010

GP practices should be offered financial incentives to support data quality and to move to paperless practices, according to GP representatives.

The BMA’s General Practitioner Committee has published a 50 point plan for the future of general practice in the UK, which includes recommendations on a series of areas including IT, the Quality and Outcomes Framework and out-of-hours care.

'Fit for the future – the evolution of general practice' says the further development of GP IT will require continual improvement in data quality and progress towards paperless practices. It calls for financial incentives to support that move.

-----

http://www.ehiprimarycare.com/news/5792/experts_fear_punch_and_judy_election

Experts fear Punch and Judy election

01 Apr 2010

Policy and healthcare IT experts have urged an incoming government to resist the temptation to shake up the NHS and radically reorganise its IT.

Asked to put forward manifesto ideas for the general election that is likely to be called after the Easter break, commentators from think tanks, analysts and the health service needed structural stability to cope with the quality and efficiency demands being made on it.

They also said the working parts of the National Programme for IT in the NHS should be retained, although trusts should be given more responsibility for their IT systems, working within a national framework of standards.

-----

http://www.who.int/goe/ehir/2010/6_april_2010/en/index.html

6 April 2010

eHealth Worldwide

:: Kenya - Kenya’s e-health potential remains untapped (24 March 2010 - All Voices)

As services assume electronic status, many sectors are coming up with innovative Information Technology (IT) solutions which make it easier to deliver cost effective services. Among the lucrative yet unexploited sectors is e-health. E-health refers to health services and information delivered or enhanced through the Internet and related technologies.

-----

http://www.e-health-insider.com/news/5807/london_it_programme_slashed

London IT Programme slashed

07 Apr 2010

NHS trusts in London have been told they will get a dramatically scaled back programme of IT modernisation following the new contract signed with BT last week.

The new deal with the local service provider cuts £112m - or about 10% of the value of the original £1.1 billion contract – from the deal signed in 2003.

Yet in return for paying a bit less, the NHS will get far less delivered. Most strikingly, many fewer acute trusts will now get Cerner Millennium, and fewer community trusts will get RiO.

-----

http://www.healthcareitnews.com/blog/preparing-professionals-nationwide-health-care-transformation

Preparing Professionals for a Nationwide Health Care Transformation

A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology

April 7, 2010

I know that health care providers are concerned about implementing new health information technology and finding professionals who can operate and maintain such systems. I know many clinicians are unsure how they will develop or strengthen their skill set to incorporate using health IT efficiently and effectively without jeopardizing their communication with patients during a clinical visit. It seems like a daunting transformation to clinicians themselves and, indeed, for our health care system overall. The HITECH Act recognized that the success of this health IT journey depends on people: people who are passionate about improving patient care, and who are supported in making those improvements.

-----

http://www.fiercehealthcare.com/story/department-veterans-affairs-spends-big-health-it-sees-big-return/2010-04-07?utm_medium=nl&utm_source=internal

Department of Veterans Affairs spends big on Health IT, sees big return

April 7, 2010 — 1:46pm ET | By Dan Bowman

Health information technology adoption ultimately can lead to better quality care and cost savings, if new research at the Department of Veterans Affairs is any indication. Investments in the Veterans Health Information Systems and Technology Architecture (VistA) between 2001 and 2007 led to fewer unnecessary or redundant tests and better quality care, which added up to $3.09 billion in overall net benefits after investment costs, according to a study recently published in the medical journal Health Affairs.

-----

http://www.kaiserhealthnews.org/Stories/2010/April/07/veterans-admin-electronic-health-record.aspx

Savings From Computerizing Medical Records Are Hard To Measure

Apr 07, 2010

This story also appeared on NPR's health blog, Shots

When it comes to health policy, few ideas find as much bipartisan support as the notion that widespread adoption of health information technology could improve medical care and save money. But putting a realistic number on those savings remains an elusive goal for health IT advocates.

A study published yesterday in the journal Health Affairs takes another step towards putting a dollar value on those savings. The Department of Veterans Affairs may have saved up to $3.1 billion between 1997 and 2007, the researchers report, but that finding is laden with caveats.

-----

http://healthit.hhs.gov/portal/server.pt?open=512&objID=1920&parentname=CommunityPage&parentid=3&mode=2&in_hi_userid=10741&cached=true

Paving the Path to Progress with a Roadmap for Health IT

A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology

April 5, 2010

The Office of the National Coordinator for Health Information Technology (ONC) is responsible for putting forward a vision for nationwide, interoperable health IT. Our work requires that we also support the creation of a learning health system that is patient-centered and uses information to continuously improve health and health care of individuals and the population. We have begun to get input for a detailed roadmap outlining goals, principles, objectives, strategies, and tactics toward this effort. This roadmap will pave the way to our vision and help keep us accountable.

----

http://govhealthit.com/newsitem.aspx?nid=73466

HIT panel wants certification labeling for EHRs

By Mary Mosquera

Tuesday, April 06, 2010

The federal Health IT Policy Committee recommended health IT vendors use labels to clarify that their products are certified to satisfy first-stage requirements for meaningful use in order to ward off potential confusion among buyers about whether systems they are considering will qualify them for the incentive program.

The labeling scheme was one of the suggestions made by the committee to the Office of the National Coordinator for Health IT, which has asked for comments about its plan to offer “temporary” certification of health IT products and systems.

The temporary certification program is designed to qualify health IT systems for first stage of the meaningful use plan, which begins next year. A permanent plan will be developed to certify health IT products for future phases of meaningful use.

-----

http://www.healthcareitnews.com/news/va-hospitals-use-video-games-rehab-vets-brain-injuries

VA hospitals use video games to rehab vets with brain injuries

April 05, 2010 | Mike Miliard, Managing Editor

TEMPE, AZ – Kinetic Muscles, Inc. (KMI), a provider of neurorehabilitation technology for stroke and cerebral palsy patients, has received a two-year Phase II Small Business Innovation Research (SBIR) grant to study a new treatment for military veterans returning from war with traumatic brain injury (TBI).

The announcement follows the promising results of Phase I of study, which combined neuropsychological therapy and digital gaming technology. This led the Department of Defense to fund Phase II, which will validate effectiveness of the therapy system through clinical testing in VA hospitals.

-----

http://www.healthcareitnews.com/news/study-it-doesnt-boost-docs-knowledge-rx

Study: IT doesn't boost docs' knowledge of Rx

April 05, 2010 | Molly Merrill, Associate Editor

HONOLULU – Despite high rates of health IT use, few Hawaii physicians are aware of the cost of medications they prescribe, and this impedes their ability to consider drug affordability for their patients, according to a new study.

The study, which was led by Chien-Wen Tseng, MD, associate professor at UH Mānoa's John A. Burns School of Medicine, surveyed 247 primary care physicians in Hawai'i in 2007 to find out how often they knew patients' out-of-pocket costs for medications when they wrote prescriptions.

-----

http://www.ehealtheurope.net/news/5804/just_752_patients_view_their_scr_online

Just 752 patients view their SCR online

07 Apr 2010

Just 752 patients out of the more than 1.2m who have a Summary Care Record have opted to view their SCR on HealthSpace.

The tiny number of patients accessing their record on NHS Connecting for Health's portal, which was launched three years ago, is equivalent to less than 0.062% of patients with an SCR.

-----

http://www.ihealthbeat.org/features/2010/longawaited-dea-rule-on-controlled-substances-could-boost-erx-adoption.aspx

Thursday, April 08, 2010

Long-Awaited DEA Rule on Controlled Substances Could Boost E-Rx Rates

Last week, the Drug Enforcement Agency took a major step in alleviating what many see as a significant barrier to electronic prescribing adoption.

In some ways, the federal government has been sending health care providers contradictory messages when it comes to e-prescribing.

CMS has said e-prescribing can help prevent medication errors and adverse events, as well as reduce prescription drug costs. The Medicare Improvements for Patients and Providers Act of 2008 provides physicians who e-prescribe with a 2% increase in their Medicare payments in 2009 and 2010, a 1% increase in 2011 and 2012, and a 0.5% increase in 2013. Beginning in 2012, health care providers who do not e-prescribe will face penalties.

-----

http://www.modernhealthcare.com/article/20100408/NEWS/304089993

Ambulatory EHR buying a ‘roller coaster ride': study

By Joseph Conn / HITS staff writer

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

Health information technology market researcher KLAS Enterprises has a new report out that says both office-based providers who use electronic health-record systems and the software developers that hawk ambulatory EHRs are both in for a wild ride this year.

The title of the Orem, Utah-based firm's 236-page report on the EHR market released this week reflects what's in store for both: Ambulatory EMR Buying: A Roller Coaster Ride in 2010. According to KLAS, it was based on interviews with more than 370 providers who plan to choose an EHR in the next two years.

-----

http://www.modernhealthcare.com/article/20100408/NEWS/304089995

Friedman discusses potential of SHARP research

By Joseph Conn / HITS staff writer

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

In just a couple of years, the Office of the National Coordinator for Health Information Technology at HHS will be looking for tangible results from the $60 million in public investment that the ONC has made in the Strategic Health IT Advanced Research Projects.

Charles Friedman, chief scientific officer at the ONC, also expects the unanticipated will emerge from the research and development program, called SHARP for short.

“You never know what's going to result from what you fund directly, but I can tell you now, the synergies have an enormous chance of paying dividends above and beyond the funding of these groups,” Friedman said. “The coalitions that are being formed through SHARP will yield these benefits beyond even the work being funded.”

-----

http://www.healthleadersmedia.com/content/PHY-249218/AHRQ-Provides-Guidance-on-Collecting-Quality-Patient-Safety-Information

AHRQ Provides Guidance on Collecting Quality, Patient Safety Information

Heather Comak, for HealthLeaders Media, April 7, 2010

The Agency for Healthcare Research and Quality (AHRQ) has released Common Formats Version 1.1, including technical specifications, which will help hospitals further standardize the collection and reporting of data related to patient safety events.

Patient safety events include unsafe conditions, near misses, and incidents of harm. The technical specifications included in this release will help software developers assist hospitals in reporting this type of data electronically, said the AHRQ.

-----

http://www.newvision.co.ug/D/8/12/715642

Govt unveils national identity card

Thursday, 8th April, 2010

By Barbara Among

THE German firm, Mühlbauer Technology Group, yesterday unveiled the new national identity card at Hotel Africana in Kampala.

The ID card will be made of polycarbonate (plastic) material. It will have as visible features a picture of the card holder, a signature, date of birth, sex, card number, date of expiry, a thumb print and the national flag with the map of Uganda.

-----

http://www.economist.com/business-finance/PrinterFriendly.cfm?story_id=15868133

When your carpet calls your doctor

Apr 8th 2010 | NEW YORK

From The Economist print edition

The coming convergence of wireless communications, social networking and medicine will transform health care

IS IT possible that amid all the hoopla about Apple’s iPad, one potential use has been overlooked? Larry Nathanson, head of emergency-medicine “informatics” at one of Harvard Medical School’s hospitals, has experimented with using the device in the casualty ward. He writes that “initial tests with our clinical applications went amazingly well…the EKGs look better onscreen than on paper. It was great having all of the clinical information right at the bedside to discuss with the patient.”

Dr Nathanson’s enthusiasm hints at the potential of wireless gadgets to improve health care, and to ensure more personalised treatment in particular. Pundits have long predicted that advances in genetics will usher in a golden age of individually tailored therapies. But in fact it is much lower-tech wireless devices and internet-based health software that are precipitating the mass customisation of health care, and creating entirely new business models in the process.

-----

VA Health IT Generates $3 Billion Savings

Over a 10-year period, the VA lowered costs while improving healthcare quality because of its health IT investments, says a research group..

By Nicole Lewis, InformationWeek

April 8, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224202277

During the decade 1997 to 2007, the Department of Veterans Affairs spent $4 billion on health IT investments and saved more than $7 billion over the same period, a new study finds.

The study reported that the VA's use of technology lowered costs by a net of $3.09 billion, while improving quality, safety, and patient satisfaction. It was conducted by members of the Center for Information Technology Leadership, a Charlestown, Mass. academic research organization that assesses the impact of health information technologies.

-----

http://www.healthcareitnews.com/news/emrs-double-edged-sword-doc-patient-communication

EMRs a 'double-edged sword' for doc, patient communication

April 08, 2010 | Molly Merrill, Associate Editor

WASHINGTON – Policies promoting electronic medical record adoption should include communication-skills training for clinicians and those using the technology, according to a new study.

The study found that while EMRs assist physicians in real-time communication with patients during office visits, they can also be a distraction and take away from visits.

The study was conducted by the Center for Studying Health System Change, a nonpartisan policy research organization (HSC), and was supported by the Commonwealth Fund.

-----

http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=218997

Addressing Gaps in Care

Self-service technology can cut costs and increase efficiency as well as improve patient care.

By Raj Toleti

Until now, implementations of self-service technology in the health care setting have primarily been driven by operational and financial objectives. And while the cost savings and increased efficiencies that self-service provides are significant, check-in kiosks and patient portals provide a number of clinical benefits as well. More specifically, these tools empower patients and equip physicians with the information needed to address gaps in care, when leveraged in combination with targeted applications such as prescription adherence management and clinical decision support.

-----

http://govhealthit.com/newsitem.aspx?nid=73478

AHRQ awards $40M to set-up HIT research center

By Mary Mosquera

Thursday, April 08, 2010

The Agency for Healthcare Research and Quality awarded almost $40 million in contracts to help equip and stand up the Health IT Research Center, a national organization designed to support the recently funded health IT regional extension centers.

-----

http://www.healthdatamanagement.com/news/breach-blues-tennessee-security-40092-1.html?ET=healthdatamanagement:e1237:100325a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_040910

BCBS Data Theft Now Affects 1 Million

HDM Breaking News, April 9, 2010

BlueCross and BlueShield of Tennessee, as of April 2, has now identified 998,422 current and former members as being at risk following the theft of 57 hard drives last October, the company announced in an update.

That's an increase from a mid-March figure of 521,761 members, as the plan has substantially completed forensic work to identify members at high or medium risk and now is focusing on identifying those at low risk--447,549 so far. Notification letters for these Tier 1, or low-risk members, started going out April 5.

-----

http://www.mmm-online.com/pfizer-seeks-ways-to-ease-adverse-events-reporting-digitally/article/166947/

Pfizer seeks ways to ease adverse events reporting digitally

Matthew Arnold

March 30, 2010

Pfizer is experimenting with electronic medical records and mobile technology to detect safety issues sooner.

The company is partnering with Sermo, Epocrates and Brigham and Women's Hospital in Boston on projects aimed at making it easier for doctors to report adverse events information or ask questions about Pfizer medications, according to a Dow Jones report.

-----

E-Health Records: Should FDA Help Certify?

Health IT policy group debates merits of bringing FDA, others into EHR certification process.

By Anthony Guerra, InformationWeek

April 1, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224201003

The Health IT Policy Committee's certification workgroup is considering whether working with the Food and Drug Administration to craft a certification program for electronic health record systems would improve patient safety.

On one side are those who argue that the FDA could add significant value in crafting a program. "We could collaborate on certification criteria that improves patient safety," says Paul Egerman, healthcare software entrepreneur and co-chair of the certification and adoption workgroup. The Office of the National Coordinator for Health IT (ONC) and the FDA could use the agency's Quality Systems Regulation as a point of reference to see what parts might work well for EHR systems, Egerman said.

-----

http://www.healthday.com/Article.asp?AID=637674

Medical Misinformation Can Spread Quickly Via 'Tweets'

Twitter users reveal misuse of antibiotics, including sharing leftover drugs, study finds

FRIDAY, April 2 (HealthDay News) -- Medical misinformation can spread quickly on Twitter, although social networks also offer the potential for sharing vital and correct health information, a new study shows.

Researchers from Columbia University and MixedInk in New York City identified more than 52,000 Twitter updates -- called "tweets" -- that mentioned antibiotics during a four-and-a-half month period in 2009.

Of those, about 700 tweets included incorrect information about antibiotics, including misunderstandings and bad advice about how they should be used or evidence of misuse. Examples included: "Well, looks like I have strep throat. Anyone have some extra antibiotics I could snag?" and "If I need to share my remaining antibiotics, I will."

-----

http://www.modernhealthcare.com/article/20100407/NEWS/304079992

EHRs improve patient contact, distract docs: study

By Joseph Conn / HITS staff writer

Posted: April 7, 2010 - 11:00 am ET

Electronic health-record systems can be a boon and a bane to physician-patient communications, according to a new report by the Center for Studying Health System Change, Washington, with support from the Commonwealth Fund, New York.

On the positive side, the study found that an EHR helps improve physician-patient interaction because it provides quicker access to patient information, affording physicians time to spend with patients that they might otherwise lose hunting for information through paper records that are less organized.

-----

http://www.bizjournals.com/sanfrancisco/stories/2010/04/05/daily9.html

John Muir Health to notify 5,450 patients of data breach

San Francisco Business Times - by Chris Rauber

John Muir Health, the Walnut Creek-based hospital system, said Monday it has begun notifying 5,450 patients by mail of a “potential breach of their personal and health information.”

The move came after the theft two months ago of two laptop computers at the John Muir Physician Network Perinatal office in Walnut Creek, officials said April 5.

-----

http://www.modernhealthcare.com/article/20100406/NEWS/304069994

ONC goes to work on a ‘lighter' network

By Joseph Conn / HITS staff writer

Posted: April 6, 2010 - 11:00 am ET

NHIN Direct, a development project recently started by HHS, is a lighter-weight version of the proposed national health information network that has been the focus of a six-year federal effort to promote a “network of networks” to facilitate interoperability between electronic health-record systems.

The official kickoff meeting of NHIN Direct was March 23, although work had been under way for about three weeks before that. Work on NHIN Direct is being driven by the urgent imperatives of the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.

The stimulus law provides an estimated $14.1 billion to $27.3 billion in federal subsidies to hospitals and office-based physicians to purchase EHR systems, contingent upon providers demonstrating they are using the EHRs in a “meaningful manner.”

-----

http://www.modernhealthcare.com/article/20100406/NEWS/304069993

Brailer interviews Blumenthal on privacy, standards

By Maureen McKinney / HITS staff writer

Posted: April 6, 2010 - 11:00 am ET

Patient privacy, the role of states in health information exchange, the effects health reform may have on health information technology adoption—these topics were all fair game when David Brailer, the first head of the Office of the National Coordinator for Health Information Technology, sat down to talk with David Blumenthal, who currently holds the post, for a newly published interview that appears in the April issue of Health Affairs.
-----

http://www.modernhealthcare.com/article/20100406/NEWS/304069986

Current EHRs have limited quality, efficiency effect: study

By Maureen McKinney / HITS staff writer

Posted: April 6, 2010 - 8:00 am ET

In spite of the ever-increasing push to implement electronic health records, the link between EHR adoption and subsequent improvements in quality of care and efficiency is weak, according to a recently published study in Health Affairs.

Researchers, led by Catherine DesRoches, assistant professor at the Institute for Health Policy at Massachusetts General Hospital, Boston, examined data from more than 2,900 hospitals and found no significant relationship between EHR adoption and performance on quality measures related to myocardial infarction, congestive heart failure or pneumonia, and found only some improvement in prevention of surgical complications.

-----

http://www.govhealthit.com/newsitem.aspx?nid=73461

ONC awards $84 million to expand health IT workforce

By Mary Mosquera

Monday, April 05, 2010

The Office of the National Health IT Coordinator last week awarded $84 million in grants to 16 universities and junior colleges to develop education and training programs to boost the number of skilled health IT workers available to help healthcare providers over the hurdles of adopting health IT.

ONC aims over time to reduce an estimated shortage of 50,000 workers in the health IT sector of the economy. That workforce is an important part of making the meaningful use of electronic health records a reality, said Dr. David Blumenthal, the national health IT coordinator, in the announcement April 2.

-----

http://www.healthleadersmedia.com/content/TEC-249116/Size-Doesnt-Matter-When-Youre-an-Early-Adopter-of-Health-IT.html

Size Doesn't Matter When You're an Early Adopter of Health IT

Gienna Shaw, for HealthLeaders Media, April 6, 2010

When you think of innovation in healthcare technology, you probably picture a large academic medical center or a large hospital system. But small and rural hospitals are perfectly capable of making investments in new technologies.

In fact, one might argue that small rural hospitals that adopt new technologies are even more adventurous than the big guys. They have a lot more to lose.

In our HealthLeaders Media Industry Survey 2010, we asked technology leaders to describe their organization's IT culture. Most (43%) answered "wait until proven." But the second most-popular choice was "early adopter," with 37% choosing the response, up from 34% the previous year. (Another 20% said they are "behind the curve.")

-----

http://www.healthdatamanagement.com/news/phr-guidance-consumer-clinician-40067-1.html?ET=healthdatamanagement:e1233:100325a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_033110

Groups Write PHR Guides

HDM Breaking News, April 5, 2010

Four industry associations have collaborated to introduce reference guides for personal health records for consumers and clinicians.

Both versions of the Personal Health Record Quick Reference Guide cover the purpose, benefits and privacy/access issues of PHRs, along with frequently asked questions.

-----

http://www.healthdatamanagement.com/news/report-security-survey-providers-compliance-40068-1.html?ET=healthdatamanagement:e1233:100325a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_033110

Survey: Mixed Bag on Security Readiness

HDM Breaking News, April 5, 2010

An updated biannual report from the HIMSS Analytics research unit of the Healthcare Information and Management Systems Society in Chicago shows health organizations take data security compliance seriously but may be missing the big picture.

Kroll Fraud Solutions, Nashville, Tenn., commissioned the "2010 HIMSS Analytics Report: Security of Patient Data," which follows a similar report issued in April 2008. The new report issued on April 5 covers the results of 250 health professionals surveyed in December 2009.

Respondents rated their organizations high in complying with existing laws and regulations, averaging a score above 6 on a scale of 1-7 for CMS regulations, HIPAA, state security laws and the Red Flags rule, and 5.75 for HITECH Act security provisions. Yet 19 percent reported a data breach in the past year, up from 13 percent in the survey two years ago.

-----

http://www.fiercemobilehealthcare.com/story/pwc-report-mobile-technologies-will-enable-patient-centered-care/2010-04-06

Mobile technologies will enable patient-centered care, PwC report says

April 6, 2010 — 11:58am ET | By Neil Versel

Rising healthcare costs and prevalence of chronic disease are not merely American problems; they are affecting the delivery of care worldwide. The crunch, says a new PricewaterhouseCoopers report, will push millions upon millions of people to take more control over their own healthcare, often enabled by mobile technologies and the Internet.

"The overarching challenge for incumbent health systems will be to shift their internal focus from a siloed bureaucratic healthcare infrastructure to one that puts the patient at the center...and engages them to be active stakeholders in their health and the health system," the report reads.

-----

http://www.ihealthbeat.org/perspectives/2010/deja-vu-objections-to-health-it-rules-similar-to-reaction-to-regulation-in-other-areas.aspx

Tuesday, April 06, 2010

Déjà Vu: Objections to Health IT Rules Similar to Reaction to Regulation in Other Areas

"Meaningful use" is an elegant concept. The very words telegraph depth and purpose, and the notion is easy to understand. The implementation of this concept, however, is unlikely to be elegant or easy.

Indeed, the battle is already engaged. CMS and the Office of the National Coordinator for Health IT have received more than 2,000 comments on the proposed regulations to enhance electronic health record adoption -- often referred to in government-speak as the "NPRM" (Notice of Proposed Rule Making) and the "IFR" (Interim Final Rule).

It won't all be happy reading. Many of those letters -- from physician and hospital groups that stand to gain or lose the most -- argue politely but strenuously that the proposed rules overreach and demand too much too soon of providers.

-----

http://www.technologyreview.com/biomedicine/24985/?nlid=2872&a=f

Tuesday, April 06, 2010

Combing Medical Records for Research

The vast data housed in electronic records and genomics databases could reveal new insights.

By Emily Singer

When the stimulus bill passed last year--allocating $20 billion to help doctors and hospitals adopt electronic medical records (EMRs)--many scientists were excited about the possibilities for medical research. EMRs provide vast amounts of medical information that can be combed automatically and used to ask questions that are too expensive or perhaps unethical to study in traditional clinical trials, such as whether newer, more expensive treatments are more effective than older ones.

"There is a lot of federal funding right now supporting the development of the infrastructure to do that kind of work, as well as to look at comparative effectiveness research using databases," says Richard Tannen, a physician at the University of Pennsylvania, in Philadelphia. "But it's a complex and difficult problem, in some ways more difficult than people appreciate."

-----

http://www.kaiserhealthnews.org/Daily-Reports/2010/April/05/Electronic-medical-records.aspx

Health IT Funding Raises Security Concerns; Some Hospitals Face Barrier To Funding

The Richmond Times-Dispatch wonders: "Two big questions yet to be answered with electronic health records are: Do they save money? And can they be made 100 percent secure? The verdict is still out on both. The thought of one's personal medical information being just a computer click away does not sit well with many consumers." The paper reviews several surveys from last year to note that "security is on everyone's mind" (Smith, 4/5).

-----

http://www.healthdatamanagement.com/news/breach-theft-notification-clinic-40063-1.html?ET=healthdatamanagement:e1231:100325a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_033110

Records Taken from Recycling Bins

HDM Breaking News, April 1, 2010

Police in Lafayette, Colo., are investigating after at least 14 patients of a medical clinic owned by Boulder Community Hospital received anonymous letters informing them that their medical records were taken from unsecured recycling bins outside the clinic.

The letters, which included copies of the records, urged patients to report violations of federal medical information privacy rules. The stolen information included patients' medical records, including names, date of birth and Social Security numbers, according to published reports from local media outlets. Boulder Community Hospital has installed lockable recycling bins; two of eight bins were not locked, according to one report.

-----

Enjoy!

David.

Thursday, April 15, 2010

What The Department Wants in a Spinner! The DoHA Public Relations Tender Reviewed.

To save regular readers all the nonsense of registering to access what clearly should be public information we provide the key section of the tender.

Number: RFT 277/0910

Link: Provision of media liaison and issues management services.

Closing Date: 27/04/2010

Here is the guts of what DoHA is asking for.

Part B – Statement of Requirement

1. INTRODUCTION

The Department of Health and Ageing (“the Department”) is seeking to test the market, in accordance with Commonwealth Procurement Guidelines, for the services of an organisation to provide media management including critical issues (Services) across a range of matters for the Department.

Tendering organisations will need to provide evidence of:

(a) previous experience in journalism and management of sensitive media issues; and

(b) an understanding and appreciation of, and experience with, health, ageing, and sport (in the context of sport and health) media issues.

The successful tenderer will be required to establish a team to be located in the Department’s premises in Canberra, to be the first point of contact for all media enquiries and issues for the Department.

This tender seeks to cover the provision of Services to the Department for an initial period of 3 (three) years with an option to extend for a period of up to a further 2 (two) years on the basis of satisfactory performance and regular review of services, and this will be reflected in a Contract for Services (refer Part D of this RFT). There is currently a separate contract with the Therapeutic Goods Administration (TGA) which is part of the Department. The TGA contract with the current service provider will remain in place until June 2011, at which time there is the potential to expand the Departmental contract to include the TGA services. This may require additional resources being provided by the successful tenderer which will be negotiated at the time.

2. CONDITIONS OF PARTICIPATION (Part A section 5.4)

In compliance with the Commonwealth Procurement Guidelines (CPGs), the Commonwealth will exclude a Tender from further consideration if the Commonwealth considers that the tenderer does not comply with the following condition(s):

(a) Capacity to comply with the draft contract conditions from a commercial, financial or technical perspective (Part A Section 4.7).

(b) Include a signed declaration with their submission that they have not engaged in collusive tendering or received improper assistance in compiling their Tender.

(c) Include a signed declaration with their submission that they do not have any adverse Court or Tribunal decision for a breach of workplace law, occupational health and safety law, or workers’ compensation law in the past two years preceding the date of this RFT.

(d) Tenderers must have or be willing to obtain if engaged the following levels of insurance and indemnity coverage in place for this project assignment (refer attached contract clauses referring to insurance and indemnity):

• Workers Compensation to an amount required by law,

• $20,000,000 Public Liability, and

• $2,000,000 Professional Indemnity.

(e) Tenderers must have or be willing to obtain and maintain for the life of the contract a Commonwealth Government security clearance to the level of Secret.

(f) Tenderers must advise of any perceived or actual conflicts of interest that would exist if the tenderer was successful in being awarded a contract.

3. MINIMUM CONTENT AND FORMAT REQUIREMENTS (Part A section 5.3)

In compliance with the Commonwealth Procurement Guidelines (CPGs), the Commonwealth will exclude a Tender from further consideration where the minimum content and format requirements have not been met. Subject to Part A section 3.4, tenderers are required to satisfy the format and content requirement including provision of the information listed in Part A section 5.3.

ESSENTIAL REQUIREMENTS

As stated above and as per Clause 5.5.1 Part A, Tenderers must:

(a) demonstrate previous experience in journalism and management of sensitive media issues; and

(b) demonstrate an understanding and appreciation of, and experience with, health, ageing and sport (in the context of sport and health) media issues.

4. BACKGROUND

The Department of Health and Ageing is a dynamic, politically sensitive Department with major initiatives being introduced to assist the Australian public and health providers.

These Services are being undertaken within the Communications Branch of the Business Group of the Department.

The principal purpose of the Services is to ensure that the public is adequately and appropriately informed through the Australian media about Australian Government policies and programs in the health and ageing portfolio and, particularly, on important emerging health issues and threats.

5. CONTEXT

The Services will need to be undertaken in close collaboration with the staff of the Communications Branch in their management of day-to-day public affairs tasks, campaigns and other communications activities.

6. OBJECTIVES

The Services are an integral component of the overall health promotion strategy mix, working to complement other strategies, policy measures and legislative compliance. The Services will assist in informing public attitudes, knowledge and behaviour to aid in meeting the goals and objectives of the Department.

7. REQUIREMENT

The successful Tenderer will be required to:

• Be the first point of contact for all media enquiries and issues for the Department and prepare responses as per the nature and urgency of the issue.

• Provide media liaison and issues management of critical and emerging health, ageing and sport (in the context of sport and health) issues.

• Handle media inquiries referred by the Ministers’/Parliamentary Secretary’s offices.

• Support the specific media liaison needs of the Secretary and the Departmental Executive.

• Serve as the Chief Medical Officer’s (CMO) primary media adviser and primary point of contact for related media issues.

• Provide media support to meetings of bodies and councils established under the Health and Ageing portfolio as required.

• Establish and cultivate relationships with news outlets and other media channels to ensure the Australian Government can effectively and promptly manage critical issues related to improving the health of all Australians.

• Provide media support as required to the Portfolio Ministers at various Minister’s meetings and/or conferences including but not limited to: Australian Health Ministers Conference; Australian Health Ministers Advisory Council; Medical Services Advisory Committee etc.

Note: there is an average of 90 media enquiries to the Department per week. Depending on the nature of the enquiry, these enquiries can take varying time to resolve and require different levels of liaison within the Department and the Ministers’/Parliamentary Secretary’s offices.

It is expected that the successful tenderer will be available to deal with urgent media enquiries and issues outside of normal office hours.

In respect of matters relating to meetings of bodies and councils associated with the Health and Ageing portfolio and as requested by relevant Division Heads and with the advance approval of the Contract Manager, the successful tenderer must:

a. undertake media liaison surrounding the regular meetings of relevant bodies, including federal/state bodies;

b. represent the Department in handling media liaison and support for selected Interdepartmental Committees (IDCs), councils or committees handling issues that may have significant media implications relating to their spheres of responsibility, including media liaison;

c. act as media adviser to designated Commonwealth/State and Territory Health Ministers including, but not limited to, the Australian Health Ministers’ Conference, the Ministerial Council on Drug Strategy, the Australia and New Zealand Food Regulation Ministerial Council, the Pharmaceutical Benefits Advisory Committee, and the Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis;

d. act as media adviser to Commonwealth/State and Territory emergency management committees such as, but not restricted to, the Australian Health Disaster Policy Planning Committee, Communicable Diseases Network of Australia and the National Influenza Pandemic Committee.

e. provide secretariat support for the National Health Emergency Media Response Network.

Note that on average it is anticipated the tenderer would spend two person days per week on media liaison associated with committee membership and two person days per week on involvement with, and preparation for, emergency management and national security.

Critical or emerging health issues

As well as being the first point of contact for all media enquiries, the successful tenderer will undertake media liaison and issues management in respect of designated critical or emerging health issues that call for a health and ageing response.

To provide greater understanding of these issues, the following are examples of critical or emerging issues:

a. Communicable diseases, pandemic influenza and immunisation;

b. Disease outbreaks or emerging diseases;

c. Indigenous health;

d. Bio-security, bio-terrorism, bio-surveillance and health-related national security issues, including chemical, biological, radiological, nuclear or explosive incidents and safety of or threats to the food supply;

e. Illicit and licit drugs;

f. Emerging health issues; and

g. Day-to-day issues that could impact the reputation of the Department (e.g. fraud and audit matters arising in relation to the Department’s business).

The successful tenderer will be responsible for advising the Department Executive on media liaison, and handling any related issues that can arise in national health emergency situations.

The successful tenderer may also be required to, either as a result of a request from the Ministers’/Parliamentary Secretary’s Offices, Department Executive, or a request from the Contract Manager:

a. Develop draft media releases and media briefing materials (eg information sheets) for clearance by relevant line managers in any Divisions of the Department, and by the Ministers’/Parliamentary Offices on specific issues.

b. Cultivate relationships with reporters specialising in the fields of activity aligned to Divisional activity to encourage balanced and responsible reporting, by facilitating through a Division, and with the prior approval of the relevant First Assistant Secretary, the provision of current information, background briefings on specific issues, and interviews with the Minister and key representatives of the programs of each Division.

c. On invitation, actively participate in line management meetings of a Division, and in meetings with Divisional executives in relation to designated media liaison and associated plans and activities.

d. Actively participate as requested on committees of a Division.

It should be noted that the Department has a Communications Branch that handles proactive media activities and this is generally not required by this tenderer

Best Practice, Standards and Procedures

The successful tenderer will be required to observe the following best practice, standards and procedures in the delivery of Services under this Contract.

· The successful tenderer must, as an obligation of this arrangement, perform and deliver Services on a priority basis, meaning the requirements specified in this arrangement will take priority over other contracts performed by the Contractor for other parties. Where a conflict arises in the delivery of priority service by the successful tenderer under this arrangement, the successful tenderer will discuss that conflict with the Contract Manager in order to resolve that conflict.

· The successful tenderer will perform and deliver Services relating to the drafting, preparation and dissemination of media releases using the systems and procedures of the Communications Branch, in accordance with practices agreed by the Department and with the Ministers’ and Parliamentary Secretary’s Offices.

· The successful tenderer will be required to, and must acknowledge, that the Department will undertake a six-monthly review of the contractor’s performance against best practice, standards and procedures and the Contractor’s performance against the requirements of this Contract will generally be consistent with the Department’s quality of service and value for money obligations.

Fees

Tenderers are to provide a fixed annual fee for the Services to be invoiced monthly.

Tenderers are to detail how the annual fee was calculated including number of staff proposed and their costs, including associated business costs.

Tenderers are to advise if the proposed fees will be subject to annual variation and the proposed method for arriving at any variation.

Proposed staff

Tenderers are to advise what staff resources they propose to provide for the Services and describe their experience and qualifications and associated roles and responsibility, and any current security clearances held.

Allowances and Costs

Travel

The services are to be provided from the Department’s Canberra offices.

The Commonwealth will not be liable for the costs of air fares, taxi fares and related travel allowances and other costs for accommodation, meals and incidental expenses for attendance by the Contractor’s personnel at the Department’s premises in Canberra for the performance of Services, or for the return of those personnel to locations away from Canberra.

Where there is a requirement to travel interstate on behalf of the Department, airfares, associated costs and travel rates will be negotiated at that time with the successful tenderer and covered by the Department.

Taxi Fares

The Contractor will be entitled to obtain Cabcharge taxi vouchers for use where deemed appropriate in relation to the performance of Services.

Tenderers are to detail any other costs that may be incurred as a result of undertaking this contract.

Assets, Facilities and Assistance

The Commonwealth currently provides the following assets, facilities and assistance free of charge to the Contractor for up to four (4) personnel in the Department’s Woden Precinct, Canberra, for the Commonwealth’s convenience in interacting with the Contractor, to permit effective performance only of the Services, and to protect the security of Contract Material, Commonwealth Material and Confidential Information:

a. Location: Level 11, Scarborough House, Woden Precinct, Canberra.

b. Suitable office accommodation at the above location is standard Departmental offices and workstations as appropriate.

c. Standard construction and fitout for the above accommodation (including standard furniture and storage items).

d. Suitable telephone (land lines) services.

e. Standard desktop computer facilities, including access to printers and standard Internet access.

f. Access to the Department’s daily online media monitoring service with assistance from the Media Monitoring team in Communications Branch; separate subscription to the main daily newspapers; and any other media monitoring as agreed with the Contract Manager.

g. Access to meeting rooms and meeting facilities of the Department.

h. Access to standard office stationery and consumables items regarded as reasonable by the Contract Manager.

i. Access to messenger and courier services as required for the purposes of the Services.

The successful tenderer will be expected to provide its own mobile phones. The mobile phone use can potentially be as high as $1,000 per month and it is expected that the successful tenderer will arrange a suitable business plan with a vendor (refer clause 7 – paragraph on Fees.)

These assets and facilities may only be used for the purposes of performing the Services for the Commonwealth.

Any additional assets, facilities or assistance will be supplied by the Commonwealth at its sole discretion, and within the limits of available budgets and resources at any time.

Optional requirement

Note that currently there also is a separate contract with the Therapeutic Goods Administration (TGA) which is part of the Department. The TGA contract with the current service provider will remain in place until June 2011, at which time there is the potential to expand the Departmental contract to include the TGA services. This may require additional resources being provided by the successful tenderer which will be negotiated at the time if required.

8. ESSENTIAL REQUIREMENTS (Part A section 5.5)

In compliance with the Commonwealth Procurement Guidelines, the Commonwealth will exclude a Tender from further consideration if the Commonwealth considers that the Tender does not comply with an essential requirement identified in the Statement of Requirement indicated by the use of the word “must”.

a. In the event of a national health emergency, the successful tenderer must work as required in the Department’s National Incident Room in Canberra.

b. Work each month must be completed before an invoice can be submitted, ie, the monthly invoice must be submitted no earlier than on the last working day of the month for which the invoice covers.

c. The monthly report as outlined in item 11 must be provided within five working days of the lodgement of the monthly invoice.

d. The successful tenderer must file all Departmental documents electronically according to the Department’s security guidelines and maintain appropriate files (see 15).

e. Tenderers must indicate any element of their Tender which may become part of any subsequent contract, which they regard as confidential and provide reasons for requiring confidentiality. Further information regarding confidentiality in this context can be sought from the Department of Finance and Deregulation’s publication “Guidance on Confidentiality in Procurement” available from: http://www.finance.gov.au/publications/fmg-series/03-guidance-on-confidentiality-in-procurement.html.

9. OPTIONS

In the event of a national health emergency, there is a potential requirement for 24-hour staffing either in or within the area of the National Incident Room in Canberra.

---- End Extract.

Among the little points I noticed were:

The tenderer had to maintain a security level of Secret. (I am surprised it was not Top Secret). I wonder what that is all about?

The mobile phone use – apparently not reimbursed - can be up to $1000 per month. Sounds like a fair bit of chatting!

The Department is expecting the work to occupy 4 people pretty much full time and these people are to be based within the Department.

It really is intended that the provider of the services be totally embedded within and work as public servants – except the hourly rates would seem to be likely to be a good deal higher.

The services are additional to the work undertaken by the Communications Branch. One wonders what they do given the scope requested here.

Frankly I think the public interest and transparency would be better served by appropriate people just being hired as standard public servants with the same levels of accountability and openness to audit etc that comes with that territory.

David.

It Seems Someone Is Running an e-Health Spruiking Campaign! I Wonder Who?

All of a sudden there seems to be a great deal of publicity to foster excitement around e-Health.
First we have a little NEHTA puff piece which demonstrates that better communication – manual or electronic – can save everyone lots of hassles. Of course the electronic version assumes an e-Health infrastructure we will all be lucky to see in the next decade or two!

Making a Difference with E-Health

E-health is about ensuring Australians get the right treatment and the right medication in the right place and time. Here, one of NEHTAs Clinical Leads, Dr Ashley Bennett, a radiologist shows the difference e-health will make to patients and healthcare providers. Here is Dr Bennett's story.
Dr Ashley Bennett
Mr Tran is a 54 year old non-English speaking man who recently visited his GP with acute-on-chronic back pain and sciatica. The condition was not severe enough to require a visit to the emergency department, but it kept him awake at night and interfered with daily activities. His GP gave him a hand-written referral saying “Please review previous films and inject level indicated as per report’s recommendations”.
.....
As an estimate, the total time from patient presentation until the conclusion of the procedure was 16 hours. In addition, Mr Tran and his daughter, myself and the GP were inconvenienced by the lack of information available and the inability to treat Mr Tran.
The difference e-health will make to this real life scenario is significant.
The GP will be able to submit the request electronically and the Radiology reception staff will be able to retrieve Mr Trans’ electronic health record instantaneously, including the previous lumbar MRI report. Seeing the ambiguity of the request, I would be asked to contact the GP straight away (before he went on leave) to clarify the procedure required. When Mr Tran arrived for his procedure, his previous images will be available for online review. After confirmation of the symptoms with Mr Tran and his daughter, a nerve root sleeve injection would have been performed. As an estimate, the total time from patient presentation until the conclusion of the procedure would be approximately 20 minutes.
Read the full saga here:
Then we have the RACGP out there spruiking NEHTA as part of their ‘being best mates’ sponsorship!

College's E-health Futures Leads The Way, Australia

09 Apr 2010
The Royal Australian College of General Practitioners (RACGP) is very pleased to announce that its latest e-health initiative, e-health Futures, will officially be launched today at College House in South Melbourne.
e-health Futures is an innovative and interactive e-health display, which involves a walkthrough experience of how e-health information will work among health care professionals.
RACGP President Dr Chris Mitchell, who will open e-health Futures in Melbourne today, said that this initiative is very important to position general practice at the centre of the e-health revolution.
"General practice is in an ideal position to be at the forefront of e-health. There are now around 115 million GP consultations taking place annually and computers are now used by 98 per cent of GPs for clinical purposes.
"Without improvements in e-health and medical information management systems, we will continue to expose patients to unnecessary risks, including adverse events and medication errors.
The college has worked closely with the National E-Health Transition Authority (NEHTA) to incorporate their Model Healthcare Community into e-health Futures.
The model provides an opportunity to learn more about the policy and implementation of Australia 's future Healthcare Identifiers Service and also to see other innovations in e-health such as the RACGP's data aggregation tool Oxygen and the Pen Clinical Audit Tool (CAT).
Dr Chris Mitchell said that the college will be adding to the e-health projects available as the resources are being developed to assist and support GPs as e-health continues to evolve.
"This project is a unique opportunity for general practice teams, other health professionals, health industry associations, consumer groups, privacy advocates, universities, information industry associations, vendors and media representatives to learn more about e-health and find out how they can utilise the model.
"With more e-health government announcements to be expected soon, e-health Futures provides a timely opportunity for everyone to get ready and experience and direct the future of electronic health," concluded Dr Mitchell.
Source
Royal Australian College of General Practitioners
The release is here:
And finally we have the Brumby Government spruiking e-Health!

Vic wants COAG decision on e-health

By Suzanne Tindal and Ben Grubb, ZDNet.com.au on April 9th, 2010 (1 day ago)
The Victorian Government yesterday called for an updated business case for the roll-out of a national individual electronic health record (IEHR) to be approved at the Council of Australian Governments (COAG) meeting this month.
"A business case for IEHRs for every Australian is ready for consideration by COAG," the state government said in its Putting Patients First proposal. "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."
The idea is that individual health records will allow Australians to easily access and share information such as test results, prescriptions and hospital discharge information with all of their healthcare providers.
The business case for the IEHR scheme, created by the National E-health Transition Authority (NEHTA), was first submitted to COAG in October 2008, but the financial crisis intervened and e-health was pushed off COAG's list of issues to consider. At subsequent COAG meetings, the business plan was not considered urgent enough to merit immediate attention.
The Victorian Government feels that now is the time for the business case to get a hearing.
More here:
Funny that the Victorians are on about the NEHTA IEHR plan and the Commonwealth is on about Personally Controlled EHRs – whatever each of those actually is?
Once is happenstance, twice is coincidence and three times is enemy action. Given NEHTA seems to be the common thread one just wonders what is going on behind the scenes. If this is the NEHTA push to get Victoria signed up to the Commonwealth version of Health Reform to assist NEHTA in getting some via some funds for NEHTA for an IEHR or whatever we should all be pretty alarmed I believe!
David.

Wednesday, April 14, 2010

Senator Sue Boyce Slams Rudd Government Efforts on E-Health. Game On for Progress in E-Health I Hope!

At last it seems we are now going to get some serious debate on just what is happening with e-Health with the Opposition firing the first salvo!

Here is a release from an few hours ago.

GOVERNMENT BUNGLING ON E-HEALTH INTRODUCTION: SENATOR SUE BOYCE

The Rudd Government's electronic health system had a snowball's chance in hell of being ready by its announced introduction date of July 1, Liberal Senator Sue Boyce, said today.

"This system which is supposed to be a state-of-the-art nationally integrated system to provide all Australians with their own identifier number is crippled by inept management, hopeless dithering and a complete lack of any political leadership," Senator Boyce said.

The system is also supposed to provide identifier numbers to all health care providers (and consumers).

Senator Boyce, a member of the Senate Community Affairs Legislation Committee, said evidence she had been provided on February 10 during Estimates about the state of the e-health network had been wildly and falsely optimistic.

"I was assured then by a senior Health Department bureaucrat that trials of the e-health system were already underway yet only days ago a Health Department spokeswoman was quoted as saying that work is yet to begin on the system," Senator Boyce said.

"I have written to the Health Minister, Nicola Roxon, asking her to explain why what I was told on February 10 in the Senate hearings appears in retrospect to have been so wrong and so utterly misleading, given the statement by the Health Department spokeswoman published recently," she said.

Senator Boyce said the hopeless management of the e-health system by the Rudd Government was underlined by the fact that the legislation to establish the system had not even been introduced to the Senate.

"The fact that we are only ten weeks or so away from the July 1 implementation date and the Rudd Government hasn't even got around to having the legislation required to establish the system introduced, speaks volumes about how badly the whole process has been mismanaged," Senator Boyce said.

"This is another example of how the Rudd Government handles the implementation of its grand schemes – big promises, massive spin and then hopeless bungling. Clearly, there is a pattern of failure across the board," Senator Boyce said.

"I would not be surprised, given how long it will take to get the system eventually bedded down, that we will go to the election with – at best – a patched-together and incomplete system," she said.

April 14, 2010-04-14

MEDIA CONTACT: RUSSELL GRENNING 0448 193 903

----- End Release.

Here is a copy of the letter which Senator Boyce has sent to the Health Minister.

April 14, 2010

Hon Nicola Roxon MP

Minister for Health and Ageing

Parliament House

Canberra ACT 2600

Dear Minister

On February 10, 2010, as a member of the Senate Community Affairs Legislation Committee, I asked several questions during the Additional Budget process Estimates hearing of your Departmental staff about progress on the implementation of the e-health project.

The following exchange, as recorded by Hansard, occurred between myself and Ms Liz Forman, Assistant Secretary, eHealth Branch, after I had asked about who in the primary care sector NEHTA had been working with in terms of developing an implementation pathway:

Senator Boyce: When did the work on implementation with each of these organisations in the primary care sector and the primary care software vendors begin?

Ms Forman: That work and that collaboration is still very much at the discussion stage I think.

Senator Boyce: So has the work actually commenced or are they talking about working?

Ms Forman: They are talking about working. They also have a working group relating to secure messaging where quite a significant amount of work has been done with the vendors.

Senator Boyce: Is secure messaging being undertaken or is talk about secure messaging happening?

Ms Forman: Talk and development of software so the vendors are able to work towards bringing their software in line with the NEHTA specifications and then testing that.

Senator Boyce: So that is being trialled?

Ms Forman: That is underway.

Senator Boyce: Are there actual trials happening? Is software that has been developed to meet the NEHTA specifications actually being trialled right now?

Ms Forman: It is being developed and we are expecting there to be a testing workshop in April.

Subsequently, I was advised in response to a Question on Notice (Question: E10-423) that; "NEHTA is working with a significant number of vendors on implementation matters across both the primary care and jurisdictional environment" and a lengthy list of companies was attached. I had asked specifically for "a list of who are the primary care sector vendors that NEHTA has been working with in terms of developing an implementation pathway."

In response to Question on Notice E10-424, I was advised that; "the Integrating the Healthcare Enterprise (IHE) Secure Messaging Connectathon will take place in Canberra from the 19-23 April, 2010". That response provided details about how the testing workshop would be conducted.

Given all of these confident predictions, I was surprised to read in The Australian (April 13, 2010) an article; "E-Health ID work yet to start" by Karen Dearne.

In that article, Ms Dearne wrote that; "six months after assuring a Senate committee that the National E-Health Transition Authority was working with primary care software firms over the proposed national Healthcare Identifier system, the federal Health Department has conceded work is yet to begin."

A spokeswoman for your Department was quoted as saying; "Currently there are no implementation projects within primary care being funded" and that your Department was "unable to supply a list of medical practice vendors previously said to be working with Nehta on an 'implementation pathway'."

Now, I learn from this story that the lengthy list that I was provided when I asked specifically for the list of "primary care sector vendors that NEHTA has been working with in terms of developing an implementation pathway" is, in fact, a list of "eligible suppliers".

I refer you specifically to the evidence of Ms Forman, quoted earlier, when she said that trials were already underway and ask how you can reconcile this evidence with the published statement by a Departmental spokeswoman in The Australian that there were no implementation projects being funded.

I also refer you to the information provided to me in response to Question on Notice E10-424 about the testing workshop expected to commence within days. Will that workshop still take place and, if not, why it has been delayed and when it might take place?

I also ask for your categorical assurance that this system will operate flawlessly and smoothly from July 1, 2010, as the government and your Department have always asserted.

Yours sincerely

Sue Boyce

Senator for Queensland.

---- End Letter.

All I can say is that this intervention is an unequivocally good thing as what is needed now is serious political engagement, from both sides, with all aspects of e-Health to see if some sensible, properly managed, planned and funded e-Health approach can be finally delivered.

Sweeping e-Health under the carpet was a very bad idea and we can now see.

All power to the Opposition for at least starting the Debate for real!

David.

Tuesday, April 13, 2010

This Anonymous Comment Needs More Exposure and for Lots of Reasons.

Anonymous said...

David, not sure that this sort of "national enquirer" commentary really helps your status as a noted member of the e-health community.

Although I share your concerns, I simply don't believe that it is possible to divine the internal machinations of government by just looking at what is publicly released. There is SO much more happening behind the scenes that punters never get to see.

The tar-drip speed of progress can be mind-bending, but I am sure that the staff in government (including ALL of the people at DoHA and NEHTA who live and breathe this too) want to get it going. And they haven't stopped working yet. Nothing at COAG is final until the meeting is over.

Think more broadly for a moment: health identifiers are *really* close, national health reform is the dominant government story in the news right now, every health department is working at local e-health projects, PIP messaging vendors are making great progress, and the big defence e-health tender has just asked the open market to build a real implementation of almost all the technical elements outlined in the national e-health strategy.

There has never been a better set of circumstances to get the fire started. Don't let the smoke get in your eyes...

Tuesday, April 13, 2010 10:27:00 PM

----- End Comment.

Let us think what is being said here.

1. Anything useful that is happening is happening behind the scenes and no one other than the ‘in crowd’ can know.

2. The fact that the progress has been minimal for the last 5 years does not mean that great things are not close.

3. NEHTA and DoHA are toiling away on this and we should all trust that they will sort it out – and they don’t need anyone’s help.

4. You and the readers do not know what is going on and apparently nor should you.

5. Lie back, enjoy and trust us – and all will be well.

Now all this may be true, but the evidence we have from the press:

See here:

http://aushealthit.blogspot.com/2010/04/and-this-lot-think-they-can-implement.html

and from Senate Estimates seems to suggest it is just not true.

If you accept this stuff you must also believe in fairies in my view. I must be a ‘doubting Thomas’ who wants evidence, and after all these years I am one who has totally lost trust in the sort of person who thinks it is useful to post this material – but is so scared of their bosses they can’t use their name.

I am really rather ashamed of a country where this secrecy would be seen as normal behaviour – but maybe things have changed now we have Mr Rudd and Ms Roxon in charge.

It is now a decade since serious plans were outlined for a National E-Health approach with Health Online and we have hardly moved in terms of practical national delivery – accepting that some projects are seemingly making headway – but at a really ‘tar-drip’ speed - other than the essentially private initiatives around GP computing and messaging supported by some quite limited funds.

I also find it really silly that the details of any NEHTA / DoHA proposal to COAG or following meetings are not being discussed and reviewed openly. Perfect wisdom these people do not have – trust me on this small point! Let us be also totally clear the IEHR and Personally Controlled EHR proposals are both very bad and ill considered ideas that should not be funded.

Manifest leadership, strategy, governance, co-ordination, support, planning and so on are just absent - and in this environment we all know little of value is ever achieved.

Everyone knows who I am. Anonymous who are you to tell us you know better and that we should just relax and enjoy?

David.