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."

Monday, April 26, 2010

Weekly Australian Health IT Links - 26-04-2010.

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:

I have the feeling that we have entered some sort of e-Health dark hole. We have a collection of mess-ups and stuff-ups just everywhere.
From Medicare Australia messing up record management, to Qld Health messing up payroll processing, to COAG ‘prioritizing’ e-health to the garbage tin, to NEHTA inventing identification systems it seems the planned users will reject and so it goes.
With a recent track record like this what next can go wrong can be the only question.
The only bright spot on the horizon is that the Federal Opposition seems now to be ‘on the case’ and maybe we will see some improved accountability and performance.
It is really hard to see how it can get much worse!
This article really takes the biscuit for reporting honestly the pathetic spin being served up by the Government.

COAG to 'prioritise' e-health record

By Ben Grubb, ZDNet.com.au on April 21st, 2010 (4 hours ago)
After two days of discussions in the Council of Australian Governments (COAG), the state and territory governments have not committed to a date to implement a national individual electronic health record, although the issue now seems to have become a priority.
"COAG noted the importance of continuing to work towards a national Individual Electronic Health Record system and agreed to prioritise discussions over the coming months to move towards the implementation phase," COAG's communiqué (PDF) said.”
It seems to me that if NEHTA had anything is vaguely credible in the way of a proposal – busy agenda and all - COAG would have given more than three lines.
If they were at all accountable their leaders would resign for having let the Australian public down so comprehensively!
Even their clinical lead is frustrated – being polite about it!

E-health upgrade 'urgent'

  • Adam Cresswell, Health editor
  • From: The Australian
  • April 22, 2010 12:00AM
THE lack of action on improving electronic health systems is emerging as an Achilles heel of the federal plans, with experts warning that the entire reform agenda will stall without an urgent commitment to upgrade IT networks.
E-health, as it is known, earned a single sentence in the 30-page COAG communique released on Tuesday, with state and federal governments saying they "noted the importance of continuing to work towards" a national electronic health record system, and had "agreed to prioritise discussions" on the issue.
But IT advocate and GP Mukesh Haikerwal -- one of the 10 members of the National Health and Hospitals Reform Commission, whose final report formed the basis for the reform plans -- said inadequate computer systems, software or differences in data-gathering practices meant many of the measures would face serious delays.
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Patient ID system may be set to fail: e-health

A LACK of identity management capability within medical offices may bring the compulsory national patient identity numbering scheme unstuck, with doctors unwilling to risk heavy fines for breaches under the proposed Healthcare Identifiers legislation.
And the new rules could shut down existing e-health programs such as shared care for patients with chronic diseases, clinical trials, secure messaging services and e-prescribing because software and third-party service providers would not be treated as eligible organisations.
The federal government's controversial bill to establish an HI service and assign a unique 16-digit health identifier to every Australian, as well as medical professionals and health organisations, is due for debate in the Senate during the brief budget session next month.
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Health identifiers: more paperwork and fines

by Jared Reed
Medical groups say heavy fines for practices that breach regulations for the new unique health identifier legislation are unnecessary and will stop doctors using them in the first place.
Contravening a minor regulation exposes practices of fines of up to $5,500 a time.
The legislation, due for debate in the Senate next month, will propose a two-year transition period for users to become familiar with the new system and rules. But consumer groups are insisting on immediate enforcement to preserve privacy and to track who might have unnecessarily accessed an identifier.
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Medicare glitch affects records

A SOFTWARE glitch in Medicare's systems in February has caused a major safety alert, with the agency set to notify thousands of doctors that some patient records may have been incorrectly updated during a three-day period.
Medicare told The Australian yesterday that changes to its online patient verification system after maintenance on February 6 could have resulted in an adverse test result not being matched to the right person.
While the agency believes there is little risk to patient safety, it will contact affected medical practices so doctors can check their records and make corrections if necessary.
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Medicare slow to fix record bungle

MARK METHERELL
April 21, 2010
MEDICARE Australia has taken 10 weeks to alert 2700 medical practices of a bungle in the agency's computer system, which could have linked patients to the wrong diagnosis.
The problem has emerged at a sensitive time for the government, which is struggling to get agreement from doctors and others for regulations for the first steps of its national e-health scheme, the introduction of unique patient identifier numbers that are supposed to be introduced in July.
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Medicare IT bungle deepens

  • Karen Dearne
  • From: Australian IT
  • April 22, 2010 9:08AM
A GLITCH of Medicare's online verification system affected nearly 30,000 patient records - not 1300 - over a three-day period in February, seriously risking the health of thousands of people, Queensland Liberal Senator Sue Boyce claims.
"I understand the fault meant that some pathology test results would not have made it back to the patient's GP, or could have been attached to the medical history of another family member," she said.
"The glitch meant that only the first name appearing on a family Medicare card was recognised, and all pathology results for persons on that card were recorded under the first name.
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Minister not told of Medicare record glitch

  • Karen Dearne
  • From: Australian IT
  • April 22, 2010 4:56PM
HUMAN Services Minister Chris Bowen was not informed of a serious glitch in Medicare's systems involving the potential incorrect updating of up to 30,000 patient records - and nor were affected doctors - until 10 weeks after the error occurred.
Medicare is writing to 2700 medical practices to warn that 22,000 patient records will need to be checked as a result of flawed data return messages from the agency's online patient verification service during a three-day period in February.
"Medicare will inform (doctors and other health providers) about the issue, and provide details of their practice records where a verification check was undertaken (before the error was fixed)," a Medicare spokesman said.
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Auditor slams document verification service

  • Karen Dearne
  • From: Australian IT
  • April 21, 2010 6:45PM
A NATIONAL document verification service intended to clamp down on fake IDs and rising identity theft has been slammed as a failure by the Auditor-General.
More than 18 months past its four-year project deadline, the $25 million IT hub intended to allow authorities to authenticate a vast range of commonly used ID documents issued by legions of federal and state agencies is yet to enrol many of the expected users and is nowhere near fully operational.
The national Document Verification Service (nDVS) has been handling fewer than 10 transactions a day instead of the expected one million daily, while no fraudulent documents were identified in more than 50,000 transactions to the end of November 2009.
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Anti-ID theft computer system flops

MARK DAVIS
April 23, 2010
A $28 million Howard government plan to create a high-tech system to address identity crime has been plagued by technical difficulties and failed to achieve its aims, the Australian National Audit Office says.
The National Document Verification Service, announced by the Coalition in 2006, is a computer network which is supposed to link federal and state government agencies responsible for key identity documents such as birth certificates, passports and drivers' licences.
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Aged carers could get cut-rate mobile e-health

Non-profit builds clinical records app, throws into the cloud
A Perth-based not-for-profit will offer its enterprise in-house built e-health smartphone application for cost-price to hundreds of aged care facilities.
The platform means nurses can build detailed patient records on medical treatments, symptoms, and pain, fatigue and nausea levels. Aged care providers can use the application for reporting and finance services.
The system, dubbed ComCare, is used by more than 1000 Silver Chain mobile nurses using Ericsson smartphones. The WA health care provider has up to 700 nurses using the system at any given time who service more than 40,000 patients a year.
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PCS Clinical Audit Tool™ now available for all SA GPs

15 April 2010

SA Health has announced that, until 30 June 2014, all general practitioners in the state will now have access to the PCS Clinical Audit Tool™ (CAT) with the take up of a state-wide license.
CAT is a population reporting tool, which aggregates data, enabling general practice teams to view their practice population as a whole. This information can be used in a variety of ways, from simply getting to know the demographics of your population through to identifying areas for attention or targeting consumer information. It can also be used to streamline practice accreditation processes.
Professor Nigel Stocks, Chair of the Royal Australian College of General Practitioners (RACGP) SA/NT Faculty, congratulated SA Health for its support of general practice and for its commitment to better health outcomes for patients, especially those with chronic disease.
“Using CAT allows general practice staff to review and analyse demographic and clinical data held within their practice to identify patients at risk (of developing diabetes, for example) and implement improved prevention and management strategies.
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EXCLUSIVE: GPs to pay $650 rego from July

20-Apr-2010
By Sarah Colyer
New fee hikes for national medical registration have been leaked to the press and are set to spark outrage among GPs.
GPs can expect to pay $650 for annual registration with the new Medical Board of Australia, a GP source has told Australian Doctor.
The GP, who asked not to be named, said the fee rise — which is more than double the $270 paid by NSW GPs — was “absolutely scandalous”.
Comment – so much for technology reducing costs and improving efficiency!
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Qld Health payroll debacle worsens

PITFALLS in Kevin Rudd's new deal for hospitals were exposed in his home state yesterday with the Queensland government in damage control mode over payroll bungling that has left health workers without their pay.
Hopes that the month-long problem would be fixed yesterday were dashed as thousands of health workers failed to receive their full wages or were not paid at all.
The Prime Minister yesterday confirmed the payroll management of hospitals would remain state-based under the much-touted National Health and Hospitals Network Intergovernmental Agreement.
Mr Rudd downplayed the role of the states yesterday, saying: "It's just a payment authority."
The payroll problems for state health workers in Queensland erupted when the $40 million WorkBrain/SAP system was introduced to replace the ageing LATTICE system.
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Health workers prepare for pay bungles

  • From: AAP
  • April 21, 2010 4:27AM
QUEENSLAND'S health workers will begin discovering today whether they've again been underpaid - or even paid.
Tens of thousands of Queensland Health (QH) staff have been underpaid, overpaid, or not paid at all since a payroll system was rolled out last month.
The Australian Services Union (ASU), which represents QH's 650 payroll staff, believes problems could stretch into the next financial year.
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Government braces for more health payroll problems

By Chris O'Brien and Melinda Howells
Deputy Premier Paul Lucas will lead a Cabinet meeting today as he also keeps an eye on Queensland Health's pay problems.
Health salaries go into bank accounts tonight for tomorrow's pay day, but the State Government is not expecting a perfect payroll run.
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D-Day for Queensland Health pay system - and it looks like it's failed again

UNHAPPY Queensland Health employees are reporting more payroll problems today as the beleaguered system comes under further attacks.
Today is D-day for Queensland Health's beleaguered payroll system, but the department's top brass have no idea how many workers will be underpaid.
But judging by comments posted on couriermail.com.au Queensland Health employees have again failed to receive their correct pay.
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DoH offers NPfIT patient admin system alternative

NEWS
A contract for the supply of a patient administration system has indicated a further revision of plans for England's NHS National Programme for IT.
The Department of Health (DoH) has confirmed that a new deal will enable some trusts in the north of England to use an alternative software to the suite to which they had been committed by their local service provider.
It has said that a £36m, four-year contract signed with McKesson would cover some trusts in the North, Midlands and East of England (NME) area, which have previously been due to take iSoft's Lorenzo suite.
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iSOFT partners Gateway Computing to deliver document management solution

20 April 2010
Scott Wilce, Sales Director, Gateway Computing said: “With iSOFT’s experience in the NHS clinical arena and Gateway’s knowledge of the NHS built up over 16 years, we believe that the EDMS offering now available via iSOFT offers an extremely good value for money solution and provides a trust-wide comprehensive solution to all areas of the NHS.”
Adrian Stevens, Managing Director of iSOFT’s UK and Ireland business, said: “With increased pressure on the NHS to meet efficiency targets, document management is becoming increasingly important. WinDIP Enterprise can retrieve any document within seconds, so finding that needle in the haystack will become a reality. iSOFT sees a great opportunity in the market place for this product.”
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iSOFT Group Limited (ASX:ISF) Agrees On UK Deals Worth A$8M

Sydney, April 20, 2010 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) - Australia's largest listed health information technology company, today said it signed two deals in the UK totaling GBP4.8 million (A$8 million) for a hospital system and an e-commerce and logistics hosting application.
Sussex Partnership NHS Foundation Trust in the South of England, one of the country's largest mental health trusts, chose to continue using iSOFT's Patient Management (formerly i.Patient Manager) solution in a deal that includes an option to become an early adopter of Lorenzo within six months. The agreement includes an initial license fee for the latest version of iSOFT Patient Management, and support services for up to five years.
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Sussex Partnership may move to Lorenzo

20 Apr 2010
Sussex Partnership NHS Foundation Trust has signed a five-year deal with iSoft that includes an option for it to become an early adopter of Lorenzo.
The trust has renewed its deal for iSoft Patient Management (formerly known as iPatient Manager or iPM). As part of the deal, iSoft will install the latest version of the application and support it for up to five years.
It will also “consider the option in the next six months of becoming iSoft’s first UK-based Lorenzo early adopter outside the National Programme for IT in the NHS.”
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Morecambe's Lorenzo go-live shifts again

21 Apr 2010
E-Health Insider understands that the go-live of Lorenzo at University Hospitals of Morecambe Bay NHS Trust is likely to be shifted from the start to the end of May.
The trust failed to hit an end of March deadline to go live with the latest version of the iSoft electronic patient record, set by Department of Health chief information officer Christine Connelly.
The failure to hit the deadline cost CSC a revised local service provider deal with NHS Connecting for Health.
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18 April 2010 By John Burke and Ian Kehoe
The IT firm working on a €60 million upgrade of the Health Service Executive (HSE) patient records systems has missed a deadline in the rollout of a similar £1 billion patient record system for the NHS in Britain.
iSoft has been contracted by the HSE to install its patient records software in hospitals and clinics in Ireland, but the system has been plagued with problems. The firm is also the main software supplier to three of Britain’s five health regions on a similar programme.
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NHS Bury experiences issues with Lorenzo

22 Apr 2010
NHS Bury, the first trust to go-live with Lorenzo Regional Care Release 1.9, is experiencing continual issues with the system’s reporting functionality.
Documents on the PCT’s website make references to problems with the iSoft electronic patient record, with which it went live at the start of November.
The documents indicate the PCT is having difficulties monitoring performance and the 18 week referral to treatment time target.
They also indicate the problems have delayed the creation of a business management centre for its provider services and the deployment of further functionality.
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NBN Co chief tries to clear record

THE head of the $43 billion national broadband network has tried to quell concerns the project will not generate a commercial return, but a network veteran has dubbed his claims "bullshit".
Speaking at the Commsday summit in Sydney yesterday, NBN Co chief Mike Quigley denied reports last week that quoted him saying the government would not make a financial return on the NBN for up to 30 years.
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If we win we'll scrap network: Coalition

ARI SHARP
April 22, 2010
THE Coalition is likely to scrap the $43 billion national broadband network if it wins office this year, a position one industry expert labelled ''a total disaster''.
The government said it would be a return to the Howard era.
The Opposition spokesman on communications, Tony Smith, said it would instead seek to attract private investment to broadband and be able to deliver improved speeds - faster than the eight years proposed by the Rudd government.
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Australia still waiting for Google Health

By Ben Grubb, ZDNet.com.au on April 19th, 2010
As state and territory governments meet to talk health reform at the Council of Australian Governments (COAG) meeting in Canberra today, Google said it had "no time frame" for the deployment of Google Health in Australia, despite its CEO formerly saying he hoped to have the service available in Australia by late 2008.
Google Health allows users to volunteer their health records either manually or by logging into their accounts at partnered health service providers. The service is only available in the US.
On 18 March 2008, Google CEO Eric Schmidt was in Sydney talking up e-health. At the time, he acknowledged tough regulatory hurdles would need to be overcome first, but said he hoped to bring the Google Health service to Australia by the end of that year.
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Paradise lost: a decade of data breaches

Australia no island of security
Do you think the moat around Australia extends around your business and hackers won’t target you? It doesn’t, and research says data breaches will be the elephant-in-the-conference-room at your next IT meet.
Australia has to date been sheltered from much of the painful data breach disclosure laws sweeping the world, and organisations here appear to have avoided the high-profile hacks that have plagued others over the last decade. But are we as lucky as it would appear?
No. For starters, the seas that girt Australia offer illusionary security, according to Gartner. Research vice-president, Rich Mogull said Australian organisations are being hacked and losing data. “It’s just hidden,” Mogull said. Moreover, he said, we are in a worse position than others because of our close proximity to Asian countries where data breaches are rife.
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Fake security software is enemy No.1

April 21, 2010 - 11:11AM
Fake security software was the biggest cybersecurity woe afflicting computer users in 2009, and Apple users lost some of their immunity to cybercrime as they stored more data online instead of on hard drives, according to the cybersecurity firm Symantec.
In a report released this week, Symantec noted that Brazil had risen to third place in the list of countries with "malicious activity," defined as spam, online scam attempts and other types of cybercrime. The United States remained in first place generating 19 per cent of malicious traffic, with China second at 8 per cent, and Brazil third at 6 per cent.
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Antivirus program sends computers berserk

April 22, 2010 - 6:39AM
Computers in companies, hospitals and schools around the world got stuck repeatedly rebooting themselves on Wednesday after an antivirus program identified a normal Windows file as a virus.
Antivirus vendor McAfee Inc confirmed that a software update posted on Wednesday morning caused its antivirus program for corporate customers to misidentify a harmless file. It has posted a replacement update for download.
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Google Docs better; ready to take on Office?

The new version adds collaboration tools and drawing software, but drops the ability to work offline.
The new version of Google Docs sports considerable collaboration tools, as well as improved editing and formatting, a faster, more useful spreadsheet and new collaborative drawing software. It's a worthwhile upgrade to the Web-based office suite, especially for those to whom collaboration is of vital importance. But because it no longer allows offline access to documents (for now), and because it's still not as powerful as Microsoft Office, it's not likely to knock Office off of its throne as king of the productivity suites.
It's likely no coincidence that this major update to Google Docs comes just before Microsoft finalizes Office 2010. Based on what I saw when I reviewed the beta of Office 2010, this new version of Google Docs is far superior to the Web-based version of Office. Those who want to collaborate on documents online will want to use Google Docs, while those who want the most powerful office suite will stay with Office.
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Enjoy!
David.

Sunday, April 25, 2010

The Canadian Auditor General Reports on Health IT Progress in Canada.

The following appeared a few days ago.

Uneven reporting on progress toward national electronic health records

The push to create a national system of electronic health records is a long way from meeting its 2010 target of covering 50 per cent of Canadians.
According to a review of previously-released federal and provincial audits, as of March 31 2009, only 17 per cent of Canadians were living in provinces where an Electronic Health Record is available.
The jointly-released overview report gives a positive review of federal efforts through the Canada Health Infoway, but warns provinces are not consistent in tracking their costs.
More here:
The report is found here:

Electronic Health Records in Canada—An Overview of Federal and Provincial Audit Reports

In brief

Introduction

Context

Shared responsibility

Funding for electronic health records

Reported audit findings

Planning for electronic health records

Implementing electronic health records

Reporting on progress to the public

Meeting important challenges

Going forward

Comments from audited governments and Canada Health Infoway

Appendix—List of audit offices and websites

Exhibits:

1—An example of what an EHR might look like

2—Infoway’s expenditures and commitments to electronic health records—as of 31 March 2009

In brief

Implementing electronic health records in Canada is a pan-Canadian initiative that requires the collaboration of stakeholders, including the federal government, Canada Health Infoway Inc., and the provincial and territorial governments, as well as other organizations involved in the delivery of health care. Every audited jurisdiction has at least one core electronic health record (EHR) system in place, and some provinces have almost finished implementing their EHR systems. Given the significant challenges of this undertaking and the substantial potential benefits of EHRs, stakeholders need to work together to comprehensively report to legislatures and Canadians on progress made and benefits achieved.
A .pdf file is available here:
This is a very useful summary of what has gone on in Canada over almost a decade with links to the various province (state) based audit reports.
The fact that many of the provinces had some substantial issues in implementation suggests to me that an audit review of NEHTA would be a very, very good idea and sooner rather than later – so lessons from Canada can be learnt and any emerging issues here can be corrected.
David.

Saturday, April 24, 2010

Weekly Overseas Health IT Links 21-04-2010.

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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With the iPad, Apple may just revolutionize medicine

By Martha C. White
Sunday, April 11, 2010; G03
Steve Jobs got a new liver, the rest of us got an easier way to watch Hulu in bed, and the health-care industry just may have gotten the big break it needed to launch into the 21st century. Following his hush-hush surgery last spring, it's easy to imagine the colossus of Cupertino, Calif., staring at the ceiling tiles in his hospital room and wishing for a way to hop online without having to bother with a laptop.
It's also no stretch to picture him watching doctors, nurses and orderlies peck away at a bevy of poorly designed, intermittently integrated and just plain ugly devices and thinking there had to be a better way.
So while the rest of the world texts, tweets and generally fawns over the thing, that's muted compared with the reception the iPad is getting in the health-care universe.
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Electronic Medical Records and Communication with Patients and Other Clinicians: Are We Talking Less?

Issue Brief No. 131
April 2010
Ann S. O'Malley, Genna R. Cohen, Joy M. Grossman
Commercial electronic medical records (EMRs) both help and hinder physician interpersonal communication—real-time, face-to-face or phone conversations—with patients and other clinicians, according to a new Center for Studying Health System Change (HSC) study based on in-depth interviews with clinicians in 26 physician practices. EMRs assist real-time communication with patients during office visits, primarily through immediate access to patient information, allowing clinicians to talk with patients rather than search for information from paper records. For some clinicians, however, aspects of EMRs pose a distraction during visits. Moreover, some indicated that clinicians may rely on EMRs for information gathering and transfer at the expense of real-time communication with patients and other clinicians. Given time pressures already present in many physician practices, EMR and office-workflow modifications could help ensure that EMRs advance care without compromising interpersonal communication. In particular, policies promoting EMR adoption should consider incorporating communication-skills training for medical trainees and clinicians using EMRs.
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A New Core Competency

By Emily Long  
Dr. David Blumenthal, the national coordinator for health information technology, has a lot of confidence in the future of his field. But he also acknowledges that since health IT workers will be in high demand as medical professionals adopt new systems, it will take time to for the workforce to match the pace of IT development.
Observers have been predicting a shortage of qualified health IT professionals, and the government is subsidizing college training programs.
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Bell sets priorities for her role at CCHIT

Posted: April 16, 2010 - 8:54 am ET
When Karen Bell comes aboard April 26 as the new chairwoman of the Certification Commission for Health Information Technology, she might still feel the chill in the room from the recent cold shoulder HHS gave the organization it conceived in 2004, helped fund most of the years since, but distanced itself from in recent months.
It will be up to Bell to steer a new course for CCHIT going forward, operating with a wider separation from HHS and still serving the needs of its former federal patron.
Bell was named Monday to replace fellow physician Mark Leavitt, the founding chairman of the not-for-profit, Chicago-based organization. Leavitt announced last fall his intention to retire by March 2010.
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Mobile health monitoring market on the rise

April 14, 2010 | Bernie Monegain, Editor
HAMPSHIRE, ENGLAND – Revenues from remote patient monitoring using mobile networks will rise to almost $1.9 billion globally by 2014, according to Juniper Research.
Heart-related monitoring applications in the United States will drive the uptake initially, researchers forecast.
The mHealth report found that mobile healthcare monitoring would demonstrate substantial growth in the United States and other developed markets. However, while mobile monitoring will contribute to healthcare cost savings in developed markets, national wealth and the structure of the healthcare market in a given geographical region will have an important bearing on the extent to which it is rolled out.
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MacPractice medical applications now available for iPad

April 15, 2010 | Kyle Hardy, Community Editor
LINCOLN, NE – MacPractice, the major Apple developer of practice management and clinical software on Macs and iPhones for medical and dental offices, has launched new iPad integration solutions that are expect to allow doctors and dentists to use all MacPractice software on an iPad. MacPractice officials said the motivation behind the launch was the due to objectives to improve efficiency and quality at the point of care.
MacPractice officials said the new iPad interface solutions are designed to leverage collaborative technologies to make the total functionality of MacPractice available on an iPad, including EMR, prescriptions and e-Prescribe, scheduling and more.
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Health IT panel focuses on NHIN ‘trust fabric’

By Mary Mosquera
Wednesday, April 14, 2010
A Health and Human Services Department advisory panel  is finalizing elements of what it calls a “trust fabric” for health information exchange in order to spur confidence in using a the nationwide health information network (NHIN).
The panel developed broad recommendations for what constitutes trusted health information exchange via “NHIN Direct,” a streamlined version of NHIN standards and services for sharing health information securely through the Internet.
The Health IT Policy Committee’s NHIN work group will deliver its final trust recommendations to the committee at its meeting April 21, said David Lansky, chairman of the panel and CEO of the Pacific Business Group on Health.
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Records pledge in Conservative manifesto

14 Apr 2010
The Conservative election manifesto has reiterated the Tories' pledge to give patients online control of their own health records.
No details are given of how this will be achieved; leaving open the possibility that a Conservative government might look beyond the NHS’s own HealthSpace to more eye-catching deals with Google or Microsoft.
The manifesto also reaffirms the pledge that a Conservative government would publish much more detailed NHS performance data online. Patients are also promised that they will be able to rate hospitals and doctors.
In the UK’s looming ‘age of austerity’, the Tories are prescribing information as the cure to what ails public services. Far more performance data is promised to be published online for all of the public sector.
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Quality improvements need reliable IT: AHRQ

Posted: April 14, 2010 - 5:59 am ET
Reliable health IT systems and high levels of provider adoption will be critical to the success of future quality improvement initiatives, HHS' Agency for Healthcare Research and Quality, or AHRQ, said in a newly released report.
In its 2009 National Healthcare Quality Report, AHRQ stressed the need for major performance improvements in all areas including patient safety, preventive care and chronic disease-management. The agency also outlined a multipronged action strategy for accelerating improvements that includes revising quality measures, removing barriers to care, and using health IT and training to empower providers.
“Realistically, HIT infrastructure is needed to ensure that relevant data are collected regularly, systematically, and unobtrusively while protecting patient privacy and confidentiality,” AHRQ said in the report.
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Scottish practices trial patient portal

13 Apr 2010
Two GP practices in Scotland are to run a trial of an online patient portal enabling patients to access their records over the internet, the Scottish Government has announced.
The Patient Portal will run at two practices in NHS Ayrshire and Arran over the next six months to enable patients to view test results and update their records from anywhere with an internet connection.
The project could pave the way for the patient portal to be rolled out across Scotland, according to health secretary Nicola Sturgeon.
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APRIL 13, 2010

Breaking Down the Barriers

When health-care providers exchange electronic medical records, costs go down and patient care goes up
To understand the potential of shared health records, consider the Bottone family.
Almost everyone agrees that health information technology could create more effective and more efficient systems in the medical world but we still face a number of hurdles in terms of widespread adoption. Journal News Editor Laura Landro discusses some of the challenges facing the medical industry as they look to digitize health records.
Born prematurely with nonfunctioning kidneys, 4-year-old Jacob Bottone has been through dialysis, angioplasty and a kidney transplant, and seen more specialists than most people will see in a lifetime. His doctors and hospitals had electronic medical-records systems, but no way to access each other's, so his parents had to collect his growing paper medical records in a large accordion folder, haul it from doctor to doctor, explain his medical history over and over again, and often wait for hours while referrals and test results were retrieved and faxed around to different providers. "It was getting to be a bit of nightmare," says his father, Jason Bottone.
Enter electronic information exchange.
Three leading health-care providers in Colorado's Front Range region recently teamed up in an electronic health-record exchange program that will allow them to share data on more than a million Colorado residents, including Jacob. The three—Children's Hospital in Denver, Kaiser Permanente Colorado's physician group and Exempla Healthcare, which operates Saint Joseph and two other hospitals in Denver—have agreed to share their records on a secure network that will allow clinics, doctors' offices and hospitals to exchange data on common patients instantly, including lab reports, radiology images and medical history.
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APRIL 13, 2010

Can Technology Cure Health Care?

How hospitals can make sure digital records live up to their promise. Because so far, they haven't.

By JACOB GOLDSTEIN

Digital medical records come with some big promises.
They'll improve patient care, in part by eliminating many errors. They'll stem the soaring growth in costs. They'll make health care more efficient.
Those are the promises, anyway. The question is, how can we make sure the technology actually delivers? How can we make sure the digitization of medical records does everything its advocates believe is possible?
David Levy, global health leader at PricewaterhouseCoopers, talks with WSJ's Laura Landro about a new report indicating increased customization of diagnosis, care and cure in the U.S. health-care system and how the new health bill accommodates these trends.
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Time to Encrypt? You Think?

Health Data Management Blogs, April 12, 2010
John Muir Health in Walnut Creek, Calif., recently started notifying 5,450 patients after the theft of two laptops containing their health information.
The data wasn't encrypted and John Muir soon will join a growing list of organizations with its data breach displayed on a Department of Health and Human Services' Web site. Most of the breaches listed on the site resulted from thefts and most of those were laptops or other portable media. And they weren't encrypted.
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Wednesday, April 14, 2010

Survey Finds Benefits of PHR Use, But Adoption Remains Low

Consumers who use personal health records say they know more about their health, ask more questions, feel more connected to their physicians and take steps to improve their health, according to a new survey that many are calling ground-breaking.
The study -- commissioned by the California HealthCare Foundation and conducted by Lake Research Partners -- surveyed a representative sample of 1,849 U.S. adults between Dec. 18, 2009, and Jan. 15, 2010. CHCF is the publisher of iHealthBeat.
Michael Perry, a partner at Lake Research Partners, said the survey provides the first data nationwide on the use and benefits of PHRs. He noted that previous research generally has been speculative, asking "would you use" this kind of tool. 
Jennifer Covich Bordenick, CEO of the eHealth Initiative, said the "survey shows that patients want to get engaged in their health care," adding, "PHRs are one of many tools that can help accomplish that. It is now just a matter of giving them the tools necessary to become meaningful participants in the health care system."
Despite the benefits of PHRs, adoption remains relatively low with just 7% of adults reporting having used a PHR. Still, that is a 159% increase from two years ago when a separate survey from the Markle Foundation found that 2.7% of consumers had used a PHR.
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Survey Tracks National PHR Use

HDM Breaking News, April 13, 2010
One in 14 Americans--seven percent--have used a personal health record, according to national survey of 1,849 people taken during December 2009 and January 2010. That figure compares with a 2.7 percent participation rate found in a Markle Foundation survey in 2008.
The California HealthCare Foundation sponsored the new survey. Washington-based Lake Research Partners conducted the survey from recruited panelists across the nation who have agreed to occasionally participate in surveys.
....
The survey, "Consumers and Health Information Technology: A National Survey," is available at chcf.org.
--Joseph Goedert
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Survey shows benefits of PHR adoption

Posted: April 13, 2010 - 5:59 am ET
A mere 7% of Americans used a personal health record in 2009, but that's up from 2.7% the year prior and there appears to be less reluctance to adopting the technology, according to a new survey.
California is still in the lead in terms of PHR adoption, with 15% of survey respondents saying they have used these records. That is largely because of systemwide rollouts at Kaiser Permanente, the Oakland, Calif.-based managed-care giant, and large medical groups in the state. Only 5% of people in the Midwest and 5% in the South said they have used a PHR, according to the survey by the California HealthCare Foundation, a not-for-profit, nonpartisan research and philanthropy group.
The survey of 1,849 people was conducted by Lake Research Partners for the foundation between Dec. 18, 2009, and Jan. 15, 2010.
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Free EMRs: Too Good to be True?

Carrie Vaughan, for HealthLeaders Media, April 13, 2010
When Allison Blazek, MD, left M. D. Anderson Cancer Center to open her private practice in June 2008, she figured EMRs, rather than paper, made the most sense. After talking with vendors and pricing EMRs, however, Blazek began thinking paper records might be the wiser option after all.
"All of them were going to be tens of thousands of dollars, and I would have to close my practice for a week, and for some I would have to pay for the training," she says. "Starting out new, I thought, 'I'm not going to go into debt trying to get an EMR. I'd rather keep my overhead low.'"
Then, Blazek heard about San Francisco—based Practice Fusion, which offers a free Web-based EMR system. The company is funded by advertising so that when a physician uses the EMR, similar to Google's AdSense program, the system recognizes keywords and sends condition-specific ads from insurers, medical equipment suppliers, and pharmaceutical companies to the EMR page.
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EHR Certification: Who, What, When, and How Much Will it Cost?

Gienna Shaw, for HealthLeaders Media, April 13, 2010
The comment window for a temporary measure that would appoint organizations to test and certify EHR systems has closed, but debate on the final certification program is ongoing.
All of the questions about ONC-authorized testing and certification bodies (ATCB) won't be answered until ONC issues its final rule. But there are hints of what's to come, including who will apply for ATCB status and how much they might charge for the service, as well as some comments that could impact the final rule.
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Avoid the boondoggle

Posted: April 12, 2010, 10:46 PM by NP Editor
Canada Health Infoway and the provinces have already spent billions on electronic health records
By Alan Brookstone
It’s hard to know exactly how many dollars Ottawa and the provinces have spent so far on the grand plan to bring electronic health records (EHR) to Canada’s health-care system. Supported by Canada Health Infoway, the federal-provincial agency promoting EHR, a rough count suggests the total to date runs to at least $2-billion, with much more to come. The last federal budget alone committed another $500-million.
As Terence Corcoran stated in a recent column, “EHR is one of those great blue-sky ideas that seem sound and logical.” The objective is to have built an electronic health record for every Canadian — from prescription history to hospital visits, from family doctor records to major surgeries. As a physician and long time proponent of the use of information technology in health care, I am frustrated by the lack of progress on EHR, despite the billions spent.
A series of recent critical Auditor’s General reports have painted a bleak picture of the challenges and experience so far in implementing a national EHR strategy. The auditors general of British Columbia and Ontario have delivered devastatingly critical reports of their respective provincial efforts. The federal auditor general, Sheila Fraser, recently gave general passing marks to Canada Health Infoway. But Ms. Fraser is slated to deliver an overall summary of the federal and provincial EHR project next week.
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Tuesday, April 13, 2010

Keeping Medical Data Private

Algorithm protects patients' personal information while preserving the data's utility in large-scale medical studies.
By Katharine Gammon
Researchers at Vanderbilt University have created an algorithm designed to protect the privacy of patients while maintaining researchers' ability to analyze vast amounts of genetic and clinical data to find links between diseases and specific genes or to understand why patients can respond so differently to treatments.
Medical records hold all kinds of information about patients, from age and gender to family medical history and current diagnoses. The increasing availability of electronic medical records makes it easier to group patient files into huge databases where they can be accessed by researchers trying to find associations between genes and medical conditions--an important step on the road to personalized medicine. While the patient records in these databases are "anonymized," or stripped of identifiers such as name and address, they still contain the numerical codes, known as diagnosis codes or ICD codes, that represent every condition a doctor has detected.
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Electronic health records prepare for their close-up

New financial incentives spark doctors, hospitals to ramp up digitization

By Kristen Gerencher, MarketWatch
SAN FRANCISCO (MarketWatch) -- Coming soon to a doctor's office near you: Electronic health records. But it may take longer to find out whether broader use of health information technology lives up to its acronym and becomes a HIT.
While a few patients already are plugged in, many more soon may be able to go online to review certain medical test results, immunization lists and summaries of their office visits. They may turn to their computers instead of their telephones to make appointments and request medication refills.
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HHS emphasizes dashboards, new datasets in transparency plan

Medicare patient claims data to be released to public for the first time
The Health and Human Services Department is unveiling two new performance management dashboards and publishing de-identified Medicare patient claims data for the public for the first time as part of 17 initiatives detailed in its Open Government Plan.
The Food and Drug Administration and HHS' Office of the National Coordinator for Health Information Technology (ONCHIT) are each developing performance management online dashboard systems to track their activities and programs, according to the plan published April 7.
The FDA-TRACK (Transparency, Results, Accountability, Credibility and Knowledge-sharing) dashboard was launched in beta mode April 7 to allow visitors to view performance data at the program office level.
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BCBS of TN Hard Drive Theft Now Threatens 1 Million Customers

John Commins, for HealthLeaders Media, April 9, 2010
The theft of 57 hard drives from a BlueCross BlueShield of Tennessee training facility last fall has put at risk the private information of nearly one million customers in least 32 states, the insurer said this week in an investigative update.
So far, there has been no documented identity theft or credit fraud affecting BlueCross members as a result of this incident, BCBS of Tennessee said in a media release.
"As of April 2, 2010, a total of 998,422 current and former members have been identified at being at risk," said BCBS of Tennessee spokeswoman Mary Thompson, adding that the total figure includes 447,549 current and former members identified in the lowest-risk Tier 1 category.
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Karen Bell to Lead CCHIT

HDM Breaking News, April 12, 2010
The Certification Commission for Health Information Technology has named Karen Bell, M.D., as its new chair, effective immediately. She succeeds the retiring Mark Leavitt, M.D.
Bell most recently served as senior vice president of health information services at Masspro, the quality improvement organization of Massachusetts. She previously served in several positions within the Office of the National Coordinator for Health Information Technology, including director of the office of health information technology adoption and acting deputy of ONC.
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Providers Seek Options In EMR Vendors

Although three vendors now dominate the ambulatory electronic medical record market, a KLAS report finds that other firms are picking up speed.
By Anthony Guerra,  InformationWeek
April 8, 2010
Though three established vendors continue to dominate mindshare, a larger pool of companies is being considered by hospitals and physician practices looking to purchase ambulatory electronic medical records, according to a new report by Orem, Utah-based KLAS.
Allscripts, NextGen, and eClinicalWorks constitute what report author Mark Wagner, KLAS general manager of ambulatory research, calls "the Big Three" in his report, Ambulatory EMR Buying: A Roller Coaster Ride in 2010. For the study, KLAS interviewed more than 370 healthcare providers who plan to choose an EMR solution in the next two years.
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Physician resistance to EHRs weakening: report

Posted: April 12, 2010 - 5:59 am ET
Physicians' resistance to Internet-based electronic health-record systems appears to be easing, according to a recent health information technology market research report.
Last week, health IT researcher KLAS Enterprises, Orem, Utah, released a new report based on interviews with 370 ambulatory-care physicians or practice leaders who intend to purchase an EHR for the first time or replace their existing EHR system in the next two years.
“What surprised us, quite frankly, was the number of practices,” interested in EHRs delivered as “software as a service,” or SaaS, said KLAS' Mark Wagner, the lead author of the 236-page report, Ambulatory EHR Buying: A Rollercoaster Ride in 2010.
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CHIME raises concerns about EHR certification

April 09, 2010 | Bernie Monegain, Editor
ANN ARBOR, MI – CHIME, an organization that represents 1,400 healthcare CIOs, is calling for a rapid analysis of existing electronic health record certification programs, asserting that "above all else providers need a stable marketplace."
In a letter filed April 7 with the Office of the National Coordinator, CHIME (The College of Healthcare Information Executives) said it supported the general concept of moving to a two-stage approach for creating a certification process for EHRs, but added "significant questions still surround the creation of the approach."
"We are very concerned that the introduction of a two-stage approach for certification will prolong the current instability in the health IT marketplace, which exists because of the un-finalized status of meaningful use and certification regulations," CHIME wrote. "The introduction of two separate certification schemes – one temporary and one permanent – carries a risk of continuing the uncertainty and promoting needless product replacement in the marketplace."
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Doctors Still Trump Internet For Medical Advice

Women prefer medical professionals over online chat sites for discussing private health matters, a study shows.
By Nicole Lewis,  InformationWeek
April 9, 2010
In the age of Oprah and the Internet, where women can go online and anonymously discuss their private health issues via the World Wide Web, a majority of women still have a higher comfort level with their doctors than with an online community, a study finds.
The online survey, conducted in February by market research firm Harris Interactive on behalf of iVillage, a Web site for women, received 2,618 responses, of which 1,342 participants were women and 310 are mothers of teenagers or younger children.
The survey noted that, "Overall, online women are more comfortable discussing private health concerns or questions that are potentially embarrassing with a medical professional than they are with an online community, their spouse or partner, a close friend, and a family member."
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Integrating and enhancing quality measures.
By Toby Samo, MD
As many hospitals, health systems and physicians scramble to comply with the initial meaningful-use requirements, some may be so focused on electronic health record (EHR) selection and deployment that they lose sight of the broader and more fundamental changes they need to confront.
A long and winding road
EHR adoption is a milestone that lays the foundation for an outcomes- and data-driven approach to quality and excellence. However, it is just the beginning of a journey that will ultimately transform today's retrospective and reactive quality initiatives into predictive and proactive ongoing performance improvement.
Once an EHR has been deployed, hospitals and physicians will no longer be constrained by the limitations imposed by a "rear-view mirror" approach to quality. Instead, they will benefit from EHR-enabled automated transactions and focused knowledge-based systems that provide near-real-time actionable data to improve patient safety, quality of care and health care provider productivity.
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Public-health labs work on data sharing, interoperability

April 12, 2010 — 1:17pm ET | By Neil Versel
The more than 600 public-health laboratories in the U.S. gather and report critical data on disease outbreaks and threats to national security, but data collection and IT infrastructure largely have been specific to a single public-health program such as HIV prevention or tuberculosis treatment. With this in mind, the Association of Public Health Laboratories joined with the Centers for Disease Control and Prevention to launch the Public Health Laboratories Interoperability Project (PHLIP) in September 2006.
For more:
- read the Public Health Reports article (.pdf)
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Report: Healthcare organizations may have a false sense of data security

April 12, 2010 — 10:07am ET | By Neil Versel
Healthcare organizations may be lulling themselves into a false sense of security when it comes to data security, according to a biannual report from HIMSS Analytics.
The white paper, commissioned by Nashville, Tenn.-based Kroll Fraud Solutions, says respondents gave their organizations high marks--an average of 6 on a scale of 1 to 7--for compliance with HIPAA, state security laws, CMS regulations and the Federal Trade Commission's "Red Flags" rule for identity theft, and a score of 5.75 for compliance with new security requirements of the HITECH Act portion of the American Recovery and Reinvestment Act. Despite these high ratings, 19 percent of organizations reported having a data breach in the past 12 months, up from 13 percent in 2008.
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Inquiry into transplant database errors

12 Apr 2010
An independent review has been launched into how as many as 800,000 people on the UK organ donor register had their preferences incorrectly recorded.
A “technical error” has lead to 21 cases in which the wrong organs may have been taken from deceased donors over the past six years.
It is believed that the error occurred when the Driver and Vehicle Licensing Authority in Swansea, which used to collect details of drivers' preferences about organ donation, transferred its records to NHS Blood and Transplant, which now runs the organ donor register.
In a call with E-Health Insider, a spokesperson for NHS Blood and Transplant said: "The problem comes from a programming error tracked back to 1999 which only came to light because we were extending the system that acknowledges registrations.
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U.K. Investigates 800,000 Organ Donor List Errors

By THE ASSOCIATED PRESS

LONDON — Britain's transplant authority said Saturday that it was investigating several hundred thousand errors in its organ donor list stretching back about a decade.
The National Health Service Blood and Transplant organization said a proportion of its 14 million-strong organ donor list has been affected by technical errors since 1999 — and that a small group of people may have had their organs removed without proper authorization as a result.
The programming error meant that, for example, people who wanted to donate organs such as their lungs or their skin were incorrectly identified as people who wanted to donate their corneas or heart.
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Enjoy!
David.

Friday, April 23, 2010

Misleading Advertising Comments

It seems, as we have more users, there are various people (read creeps) trying to place comments with blatant advertising - and banal comments - on the blog.

I try to filter them out. If you see one that has slipped through - let me know!

Thanks

David.