Quote Of The Year

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

or

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

Sunday, May 02, 2010

Weekly Australian Health IT Links - 02-05-2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or payment.

General Comment:

The fallout from the proposed Rudd / Roxon ‘Health Reform’ just rolls on. This appeared a day or so ago.

http://www.theaustralian.com.au/news/opinion/health-system-is-still-ailing/story-e6frg6zo-1225860367211

Health system is still ailing

THE Council of Australian Governments meeting on April 19 and 20 was the culmination of events with origins in Kevin Rudd's political commitment in 2007 to take over and fix the health system if the states had not done so. Following the prolonged study by the National Health and Hospitals Reform Commission and more than 100 hospital visits across the nation by the Prime Minister and Health Minister Nicola Roxon, hopes were high. In reality, the COAG communique is a mixed bag and must be tested as to whether it represents a workable framework for reform.

Rudd rightly discerned the system was at a tipping point in respect of funding for the future. In every Western country, health costs are rising well ahead of the consumer price index. This is even more critical in the light of costs associated with our ageing population detailed by this year's Intergenerational Report in January. The capacity to fund future growth has now been resolved by COAG, subject to ongoing negotiations with Western Australia, with significant funding from the commonwealth with its access to growing revenue. This is the one big tick.

The premiers at COAG were concerned primarily with public hospitals, always a big issue for state budgets. These views were put most stridently by Victorian Premier John Brumby.

Concern in the community, however, is for the quality of health care more broadly and people's access to it. Primary care, and its interface with hospitals, matters as much as hospitals themselves, as services increasingly will be delivered outside hospitals.

Aged care is becoming an urgent issue. There is a need for elderly people to be looked after in or near their homes, with expanded community nursing and nurse practitioners and access to rehabilitation hospitals and services, rather than seeing the elderly as a negative issue for public hospitals, just needing more nursing homes.

The full article is well worth reading – from a genuinely independent expert – as it makes clear just how superficial the proposed reforms are and how many problems are essentially left unaddressed.

I really hope there can be some improvements to what we have been offered so far. Maybe the budget will have some pleasant surprises! We live in hope.

Now back to e-Health.

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http://www.smh.com.au/national/keeping-me-alive-costs-100000-a-year-20100429-twmm.html

'Keeping me alive costs $100,000 a year'

MARK METHERELL HEALTH CORRESPONDENT

April 30, 2010

HELEN OWENS is a health economist whose long struggle with illness has given her a sharp insight into the health system.

She has had breast cancer for 16 years and yesterday did the unusual - she gave the patient's perspective to health leaders gathered to thrash out the worth of Kevin Rudd's reforms.

''It is costing you, the community, probably $100,000 a year to keep me alive,'' said Ms Owens, a former Productivity Commission member. ''Can this continue?''

......

Christine Bennett, a former chairwoman of the National Health and Hospitals Reform Commission, said the high cost of many treatments was often not appreciated.

''The first thing we need is a more effective system.''

The introduction of national e-health patient records would generate big efficiencies, reduce waste and improve patient safety, Dr Bennett said.

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http://www.theaustralian.com.au/news/health-science/care-at-the-click-of-a-mouse-health-vault/story-e6frg8y6-1225860394951

Care at the click of a mouse: Health Vault

IS it possible to reform health care without access to computer systems and secure email? While nobody does business any other way it seems the Rudd government believes the answer is yes.

The recent health reform plan comes down to more beds, doctors and aged-care places, the only innovation being some fancy funding footwork between federal and state governments. What's missing is the information technology infrastructure to make it happen, let alone the smart devices and software that, for instance, will keep patients out of emergency departments and elderly people out of nursing homes.

The medical software industry and doctors say it's not rocket science. Programs exist. They just need to be pulled together under commonwealth leadership.

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http://www.smh.com.au/lifestyle/wellbeing/online-remedy-for-stuttering-20100501-u0af.html

Online remedy for stuttering

NICK GALVIN

May 2, 2010

Relief may be at hand for millions of people around the world who stutter, thanks to the pioneering work of Australian experts.

The Australian Stuttering Research Centre in Sydney has won a federal grant of nearly $5 million to develop a system that sufferers can access via the internet. The simple program has cured pre-schoolers in 12 weeks.

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http://www.computerworld.com.au/article/344991/queensland_health_deploy_nurse_midwife_management_system/

Queensland Health to deploy nurse, midwife management system

New system aims to better manage deployment of midwives and temporary nurses in regional and remote parts of the state

Queensland Health will centralise the deployment, procurement and management of rural nurses and midwifes in the state.

A new IT system will go-live later this year and will apply to all rural Queensland nursing agency services.

According to department tender documents, the internal management service will provide a low clinical service risk, use "service governance mechanisms", and provide a "fiscally responsible approach" to service cost recovery. The agency expects the system will be progressively implemented state-wide commencing with a trial and incremental rollout to metropolitan facilities, other South-East Queensland health service districts, and then other regional centres.

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http://www.theage.com.au/victoria/hospitals-waiting-shame-20100429-twll.html

Hospitals' waiting shame

KATE HAGAN

April 30, 2010

A THIRD of patients in Victorian emergency departments were not moved to hospital beds within eight hours in the second half of last year, casting serious doubt on Prime Minister Kevin Rudd's pledge to reduce waits to four hours.

More than 47,000 Victorians languished on trolleys for longer than eight hours, meaning that 34 per cent of the total 140,487 patients transferred to beds were not moved within the state government's target time.

The state government failed to meet six of its nine targets - including that all urgent elective surgery patients receive treatment within 30 days - according to a biannual report card released yesterday.

In light of his government's failure to move emergency patients off trolleys and into beds within eight hours, state Health Minister Daniel Andrews yesterday admitted: ''The four-hour target is not an easy thing to meet.''

.....

Mr Andrews said the data was ''a fair and accurate report of performance across the hospital system'' following his scrapping of a bonus funding pool and tougher auditing of hospital data introduced in April last year in response to revelations that some hospitals had fudged waiting lists.

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http://news.smh.com.au/breaking-news-national/calls-for-qld-payroll-bungle-inquiry-20100430-twyo.html

Calls for Qld payroll bungle inquiry

April 30, 2010 - 8:14AM

AAP

The state opposition wants an independent inquiry into the Queensland Health payroll bungle.

Opposition health spokesman Mark McArdle told ABC radio on Friday that Queensland Health staff will also lose superannuation entitlements.

Tens of thousands of Queensland Health staff have been underpaid, overpaid, or not paid at all under a new computerised payroll system introduced last month.

Doctors on Thursday joined nurses and other employees in the public hospital system to protest outside the Royal Brisbane Women's Hospital.

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http://www.rustreport.com.au

ICSGlobal sells Thelma business

ICSGlobal has agreed to sell its Thelma health transaction network to eHealthWise, a subsidiary of logistics systems developer CargoWise. The transaction is valued at $A1.45 million and eHealthWise will begin operating Thelma on May 1.

When the deal is completed ISCGlobal will continue to operate its UK business, Medical Billing & Collection, explained Geoff Lambert, a director of ICS Global. http://icsglobal.net/

InterSystems cure for clinic

Global Integration has implemented the Ensemble healthcare platform from US developer InterSystems to build an integrated information environment for the Sydney IVF infertility clinic. The platform will operate with a fertility management system that was recently acquired by Sydney IVF, and will integrate with the Navision financial software system already in use at the clinic. www.globalintegration.com.au

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http://www.computerworld.com.au/article/344490/crashing_e-records_leave_paramedics_stricken/?eid=-255

Crashing e-records leave paramedics stricken

Ambulance staff say government-backed record system is sick

Paramedics are divided on the benefits of an electronic Patient Care Record (ePCR) system that is replacing old paper-based notes across Australia.

The ePCR system is the four-year brainchild of the former Metropolitan Ambulance Service, now Ambulance Victoria, and is dubbed the Victoria Ambulance Clinical Information System (VACIS) in that state.

The current paper-based Patient Care Records contain information from paramedics on a patient’s condition and are handed over to doctors and nurses when an ambulance arrives at a hospital.

Through moving them to digital records via the ePCR system paramedics will in theory cut down on the time filling out carbon-copy paper reports and create new lines of digital data which can be analysed to improve healthcare delivery.

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http://www.computerworld.com.au/article/344969/ambulance_victoria_looks_cover/

Ambulance Victoria looks for cover

OHS and Work Cover management system on the cards

Ambulance Victoria has moved to better manage its Occupational Health & Safety (OHS) incident and hazards, WorkCover claims and peer co-ordination activities with the assessment of a new Information Management System (IMS).

If adopted, the IMS would allow all 4200 Ambulance Victoria employees to log incidents and hazards for appropriate escalation to the organisation’s Health Safety and Wellbeing (HSW) department.

The system would also allow the HSW department to perform early intervention andinjury management, claims management and peer co-ordination activities.

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http://www.itwire.com/it-policy-news/government-tech-policy/38586-microsoft-plans-to-pilot-e-health-system-in-australia

Microsoft plans to pilot e-health system in Australia

By Beverley Head

Tuesday, 27 April 2010 14:02

Software giant Microsoft hopes to pilot its Health Vault system in Australia within the next year to 18 months and is seeking partners to launch the service locally– and in turn hand the Government a get-out-of jail-free card as far as big bang spending on e-health systems is concerned.

Health Vault, which is a cloud based service, is being offered to patients by some clinics such as the Virginia Mason Clinic in Seattle and Denver Health in the US. It allows patients to use the cloud to store and access their health related information – and also allow their medical providers access to the content.

Although the end result is similar to that available from Google Health, which allows users to store their medical and health information in a cloud, Microsoft doesn’t offer the service direct, instead sells the platform to health providers which can then use it to develop a service for clients.

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http://www.theaustralian.com.au/australian-it/microsoft-looking-for-partnership-for-health-vault/story-e6frgakx-1225858547052

Microsoft looking for partnership for Health Vault

MICROSOFT is "actively looking" at bringing HealthVault, its personal e-health record platform, to Australia, and is talking to potential private sector partners.

Michael Gration, Microsoft's local health director, says that while there isn't a timeframe as yet, "as a reality, we will bring HealthVault here" and commercial arrangements are being investigated.

"A lot of stakeholders on the private health side are very keen to get HealthVault into the country (as a platform for) stronger care pathways for their customers," Mr Gration said.

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http://www.theaustralian.com.au/australian-it/e-health-is-kevin-rudds-little-orphan-annie/story-e6frgakx-1225858544370

E-health is Kevin Rudd's little orphan Annie

THE glaring omission of e-health in the Rudd government's long-awaited national health and hospitals reform package has stunned and dismayed the IT industry.

"The missing link is health IT," said Health Informatics Society of Australia president Michael Legg.

"There was every expectation e-health would be addressed in the Council of Australian Governments agreement, as the National Health and Hospitals Reform Commission made it clear the reforms had to be underpinned by a robust IT infrastructure.

"But e-health is notable for its absence in these announcements."

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http://computerworld.co.nz/news.nsf/news/software-bug-mixes-patient-health-data

Software bug mixes patient health data

iSoft stands by product after mix-up at Gisborne Hospital

By Randal Jackson | Wellington | Wednesday, 28 April, 2010

A system bug in an iSoft application used at Gisborne Hospital resulted in one patient’s details being displayed as those of another.

The incident led to extensive remedial work on the iSoft product involved.

The hospital says the error was detected early in March. Computerworld had been told by a health source, however, that the bug, in an iSoft system called Healthview, had gone undetected for two years.

“Investigation and notification to iSoft showed the error to be a system error within the Healthviews product and affecting most sites using Healthviews. All sites have been advised and have carried out their own checking processes,” the hospital says in a statement.

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http://www.marketwatch.com/story/health-care-it-solutions-company-isoft-chooses-verizon-business-for-global-communications-expansion-2010-04-28?reflink=MW_news_stmp

Health Care IT Solutions Company iSOFT Chooses Verizon Business for Global Communications Expansion

Cloud-Based Approach Enhances Flexibility to Support Expansion Plans

SINGAPORE, April 28, 2010 /PRNewswire via COMTEX/ -- Health care IT solutions company iSOFT wanted a flexible, secure, advanced communications network that would help drive collaboration and growth. By choosing a fully managed, cloud-based IT and communications solution from Verizon Business, iSOFT expects to meet those goals while also realising significant cost and management efficiencies.

One of the world's largest providers of health care IT solutions, iSOFT works with customers in more than 40 countries across five continents to manage patient information and drive improvements in core processes. The company has expanded rapidly in recent years, both organically and through acquisition, resulting in a number of different networks and systems outside its core IP network, which were expensive to run, unreliable, and restricted productivity and expansion.

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http://www.e-health-insider.com/news/5861/nw_trusts_can_get_off_the_lorenzo_bus

NW Trusts can get off the Lorenzo bus

27 Apr 2010

Trusts in the North West of England have been asked if they want to get off the ‘Lorenzo Bus’ and told they will not have to pay penalties if they do.

A letter seen by E-Health Insider asks trusts if they would “formally withdraw from the [National Programme for IT in the NHS]” and says “a trust’s financial liability will only occur when you have committed to a project and signed a project initiation document.”

The move is understood to be a much wider plan to get as many as 30 NHS trusts to opt out of the iSoft strategic patient record that CSC is due to implement across the North, Midlands and East of England.

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http://www.smh.com.au/nsw/new-drug-pumps-pose-dose-risks-20100427-tq1e.html

New drug pumps pose dose risks

JULIE ROBOTHAM HEALTH EDITOR

April 28, 2010

THE NSW Health Department's $70 million introduction of computerised intravenous fluid and medicine pumps has suffered a series of technical errors that have forced Royal North Shore Hospital to stop using the machines for cancer patients.

The errors involve leaks from the tubing that connects to syringes of medication. Staff have noticed drops of medication still present after the tubes have been withdrawn, raising the possibility that patients might receive an inaccurate dose.

Greg Knoblanche, the director of anaesthetics at Royal North Shore, confirmed the devices were not being used for chemotherapy, for patients' safety and to protect staff who might be exposed to the highly toxic drugs.

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http://www.theaustralian.com.au/news/health-science/assessors-too-overloaded-by-new-system-to-judge-research-grant-applications/story-e6frg8y6-1225858126072

Assessors too overloaded by new system to judge research grant applications

RESEARCH grant assessors have to trawl through tens of thousands of pages of applications under cumbersome new procedures that threaten to undermine the system, a researcher has warned.

"They are already suffering from referee fatigue -- if peers get annoyed enough, they'll drop out next year," National Health & Medical Research Council senior principal research fellow Phil Robinson said yesterday.

Under the peer review system used to select the grants, each panel member has been sent a pack of about 80 applications from researchers for assessment.

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http://news.smh.com.au/breaking-news-national/govt-under-pressure-on-broadband-20100427-tnoy.html

Govt under pressure on broadband

April 27, 2010 - 7:44AM

AAP

The opposition and minor parties are again putting pressure on the federal government over its proposed National Broadband Network (NBN).

Debate on legislation related to the rollout of the $43 billion NBN is likely to resume in the Senate in a fortnight.

Communications Minister Stephen Conroy has also promised to release a report into its viability before the May budget.

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And totally off base – but interesting!

http://www.theaustralian.com.au/news/health-science/aliens-may-not-come-in-peace-stephen-hawking/story-e6frg8y6-1225858258767

Aliens may not come in peace: Stephen Hawking

  • From: AFP
  • April 26, 2010 10:01AM

ALIENS may exist but mankind should avoid contact with them as the consequences could be devastating, British scientist Stephen Hawking has warned.

“If aliens visit us, the outcome would be much as when Columbus landed in America, which didn't turn out well for the Native Americans,” said the astrophysicist in a new television series, according to British media reports.

The programs depict an imagined universe featuring alien life forms in huge spaceships on the hunt for resources after draining their own planet dry.

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Enjoy!

David.

Saturday, May 01, 2010

AusHealth IT Now Fed to Medipedia.

I have just been told we are now more available in the US on one of the major US Health Information Resources.

See here for the link:

http://www.medpedia.com/news_analysis/310-Australian-Health-Information-Technology

Here are some details about the site.

About The Medpedia Project

The Medpedia Project is a long-term, worldwide project to evolve a new model for sharing and advancing knowledge about health, medicine and the body among medical professionals and the general public. This model is founded on providing a free online technology platform that is collaborative, interdisciplinary and transparent. Read more about the model.

Users of the platform include physicians, consumers, medical and scientific journals, medical schools, research institutes, medical associations, hospitals, for-profit and non-profit organizations, expert patients, policy makers, students, non-professionals taking care of loved ones, individual medical professionals, scientists, etc.

As Medpedia grows over the next few years, it will become a repository of up-to-date unbiased medical information, contributed and maintained by health experts around the world, and freely available to everyone. The information in this clearinghouse will be easy to discover and navigate, and the technology platform will expand as the community invents more uses for it.

In association with Harvard Medical School, Stanford School of Medicine, Berkeley School of Public Health, University of Michigan Medical School and other leading global health organizations, Medpedia will be a commons for the gathering of the information and people critical to health care. Many organizations have united to support The Medpedia Project. See the Record of Merit.

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Never thought I would be associated with these heavy hitters!

Also nice to see some international readers etc!

David.

Friday, April 30, 2010

AusHealthIT Man Poll Number 17 – Results - 28 April, 2010.

The question was:

What Do You Think of the Outcomes of the Rudd Government Health Reform?

Visionary

- 4 (10%)

Pretty Good

- 4 (10%)

OK

- 6 (15%)

Not Much Good

- 2 (5%)

A Missed Opportunity

- 18 (45%)

A Disaster

- 6 (15%)

Votes: 40

Comment:

Looks like we have 65% negative and 35% thinking OK or better! Hardly a great endorsement from a range of people who are likely to have a clue about what it is they are talking about.

Again, many thanks to all those who voted

David.

Weekly Overseas Health IT Links 28-04-2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or payment.

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http://www.modernhealthcare.com/article/20100423/NEWS/100429958

E-care discussed at aging committee meeting

By Rebecca Vesely

Posted: April 23, 2010 - 12:30 pm ET

Widespread adoption of home health monitoring won't happen without changes to the payment system and expansion of affordable broadband services, experts said at a Senate hearing.

The Senate Special Committee on Aging took on the topic of e-care, the burgeoning field of remote health monitoring. New at-home technologies include blood pressure and glucose monitoring and devices that measure such factors as prescription drug intake and balance and coordination to prevent falls.

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http://govhealthit.com/newsitem.aspx?nid=73573

HHS panel endorses patient safety database

By Mary Mosquera

Thursday, April 22, 2010

The Health IT Policy Committee endorsed recommendations for the creation of a national database to which healthcare providers can confidentially report patient data errors and unsafe conditions they encounter using electronic health records. Reporting of safety issues would become part of Stage 2 of meaningful use requirements.

A patient safety organization will also be established to analyze the reports and will emphasize tracking and sharing information from the database to make healthcare a learning system, according to the Health and Human Services Department advisory panel at its meeting April 21.

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http://www.healthcareitnews.com/news/brandeis-offer-masters-degree-medical-informatics

Brandeis to offer master's degree in medical informatics

April 22, 2010 | Mike Miliard, Managing Editor

WALTHAM, MA – Brandeis University has announced that it will offer a new online master's degree in health and medical informatics – part of its effort to help create the 50,000 new IT jobs necessary to usher the healthcare system "fully into the digital age."

The Health and Medical Informatics program will address the growing need for professionals who possess both analytical skills and business acumen, with the goal of improving healthcare delivery systems through information technology.

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How To Succeed At Electronic Medical Records

Cultural change, training and communication are key to solid EMR implementations, survey says.

By Nicole Lewis, InformationWeek

April 20, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224400880

Implementing electronic medical record systems often requires changes to a healthcare provider's management culture, according to a recent survey of hospitals that are far along in their EMR efforts.

Other best practices cited in the report include effective communication, hands-on IT training and flexibility in financing costs associated with digitizing medical records. The report is based on a survey of 28 hospitals that are members of the Premier Healthcare Alliance, a network of 2,300 nonprofit U.S. hospitals and 63,000 other healthcare sites.

A summary of the survey's results, authored by Susan D. DeVore, Premier's president and CEO, and Keith Figlioli, the organization's senior VP of healthcare informatics, was published in the April issue of Health Affairs.

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http://www.ihealthbeat.org/features/2010/new-toolkit-for-disaster-response-social-media-mobile-tools--telehealth.aspx

Thursday, April 22, 2010

New Toolkit for Disaster Response: Social Media, Mobile Tools & Telehealth

by Kate Ackerman, iHealthBeat Senior Editor

WASHINGTON, D.C. -- When you think of large-scale disasters, such as the recent earthquake in Haiti or 2008's Hurricane Ike, Facebook, text messages and telehealth technologies might not be the first things that come to mind, but these tools are playing an increasingly important role in emergency response efforts.

At an event held by the Brookings Institution in Washington, D.C., this week, disaster relief and emergency management experts discussed how telehealth, mobile communications and social media are changing the way the U.S. responds to disasters.

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http://www.modernhealthcare.com/article/20100422/NEWS/100429972

IT policy group proposes patient safety monitor

By Joseph Conn / HITS staff writer

Posted: April 22, 2010 - 12:30 pm ET

Part one of a two-part series

A federal health information technology policy work group has called for the creation of a national monitoring program for patient safety problems stemming from the use of a broad range of healthcare IT systems.

The recommendation by the electronic health-record certification and adoption work group of the Health Information Technology Policy Committee came Wednesday during a meeting in Washington, while, perhaps ominously to some, an official with the U.S. Food and Drug Administration listened in.

The FDA currently regulates medical devices and has received more than 200 reports of adverse events associated with health information technology, according to a recently published report by a team of investigators for the online news outlet, the Huffington Post. Meanwhile, Sen. Chuck Grassley (R-Iowa) has shown an interest in HHS or FDA monitoring health IT systems.

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http://www.healthdatamanagement.com/news/monitor-personal-wearable-implantable-fda-40146-1.html

FDA OKs Wearable Monitor

HDM Breaking News, April 21, 2010

The Food and Drug Administration has given 510(k) clearance to Proteus Biomedical Inc. to market the Raisin Personal Monitor, a wireless personal, wearable health status-recording device.

The monitor attaches to skin with an adhesive layer and is worn like a bandage. It records such data as heart rate, respiration rate, physical activity, and body position, which is transmitted via Bluetooth technology to a mobile phone or other computing device.

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http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/04APR2010/100419HHN_Weekly_Metzger&domain=HHNMAG

Achieving CPOE by 2011 (or at least by 2012)

By Jane Metzger and Donna Schmidt

Hospitals can implement computerized provider order entry systems quickly, as long as they avoid pitfalls and reject common myths.

Thanks to the financial incentives (and disincentives) built into the HITECH provisions of the American Recovery and Reinvestment Act (ARRA) of 2009, many hospital executives are accelerating plans to implement or optimize computerized provider order entry (CPOE), one of the requirements for "meaningful use" that must be demonstrated under the HITECH provisions. CPOE has been identified as a critical element in every Institute of Medicine report, beginning with To Err Is Human in 1999, and was mentioned in the ARRA, along with the clinical decision support that can be delivered during electronic ordering.

The Goal for Hospitals

The HITECH timeframe for demonstrating meaningful use is very tight, especially in the approximately 86 percent of hospitals in which CPOE is not yet in use. (See Craig A. Pedersen and Karl F. Gumper, "Assessment of the Adoption and Use of Pharmacy Informatics in U.S. Hospitals—2007" [ASHP National Survey on Informatics], in American Journal of Health-System Pharmacy, vol. 65 [Dec. 1, 2008].) Reaching Stage 1, the first incentive milestone, requires that 10 percent of orders for hospitalized patients be entered directly by the authorizing providers (physicians and other clinicians such as nurse practitioners who can order services under applicable state law); there are indications that this bar will be raised in Stage 2 or 3.

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http://www.ehealtheurope.net/news/5839/slovakia_signs_%E2%82%AC32m_e-health_deal

Slovakia signs €32m e-health deal

21 Apr 2010

The Slovakian Ministry of Health has signed a €32.4m deal with US company Ness Technologies to implement the first phase of its electronic healthcare system.

The two year deal will provide an 'electronic health book' for every citizen to provide doctors with a patient’s health data.

It will also lead to the creation of a National Health Portal, to centrally distribute public health-related information to patients, staff and external organisations.

The company will also build eAllocation, an electronic appointment and scheduling system aimed at improving patient access to services, and e-prescribing system for drug distribution.

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http://www.healthleadersmedia.com/content/MAG-249300/Quality-The-Medical-Home-as-Community-Effort

Quality: The Medical Home as Community Effort

Janice Simmons, for HealthLeaders Magazine, April 8, 2010

A collaborative ACO model is yielding clinical and financial results.

One of the first sites in the country to test the relationship involving a patient-centered medical home, value-based insurance design, and a community collaborative that includes healthcare providers, local employers, consumer groups, and payers initially got a kickstart with a rejection.

Today, this Michigan collaborative, called "Pathways to Health," has been garnering national attention because it has the outlines of the new delivery model—an accountable care organization (ACO)—that has received close attention during the healthcare reform debate. Plus, new data show that patient health is improved and money saved when it comes to using this patient-centered model to care for patients with chronic conditions.

Several years ago, Integrated Health Partners, a physician hospital organization that joins the Battle Creek (MI) Health System and the Calhoun County Physicians Organization, had been participating in a BlueCross BlueShield of Michigan's (BCBSM) Physician Group Incentive Program that financially rewarded physicians in a PPO network by addressing issues such as chronic disease management and generic drug use.

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http://www.healthdatamanagement.com/news/survey-breach-identity-theft-hospital-40136-1.html

Survey: Breaches, ID Theft Increase

HDM Breaking News, April 20, 2010

A vendor survey of more than 200 hospital executives finds instances of health information data breaches and medical identity theft continue to increase despite new federal regulations like the breach notification rule and the Red Flag rules.

Identity Force, a Framingham, Mass.-based vendor of identity theft prevention services, conducted the survey between March 30 and April 13 among members of the American Hospital Association. The company received e-mail outreach assistance from the AHA, which previously endorsed its services.

.....

The full report is available at identityforce.com/Press.php.

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http://health-care-it.advanceweb.com/Editorial/Content/Editorial.aspx?CC=219596

Social Media's Promise for Health Care

Drive engagement, boost satisfaction and improve treatment outcomes.

Social media technology can help drive engagement, boost satisfaction and improve treatment outcomes.

By Amy Cueva

Odd looking red spot on your arm after working outside? Kids come home from school with a note stating that their classmate has "fifth disease"? Can't remember whether to starve your cold or feed your fever? Chances are good that you fired up your computer and "Googled" it.

According to a recent Pew Internet and American Life Project survey, 61 percent of Americans go online for health information. We self-diagnose, check out our doctors' credentials, and refill our prescriptions. And now millions of us have been "found" on Facebook and follow each other on Twitter. How long before it's common practice to use social media sites to address common medical questions?

Social media is beginning to change the healthcare landscape. It connects people with shared experiences. It facilitates the exchange of ideas, information and emotional support.

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http://health-care-it.advanceweb.com/Editorial/Content/Editorial.aspx?CC=220274

The Unwitting Accomplice

When it comes to preventing data breaches, employees can be the best defense or the worst enemy.

By Andrew Sroka

There is no debate that the HITECH Act and proliferation of electronic health records (EHRs) are prompting new concerns over the privacy of patient data. As the explosion of soft data unfolds across the industry, health care providers -- from both a regulatory and reputation standpoint -- are struggling to comply with the information security demands that customers, policymakers and regulators are placing on them.

To that end, health care CIOs are feeling the heat. New legislation expands current privacy and security protections for health information and places stringent breach notification requirements on insurers and providers. The new laws also demand that patients get increased control over what medical and personal data are disclosed and to whom, which is forcing CIOs to build systems that closely manage control of information access among employees, contractors, partners and would-be hackers.

Even more daunting is the reality of regulator audits to ensure that privacy practices are in compliance with the new laws. A failure to comply or adequately deal with a data breach can mean running afoul of regulators, potential business disruptions and long-term reputational harm.

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http://trueslant.com/huffpostfund/2010/04/21/as-doctors-shift-to-electronic-health-systems-signs-of-harm-emerge/

As Doctors Shift to Electronic Health Systems, Signs of Harm Emerge

Posted by Fred Schulte@Huffington Post Investigative Fund

Reports Link System Malfunctions to Injuries, Deaths

By Fred Schulte and Emma Schwartz

Huffington Post Investigative Fund

One day in March 2009, hospital workers misread small print on a computer screen, causing them to dispense 10 times the prescribed dose of a drug. Result: The patient has a heart attack.

Another time, a computer fails to alert doctors and nurses when a patient is moved from intensive care to their ward. Left unattended during the night, the patient suffers seizures for hours.

In December 2009, there’s a report of a software glitch that delays a patient’s medical treatment, causing a disabling injury. “Breakdowns of this magnitude endanger hundreds of patients simultaneously,” warns a report on the incident.

Scores of reports on file with the Food and Drug Administration detail consequences to patients when an electronic medical record system fails. Those reports, reviewed by the Huffington Post Investigative Fund, show that a central function of the record systems, known as computerized provider order entry, or CPOE, has been linked to instances in which patients died or suffered serious injuries.

While the data obtained by the Investigative Fund affords only a small glimpse at problems with the system, it could suggest a much larger challenge as the nation’s medical establishment swiftly moves from paper medical files to digital ones.

----

http://www.ehiprimarycare.com/news/5833/scr_roll-out_suspended

SCR roll-out suspended

16 Apr 2010

The Department of Health has suspended the roll-out of the Summary Care Record in the five strategic health authorities where accelerated implementation has been underway.

The DH said SCRs would not be created in the regions identified for accelerated implementation “until appropriate professional and public awareness has been raised."

The move was welcomed by the BMA, which wrote to health minister Mike O’ Brien last month calling for a suspension of the roll-out.

It claimed this was being carried out without patient awareness and before the independent evaluation of the early adopter areas had been published.

-----

http://www.who.int/goe/ehir/2010/20_april_2010/en/index.html

20 April 2010

eHealth Worldwide

:: Africa: New broadband network for Africa approved (13 April 2010 - SciDev)

Funding for the first phase of an initiative to connect African research centres and link them to an existing European network has been approved by the European Commission. The approval follows a report that identified sufficient IT infrastructure in Africa to support the AfricaConnect Initiative, which aims to improve research collaborations and access to information.

------

http://www.healthleadersmedia.com/content/TEC-249760/EHRs-Can-Improve-Patient-Care-Through-Electronic-Documentation

EHRs Can Improve Patient Care Through Electronic Documentation

Andrea Kraynak, for HealthLeaders Media, April 19, 2010

Physicians need to take control of technology.

EHR documentation can be dictated by billing rules and legal requirements, or by your need to describe your patients and provide quality care, according to the New England Journal of Medicine.

"Clinicians need to take back ownership of the medical record as a tool for improving patient care; such a move could have many benefits, including reducing the frequency of diagnostic errors," according to authors David W. Bates, MD, and Gordon D. Schiff, MD.

Increasing physician efficiency and improving patient care may be possible through the use of EHRs—but a system lacking the right capabilities can hinder the process. For this reason, physicians may want to weigh in when it comes time to adopt new technologies or upgrade older systems at their organizations.

-----

http://www.govhealthit.com/newsitem.aspx?nid=73540

NCI will offer cancer e-care record for providers

By Mary Mosquera

Monday, April 19, 2010

The National Cancer Institute plans to release a lightweight electronic health record designed to capture data specific to a cancer patient’s office visit.

The standards-based software has core EHR features for sharing information about patient diagnosis, treatment and outcomes, said Ken Buetow, associate director for bioinformatics and IT at the National Cancer Institute (NCI).

The EHR is based on a early reference implementation of the Patient Outcomes Data Service, an open source “ultra-light record” derived from standards of NCI’s Cancer Biomedical Informatics Grid (caBIG).

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http://online.wsj.com/article/SB10001424052702304159304575184624170912494.html

More Doctors Are Prescribing Medicines Online

By TIMOTHY W. MARTIN

Doctors are increasingly prescribing medications electronically, abandoning the traditional paper scripts that can result in drug errors due to hard-to-read writing or coverage denials by a patient's insurer.

The number of e-prescriptions nearly tripled last year to 191 million from the previous year's 68 million, representing about 12% of the 1.63 billion original prescriptions, excluding refills, according to Surescripts LLC, whose online network handles the bulk of the electronic communications. The growth has accelerated. For the first three months of this year, nearly one in five prescriptions was filed electronically, Surescripts says. About 25% of all office-based doctors currently have the technology to e-prescribe, more than twice as many as at the end of 2008, Surescripts says.

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http://www.modernhealthcare.com/article/20100420/NEWS/100429995

NIST 'furiously working' on EHR program certification

By Joseph Conn / HITS staff writer

Posted: April 20, 2010 - 12:00 pm ET

A brief sense of palpable relief flowed through much of the health information technology community last month when David Blumenthal, head of the Office of the National Coordinator for Health Information Technology at HHS, announced the release of a draft rule governing the process ONC would use to select organizations to certify electronic health-record systems under the American Recovery and Reinvestment Act of 2009.

Bettijoyce Lide was not so much among the relieved as among the empowered and the belabored.

Lide is a scientific adviser and the coordinator of the health IT program for the National Institute for Standards and Technology, the federal agency charged by Congress under the stimulus law with a key role in helping the ONC establish a national program for testing and certifying EHRs.

-----

http://www.healthleadersmedia.com/content/TEC-249679/Large-Patient-Information-Breaches-Skyrocket

Large Patient Information Breaches Skyrocket

Dom Nicastro, for HealthLeaders Media, April 16, 2010

The number of entities reporting breaches of unsecured PHI affecting 500 or more individuals has doubled since the agency that enforces the HIPAA privacy and security rules first posted them on its Web site two months ago.

The Office for Civil Rights (OCR) in February posted a list of 32 entities that since September 22, 2009, had reported the egregious breaches to OCR. On Friday, that number climbed to 64.

HITECH requires OCR to make public any breaches of 500 or more. OCR said on the site it will continue to update the page as it receives new reports of breaches of unsecured PHI.

-----http://www.healthleadersmedia.com/content/PHY-249700/OCR-Will-Post-Names-of-Private-Practices-That-Violate-HIPAA

OCR Will Post Names of Private Practices That Violate HIPAA

Dom Nicastro, for HealthLeaders Media, April 16, 2010

The Office of Civil Rights (OCR) confirmed in an e-mail to HealthLeaders Media Friday afternoon that it will begin posting on its breach notification Web site the names of entities they consider "individuals" regardless of whether or not those entities give consent.

Currently, OCR does not post the names of such entities (namely sole practitioners) who report breaches affecting 500 or more individuals if they do not give OCR consent; OCR treats them as protected "individuals" per the Privacy Act of 1974. Instead, OCR lists them as "private practice."

-----

http://www.fiercehealthit.com/story/health-it-data-glut-altering-patient-physician-relationship/2010-04-19?utm_medium=nl&utm_source=internal

Health IT, data glut altering patient-physician relationship

April 19, 2010 — 11:45am ET | By Neil Versel

Even with the vast majority of medical records still stored in paper files, health IT already has had a profound effect on the ways in which people seek and receive care, thanks to social networking, electronic patient-physician communication, mobile applications and, of course, the growing number of EMRs, some experts say.

"For as long as we've known, healthcare has been 'I go to the physician, and they tell me what to do, and I do it,'" says Dr. Nitu Kashyap, research fellow at the Yale Center for Medical Informatics, tells Scientific American.

To learn more:

- have a look at this Scientific American story

-----

http://www.healthdatamanagement.com/news/hie-consolidation-report-meaningful-use-40116-1.html

Report: Big Changes Soon to HIE Market

HDM Breaking News, April 15, 2010

The health information exchange market will dramatically change during the next two years as providers seek electronic health records systems that support data exchange to qualify for meaningful use incentives, according to a new report from research firm IDC Health Insights.

Enterprise HIEs serving delivery systems will be the fastest-growing segment of HIE networks, the Framingham, Mass.-based firm believes. "Unlike regional health information organizations and statewide or national HIEs, Enterprise HIEs can establish a sustainable business model and are not as encumbered by organizational and data governance issues."

-----

http://www.healthdatamanagement.com/news/icd-10-report-crosswalks-consultant-coding-40120-1.html

Report Examines ICD-10 Crosswalks

HDM Breaking News, April 15, 2010

A new, free report from consulting firm Computer Sciences Corp. examines the data crosswalks, particularly a bi-directional crosswalk, that will be required to transition from the ICD-9 code sets to ICD-10.

The Falls Church, Va.-based consultancy notes that with many items at the top of priority lists, few health organizations are far along in their preparations for the new diagnosis and procedure codes, which have a compliance date of 2013.

"The sheer magnitude of the business process and technology changes that are required for ICD-10 implementation may be a deterrent to assessment and planning as well," according to the report. "The fact remains, however, that organizations that have not begun their ICD-10 remediation efforts are at risk of missing the current deadlines. What's equally clear is that the deadlines are unlikely to be adjusted again."

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http://www.informationweek.com/news/healthcare/clinical-systems/showArticle.jhtml?articleID=224400392

HIT Critical To Improving Patient Care

Supplying medical providers with health information technology will ultimately yield improvements in patient health, says a government report.

By Nicole Lewis, InformationWeek

April 15, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224400392

If the nation is to achieve a higher quality of healthcare in the foreseeable future, the adoption of health information technology is a critical step that will empower providers as they administer care to patients, a National Healthcare Quality Report said.

Published on Tuesday by the Department of Health and Human Services, the report said medical providers need reliable information about their performance which will help them improve their activities.

-----

http://www.ihealthbeat.org/perspectives/2010/health-care-reform-hit-for-ltc-and-the-hidden-threat-to-hit.aspx

Monday, April 19, 2010

Health Care Reform: HIT for LTC and the Hidden Threat to HIT

by Bruce Merlin Fried, Esq.

Last July, I bemoaned the fact that there was no health IT component to the health care reform proposals then under consideration. In that iHealthBeat column, I urged Congress to go beyond the provisions of the American Recovery and Reinvestment Act of 2009 and HITECH to recognize that other health care providers, in addition to hospitals and doctors, could benefit from health care IT investments, specifically the long-term care (LTC) community.

Well, what do you know, sometimes you get what you wish for.

-----

Enjoy!

David.

Thursday, April 29, 2010

Just Watch The Bureaucrats Game This System – Reliable National Hospital Performance Monitoring Will Not be Easy.

There is a key platform of the new Health Reform Plan that relies on much improved measurement of the performance of Public Hospitals all around the country.

National monitor of how hospitals stand out or fail

MARK METHERELL HEALTH CORRESPONDENT

April 22, 2010

AUSTRALIANS should soon be able to find out how the nation's hospitals compare in terms of quality and safety measures such as the incidence of bungled treatment and introduced infections.

State and federal health officials are expected next week to decide on hospital performance measures, although the timing of their publication will be up to individual states.

The measures to be published are expected to include the rate of ''adverse events'' such as treatment mistakes, unexpected re-admissions, possibly resulting from substandard surgery, and delays in access to hospital emergency departments, general practitioners and dental care.

The development of greater consumer awareness comes as the government foreshadows a shake-up in the heavily regulated aged-care sector, having announced a wide-ranging inquiry by the Productivity Commission.

On the hospital reporting issue, a spokeswoman for the federal Health Minister, Nicola Roxon, said yesterday the first report on a national healthcare agreement would be considered next week. ''It will then be released publicly as soon as possible following endorsement from all [state] jurisdictions.''

Under the reforms agreed to this week, each of the proposed 100 local hospital networks, individual hospitals including private hospitals and the proposed primary healthcare organisations will have important aspects of their performance measured and published.

But while high performers will be held up as examples, secret reports will be lodged with national and state authorities on poor performers under the Council of Australian Governments' agreement on the national health and hospitals network.

A new National Performance Authority will provide ''clear and transparent quarterly public reporting'' on the performance of every hospital and primary care organisation, as the text of the agreement between the Prime Minister and the premiers states.

More here:

http://www.smh.com.au/national/national-monitor-of-how-hospitals-stand-out-or-fail-20100421-t0mi.html

The proposal here is to permit those who are failing to do so in secret. The quality of this farce will only be missed by the senior health bureaucrats. The rest of us will merely emit a pathetic and frustrated – “they are doing what?!!!!!”

All this reminds one of the good old days when the size of public hospital waiting lists – which were always hopeless gamed and inaccurate – used to shrink just before elections and then grow dramatically just after – to progressively decrease as the next election approached.

Only audited data obtained from live operational systems that clinicians actually use to deliver care, and so are concerned about information accuracy, should be used to monitor hospital performance. Having ward clerks and administrators gather data manually and then report it just puts too much temptation in the way of such administrators to ‘adjust the figures’.

See here for the gory details from Victoria last year!

http://aushealthit.blogspot.com/2009/04/lies-damned-lies-statistics-and.html

Sadly we have neither the systems nor the resolve it would seem to do information gathering properly. Just watch how it plays out and just how dodgy the Key Performance Indicators that are used to measure Hospital Performance turn out to be!

What a shame!

David.

Secure Clinical Messaging Gets A Boost from The Recent IHE Australia Connectathon.

For those who were not there these two releases – which I was sent this morning – provide some useful information and background.

Media Release 1:

IHE Australia

SMD Connectathon 19 - 23 April 2010

Australian Health IT vendors gathered in Canberra to develop and test their capacity to securely message key healthcare information.

The IHE Australia Secure Message Delivery (SMD) Connectathon was conducted from 19-23 April 2010 in Canberra. A total of 13 vendors took part with a focus on achieving interconnectivity using the web service messaging profile according to the new Standards Australia Technical Specification for E-Health Secure Message Delivery. (ATS 5822:2010 – eHealth Secure Message Delivery published 5 March 2010). NEHTA joined the Connectathon to test its own implementation of the SMD specification alongside those of other participants and to provide volunteer technical expertise to assist other early adopters of the SMD profile.

The use of web services for communication brings Australian vendors in line with international approaches; a vital step towards adopting the next generation of health communication technology and improved access to health information such as electronic test results and hospital discharge summaries.

At the Connectathon each system has to exchange data with 3 other systems and an online testing facility and have independent industry appointed monitors check the test results. Successful vendors can now incorporate this communication technology in products and publish a conformance statement as a guide to purchasers and system users. The results are being validated and IHE expects to announce the results over the next few weeks at http://ihe-australia.wikispaces.com/Connectathon+2010+April.

Connectathon background:

IHE Australia recognises the support of many organisations and individuals for this event and in particular the Australian Federal Department of Health and Ageing (DoHA) who supported this event and the development of the messaging profile.

IHE Australia has run three previous Connectathons in Australia and is one deployment committee of an international organisation made up of vendors, professionals associations and others interested in implementation of standards based e-Health communication systems (www.ihe.net and www.ihe.net.au). The Australian sponsor organisations are HISA, MSIA, HL7 Australia, and RANZCR. Other members include ADIA, RACS, and HIMAA.

IHE Australia was contracted by the Federal Department of Health and Ageing to run the Secure Message Delivery (SMD) Connectathon in Canberra from 19-23 April 2010, as a special event, under established IHE rules and procedures. In turn, IHE Australia commissioned the eHealth NATA-accredited Australian Healthcare Messaging Laboratory (AHML) to develop a Secure Messaging test facility and procedures. AHML conducted all testing at the Connectathon against the published Standards Australia Secure Messaging Technical Specification (ATS 5822:2010).

The IHE Australia SMD Connectathon was the result of a collaborative development process between:

• NEHTA

• Medical Software Industry (MSIA)

• Standards community (Standards Australia IT14-06)

NEHTA joined the Connectathon, to test its own implementation of the SMD specification alongside those of other participants and to provide volunteer technical expertise to assist other early adopters of the SMD profile.

For further information, contact Vincent McCauley at vincem@mccauleysoftware.com or admin@ihe.net.au.

Phone: +61 2 9818 6493.

Media Release 2:

IHE Australia Open Day Seminar Wednesday 21 April 2010

Australian Health IT vendors gathered in Canberra to develop and test their capacity to securely message key healthcare information at the 3rd IHE Australia Connectathon. During the event some 45 participants from industry, government and GP Divisions visited the Connectathon The objective of the seminar was to provide participants with an introduction to IHE Australia activities and an overview of developments in secure messaging.

Speakers were:

Vincent McCauley – Chair, IHE Australia

Bernie Crowe – IHE Australia, SMD Connectathon Manager

Jon Hilton – IHE Australia, HISA Board

John McMillan NEHTA Manager Secure Messaging and Andy Berry – Specifications

Jane Gilbert -Director, Operations and Strategy at Australian Healthcare Messaging Laboratory (AHML)

Janine Bevan – Director Clinical Communications, Department of Health and Ageing (DoHA)

A highlight of the day was the presentation by HISA Board member Jon Hilton on the development of the Patient Centered Coordination Plan (PCCP) Profile to support Care Coordination and Planning across different healthcare organisations and information systems. This profile, based on the IHE Cross Enterprise Document Share (XDS) platform, supports the development of care teams, exchange of care plans, patient progress reports and tracking of key tasks and outcomes. Australia is an international leader in care planning, so it is not surprising that we are leaders in the systems used to support care management.

Background:

The IHE Australia Secure Message Delivery (SMD) Connectathon was conducted from 19-23 April 2010 in Canberra. A total of 13 vendors took part with a focus on achieving interconnectivity using the web service messaging profile according to the new Standards Australia Technical Specification for E-Health Secure Message Delivery. (ATS 5822:2010 – eHealth Secure Message Delivery published 5 March 2010). NEHTA joined the Connectathon, to test its own implementation of the SMD specification alongside those of other participants and to provide volunteer technical expertise to assist other early adopters of the SMD profile.

IHE Australia recognises the support of many organisations and individuals for this event and in particular the Australian Federal Department of Health and Ageing (DoHA) who supported this event and the development of the messaging profile.

For further information, contact Vincent McCauley at vincem@mccauleysoftware.com or admin@ihe.net.au.

Phone: +61 2 9818 6493.

----- End Releases.

This is really good news that, at least in one area, there appears to be good, and valuable, co-operation between various Government entities and a range of private messaging providers.

There is a report on the even – with a few photos here:

http://ihe-australia.wikispaces.com/Connectathon+April+2010+Report

Additional results will appear over the next few weeks.

This is clearly a step in the right direction, although I would be interested to be re-assured that all present SM providers were involved. If this was not the case it would be pretty sad.

A link to the presentations would be good, but maybe I missed it!

David.

Wednesday, April 28, 2010

A Really Important Review of European Health Information Sharing I Initially Missed.

The study cited here seems to me to be of considerable importance to all of us here in Australia as well.

Across the Pond

Should HIE leaders in the U.S. look to European progress for clues going forward? Yes, with caveats, says one international IT expert

by Mark Hagland

Health information exchange (HIE) development experiences in a number of European nations should give HIE innovators in the United States both some hope and some cause for concern, as they consider the many hurdles facing HIE progress in this country. Indeed, says one expert on international healthcare IT development, lessons learned from Europe offer the classic “glass half-full or half-empty” conceptual quandary. For CIOs helping to lead their organizations and communities along the first steps of inter-organizational connectivity, the message is clear: we've got a very long way to go to resolve some basic issues.

The experiences of the U.K., the Netherlands, and Denmark in HIE speak to some of the challenges that American HIE leaders face in the future.

Among the issues that some European countries have taken on - head-on - include the creation of a national patient identifier and nationwide patient identification; privacy and security of patient data; governance and communications around patient data sharing, and the technical architecture, standards, and certification needed to establish and broaden nationwide health information exchanges. It has taken several years to work out some of these issues in the Netherlands, Denmark, and the United Kingdom, which were special countries of focus in a study co-authored by Fran Turisco, principal researcher in the Waltham, Mass.-based Emerging Practices division of the Falls Church, Va.-based CSC. The study, entitled “Accomplishing EHR/HIE (eHealth): Lessons from Europe,” was published in late 2009.

For example, Turisco says, “In researching this topic, I found that the fundamental issue around patient data ownership and privacy issues is around communication, in terms of letting patients and healthcare consumers know ahead of time what the parameters are, giving them choices, and setting the right expectations.” One big issue, she says, is the question of opting in or opting out” of whatever protocols are created in terms of the sharing of patient-identifiable data.

So, for example, when the government of the Netherlands created a nationwide HIE, “They sort of forgot about communicating the terms of opt-in/opt-out to patients, and realized after the fact that they needed to establish patient consent to share data, and that delayed communication freaked people out,” Turisco notes. Two lessons learned are important in that context, she says. First, of course, sets of rules on patient consent, on release of information have to be established in advance. And second, whatever protocols are envisioned have to be incorporated into the building of the infrastructure itself.

Furthermore, Turisco says, it's far easier and more useful to create “opt-out”-based permissions systems, rather than “opt-in”-based ones. But, according to Turisco, even in opt-out-based permissions systems, architecting and implementing the systems has required years of optimization in European countries.

Another issue that has been resolved, over time, in some European countries, is that of a national patient identifier number. In the Netherlands, for example, Turisco notes, it took several years to get a national patient identifier approved in the nation's parliament, primarily because of considerable turnover in parliament members. Meanwhile, in the U.K., a national patient identifier was put in place, but it wasn't being correctly captured across the various health systems, called trusts, nationwide; and considerable work had to be done to establish consistency and reliability of identification across the nationwide system.

Much more is found here:

http://healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=9D84FDCEC90540119B23589C7472D1D8

The source article reference is:

Healthcare Informatics 2010 April;27(4):32-34

The original source is here:

http://www.csc.com/health_services/insights/29433-accomplishing_ehr_hie_ehealth_lessons_from_europe

Insights

Accomplishing EHR/HIE (eHealth): Lessons from Europe

Author:

Dr. Harald Deutsch, Fran Turisco

Summary:

Health reform, a top priority for the Obama administration, requires EHR and HIE technology solutions to be successful. The recently enacted Health Information Technology for Economic and Clinical Health (HITECH) Act is re-invigorating discussion activities surrounding state and regional eHealth efforts by addressing a number of the current obstacles - interoperability, privacy and sustainability.

Understanding the risks and issues from similar efforts can help the U.S. to avoid making the same mistakes. Fortunately, comparable efforts do exist. Our first-hand experience in Europe (Denmark, the Netherlands, and three regions in the UK) has enabled us to identify major decision points, best (exemplary) practices, and lessons learned that are transferrable to U.S. projects. While the size of the European efforts is far smaller than the U.S., they are comparable to our state efforts and often have encountered many of the same issues under discussion at the national level.

Download "Accomplishing EHR_HIE (eHealth)_Lessons from Europe"

I mentioned this report once before on the blog last year but having now browsed it closely it is clear it needs careful review, and the lessons need to be carefully considered.

I hope NEHTA as taken all the lessons on board – they are pretty important!

David.