Quote Of The Year

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

or

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

Friday, July 23, 2010

Weekly Overseas Health IT Links - 22 July, 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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Kodak, MedCo Data Automate Health Chart Scanning

Paper-based patient charts are converted to digital files for transfer into electronic medical records.

By Nicole Lewis, InformationWeek

July 14, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=225800154

As healthcare delivery organizations make the transition from a paper-based system to electronic medical records (EMRs), a new product from Kodak and MedCo Data will help doctors automate conversion of paper-based patient charts to digital files for secure storage and transfer into EMRs.

Launched in late June at the TechData Technology Solutions Tour, the Patient Chart Scanning Solution uses Kodak Capture Pro Software and Kodak Scanners to capture data from patient charts and transfer it automatically into MedCo Data Vault -- a Health Insurance Portability and Accountability Act (HIPAA) compliant product -- where the information can be stored and accessed as needed.

According to Kodak executives, because scanned files are automatically formatted using industry-accepted health data standards, including HL7, NCPDP, and CCD, the Patient Chart Scanning Solution facilitates easy and accurate export from the MedCo Data Vault into the practice's existing or future EMR system.

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http://healthcareitnews.com/news/ehr-certification-what-certification

EHR certification? What certification?

July 15, 2010 | Bernie Monegain, Editor

BURLINGTON, VT – A new poll of 850 healthcare providers across the country shows most providers view certification of their electronic health record systems as critical, yet they remained uncertain of the requirements to qualify for government incentives.

The "2010 U.S. Ambulatory Electronic Health Records Certification Study" from research and consulting firm CapSite aims to assess the industry views on ambulatory EHR certification.

"The study provides clear evidence that there is considerable confusion in the market in terms of the certification requirements for Ambulatory EHRs," says Brendan FitzGerald, research director for CapSite. "Although the ONC has not designated Authorized Testing and Certification Bodies (ATCB) at this time, 69 percent of respondents were not aware there will be federally accredited alternatives to CCHIT (Certification Commission for Health IT) for ambulatory EHR certification."

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http://www.lightreading.com/document.asp?doc_id=194345&f_src=lightreading_gnews

Verizon Launches Health Information Exchange

July 14, 2010 | Carol Wilson | Post a comment

Verizon Business today announced its entry into the health information exchange business, launching a cloud-based service that makes personal medical records available to authorized medical personnel.

The Verizon Health Information Exchange (VHIE) will provide a unified view of a patient's medical record that can be accessed via an Internet connection from a doctor's office or hospital.

Built using Oracle Corp. (Nasdaq: ORCL)'s Enterprise Master Patient Index, which enables all the medical records of a given patient to be associated to a unique key, the VHIE will have built-in identity management to protect individual records, and Verizon security to prevent denial-of-service attacks and other threats.

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http://www.fierceemr.com/story/knowledge-networks-says-half-docs-now-use-emrs/2010-07-15

Knowledge Networks says half of docs now use EMRs

July 15, 2010 — 1:05pm ET | By Neil Versel

Hard to believe, but 52 percent of specialists and 50 percent of primary-care physicians claim to be using EMRs, up from 42 percent and 38 percent, respectively, two years earlier, a new survey indicates. The survey does not specify what EMR usage means.

"While use of this technology will soon be mandated, these 'early adopter' levels suggest a desire for digital convenience at a time when patient record keeping promises to become exponentially more complex," reports New York-based survey firm Knowledge Networks. The company conducted the study of nearly 11,000 healthcare professionals through the Physicians Consulting Network, which maintains a research panel of physicians and other caregivers.

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http://www.healthcareitnews.com/news/most-wired-hospitals-2010-named

'Most Wired Hospitals' for 2010 named

July 14, 2010 | Molly Merrill, Associate Editor

CHICAGO – The Most Wired Survey and Benchmarking study, conducted annually by Hospitals and Health Networks, has named the "Most Wired Hospitals and Health Systems" for 2010. The survey included new questions about meaningful use.

The survey recognizes organizations for their achievements in four focus areas: infrastructure, business and administrative management, clinical quality and safety and the care continuum. Hospitals were awarded under the categories of "25 Most Improved," the "25 Most Wireless" and the "25 Most Wired - Small and Rural" hospitals.

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http://govhealthit.com/newsitem.aspx?nid=74215

Public comments reshaped CMS final rule

By Mary Mosquera

Tuesday, July 13, 2010

The Centers for Medicare and Medicaid Services received some 2,000 comments after it published its proposed meaningful use rule in January, and they were key both to changes in the scope of the final rule published today and to the speed with which it was adopted.

“We have sought and received extensive input from the healthcare community, and we have drawn on their experience and wisdom to produce objectives that are both ambitious and achievable,” Dr. David Blumenthal, the national health IT coordinator, said in announcing the final rule.

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CIOs, Others React To Meaningful Use Final Rule

Most healthcare stakeholders are reacting positively, so far, to the feds' meaningful use final rule, but not everyone is pleased.

By Marianne Kolbasuk McGee, InformationWeek

July 14, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=225800167

While CIOs, vendors and other health IT stakeholders are still poring over the 864-page e-health meaningful use final rule released this week by the Dept. of Health and Human Services, reaction so far to the HITECH Act's $20 billion-plus financial incentive program's regulations has been mostly positive.

That's mainly because HHS and its various advisory committees took to heart the gist of many of the approximately 2,000 comments it received from the public -- including hospitals, nurses, doctors, medical associations and patients -- during the crafting processes of the final rule.

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http://www.cmaj.ca/earlyreleases/14july10_canadian-medical-schools-slow-to-integrate-health-informatics-into-curriculum.dtl

NEWS

July 14, 2010

Canadian medical schools slow to integrate health informatics into curriculum

In a world where Canada will spend billions to computerize all health records by 2016, it seems almost simple minded to ask if Canadian medical schools have begun training their students in how to create, understand, and make best use of that data.

Simple minded in theory, but when a quartet of researchers at Dalhousie University in Halifax, Nova Scotia surveyed 16 of Canada’s 17 medical schools, they discovered that none have included what is formally known as health informatics into their core curriculum. And while three schools reported offering health informatics as an elective course, it was unclear whether any students were actually enrolled in these courses.

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http://www.modernhealthcare.com/article/20100713/NEWS/100719999

Privacy rule exempts conduits: HHS lawyer

By Joseph Conn / HITS staff writer

Posted: July 13, 2010 - 10:30 am ET

So-called “conduits” used to move electronic health records are not covered by the recently released federal privacy and security rule, according to an HHS privacy expert. And Google's and Microsoft Corp.'s personal health-record platforms may also be exempt, at least in terms of some of their current and future relationships with healthcare providers, according to the expert.

Adam Greene, a lawyer with HHS' Office for Civil Rights, gave an overview of the new rule July 9 at a meeting of the Privacy and Security Tiger Team of the Health IT Policy Committee.

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http://www.ehiprimarycare.com/news/6072/lansley_leads_information_revolution

Lansley leads information revolution

13 Jul 2010

The government has promised an “information revolution” for patients in its white paper, ‘Equity and excellence: Liberating the NHS’.

The white paper, which was presented to the House of Commons by health secretary Andrew Lansley yesterday, uses much of the same language as the Conservative manifesto in the run-up to the general election, but sets out some specific steps to bring about the "revolution".

It says that assessments of commissioner performance will be published, that quality audits will be extended to more NHS providers, and that clinical teams will be subject to “meaningful, risk adjusted assessment of their performance against their peers”, with the results put into the public domain.

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http://www.ehiprimarycare.com/news/6073/white_paper_backs_choose_and_book

White paper backs Choose and Book

12 Jul 2010

The NHS white paper published yesterday by health secretary Andrew Lansley gives a major role to Choose and book in radically extending patient choice across the health service.

The paper – 'Equity and excellence: Liberating the NHS' – says the government wants to “maximise the use” of the NHS’ electronic booking service, on which it says momentum has “stalled.”

“It has remained the case for several years that just under half of patients recall that their GP has offered them choice.

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http://www.ihealthbeat.org/perspectives/2010/preserving-public-trust-in-personal-health-records.aspx

Tuesday, July 13, 2010

Preserving Public Trust in Personal Health Records

by Deven McGraw

Personal health records have great potential to empower patients to manage their own health care. Through PHRs, people can monitor chronic conditions, explore treatment and insurance options, ensure their health information is correct, share data with others to gain insight and support, and hold health care providers to high standards of accountability. However, as a 2010 California HealthCare Foundation survey recently demonstrated, the success of PHRs will depend in substantial part on whether consumers trust that their sensitive information is protected.

To preserve this trust, the Center for Democracy and Technology (CDT) believes PHRs should be subject to a comprehensive policy framework comprised of a mix of legal requirements and voluntary best practices. CDT will be recommending baseline rules in a report on PHRs to be released this month; this piece provides a summary of those rules. CDT further urges that the best practices be modeled closely on the Markle Common Framework for Networked Personal Health Information. The Markle Foundation's Common Framework was developed and supported by a diverse group of 56 organizations, including leading technology companies, consumer organizations and representatives of HIPAA-covered entities.

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http://www.fiercehealthcare.com/story/computerized-monitoring-systems-linked-use-best-practices-war-hais/2010-07-13

Computerized monitoring systems linked to use of best practices in war on infections

July 13, 2010 — 2:15pm ET | By Sandra Yin

Hospitals that adopt more advanced computerized monitoring systems to identify healthcare-associated infections (HAIs) are more likely to have implemented best practices to prevent such infections, according to a study presented at an annual meeting of the Association for Professionals in Infection Control and Epidemiology (APIC).

Only one-third of hospitals use computers to identify infections in a timely and accurate way, according to a survey of quality directors at 241 general acute care hospitals in California.

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http://www.ihealthbeat.org/features/2010/longawaited-final-rule-on-meaningful-use-strikes-compromise.aspx

Thursday, July 15, 2010

Long-Awaited Final Rule on 'Meaningful Use' Strikes Compromise

Much of the health care community is still sifting through the 864-page final rule CMS released Tuesday describing how health care providers can demonstrate "meaningful use" of electronic health records to qualify for Medicare and Medicaid incentive payments under the 2009 federal stimulus package.

The long-awaited rule comes exactly six months after CMS published a Notice of Proposed Rulemaking on meaningful use. Federal officials received more than 2,000 comments on the proposed rule, often getting conflicting advice.

Some health provider groups -- such as the American Hospital Association and the American Medical Association -- argued that the proposed rules were unreachable for most health care providers and needed to be relaxed. On the other hand, consumer groups -- such as the National Partnership for Women & Families and AARP -- urged federal health officials to maintain the high bar of the proposed rule. Even lawmakers weighed in, offering recommendations on how to improve upon the proposal.

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http://www.healthdatamanagement.com/news/meaningful-use-final-rule-incentives-hitech-ehr-40624-1.html

A First Look at Final MU Criteria

HDM Breaking News, July 13, 2010

The Department of Health and Human Services has released the final rule establishing Medicare and Medicaid incentive programs for the meaningful use of electronic health records. The rule is available for download now at ofr.gov/inspection.aspx, and will be officially published July 28 in the Federal Register, effective 60 days later. Also released was an accompanying final rule to establish initial data standards, implementation specifications and certification criteria for EHRs.

Meaningful use criteria in the final rule are substantially relaxed from what was previously proposed, but still comprehensive and a challenge to meet. David Blumenthal, M.D., national coordinator for health information technology in recent months has said federal officials heard "loud and clear" that the proposed criteria were too ambitious. The final rule represents that the message was received, as the criteria no longer is the "all or nothing" approach that was proposed. "We very much want well-intentioned providers to become meaningful users of electronic health records," Blumenthal said during a media conference call on July 13.

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http://www.healthleadersmedia.com/content/TEC-253757/Winners-and-Losers-in-HHS-Final-Meaningful-Use-Rule.html

Winners and Losers in HHS Final Meaningful Use Rule

Gienna Shaw, for HealthLeaders Media, July 13, 2010

There were a number of changes from the proposed to the final version of HHS' meaningful use rule—requirements that will qualify hospitals and physician practices for federal reimbursements for electronic health records and other IT initiatives, many based on feedback in roughly 2,000 letters responding when the rule was first proposed in January.

The HHS meaningful use final regulations announced Tuesday specify what physicians and hospitals will have to do to receive a share of up to $27 billion in bonus Medicare payments for adoption of electronic health records over the next ten years. Eligible professionals can get up to $44,000 under Medicare and $63,750 under Medicaid, and hospitals may receive millions of dollars for implementation and meaningful use of certified EHRs under both Medicare and Medicaid.

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http://channel.hexus.net/content/item.php?item=25493

Telefónica trumpets global e-health Unit

Sarah Griffiths - 13 Jul 10, 4:19pm

Mobile medicine

Telefónica has launched its global e-health Unit and healthcare sector strategy in a bid to become a major player in the industry by providing products and services based on communications technologies.

The Spanish company which owns O2 has proposed the healthcare sector should decentralise clinical processes by using integrated service networks plus remote access to services, which will "increase efficiency and modernise the sector."

Speaking at the firm's e-health workshops, chairman of Telefónica, César Alierta said: "This global unit has a cross-company character and already has local units in Spain, Europe and Latin America, composed of professionals who define the strategy and planning of services and their industrialisation, operation and support. It aims to become a standard bearer in the areas of products, pilot projects and know-how."

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HP Offers Hospitals, Doctors EHR Help

The EHReady program offers affiliated doctors financing and support services and marketing assistance to hospitals for for e-health record deployments.

By Marianne Kolbasuk McGee, InformationWeek

July 13, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=225702927

With tens of thousands of small, independent physician practices in the U.S.---many of them spread apart by dozens of miles in rural communities--one good way to get the word out to them about the government's meaningful use of health IT programs is to reach them through their affiliated hospitals. That's what Hewlett Packard is trying to help hospitals do via a new program introduced today.

The HP EHReady offering is aimed at helping hospitals work with their affiliated doctors in deploying electronic health records. Under HP EHReady, HP will provide hospitals with customized or standard marketing support services to educate affiliated physicians about programs to get doctors deploying e-health record systems in their practices.

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http://www.computerworld.com/s/article/9179129/Feds_publish_final_e_health_meaningful_use_rules?taxonomyId=13

Feds publish final e-health 'meaningful use' rules

Just 20% of physicians, 10% of hospitals have basic EMRs today

Lucas Mearian

July 13, 2010 (Computerworld)

The U.S. Department of Health and Human Services today issued the final guidelines that will determine how doctors, hospitals and other medical care facilities can qualify for reimbursements by rolling out electronic medical records (EMR) over the next four years.

Dr. David Blumenthal, national coordinator for health information technology, said the final "meaningful use" rules offer greater flexibility to physicians and hospitals than the initial guidelines first proposed earlier this year.

The new rules were finalized after a three-month public comment period during which more than 2,000 recommendations were received by HHS on its preliminary "notice of proposed rule making" effort. The final document is 864 pages long.

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http://www.nytimes.com/2010/07/11/business/11seattle.html?_r=2&hpw

Factory Efficiency Comes to the Hospital

By JULIE WEED
Published: July 9, 2010

SEATTLE

TWO years ago, the supply system at Seattle Children’s Hospital was so unreliable that Susanne Matthews, a nurse in the intensive care unit, would stockpile stuff — catheters in the closet, surgical dressings in patients’ dresser drawers and clamps in the nurse’s office. And she wasn’t the only one.

“Nurses get very anxious when we can’t get our hands on the tools we need for our patients,” Ms. Matthews says, “so we grabbed them when we saw them, and stashed them away.” This, in turn, made the shortages more acute.

On a busy day last month in the I.C.U., it took Ms. Matthews just a few seconds to find the specialized tubing she needed to deliver medicine to an infant recovering from heart surgery. The tubing was nearby, in a fully stocked rack, thanks to a new supply system instituted by the hospital early last year following practices typically used in manufacturing or retailing, not health care.

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http://healthcareitnews.com/news/healcam-offers-new-model-health-info-and-support

HealCam offers new model for health info and support

July 08, 2010 | Mike Miliard, Managing Editor

EL GRANADA, CA – Medgadget, an El Granada, Calif.-based blog that's maintained by a group of doctors and biomedical engineers from around the world, has announced the beta release of a new interactive online service for people with medical conditions.

HealCam (healcam.com) is a video chat site designed by Medgadget (medgadget.com) members that enables users to speak, on camera and in real time, with other people who share conditions such as diabetes or depression.

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http://www.modernhealthcare.com/article/20100712/NEWS/100709924

Putting IT to work

By Joseph Conn / HITS staff writer

Posted: July 12, 2010 - 12:00 pm ET

The nine winners of this year's annual awards for outstanding achievement in applied medical informatics from the Association of Medical Directors of Information Systems share a common theme, according to AMDIS President William Bria—they know how to employ information technology to get the patient-care improvement job done.

The AMDIS competition previously yielded as winners many physician champions who led their organizations through the perilous waters of vendor selection and systems implementation.

Read profiles of the AMDIS award winners

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http://www.fiercehealthit.com/story/health-systems-embracing-single-sign-while-still-working-out-bugs/2010-07-12

Health systems embracing single sign-on while still working out the bugs

July 12, 2010 — 12:44pm ET | By Neil Versel

Holy Spirit Hospital in Camp Hill, Pa., has greatly streamlined the process of logging on to its Eclipsys EMR by implementing biometric technology for single-sign-on access.

"SSO definitely saves time logging in to the network, and subsequently into individual applications," Chief Medical Information Officer Dr. Richard Schreiber tells CMIO magazine. "There is no doubt that going up to an SSO machine, putting my finger down and getting into the network to quickly jump into an application within a few seconds is clearly an advantage."

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http://www.fiercehealthit.com/story/microsoft-touts-cloud-computing-healthcare-providers-wait-better-security/2010-07-12

Microsoft touts cloud computing in healthcare as providers wait for better security

July 12, 2010 — 12:09pm ET | By Neil Versel

While acknowledging the myriad privacy and security concerns about cloud computing, a top Microsoft healthcare official is touting the technology as an affordable means of network maintenance, health information exchange and strengthening relationships between hospitals and referring physicians.

"Cloud computing promises enormous benefits for [the] healthcare world," Steve Aylward, Microsoft's U.S. general manager for health and life sciences, writes on the company's blog. "These could include improved patient care, better health for the overall populations providers serve and new delivery models that will make healthcare more efficient and effective. And cloud computing can help do all of this in a cost-effective way.

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Enjoy!

David.

Thursday, July 22, 2010

The Spin Just Seems To Go On and On. With the Health Identifier Legislation Passed We Deserve The Promised Transparency.

The following appeared late yesterday.

Medicare snoops escape sack

  • Karen Dearne
  • From: Australian IT
  • July 21, 2010 5:05PM

NO Medicare staffers have been sacked for snooping on confidential client records, with most privacy breaches resulting in an emailed warning only.

Medicare has revealed that 51 staff members made "unauthorised access" to customer information held by the agency in the first six months of 2009-2010.

.....

Medicare has also confirmed it spent $48.7 million on building the identifier system, under a two-year contract with the National e-Health Transition Authority originally worth $57 million. NEHTA received $98 million in funding for the project from the Council of Australian Governments.

NEHTA chief executive Peter Fleming told The Australian tenders would soon be issued for private sector partners for a range of e-health programs, including implementation of the identifier service switched on by Medicare this month.

However, the only way medical practitioners or healthcare organisations can presently obtain their patients' individual healthcare numbers is by phoning Medicare.

None of the major software-makers are ready to supply the necessary interfaces to link doctors' systems with the new service as technical specifications were only released last month.

Full Article Here:

http://www.theaustralian.com.au/australian-it/government/medicare-snoops-escape-sack/story-fn4htb9o-1225895209553

What is most important – other than the obvious point that Medicare can’t seem to actually control its employees – is that the last four paragraphs reveal just how little has actually been achieved in the implementation of the Health Identifier Service, and how spectacularly expensive it seems to have been so far – for so little apparent progress.

It makes really good sense that the facts as to just how these funds were expended gets revealed by an audit as discussed here.

http://aushealthit.blogspot.com/2010/07/what-excellent-idea-long-overdue.html

This should happen well before further large scale funds are committed.

If the only access to the HI service is by telephone, one wonders just what has exactly been developed so far other than an implementation of a data-base schema in something like DB2 and development the various access paths and controls as outlined in the ‘Concept of Operations’.

We learn further on the electronic interfaces etc are still a ‘twinkle’ in the developers eyes – so I guess there will be more continuing cost.

Has anyone else wondered just why there has not been disclosure of the predicted ongoing operational costs of the HI Service and who is actually going to be funding this in perpetuity? It would be a bit sad if it got going and was then defunded a few years later – unless of course it wasn’t being used to any substantial level. Without some incentives for providers to adopt the HI Service this is, of course, a real risk.

Of course there is also the small matter that there is no public business case to justify all this. One wonders just where that is hiding in the era of so-called ‘open government’.

We can be sure it won’t be anywhere near free!

Now the legislation is passed, all this should be on the public record I believe. We could do with the transparency promised here:

http://www.theaustralian.com.au/australian-it/nehta-puts-finishing-touches-to-health-identifier-plan/story-e6frgakx-1225890944023

Nehta adds final touches to e-health

· Fran Foo

· From: The Australian

· July 13, 2010 12:00AM

“Mr Fleming was happy with NEHTA's progress.

"When I joined, the commitment was by July 1 we would have the identifiers in place, and that was delivered," he said.

Unique healthcare identifiers were "created" by Medicare on July 1 for more than 96 per cent of the population.

He accepted that there were multi-faceted challenges in setting up e-health system and vowed to be as transparent as possible. The key to success would be change management.”

One also wonders just what NEHTA is going to go to tender for. They will make very interesting reading indeed when released!

David.

Wednesday, July 21, 2010

This May Be A Further Blow to Progress with the Health Identifier Service.

The following appeared a day or so ago.

Health staff unable to work as agency overloaded

KATE BENSON

July 17, 2010

Hundreds of desperately needed doctors and nurses have been told it could be months before they can work because of ''incompetent bungling'' by a new federal government agency which did not employ enough staff to answer phones.

The Australian Health Practitioner Regulation Agency is now responsible for registering and accrediting more than 560,000 health workers nationally but has been in meltdown since opening two weeks ago.

Its office has been swamped with more than 3000 calls a day, forcing it to outsource inquiries to an external call centre and set up new state-based phone numbers to spread the load.

The agency, which takes over the work of 85 smaller state-run boards, was designed to reduce costs and multiple layers of red tape but health workers say the transition has been bungled and the service was launched without adequate resources.

They complain that phones are not attended, staff have not been adequately trained and registrations are not being processed.

The bungle affects a wide range of health workers, including overseas-trained doctors recruited to work in Australia, and nurses, dentists, pharmacists, physiotherapists, chiropractors, optometrists, psychologists and osteopaths wanting to renew their registrations or register for the first time.

.....

''It is another case of incompetent government bungling and the backlog is putting huge pressure on hospitals and patient care,'' said Chris Tsolakis, the director of the recruitment agency Medipeople.

.....

A spokeswoman for the agency conceded there had been ''teething problems'' because the project, which required moving about 1.5 million records, some which were not computerised, to one IT system, had been ''very ambitious''.

......

The chairwoman of the Medical Board of Australia, Joanna Flynn, said doctors had been asked not to contact the new agency for the first 10 days to avoid overloading it during the transition phase.

.....

The vice-president of the Australian Doctors Trained Overseas Association, Sue Douglas, said it was unacceptable that doctors were being prevented from working because of problems with the introduction of the new agency.

''This has been three years in the making,'' Dr Douglas said.

''You'd think it would have been ready, but it doesn't surprise me.

''The old system was so incredibly cumbersome, such a bureaucratic bungle of inefficiencies, that how could the new one be any better?''

''This just wreaks havoc on doctors' livelihoods and on patients.''

Full article here:

http://www.smh.com.au/federal-election/health-staff-unable-to-work-as-agency-overloaded-20100716-10e72.html

Looks like we have another ‘pink bats’ or ‘BER’ saga building here. I have to say it sounds like a bit of an unplanned administrative messs.

We really can’t have the situation like the one reported in 6minutes.com.au last very long!

Medical board meltdown

by Jared Reed

The new national medical board has had to revert to state-based reporting of medical complaints after being swamped by enquiries over registration details.

The Australian Health Practitioner Regulation Agency says it is fielding 3000 enquiries per day for medical and other health practitioners, which along with IT problems has forced it to redirect complaints handling back to the states.

AHPRA says it will publish state-specific phone numbers within the next 24 hours to ensure “concerns can be raised efficiently about individual practitioners.”

See:

http://www.6minutes.com.au/articles/z1/view.asp?id=520375

There are few implications of all this.

First if just creating a professionals register of 560,000 people works this well one wonders just how the Government will all go with the with the HI Service establishment involving 20+ million people.

Second, given practitioner authentication is to be based on these registration records, we can be pretty sure any planned progress for the National Authentication System for Health (NASH) won’t be running as smoothly as might have been hoped. I am sure this will all get fixed at some point – the only question really is when. This does not have the feel of a quick fix.

Third the implications for health service delivery of having professional registration and re-registration delayed or made uncertain are obvious!

This is a sense that this might be a bit too accident prone to me!

David.

A Trivial Bit of Site News

The usage of the blog has steadily grown - especially over the last year.

This does seem like a bit of a milestone however.

PAGE VIEWS

Total300,018
Average Per Day376
Average Per Visit1.6
Last Hour21
Today224
This Week2,635

Thanks to all those visitors!

David.

Tuesday, July 20, 2010

A Sobering Tale of A Mess in E-Health in Holland.

The following appeared a while ago

Dutch EHR plans put on hold

09 Jul 2010

Holland may have flown high in the World Cup but plans for a national electronic health record system now look set to go into extra time, Ton Smit reports.

Plans for a national Electronic Health Record in the Netherlands have been put on hold after the Dutch Senate voted to make major changes to the national programme.

Until the EHR legislation is approved the Dutch EHR programme will no longer be mandatory. Care providers will now only be allowed to link to the national EHR on a strictly voluntary basis.

In addition, there will be no more financial incentives to encourage GPs, pharmacists and hospitals to link to the national EHR infrastructure.

In the proposed legislation individual providers who refuse to connect to the national infrastructure face potential €33,500 fines.

The proposed EHR legislation fell into disgrace, after too many amendments were introduced. Many Senators also felt that the wrong technological model had been adopted. The Dutch EHR system is based on a pull model that dynamically pulls together records from local source systems.

The Dutch EHR is based on an online medication list and a patient medical summary for GPs.

The rollout of these two core services will now continue on a strictly voluntary basis –without financial carrot/stick incentives from The Hague.

In addition the Department of Health (VWS) will not be allowed to add new functionality to the present EHR rollout.

Considerable delays are likely as the legislation will probably be returned to Parliament. This decision will be made in two months.

Indonesian born Dutch Labour MP, Ing Yoe Tan, who was a key mover in the legislative changes- expects a delay of at least one year.

Much more here:

http://www.ehealtheurope.net/comment_and_analysis/608/dutch_ehr_plans_put_on_hold

Please read the whole article. This is a sobering tale that shows how badly these mega-projects can go if not managed to fully engage both the public and the providers.

A salutary lesson for both NEHTA and DoHA as they dream the their ‘greata bigga system’!

Much better to go ground up – or even ‘middle out’ – rather than top down, which seems to be the only way some of the bureaucrats are thinking.

Be afraid, very afraid is all I can say!

Monday, July 19, 2010

AusHealthIT Poll Number 27 – Results – 19 July, 2010.

The question was:

Do You Believe Clinicians Should be Obliged To Provide Information For Patient Held Records Under Threat of Medicare Payment Withholding?

For Sure

- 18 (51%)

Probably

- 4 (11%)

Neutral

- 3 (8%)

Probably Not - Without Incentives

- 4 (11%)

Not At All Without Cost Recovery

- 6 (17%)

Votes: 35

I was surprised by this outcome. I would argue that if you want quality, usable information then you are going to have to provide some incentive for the providers to assemble and transmit the information.

Obviously a good many don’t agree with that view. We shall see if we ever get to the stage where the workability of this proposal is tested.

Again, many thanks to all those who voted!

David.

What an Excellent Idea! – A Long Overdue Intervention in Australian E-Health.

I spotted this a few days ago

E-Health, Gershon face progress audit

By Luke Hopewell, ZDNet.com.au on July 16th, 2010

The Australian National Audit Office (ANAO) has flagged possible audits into the Federal Government's progress on e-health and the implementation of the Gershon Review recommendations.

The office's 2010/11 work report, released today, contains over 130 pages of current and proposed government audits.

It mentions a possible audit of the Department of Health and Ageing's national e-health implementation scheme to investigate management and co-ordination strategies used in deploying e-health in Australia.

In the 20010/11 budget, the Rudd Government made a hefty financial commitment to the implementation of e-health records in Australia, allocating $466.6 million to the scheme. Earlier this month, Health Minister Nicola Roxon laid out a "roadmap to reform" for the next two years, providing an overview of the national e-health deployment plan.

More here:

http://www.zdnet.com.au/e-health-gershon-face-progress-audit-339304592.htm

A bit of checking found that few days ago the Australian National Audit Office published their draft work program for 2010-11.

The full document can be found here:

http://www.anao.gov.au/uploads/documents/2010_Audit_Work_Program1.pdf

The document title is as follows.

Australian National AUDIT Office

AUDIT WORK PROGRAM JULY 2010

Where is gets really interesting is in the proposals for some audits that are still not locked in but planned for next year.

There are two that would make a riveting read.

On Page 73 we read.

National E-Health Implementation

In the 2009−10 budget, the Australian Government committed $57 million to E-Health to facilitate the transition of paper-based clinical record keeping to electronic means for better information exchange to deliver safer, more efficient, better quality healthcare.

Over the period July 2009 to June 2012, the National E-Health Transition Authority (NEHTA) will deliver key components of the National E-Health Strategy, endorsed by Australian Health Ministers in late 2008. The Council of Australian Governments (COAG) has agreed to provide $208 million to NEHTA, with 50 per cent funded by the Commonwealth and the remainder by the states and territories under the COAG funding formula.

An audit would examine DoHA’s management and co-ordination of E-Health developments within DoHA and with state/territory governments.

And this would be fun also

Page 84

Medicare Australia’s Role in the Development of the Unique Healthcare Identifier (UHI) Service

The provision of modern health care requires a greater sharing of health information between practitioners. The Unique Healthcare Identifier (UHI) will identify patients, practitioners and organisations involved in health care across Australia, and provide assurance regarding the identity of health records being communicated electronically.

In December 2007, the National E-Health Transition Authority (NEHTA) signed a two-year, $51.6 million contract with Medicare Australia to design, build and test the UHI Service, which was to be delivered in December 2009.

An audit would examine Medicare Australia’s role in the development and delivery of the UHI Service, including the management of the contract with NEHTA.

----- End Quotes.

There is really little to say about this other than I would really look forward to highly constructive audits that might improve things a little!

I wonder who suggested these audits to the ANAO?

David.

Sunday, July 18, 2010

Australian Medical Journal (and clearly the AMA) Lose Faith in NEHTA.

There is an amazing editorial in the just released Medical journal of Australia. It is a MUST read for all those interested in Australian e-Health.

Read it here:

http://www.mja.com.au/public/issues/193_02_190710/van10637_fm.html

The key to what it is being said is here:

“Since its inception in July 2005, NEHTA has been spending just under $164 000 a day.7 It is yet to deliver any e-health outcomes beyond a 2009–2012 strategic plan and the development of a national health care identifier system that was recently ratified by the Australian Government.10

In May this year, the federal government allocated NEHTA a further $466.7 million over 2 years, ostensibly to fund development of core national standards and tools that can provide all Australians with access to a personally controlled electronic heath record from 2012–13. The federal government will thus spend $639 315 each day on the implementation of personally controlled electronic health records.7 Despite this, vigorous debate is ongoing as to who will actually control the records! Confusion reigns.

It must be remembered that the realisation of e-health infrastructure in Australia is underpinned by taxpayers. Whether it will ever produce a functional electronic communication and record system, which actually improves health care delivery, is the million-dollar question.”

----- End extract and read the rest at the site above.

What a massive and stupid mess up this is, as this blog has been reporting for as long as it has existed.

This is truly ‘game on’ for the arrogance of NEHTA and my sense is, whatever happens at the election, we will see great changes follow!

This is a game changer that both parties cannot ignore! NEHTA has just moments to show it is either useful, or that it needs to be put out of its misery. Clearly the latter, with relevant safeguards to protect the limited value we have had for all this money, is the right course.

David.