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."

Tuesday, September 14, 2010

Weekly Australian Health IT Links – 13 September, 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 subscription payment.

General Comment:

A very interesting week with a new Government established and a new Cabinet put in place a day or so ago.

It will be a little while until we can form a view as to how it will all work out.

Specific e-Health and Internet and NBN matters will doubtless become clearer over coming weeks.

We will just have to ‘stand by’.

-----

http://www.theaustralian.com.au/australian-it/information-revolution-transforms-healthcare/story-e6frgakx-1225915000159

Information revolution transforms healthcare

ARCHITECTS, doctors and IT professionals are discussing how technology can transform healthcare services.

The discussion comes as public hospital projects worth more than $33 billion are in the design or construction phase nationally.

A two-day digital hospital design workshop in Melbourne attracted 130 people, who planned to explore ways of overcoming healthcare and workforce problems through better operational processes and more integration with primary care.

NSW Children's Hospital Westmead information services and planning director Ralph Hansen said connectivity and integration through technology had changed healthcare delivery.

-----

http://www.theaustralian.com.au/news/health-science/aiming-for-co-ordinated-care-public-hospitals-are-undergoing-a-quiet-revolution/story-e6frg8y6-1225916794259

Aiming for co-ordinated care: public hospitals are undergoing a quiet revolution

  • Karen Dearne, IT writer
  • From: The Australian
  • September 11, 2010 12:00AM

PUBLIC hospitals are undergoing a quiet, if stop-start, revolution.

They are moving away from "doctors' egos and heroic interventions" to a culture of teamwork and community outreach. The shift is reflected in a new willingness among medicos, architects, administrators and technologists to hammer out key design issues together.

At stake is the $33 billion or so being spent on facilities under construction or being planned across the nation. These new hospitals will form the healthcare backbone for the next 50 to 60 years.

Reflecting a keen interest to get it right, this month 130 doctors, nurses, architects and information technology professionals gathered in Melbourne for a two-day Digital Hospital Design workshop hosted by Sydney-based Cisco Systems.

"For a long time, healthcare IT was about delivering a piece of information; now it's about bringing people together," explains Brendan Lovelock, Cisco's health practice leader. "We're discussing ways to combine IT with the built environment to make hospitals more effective and create better experiences for patients."

-----

http://www.theaustralian.com.au/australian-it/government/acs-calls-for-it-ministry/story-fn4htb9o-1225915501001

Election result a win for IT, e-health

  • Fran Foo, Karen Dearne
  • From: Australian IT
  • September 07, 2010 5:52PM

THE Australian Computer Society has renewed calls for a minister dedicated to an IT portfolio as industry awaits a new Finance Minister.

The call was made as key rural independents Rob Oakeshott and Tony Windsor decided to back Labor, giving Julia Gillard the numbers to form the next government.

Mr Windsor said the most critical issue to winning his support was Labor's NBN.

"To miss that opportunity for millions of country Australians was too good an opportunity to miss ... you do it once, you do it right and you do it with fibre," Mr Windsor told reporters today in Canberra.

ACS chief executive Bruce Lakin hopes the Gillard government will consider consolidating IT into a single portfolio. He lamented the fact that in the past there have been instances where the ACS had to deal with several ministers to resolve a single IT issue.

-----

http://www.motioncomputing.com/about/news/press_release_081210.asp

Aged Care Residential Home Chooses Tablet PCs to Drive Mobility and Paperless Initiative

Motion’s new C5v Mobile Clinical Assistant ‘sold itself’ as mobile wireless solution

SYDNEY and AUSTIN, TX – August 12, 2010 – Residential aged care home Jacaranda Village is one of the first Australian healthcare organisations to take delivery of the new Motion C5v Mobile Clinical Assistant (MCA) as it commits itself to mobility solutions and aims to be paperless within two years.

The aged care facility ordered the new Motion C5v for nursing staff through Melbourne-based aged care solutions experts Axishealth; and early reaction to the new wireless technology is universally enthusiastic.

Jacaranda Village CEO Susan Bowditch said that they wanted to work more efficiently, while operating within their limited resources. “We have been working for some time finding ways to work smarter. So far this has generally been in areas of work practices and equipment, such as trying to cut down staff time spent walking up and down corridors. This is our first serious venture into technology solutions.

“We discussed our goal of going paperless for greater efficiency with Axishealth’s Doug Smith, who suggested adding a solution of mobile tablet PCs to more efficiently use our specialist aged care software i-Care.

-----

http://www.whatech.com.au/technology-releases/enterprise-software/2606-jacaranda-healthcare-launches-landmark-electronic-hospital-information-system-in-papua-new-guinea

Jacaranda Healthcare Launches Landmark Electronic Hospital Information System in Papua New Guinea

Technology Releases - Enterprise Software

Today Australian-based Jacaranda Healthcare launched Papua New Guinea’s first Electronic Hospital Information System with the Deputy Prime Minister of Papua New Guinea, Don Polye present.

Ken Blaikie, Director of Jacaranda Healthcare said that through the vision of the Directors of the Port Moresby Private Specialist Medical Centre, a major step forward has been taken for health management in Papua New Guinea.

The software system being implemented by Jacaranda Healthcare allows for seamless access of data between multiple hospital departments and ensures patient information is instantly available to suitably authorised healthcare workers. Delivering significant improvements in the coordination of general medical services, specialist medical consultations, pharmacy, radiology, pathology, dental, obstetrics, minor surgery and other services within the centre.

“This will increase patient care standards and improve the efficient use of resources within the Centre. The system will also allow virtually unlimited expansion of services and users, future-proofing the use and access to vital health information.

----

http://www.smh.com.au/nsw/hospitals-failing-to-treat-critical-cases-on-time-20100909-153aq.html

Hospitals failing to treat critical cases on time

Julie Robotham

September 10, 2010

BIG regional hospitals are struggling to treat on time emergency department patients who need urgent attention, according to independent statistics that highlight a continuing bottleneck in the NSW health system.

The figures reveal a big variation across the state in how quickly patients in triage category 3 - whose condition is deemed ''potentially life threatening'' - are able to begin receiving medication or recommended treatment.

Government benchmarks say 75 per cent of such patients should start their treatment within 30 minutes of being assessed by the triage nurse.

But at Manning Base Hospital only 50 per cent were able to do so. At Calvary Mater in Newcastle the figure was 53 per cent, while at Lismore, Tamworth and Port Macquarie Base hospitals it was 56, 60 and 61 per cent, respectively.

-----

http://www.misaustralia.com/viewer.aspx?EDP://1284080364109&section=news&xmlSource=/news/feed.xml&title=Aged+care+turns+away+from+Microsoft

Aged care turns away from Microsoft

Australia's aged-care industry has started rapidly developing low-cost alternatives to Microsoft's proprietary products after not-for-profit providers were slugged with licensing fee increases of up to 400 per cent by the software giant.

-----

http://www.theaustralian.com.au/australian-it/clinical-systems-clarify-medical-messages/story-e6frgakx-1225915000454

Clinical systems clarify medical messages

CHANGING demands in healthcare are behind changes in technology used in hospitals, Cisco Systems health practice lead Brendan Lovelock says.

"Ten years ago, IT in hospitals was all about accounting and building management systems, and if you were lucky there was a basic patient administration system," Dr Lovelock said.

"Now, health IT is an integral part of the clinical process, from intelligent monitors talking to the medication management system and collaboration not only internally but also with the patient's GP, family and other carers back in the community."

"Patient-centric" care relies on more effective communication and collaboration between all parties.

-----

http://www.tradingmarkets.com/news/stock-alert/occaf_isoft-brothers-turn-full-circle-1151106.html

iSoft brothers turn full circle

Posted on: Sun, 05 Sep 2010 17:36:06 EDT

Symbols: OCCAF

Sep 05, 2010 (The Australian Financial Review - ABIX via COMTEX) --

Gary Cohen resigned as CEO of iSoft after the firm he co-founded posted a $A382 million net loss for 2009-10. It is only three months since Cohen, who founded the firm with brother Brian, quit as chairman so that leading shareholder Oceania Capital Partners could put its MD, Robert Moran, into the role. Experts disagree about whether iSoft will enter administration or undergo a trade sale. The firm has survived rocky patches in the past.

Publication Date: 4 September 2010

-----

http://www.e-health-insider.com/news/6223/darent_valley_first_with_isoft_kiosks

Darent Valley first with iSoft kiosks

08 Sep 2010

ISoft has won a deal to provide Dartford and Gravesham NHS Trust with five self-service kiosks, which will be used to cut queues and reduce the pressure of incoming patients on reception and nursing staff.

The deal is iSoft’s first sale of Savience kiosks since agreeing a partnership with the company in February.

The kiosks will be implemented in Darent Valley Hospital’s reception area and fracture clinic and will allow patients to check-in for appointments and update their demographic information.

Paul Wilson, the trust’s outpatient project manager, said they should also help to cut 'did not attend' rates.

-----

http://www.e-health-insider.com/news/6230/little_change_on_lsp_contracts:_connelly

Little change on LSP contracts: Connelly

10 Sep 2010

The Department for Health’s director general for informatics has emphasised that local service provider contracts are still in place; although negotiations with CSC have yet to be concluded.

In a briefing at Richmond House to expand on a ministerial statement about the future of NPfIT, Christine Connelly said: “The Coalition government looked at the [BT and CSC] contracts and the best way to provide value for money is to fully honour them."

However, she added: "We will be looking to reduce what we spend both with suppliers and internally.”

She also confirmed that trusts choosing to go outside the programme will have to pay for systems themselves.

-----

http://www.theregister.co.uk/2010/09/10/npfit_erm/

NHS IT juggernaut rumbles on

Coalition's conservative cuts

Analysis The major casualty of an overhaul of NHS IT has been revealed. The National Programme for IT (NPfIT) is no more - up to a point.

The death of an unwieldy acronym is hard to mourn, but otherwise the coalition's changes to the scheme are marginal. Indeed, if anyone is to suffer as a result of the decision to trim £700m from the scheme, it's unlikely to be BT or CSC, the last contractors standing.

Christine Connelly, the Department of Health's director general of informatics since 2007, insisted yesterday their multibillion pound contracts will be honoured by taxpayers.

"The best way to deliver value is to honour the contracts," she said.

-----

http://www.theaustralian.com.au/australian-it/government/regional-areas-an-nbn-priority-gillard/story-fn4htb9o-1225915505553

Regional areas an NBN priority: Gillard

  • Joe Kelly, Fran Foo
  • From: Australian IT
  • September 07, 2010 6:02PM

JULIA Gillard said the federal government will work with NBN Co to ensure a priority roll out in regional Australia based on a uniform wholesale price.

Ms Gillard said the initiative would equalise the cost of telecommunications across the country, noting that a normal phone call from Tamworth to Sydney currently costs more than a local call made from within Sydney.

"Obviously we will be working through with NBN Co to do this priority roll out in regional Australia," she told reporters in Canberra today after rural independents Tony Windsor and Rob Oakeshott threw their support behind Labor allowing her to form the next government.

-----

http://www.theaustralian.com.au/national-affairs/deal-on-national-broadband-network-to-cost-billions/story-fn59niix-1225916138585

Deal on National Broadband Network to cost billions

  • Mitchell Bingemann and Anthony Klan
  • From: The Australian
  • September 09, 2010 12:00AM

JULIA Gillard's promise to deliver the ambitious National Broadband Network to regional areas before major cities will cost taxpayers billions of dollars and undermine the project's business case, the opposition has warned.

The Prime Minister promised to roll out the $43 billion NBN to regional areas first as part of a deal to secure the support of two independents needed to form a minority government.

But opposition finance spokesman Andrew Robb warned yesterday that rolling out the NBN to the bush before lucrative metropolitan markets could jeopardise the project's economic case.

"The NBN business plan was to minimise the cost of the rollout and keep the maximum public exposure to $26bn by first attaining a critical mass in the cities that would allow them to generate revenues to assist the regional rollout, but now that whole thinking has been turned on its head," Mr Robb told The Australian.

-----

http://www.theaustralian.com.au/business/redrawn-nbn-rollout-to-put-rural-users-first/story-e6frg8zx-1225916099298

Redrawn NBN rollout to put rural users first

THE government and the NBN Co will meet in coming days to tweak the business case for the ambitious $43 billion National Broadband Network.

The changes are intended to ensure that broadband-starved users are the first to receive the promised superfast internet services.

After a seven-week moratorium on the NBN's work schedule -- upheld during the lead-in to the election -- NBN Co chief executive Mike Quigley can get back on with his job of connecting 93 per cent of the nation to a fibre-to-the-home network capable of 1000 megabit-per-second internet access speeds.

However, the task of completing the eight-year build will now take on new direction, as the concessions required to secure the support of the key rural independents Rob Oakeshott and Tony Windsor mean broadband-deprived rural areas will be the first to be connected.

-----

http://www.theaustralian.com.au/business/telco-sees-nbn-pitfalls/story-e6frg8zx-1225916117381

AAPT chief executive Paul Broad sees NBN pitfalls

THE head of the nation's third-biggest telco has warned that the National Broadband Network could duplicate existing fibre in some areas.

He also said there were no guarantee that increased competition would lead to better prices.

"We've got fibre running down the centre of (independent MP) Tony Windsor's electorate -- I don't know if he knows that," said AAPT chief executive Paul Broad.

"We've got 24 strands of fibre up and down the east coast and we're only using two of them.

"Our number one worry is that we're going to re-nationalise the network and overbuild what's already there."

-----

http://www.theaustralian.com.au/national-affairs/industry-demands-nbn-cost-benefit-analysis/story-fn59niix-1225916766974

iiNet chief executive demands NBN cost-benefit analysis

  • Tracy Lee, Mitchell Bingeman
  • From: The Australian
  • September 10, 2010 12:00AM

THE country's third-largest internet service provider has renewed calls for a cost-benefit analysis of the National Broadband Network.

iiNet chief executive Michael Malone argued that any subsidy to provide access in rural and remote areas should be transparent.

"The one thing that's been missing from this debate is transparency. When [former prime minister] Kevin Rudd and [Communications Minister] Stephen Conroy came to power, they promised transparency but they've reneged on that," he said.

With the NBN rollout set to prioritise rural areas ahead of urban centres, there is speculation the change in implementation will push out the timeframe for the project to achieve a commercial return and could require a subsidy to connect the most remote users.

-----

http://www.theaustralian.com.au/australian-it/government/isp-filter-plan-could-be-buried/story-fn4htb9o-1225915395171

ISP filter could be buried

  • Fran Foo
  • From: Australian IT
  • September 07, 2010 3:44PM

LABOR'S controversial internet filter plan faces near-death despite the ascension of Julia Gillard as Australia's 28th prime minister.

Ms Gillard won the backing of independent MPs turned powerbrokers Tony Windsor and Rob Oakeshott despite Bob Katter supporting the Coalition and Tony Abbott.

The country has been in limbo since the August 21 poll didn't deliver an outright winner.

Labor went into the 2007 election pledging to censor the internet but since then Communications Minister Stephen Conroy has changed the shape of his plan several times. At last count Senator Conroy ordered a 12-month review into how refused classification content is rated.

Labor's mandatory filtering program will force all internet service providers to block web pages rated as refused classification on a secret blacklist.

The Coalition vowed to dismantle the plan regardless of last month's election outcome. And with the Greens set to hold the balance of power in the Senate from next July, it is almost certain Labor's filtering aspirations are as good as dead.

-----

http://www.computerworld.com.au/article/360154/fact_fiction_top_8_linux_myths_debunked/?eid=-219

Fact or fiction? Top 8 Linux myths debunked

Think Linux is just for experts, or that it's less secure than Windows or Mac OS? It's time to dispel such false perceptions

If the idea of using Linux in your business is one that makes you nervous, chances are you've fallen prey to one or more of the many myths out there that are frequently disseminated by competing vendors such as Microsoft. After all, each Linux user means one less sale for such companies, so they have a powerful motivation to spread such FUD.

In fact, the ranks of businesses and government organizations using Linux grows every day, and for good reason: it's simply a good business choice. Let's take a look, then, at some of the top anxiety-causing myths and dispel them once and for all.

----

Enjoy!

David.

Monday, September 13, 2010

More Evidence About How Hard Mega Projects Are and How There Are Probably Better Ways.

A few days ago an important paper was published in the British Medical Journal.

BMJ 2010; 341:c4564 doi: 10.1136/bmj.c4564 (Published 2 September 2010)

Cite this as: BMJ 2010; 341:c4564

Implementation and adoption of nationwide electronic health records in secondary care in England: qualitative analysis of interim results from a prospective national evaluation

  1. Ann Robertson1,
  2. Kathrin Cresswell1,
  3. Amirhossein Takian2,

For full list see the paper - there are about 20!

  1. Correspondence to: A Sheikh, professor of primary care research and development, aziz.sheikh@ed.ac.uk
  • Accepted 5 August 2010

Abstract

Objectives To describe and evaluate the implementation and adoption of detailed electronic health records in secondary care in England and thereby provide early feedback for the ongoing local and national rollout of the NHS Care Records Service.

Design A mixed methods, longitudinal, multisite, socio-technical case study.

Setting Five NHS acute hospital and mental health trusts that have been the focus of early implementation efforts and at which interim data collection and analysis are complete.

Data sources and analysis Dataset for the evaluation consists of semi-structured interviews, documents and field notes, observations, and quantitative data. Qualitative data were analysed thematically with a socio-technical coding matrix, combined with additional themes that emerged from the data.

Main results Hospital electronic health record applications are being developed and implemented far more slowly than was originally envisioned; the top-down, standardised approach has needed to evolve to admit more variation and greater local choice, which hospital trusts want in order to support local activity. Despite considerable delays and frustrations, support for electronic health records remains strong, including from NHS clinicians. Political and financial factors are now perceived to threaten nationwide implementation of electronic health records. Interviewees identified a range of consequences of long term, centrally negotiated contracts to deliver the NHS Care Records Service in secondary care, particularly as NHS trusts themselves are not party to these contracts. These include convoluted communication channels between different stakeholders, unrealistic deployment timelines, delays, and applications that could not quickly respond to changing national and local NHS priorities. Our data suggest support for a “middle-out” approach to implementing hospital electronic health records, combining government direction with increased local autonomy, and for restricting detailed electronic health record sharing to local health communities.

Conclusions Experiences from the early implementation sites, which have received considerable attention, financial investment and support, indicate that delivering improved healthcare through nationwide electronic health records will be a long, complex, and iterative process requiring flexibility and local adaptability both with respect to the systems and the implementation strategy. The more tailored, responsive approach that is emerging is becoming better aligned with NHS organisations’ perceived needs and is, if pursued, likely to deliver clinically useful electronic health record systems.

The full paper is accessible from here (free) along with some additional web-only material.

http://www.bmj.com/content/341/bmj.c4564.full

What I found most interesting in this were the voices of the individual clinicians who clearly seemed to recognise the value in a working system but who were frustrated about the inflexibilities, slowness and inefficiencies that seemed to be associated with reaching a practical end-point.

It is also clear that and complex system implementation needs to be addressed at a coherent organisation that can work well internally to solve problems. This means there needs to be, in my view, implementation flexibility at the level of the area health service or region. The approach of state-wide implementations and equally the approach of giving every tiny organisation too much choice in how they proceed both seem to be problematic - as we have seen here in Australia.

The key to success I believe is to be clear just what aspect of any initiative need to be locally driven, what needs to be state driven and what should be nationally consistent. Getting this right can save a lot of money and angst!

This work and the papers that follow will become regarded as classics of the Health IT literature and those who worked on it are to be congratulated.

The lessons are pretty clear. I hope the relevant authorities are listening.

David.

Educational Pre-Conference Seminar Announcement - System Dynamic Modelling in the Emergency Department.

Here is the information from the web-site:

Systems Thinking and Modelling for Health: The Emergency Department-Medical Imaging interface with a focus on Patient Flow Improvement

Date: Wednesday 10 November 2010

Time: 2:00pm - 5:00pm

Location: Swiss Grand Bondi Beach

Cost: $50 per person (includes afternoon tea)

REGISTER NOW

*Delegates who have already registered for the conference, please contact Conference Works directly on Ph: 03 9870 2611 Email: events@conferenceworks.net.au

The health care system is a complex collection of interactions. Navigating the health care system is an increasingly difficult and frustrating task. This applies for patients, carers, clinicians, policy makers, funders, politicians and citizens. This is particularly true in the Emergency Department, and an emerging focus of attention is the clinical interface between Emergency Medicine and Medical Imaging. This focus has included aspects of patient safety, quality of care, communication/teamwork, and error including diagnostic error. Inappropriate use of imaging, and the downstream impacts on patient flow, and ED overcrowding, is also on the radar. Recent healthcare reforms now mean there is an quality improvement imperative in the Emergency Department with a specific emphasis on identifying and removing impediments to patient flows. This workshop will therefore be of specific interest to those involved in analysing and improving patient flows in Emergency Departments and Medical Imaging.

A continual stream of new technologies and health conditions adds a dynamic dimension to this confusing world. These advances in biomedical knowledge and technologies have forced specialized clinicians and policy makers to focus on understanding and analyzing the parts of the system rather than taking an overall systems approach. Tools and methods for understanding complexity and designing social systems are being developed and applied, particularly in the systems science and engineering disciplines. Their use in healthcare, including at the Emergency Medicine-Medical Imaging interface, is increasing with the wider availability of powerful computer simulation tools which can be applied to patient flow issues in the Emergency Department for example.

However, overall uptake has been slow due to health professionals’ lack of familiarity with the concepts, technical language and tools required to tackle the dynamics of complex systems. One such tool is system dynamics modelling.

In this workshop, simple computer models will be used to teach health professionals and researchers with minimum or no experience in modelling some of the key health system dynamics applicable in real world problems such as those found in the Emergency Department. This will be a hands-on workshop using computer models to understand the concept of how structure determines behaviour by running virtual “what-if” experiments. This will include patient flow in the Emergency Department, and the impact of Emergency Department-Medical Imaging interface interactions.

Audience/Key participants:

Emergency Department staff,

Medical Imaging staff,

Managers/Administrators,

Quality, Safety, Performance and Risk staff,

Quality and systems researchers

Learning Outcomes:

You will understand the difference between process maps and dynamic system models, the approach and language of systems modelling and the methods of system dynamics model development and use for what-if experiments, with particular emphasis on the Emergency Department, the ED-Medical Imaging interface, and patient flow analysis and improvement.

Facilitator:

Geoff McDonnell is Simulation Research Fellow at the Australian Institute of Health Innovation , UNSW, and trained as a specialist physician and engineer at UNSW, Harvard and MIT, with public and private health sector experience, including IBM Asia Pacific. He is a cofounder of the Health Policy Special Interest Group of the international System Dynamics Society.

The web site and the full conference details can be found from here:

http://www.conferenceworks.net.au/apsf/workshop

I raise this as Dr.Geoff McDonnell is an old ‘mate’ and I know that it would be helpful for those wanting to understand just how Systems Dynamics Modelling can help in the health sector and in this domain particularly.

David.

Sunday, September 12, 2010

Minister Roxon Is Back. I Hope She Is Planning to Do A Lot Better With E-Health.

It was announced yesterday that Nicola Roxon is to continue as the Federal Health Minister.

Roxon pushes on with health reform

September 11, 2010 - 5:09PM

AAP

Health Minister Nicola Roxon says she will press on with Labor's program of reforming the health system.

Ms Roxon said she was pleased and honoured to retain the health portfolio and to continue leading the government's health reform agenda.

"Following a very busy first term introducing health reform, I now look forward to implementing changes that will deliver better health and hospital services across the country," she said in a statement.

"In particular, I will focus on the better delivery of health services through improved GP clinics, modernised hospitals, an expanded medical and nursing workforce, better after hours services and unleashing the benefits of e-health and telemedicine."

More here:

http://news.smh.com.au/breaking-news-national/roxon-pushes-on-with-health-reform-20100911-155sp.html

Additional commentary on where reform is heading is found here:

Health reforms survive as Independents back Labor

7th Sep 2010

Shannon McKenzie

THERE is to be no reprieve from wide-ranging reforms for the health sector, with key Independents today handing the Australian Labor Party a second term in office.

After more than two weeks of negotiation and deliberation, Rob Oakeshott and Tony Windsor have joined with fellow Independent Andrew Wilkie and Green Adam Bandt in pledging their support for Prime Minister Julia Gillard form a minority government.

Earlier in the day, Bob Katter announced he would back the Coalition, leaving the parties deadlocked at 74 seats apiece. However, Tony Windsor's announcement to back Labor gave them a 75-74 lead before Rob Oakeshott's final vote gave Labor the 76 seats needed to form government.

Parliamentary reform – rather than health – appeared to be at the heart of the protracted negotiations with the Independent MPs.

The result means controversial reforms included in the National Health and Hospitals Network plan – such as the diabetes scheme and the new nurse incentive – remain firmly on the agenda.

The rollout of the unpopular GP Super Clinics scheme also looks set to continue, with Labor now able to push forward with its planned 23 new clinics.

Both the diabetes scheme and the nurse incentive payments have faced an avalanche of criticism since they were announced, with GPs across the country arguing they may be left financially worse off under the new measures.

More here:

http://www.medicalobserver.com.au/news/health-reforms-survive-as-independents-back-labor

GP groups tell Gillard to prioritise primary care

8th Sep 2010

Shannon McKenzie

THE Gillard Government must maintain its strong focus on primary health care and general practice, GP groups have urged.

Both the RACGP and the AGPN have welcomed yesterday’s decision by Independent MPs Rob Oakeshott and Tony Windsor to support the Australian Labor Party in a second term of office.

The Independents’ decision means controversial reforms included in the National Health and Hospitals Network plan – such as the diabetes scheme and the new practice nurse incentive – remain firmly on the agenda.

The rollout of the unpopular GP Super Clinics scheme also looks set to continue, with Labor now able to push forward with its planned 23 new clinics.

More here:

http://www.medicalobserver.com.au/news/gp-groups-tell-gillard-to-prioritise-primary-care

All I wish to say is that this new Government should be seen as an opportunity to alter the modus operandi of the Government to one where there is vastly more transparency and consultation and where ideology is left at the door of the room where decisions are being made.

In e-Health I have made it pretty clear where I stand. I hope we see a rethink etc. on how things should be done.

See here:

http://aushealthit.blogspot.com/2010/08/there-is-small-window-for-sanity-in-e.html

and here:

http://aushealthit.blogspot.com/2010/09/where-to-for-e-health-in-australia-now.html

David.

AusHealthIT Poll Number 35 – Results – 12 September, 2010.

The question was:

Will developing eScript Exchanges and a Consumer Focussed Medication Management Record Drive Community Demand for e-Health?

For Sure

- 9 (40%)

Possibly

- 7 (31%)

Probably Not

- 3 (13%)

No Way

- 3 (13%)

Votes 22

An interesting split with 40% certain and the rest scattered with more thinking it is more than less likely that Script Exchanges will be a good thing in consumer’s eyes.

Again, many thanks to all those who voted!

David.

Saturday, September 11, 2010

Weekly Overseas Health IT Links - 10 September, 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 subscription payment.

-----

http://finance.yahoo.com/news/HighTech-Rx-for-Consumer-usnews-1346155075.html?x=0

High-Tech Rx for Consumer Health Records

Philip Moeller, On Friday August 27, 2010, 11:06 am EDT

It's rare that government gets accused of moving too fast. But in only five months, federal incentive payments will be available for healthcare providers that implement electronic health records (EHRs). There is a $20-billion-plus pot of money that can fund these projects, so the gold rush is on. But according to the American Medical Association, there are no EHR systems that currently meet the government's new standards. Of course, those standards were published all of a month ago. And while the incentive payments are the carrot, beginning in 2015, healthcare providers can be penalized for not providing acceptable EHRs.

So, it's a safe bet we are on the front edge of a massive information technology overhaul to digitize the U.S. healthcare system. Many participants, particularly doctors in smaller practices, will be kicking and screaming all the way. Consumers may not feel this technological pull for a while. But they will, especially in Medicare, Medicaid, and other programs used heavily by older Americans. These large-scale programs with heavy government controls will likely lead the digital charge.

-----

http://www.modernhealthcare.com/article/20100902/NEWS/100909994

AMIA creates global informatics group

By Shawn Rhea / HITS staff writer

Posted: September 2, 2010 - 11:15 am ET

The American Medical Informatics Association, a trade group representing healthcare-informatics professionals, has created an organization to serve as an international training ground, resource center and facilitator of informatics use in low-resource regions.

-----

http://www.modernhealthcare.com/article/20100902/NEWS/100909995/

CER can be part of health IT push: policy group

By Maureen McKinney / HITS staff writer

Posted: September 2, 2010 - 11:45 am ET

Policymakers charged with disseminating comparative effectiveness research will need to proceed carefully and strategically to overcome obstacles such as a lack of standardized methodology and public perceptions of CER.

Those were among the findings of a recently released issue brief from the New England Healthcare Institute, a not-for-profit health policy research organization based in Cambridge, Mass. The brief's authors recommended several strategies for effective CER dissemination, including the integration of CER into the current push for expanded use of health information technology.
-----

http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/08AUG2010/082310HHN_Weekly_Marino&domain=HHNMAG

An EMR That Pays for Itself

By Daniel J. Marino

To see a return on their EMR investment, hospitals need to create new processes, partnerships and skills.

While hospitals nationwide are taking a leading role in helping physicians implement electronic medical records, many do not have a clear plan for recouping the cost of their investment.

The lack of a plan is unfortunate, as the total cost of rolling out an electronic medical record (EMR) outweighs any direct savings from improved information management. Many hospital leaders figure the cost is simply the price of keeping up with technology. The problem is that an ongoing EMR cost imbalance could threaten a hospital's ability to make future IT investments.

The only way to avoid chronic losses is to enhance the value of the physician EMR. The key is to create new processes, new connections and new management skills that amplify the clinical, financial and strategic utility of the core EMR system.

-----

http://www.fierceemr.com/story/klas-true-cost-emr-ownership-often-much-higher-expected/2010-09-02

Cost of EMR ownership often much higher than expected

September 2, 2010 — 2:09pm ET | By Neil Versel

Surprise, surprise! Even as buyers have grown more savvy and able to find a cost-effective EMR, the true cost of ownership of an acute-care EMR often is far higher than expected, KLAS Enterprises reports. And vendor choice can play an important part in whether a hospital gets its money's worth.

For example, the Orem, Utah-based research firm says in a new report, it often takes huge investments in staffing, vendor and consultant services to move from "general clinical use" of an inpatient EMR to strong adoption of advanced functions like computerized physician order entry.

-----

http://www.healthcareitnews.com/news/detroit-medical-center-pegs-emr-savings-5m-year

Detroit Medical Center pegs EMR savings at $5M a year

August 30, 2010 | Bernie Monegain, Editor

DETROIT – Detroit Medical Center executives say they have achieved improved patient safety and saved $5 million to boot, thanks to DMC's system-wide electronic medical system.

It is the second year in a row in which computer-based healthcare information processing created major improvements in quality of care and cost-savings for DMC's eight hospitals, officials said.

The windfall in savings - triggered by highly effective electronic monitoring of critical tasks such as treating pressure ulcers and preventing medication errors - resulted in a healthy return on investment, they said.

The $50 million system powered by Kansas City, Mo-based Cerner Corp, has gone online throughout the DMC in gradual stages over a 12-year period, starting in 1998.

-----

EHR Revenue To Hit $3 Billion In 2013

Changes in reimbursement practices more important that government incentives in driving physician practices to adopt electronic health record software, reports Frost & Sullivan.

By Nicole Lewis, InformationWeek

Aug. 31, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=227200057

A study by Frost & Sullivan predicts that revenue for the U.S. ambulatory electronic health record (EHR) market will double from $1.3 billion in 2009 to an estimated $2.6 billion in 2012. Further, by 2013, the market will reach its peak, posting revenue of $3 billion. However, by 2016 market saturation will have occurred and revenue is expected to fall to $1.4 billion.

Published this month, the U.S. Ambulatory EHR Market report said that, while the federal funds from the American Recovery and Reinvestment Act of 2009 and the Medicare and Medicaid EHR incentive programs are contributing to the acceleration of EHR adoption, there are other factors such as the need to improve safety and the drive to build greater efficiency into physician workflows that are important drivers in the adoption of EHRs.

-----

http://www.modernhealthcare.com/article/20100901/NEWS/100839988/

For vets, records at the click of a blue button

By Joseph Conn / HITS staff writer

Posted: September 1, 2010 - 11:00 am ET

The Veterans Affairs Department, which has been a pacesetter in healthcare information technology for more than 30 years, is proving to be a role model once more. This time it is giving patients easier access to their own health information.

The New York-based Markle Foundation's Connecting for Health program has released a policy paper co-signed by 46 organizations, including more than a dozen health IT companies, in support of the so-called “blue button” technology being developed by the VA in conjunction with the Medicare and Medicaid programs at the CMS.

The technology aims to make it easy for patients to go online and download copies of their medical records.

-----

http://www.ehealtheurope.net/news/6188/european_pacs_market_predicted_to_double

European PACS market predicted to double

25 Aug 2010

The value of the European picture archiving and communications system market is predicted to double over the next six years, driven by demand for radiology information systems.

New analysis from Frost and Sullivan has found that the market was valued at €535m ($679m) in 2009 and estimates that this will reach €1,065m ($1,353m) in 2016.

While the uptake of PACS in European hospitals is 80%, the RIS systems that drive PACS have only reached a penetration level of about 41%.

-----

http://www.healthleadersmedia.com/content/TEC-255847/5-Technologies-to-Make-Surgery-Safer.html

5 Technologies to Make Surgery Safer

Gienna Shaw, for HealthLeaders Media, August 31, 2010

Low-tech solutions such as checklists and calling a time-out before surgery can dramatically improve safety in the operating room, according to the American College of Obstetricians and Gynecologists (ACOG), which recently released guidelines to deter surgical errors. But there are plenty of technologies that can help make the OR a safer place—from systems that keep track of sponges and to robots that may someday be able to deliver anesthesia remotely to systems that help counteract alert fatigue.

The ACOG guidance supports the Joint Commission's "three-part universal protocol" as a useful tool for healthcare teams to prevent surgical errors. The first protocol calls for the healthcare team to ensure that each patient's relevant documents and all of the surgical equipment are available, correctly identified, and reviewed before surgery."Using standard checklists, systems, and routines may sound to some like cook-book medicine, but they have been proven to greatly reduce surgery errors," said Richard Waldman, MD, ACOG's president.

-----

http://www.healthdatamanagement.com/news/health-care-technology-news-ehr-sales-meaningful-use-40950-1.html

Reports Show State of EHR Market

HDM Breaking News, August 31, 2010

Recent reports show electronic health records sales ramping up sharply in coming years, along with a reality check on why those sales are being made.

According to HIMSS Analytics, a Chicago-based research firm with a database that tracks hospital use of I.T., 86 percent of hospitals today are not in position to qualify for the first of three stages of EHR meaningful use criteria, which start in 2011. But 51 percent of hospitals are close to meeting the first criteria stage and receiving incentive payments, and another 17 percent are a year or two behind.

Kalorama Information, a New York-based research firm, estimates the total EHR market in 2008 for hospitals and ambulatory providers was $12 billion. The firm expects the market will more than double to $25.3 billion by 2013, with a 2009-2013 compound annual growth rate of 16.2 percent. These numbers cover only clinical information systems.

-----

http://www.washingtonpost.com/wp-dyn/content/article/2010/08/30/AR2010083003939.html?hpid=sec-health

Physicians use photos from patients' cellphones to deliver 'mobile health'

By Leslie Tamura

Washington Post Staff Writer

Tuesday, August 31, 2010; HE01

The night before his fourth birthday, Rohan Giare of Rockville rolled off his bed and gashed the bridge of his nose. Rohan's dad, not knowing whether he should focus on getting the bleeding to stop or go immediately to the emergency room, snapped pictures of the cut with his BlackBerry and sent them to his doctor friend, Neal Sikka.

"I just gave [Sikka] a ring," Vishal Giare said, "and got initial input on how serious it might be."

Sikka, an emergency physician at George Washington University, looked at the photos and recommended a trip to the hospital.

-----

http://www.modernhealthcare.com/article/20100831/NEWS/100839996/

CCHIT, Drummond Group eager to get to business

By Joseph Conn / HITS staff writer

Posted: August 31, 2010 - 11:15 am ET

"Relief."

It's the first word that came out of Karen Bell's mouth when asked how she felt about Monday's big news.

HHS had tapped the Certification Commission for Health Information Technology, of which Bell serves as chairwoman, as one of the first two organizations qualified to test and certify electronic health-record systems as eligible for federal reimbursements under the American Recovery and Reinvestment Act of 2009.

"We've been ready to go for some time," Bell said. "We know the industry is ready to go. We've just been waiting for the day to get beyond all this."

In fact, folks at CCHIT, a Chicago-based not-for-profit organization, have been in prolonged limbo, waiting more than a year for final word as to whether their practice of testing and certifying EHR systems according to federal standards would continue to have HHS' blessing.

EHR testing at CCHIT pursuant to government specifications began in 2006 after the commission received a $7.5 million contract with the federal Office of the National Coordinator for Health Information Technology. CCHIT's work was put on hold last year while ONC head David Blumenthal decided whether he would exercise the authority given to him under the stimulus law and keep CCHIT as the only government-anointed body to certify health IT systems. The stimulus law authorized Blumenthal to "keep or recognize a program or programs for the voluntary certification of health information technology."

-----

http://www.zdnet.com/blog/healthcare/cchit-finally-gets-foot-in-onchit-certification-door/3981

CCHIT finally gets foot in ONCHIT certification door

By Dana Blankenhorn | August 31, 2010, 5:30am PDT

The Certification Commission for Health IT (CCHIT), created by the HIMSS trade group to seek a monopoly on certifying gear to meet government standards under the Bush Administration, finally got approval to certify, along with the Drummond Group of Austin, Texas.

The news comes just one month before the start of the 2011 fiscal year, under which meaningful use will qualify for that sweet, sweet stimulus cash. And the government press release announcing the decision pointedly noted other applications are under review.

-----

http://www.ehiprimarycare.com/comment_and_analysis/623/record_makers

Record makers

26 Aug 2010

The Summary Care Record is not the only shared record in town. Sarah Bruce reports from a Graphnet event at which NHS Hampshire and Birmingham Teaching Primary Care Trust shared their experiences of creating shared detailed care records using the company’s technology.

As debate continues about the merits or otherwise of the national Summary Care Record, Graphnet has been holding a series of intimate meetings to show trusts what others have been doing to create a locally held detailed care record.

At one recent event at Bletchley Park, two primary care trusts from different strategic health authority areas gave their perspective on what detailed health records can do for the local health economy.

-----

http://online.wsj.com/article/SB10001424052748703418004575456103886552286.html

The Jewelry Prescription

Medical Bracelets Go High-Tech. Style Aside, More People Find They Should Wear Them.

· By LAURA LANDRO

It's a simple step, but one many doctors forget to remind patients to take: Wear a medical-alert bracelet.

A growing number of American adults and children face complex medical conditions like heart disease and diabetes. They may have drug or food allergies, suffer from disorders like autism, or take medications like the blood thinner coumadin that medical staff should know about in an emergency.

New bracelets and other medical-identification systems can fill in first responders on practically a patient's complete health history. They're a far cry from the simple identification bracelets of the past, which with a few engraved words informed medics that a person was, perhaps, allergic to penicillin. They can steer first responders to a secure website or toll-free phone number, or initiate a text message, to get the medical and prescription history of a patient who may be unconscious or unable to talk about their condition.

-----

http://www.modernhealthcare.com/article/20100830/NEWS/100829923/

VA brings stricter info-sharing controls to Ind.

By Joseph Conn / HITS staff writer

Posted: August 30, 2010 - 11:30 am ET

As the Veterans Affairs Department put another toe in the water of electronic health information exchange with the private sector, one of the oldest and most prominent of the nation's regional health information exchanges will adapt to the VA's legal and cultural approach to privacy protection.

Last week, the VA announced it will run a pilot project with the Indianapolis-based Indiana Health Information Exchange as part of the government's virtual lifetime electronic record project, an ongoing federal effort announced last year by President Barack Obama to provide veterans and active-duty armed-services personnel with a longitudinal electronic health record.

The 153-hospital, 768-clinic Veterans Health Administration also has clinical information-sharing tests under way in San Diego with the Defense Department and the integrated delivery network Kaiser Permanente and in the Hampton/Tidewater area of Virginia with the MedVirginia RHIO.

-----

http://healthcareitnews.com/news/health-it-work-abounds-state-and-local-projects

Health IT work abounds for state and local projects

August 27, 2010 | Bernie Monegain, Editor

RESTON, VA – Spending on state and local health IT systems will increase by 19 percent over the next five years, forecasts a new report from market research firm INPUT.

"States, localities, and regional extension centers are going to move quickly to capitalize on EHR funding," said Kristina Mulholland, senior analyst, at INPUT. "It is essential that they fulfill Stage 1 requirements – especially when it comes to meeting computerized physician order entry, and they will need to seek technical assistance from contractors that specialize in system integration and hardware, software, and professional services along the way."

-----

http://healthcareitnews.com/news/deloitte-mobile-phrs-game-changing-self-care

Deloitte: Mobile PHRs 'game-changing' for self-care

August 27, 2010 | Bernie Monegain, Editor

WASHINGTON – The convergence of personal health records and mobile communication devices may offer the right tool to engage consumers to use technology for self-care, taking cost out of the healthcare system, according to a new Deloitte Issue Brief from the Deloitte Center for Health Solutions.

The brief explores the potential benefits of mobile communication devices, such as cell phones, smart phones and other mobile tablet personal computers, to collect environmental and patient-entered information and transmit it via the Internet to a personal health record. Combined with actionable decision support, the combination of mobile device and PHR, which Deloitte calls "mPHR," can analyze aggregate data to activate patient-specific output such as medication reminders, healthy habit tips and medical bill reminders.

-----

http://www.healthdatamanagement.com/news/health-care-technology-news-ambulatory-physician-vendor-selection-40941-1.html

Free Vendor Selection Service for Docs

HDM Breaking News, August 27, 2010

Vinson Hudson, president of the Jewson Enterprises consultancy in Austin, Texas, and proprietor of the POMIS database of the products, functions and capabilities of ambulatory care information systems, is offering free vendor selection consulting services to physician practices.

Of course, there is a catch, as Hudson expects to make money off the consulting, but it won't be the docs who pay. Rather, practice management and electronic health records vendors will be offered, for a fee, a customized report of "must have" and "nice to have" requirements, and other information that must be in their presentation to a physician practice that has three to five vendors on its finalist list.

-----

http://www.healthdatamanagement.com/news/health-care-technology-news-survey-ehr-satisfaction-40935-1.html

Which Acute EHRs Give Money's Worth?

HDM Breaking News, August 26, 2010

A new report from vendor research firm KLAS Enterprises shows many hospitals don't believe they are getting their money's worth from their acute care electronic health records systems.

The Orem, Utah-based company surveys thousands of provider organizations annually and produces a range of reports looking at customer satisfaction with various information technology products and services.

-----

http://govhealthit.com/newsitem.aspx?nid=74529

HIE panel pushes for state provider directories

By Mary Mosquera

Friday, August 27, 2010

For health information exchanges to gain a footing, states will have to make sure physicians can access provider directories. Without these electronic listings of providers and patients across a state or region, vital health records and messages might not get to its proper destination.

To help pave the way, the Health IT Policy Committee this week created a task force to pursue the use of directories across state HIEs to support provider and patient look-up as well as to enhance public health reporting.

The task force, to operate under the Committee’s HIE workgroup, intend to make recommendations in October on best approaches to the issue, said Micky Tripathi, chairman of the HIE workgroup.

-----

http://www.fiercepracticemanagement.com/story/why-physicians-should-get-know-google/2010-08-24

Why physicians should get to know Google

August 24, 2010 — 7:50pm ET | By Debra Beaulieu

It's not just patients who turn to Google or other search engines to research medical information. According to Google, 86 percent of doctors say they now regularly use the Internet on the job. Of that group, the majority start at Google, which they use as a springboard to look for general information about diseases and drugs, writes pediatrician Dr. Rahul K. Parikh in a special piece for the Los Angeles Times.

"Having the Internet at my fingertips makes me a better doctor," he writes, "though I'll admit that sometimes it feels a bit like cheating on an exam." He provides the example of looking up "retinitis pigmentosa" on the fly while gathering a patient's medical history to quickly determine that annual vision checks would suffice for the patient.

-----

http://www.fiercehealthit.com/story/consultant-meaningful-use-fire-ready-aim-absence-hhs-guidance/2010-08-30

Meaningful use is like 'fire, ready, aim" in absence of HHS guidance

August 30, 2010 — 12:03pm ET | By Neil Versel

This may be the best characterization we've heard of the current HHS strategy for providers to achieve meaningful use of health IT and thus qualify for federal EMR subsidy payments: "It's a bit like, 'Fire, ready, aim,'" explains Brian Baker, senior VP of Regents Health Resources, a Brentwood, Tenn.-based consulting firm, according to AuntMinnie.com.

Baker, speaking at this month's American Healthcare Radiology Administrators (AHRA) annual conference in Washington, D.C., said that hospitals and physicians need to keep moving forward with EMR implementation plans, even as HHS develops much-needed guidance for meeting the standards for meaningful use. "These meaningful use guidelines are a mixed bag," Baker is quoted as saying. "Their implementation is great news and bad news, all at the same time."

-----

http://www.fiercehealthit.com/story/csc-hospitals-struggling-cpoe-while-physicians-need-help-capturing-data-reporting-cds/2010-08-

Hospitals struggling with CPOE

August 30, 2010 — 12:31pm ET | By Neil Versel

As they prepare to meet federal requirements for "meaningful use" of EMRs, hospitals seem to be struggling most with getting CPOE right and with helping physicians embrace EMR technology, according to consulting firm Computer Sciences Corp. For "eligible professionals"--physicians, dentists, podiatrists, optometrists, chiropractors and, for Medicaid purposes, nurse midwives and some physician assistants--the top challenge is capturing data for clinical decision support and outcomes reporting. That's followed by establishing proper workflows to simplify data entry.

In two new papers, CSC, which has been busy churning out reports on health IT and meaningful use, identifies the top 10 challenges in achieving meaningful use for both hospitals and eligible health professionals. CPOE also makes the list for eligible professionals, while data capture is among the top 10 for hospitals.

-----

Enjoy!

David.