Quote Of The Year

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

or

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

Sunday, October 17, 2010

Weekly Australian Health IT Links – 17 October, 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:

It has been a pretty quiet week but I suspect there may be a bit more activity next week with Senate Estimates Committee covering the Health and Ageing apparently meeting on Wednesday 20th and Thursday 21st October 2010. Wednesday is the day where DoHA (where e-Health sits) is on Wednesday according to the current program which can be found here:

http://www.aph.gov.au/Senate/estimates/schedule.pdf

When I know timing I will let people know:

The sessions are available to watch here:

http://www.aph.gov.au/live

-----

http://blogs.crikey.com.au/croakey/2010/10/11/more-mostly-depressing-reading-on-e-health-a-bit-on-why-a-lot-on-why-not-and-not-much-at-all-on-how/

More (mostly) depressing reading on e-health: a bit on why, a lot on why not, and not much at all on how…

, by Melissa Sweet

E-health: WHY?

When it comes to e-health, we know at least some of the reasons why it should be a good thing (quite apart from the fact that the e-revolution is bringing benefits to so many other aspects of life).

As a new Canadian study suggests, electronic drug information systems can help reduce adverse drug events and increase pharmacist and prescriber productivity. The study also finds that they increase “medication compliance”, but I hate that term so will instead report that they are associated with a more appropriate use of medicines.

The study, which estimates Canada’s investments in drug information systems will generate $436 million in cost savings and efficiencies in 2010, was released by Canada Health Infoway, “an independent not-for-profit corporation created by Canada’s First Ministers in 2001 to foster and accelerate the development and adoption of electronic health record systems with compatible standards and communications technologies”.

-----

http://www.smh.com.au/digital-life/mobiles/heart-to-heart--directly-with-your-doctor-20101011-16fh3.html

Heart to heart - directly with your doctor

Glenda Kwek

October 11, 2010 - 3:49PM

A Dutch research centre has developed a wireless monitor that allows your organs to send alerts to your mobile phone.

The electrocardiogram-sensor system - called the Body Area Network (BAN) - sends information about your heart's performance, brain and muscle activities to your phone, nanoelectronic research institute Imec said this week.

The data is then processed and sent over the internet to your doctors.

A wireless monitor that allows your organs to send alerts to your mobile phone.

"Potentially it could be quite useful," Australia's Heart Research Institute deputy director Professor Michael Davies said.

-----

http://www.bjhcim.co.uk/news/2010/n1010011.htm

Scottish Government praises Greater Glasgow and Clyde Clinical Portal

13 October 2010

A recent Scottish government report on the use of clinical portals and telehealth in Scotland confirmed that the NHS Greater Glasgow and Clyde Clinical Portal is widely used and delivering value for a broad user base across the Health Board.

NHS Greater Glasgow and Clyde is the largest health board in Scotland, with 44,000 staff, 35 major hospitals, 50 health centres and clinics and 1000 GPs.

The Clinical Portal provides a single and unified view of information from the Health Board's Scottish Care Information Store, a central data repository for nearly two million people, consisting of a clinical data repository, scanned paper case notes and an encounter repository. The Portal uses Orion Health technology to provide a clinician-friendly view of information from multiple information sources, including Meditech and iSOFT patient administration systems, and access to test results, referrals and clinical documentation.

-----

http://www.hospitaliteurope.com/default.asp?title=iSOFTannouncesLorenzodevelopments&page=article.display&article.id=23386

iSOFT announces Lorenzo developments

Wednesday 13th October 2010

iSOFT has announced key Lorenzo developments, including the release of Lorenzo 3.6 and a drive to make Lorenzo components available to meet specific market needs, under its new Smart Solutions strategy.

The latest release of Lorenzo Enterprise features a host of new and improved functions, including nurse process management. Under a policy of delivering quarterly updates of new features and improvements, the new nursing functions are for managing day-to-day tasks, clinical forms and correspondence and clinical noting. Lorenzo 3.7, due next year, will include additional nursing functions such as shift handover support and patient cockpit.

The nursing component is just one key element of iSOFT’s Lorenzo Smart Solution strategy to provide vital new applications to the market at lower costs, in a faster go-to-market fashion, and allowing its customers to benefit from new functionalities. Based on Microsoft’s Silverlight technology, these are infrastructure-light solutions that can be installed without the need for new hardware, additional database licenses, or the upheaval of replacing existing systems.

-----

http://www.ehiprimarycare.com/news/6317/isoft_commits_to_synergy_in_primary_care

ISoft commits to Synergy in primary care

14 Oct 2010

ISoft is to focus primary care development in the UK on its existing primary product Synergy, and to use a Lorenzo-based portal to enable information sharing.

The healthcare IT system supplier has launched a hosted version of Synergy, which is used by 80% of iSoft primary care customers in the UK, and said it is committed to primary care.

Last year Gary Cohen, former iSoft executive chairman and chief executive, announced that Lorenzo Primary Care would be available in the UK from quarter four 2010.

However, when asked about this launch this week, an iSoft spokesperson told EHI Primary Care: “ISoft remains committed to primary care and continues to intensify its focus through continued development of our Synergy solution, which has a strong clinical following, particularly in large practices.

-----

http://ehealtheurope.net/news/6309/isoft_markets_lorenzo_modules_to_trusts

ISoft markets Lorenzo modules to trusts

12 Oct 2010

ISoft has announced that it will market components of its electronic patient record, Lorenzo, to hospitals in the UK and worldwide under a Lorenzo smart solution strategy.

Lorenzo, which is due to be delivered to trusts in the North, Midlands and East of England as part of the National Programme for IT in the NHS, will be made available to meet specific market needs in a more modular format called Lorenzo Enterprise suite.

Functionality that will be made available will include new nursing releases for managing day-to-day tasks, clinical forms and correspondence, and clinical noting.

Michael Dawlheid, global chief marketing and medical officer, told E-Health Insider: “These components are specifically designed for faster time to market, quicker revenue and much faster implementation than implanting the full blown Lorenzo.

-----

http://www.ehiprimarycare.com/news/6307/pennine_on_brink_of_dropping_lorenzo

Pennine on brink of dropping Lorenzo

11 Oct 2010

Pennine Care NHS Foundation Trust may be on the brink of abandoning its Lorenzo implementation following continuing concerns and difficulties around implementing the system, E-Health Insider has learned.

Pennine is meant to be the first mental health trust to take Lorenzo. One mental health; one acute – University Hospitals of Morecambe Bay NHS Foundation Trust; and one PCT, NHS Bury, are required to go live with Lorenzo to trigger key NPfIT contract milestones and payments to CSC and iSoft.

Sources have told E-Health Insider that Pennine is struggling with the implementation of the electronic patient record from iSoft and may not only further delay the go-live but drop the implementation altogether.

-----

http://www.theaustralian.com.au/australian-it/three-month-testbed-delay-for-health-project/story-e6frgakx-1225937337510

Three-month testbed delay for health project

A THREE-month-old draft Healthcare Identifiers Service implementation plan has been reissued almost unchanged by NEHTA.

But a project plan is still some way off.

National E-health Transition Authority public affairs chief Heather Hunt says the material and timelines provided in the HI implementation approach and communication strategy were "only designed to show the public that the service will be adopted incrementally, rather than overnight in all locations".

-----

http://www.theaustralian.com.au/australian-it/government/nehta-escapes-scrutiny/story-fn4htb9o-1225938540282

Health rejects Opposition calls to reveal NEHTA spending

  • Karen Dearne
  • From: Australian IT
  • October 14, 2010 10:21AM

THE Health Department has refused to reveal how much the National E-Health Transition Authority has spent on travel in the past financial year, saying the taxpayer-funded body is not required to report such information under its funding agreement.

"Provision of this information to the department is not required, and is not provided in NEHTA’s annual reports," the department said in response to questions on notice from Senate estimates hearings in June but only published this week.

Liberal Senators Sue Boyce and Concetta Fierravanti-Wells have been pursuing details of NEHTA’s spending and accountability to parliament over the past year.

-----

http://www.psnews.com.au/Page_psn2386.html

Health number plan in good shape

An implementation plan for the introduction of e-health identifier numbers has been released by the National E-Health Transition Authority, NEHTA.

The Healthcare Identifiers Communications Plan aims to guide the implementation of the Healthcare Identifiers Service (HI) through education and marketing initiatives for consumers, healthcare providers, and healthcare organisations.

Operated by Medicare Australia, the HI Service aims to improve healthcare communication between individuals and medical providers.

It is a national system for uniquely identifying healthcare providers and individuals.

-----

http://www.nehta.gov.au/media-centre/nehta-news/713-racgp

E-health focus in new RACGP standards

8 October 2010. NEHTA has welcomed the increased number of specific criteria to address e-health in the 4th edition of the Royal Australian College of General Practitioners (RACGP) Standards for general practices launched at GP10 in Cairns today.

The 4th edition of the Standards represents a template for quality and risk management in contemporary general practice and the review process included a separate e-health standards working group to review all the standards and their alignment with national e-health initiatives (patient, provider and organisation healthcare identifiers, and electronic health records) and best practice.

The working group comprised of the RACGP e-health working group members and NEHTA clinical leads.

Professor Claire Jackson, President of the Royal Australian College of General Practitioners (RACGP) and GP in Inala, Brisbane said a new section has been included on patient identification.

-----

http://www.smh.com.au/business/nbn-sees-conflict-ahead-20101015-16npe.html

NBN sees conflict ahead

Lucy Battersby

October 16, 2010

NBN Co chief executive Mike Quigley has foreshadowed potential clashes between the government and companies that own fibre backhaul networks as final details of the broadband network are ironed out.

A decision on whether to install hundreds or just a few ''points of interconnect'' will either leave regional users with fewer providers to choose from or reduce the market for competitive backhaul - the high-capacity fibre that carries data between towns.

Mr Quigley yesterday ruled out widespread compensation for telecommunications providers for building over existing infrastructure.

-----

http://www.smh.com.au/business/buy-or-beware--competitors-gear-up-to-do-battle-with-nbn-20101016-16oby.html

Buy or beware - competitors gear up to do battle with NBN

Garry Barker

October 17, 2010

INTERNET and cable TV service providers that do not get an offer from the national broadband network company to buy their infrastructure say they will compete with it.

''We are not going to just walk away from our investment,'' said Andre Koot, general manager of TransACT in Canberra and Neighborhood Cable in Geelong, Ballarat and Mildura.

''We either have to make our networks attractive enough for the NBNCo to buy them, or we compete,'' he said. ''NBN is pretty earth-shattering for people like us.''

-----

http://www.smh.com.au/technology/technology-news/connect-to-nbn-now-or-pay-up-to-300-for-phone-line-20101015-16ms3.html

Connect to NBN now or pay up to $300 for phone line

Ben Grubb

October 15, 2010 - 4:08PM

Sign here if you want to keep your fixed-line telephone.

If Australians do not opt in to the national broadband network (NBN) as it is rolled out they will lose their fixed-line phone service unless they pay a one-time fee of about $300.

Communications Minister Stephen Conroy has said repeatedly that he would not be forcing homes on to the NBN, however, if consumers want to keep their fixed-line telephone service once Telstra has decommissioned its copper network, then they will need to connect to the new network.

Although the government is covering the installation costs now, those who decline to allow NBN Co on to their property will need to pay up to $300 to connect to the NBN at a later date, according to ISP iiNet chief regulatory officer Steve Dalby.

-----

http://www.theaustralian.com.au/national-affairs/competition-chief-rejects-cost-benefit-analysis/story-fn59niix-1225938383789

Competition chief rejects cost-benefit analysis

  • Damon Kitney and Mitchell Bingemann
  • From: The Australian
  • October 14, 2010 12:00AM

THE competition regulator has questioned the need for a cost-benefit analysis for the $43 billion National Broadband Network.

Australian Competition & Consumer Commission chairman Graeme Samuel said it was the proper role of governments to spend money on visionary projects for the future.

And it would be impossible to measure the flow-on social and economic benefits of a high-speed internet network over the next two or three decades, he said.

"It is this crystal ball gazing that can't be done, and ultimately with these things that's where government steps in because the private sector won't do the crystal ball gazing," Mr Samuel told The Australian yesterday.

-----

http://www.smh.com.au/business/a-network-going-nowhere-20101012-16hrn.html

A network going nowhere

Peter Martin

October 13, 2010

I AM worried about the state of our roads, but I've got an idea. Bear with me, even if it reminds you of the national broadband network.

Let's replace the lot - every single road - with brand new, state-of-the-art roads. They will be faster, they will unleash new uses for roads not yet dreamed of, and they will boost our productivity in ways that cannot yet be quantified; so there's no point in subjecting the idea to a cost-benefit analysis.

Sure, it will cost tens of billions of dollars, tie up our construction workforce for years and destroy existing, fully functioning infrastructure on a never before imagined scale. But it will be nation building. And let's do it without even considering alternative uses of the money, because, well …

And that's where I lose my way.

-----

http://www.theaustralian.com.au/business/industry-sectors/nbn-bill-at-risk-of-1bn-blowout/story-e6frg9hx-1225937890591

NBN bill at risk of $1bn blowout

THE cost of building the NBN could blow out by $1 billion if the government adopts the principles of its Tasmanian rollout around the country.

NBN Co, the government body set up to roll out the NBN, yesterday confirmed it was extending the fibre network from the street to the outside of every house it passes as part of its deployment in the Tasmanian towns of Midway Point, Scottsdale and Smithton.

It is understood that the same connection process has been extended to the first release sites on the mainland and is likely to be adopted for wider rollout around the nation.

-----

http://www.theaustralian.com.au/business/time-to-call-out-national-broadband-network-naysayers/story-e6frg8zx-1225937863465

Time to call out National Broadband Network naysayers

MIKE Quigley will start to fill the information void on the NBN today, with an address to an industry conference in Melbourne.

Next week, he will appear before a Senate Estimates Committee, which should clear more issues, but with his business case still to go to the government the reality is there are still many unanswered questions.

This, it must be noted, should not be confused with any slowdown from either Telstra or the government's side, because the reality is they both need each other.

-----

http://www.theaustralian.com.au/business/industry-sectors/nbn-is-financially-viable-says-optus/story-e6frg9hx-1225938048763

NBN is financially viable, says Optus

AUSTRALIA'S number two telco has hit back at critics of the $43 billion National Broadband Network, claiming it is financially viable.

And according to Optus, owner of the second largest mobile network in Australia, wireless solutions are not the answer to Australia's slow broadband speeds either.

But the telco's director of government and corporate affairs, Maha Krishnapillai, says reports that Optus is poised to sign on the NBN are premature.

In an interview with Sydney radio station 2UE this morning, Mr Krishnapillai was blunt about whether the NBN would be affordable for consumers, saying: “We have done a lot of modelling on this, we've been through NBN Mark 1, we've been through years of modelling and work on this with the government and we know that the NBN, as it is characterised now, is commercially viable.”

-----

http://www.theaustralian.com.au/national-affairs/customers-may-be-forced-on-to-nbn-to-keep-phones/story-fn59niix-1225937394605

Customers may be forced on to NBN to keep phones

  • Annabel Hepworth and Lauren Wilson
  • From: The Australian
  • October 12, 2010 12:00AM

THE Gillard government and the key providers of the NBN are still working out how to ensure basic phone services to those people who do not sign up to it.

In Tasmania, official estimates forecast that just 16 to 25 per cent of premises passed by the NBN rollout would subscribe.

This prompted the state government to switch to an "opt-out" model, where homes and businesses would be automatically connected to the service unless they refused.

Last night, the government revealed that those wanting to retain a fixed-line telephone service in their home would be forced to connect to the NBN.

-----

http://www.theaustralian.com.au/national-affairs/telstras-warning-over-nbn-deal/story-fn59niix-1225936195227

Telstra's warning over NBN deal

TELSTRA has warned that its $11 billion deal with Labor's National Broadband Network company threatens to unravel.

The telco says the deal will fall apart if it is forced to maintain its ageing copper network for people who refuse to connect to the fibre network.

Under the terms of the non-binding deal, Telstra will be paid $9bn to transfer its traffic on to the NBN and to gradually shut down its copper network as customers move to the new fibre network.

But fresh concerns over the sluggish NBN take-up rates in Tasmania, coupled with the disparate methods used by state governments to connect the new fibre cable to premises, could see large parts of Telstra's copper network maintained past its use-by date and in parallel with the new NBN.

-----

http://www.theaustralian.com.au/australian-it/government/gillard-committed-to-isp-filter-plan/story-fn4htb9o-1225938067670

Gillard committed to ISP filter plan

  • Fran Foo
  • From: Australian IT
  • October 13, 2010 11:29AM

PRIME Minister Julia Gillard will push ahead with plans to introduce mandatory internet filters but the implementation date still remains unclear.

The government wants all ISPs to automatically block web pages with a refused classification (RC) rating on a secret blacklist.

On July 9, Communications Minister Stephen Conroy said the legislation would be deferred to allow a review of the RC processes central to the policy.

The Standing Committee of Attorneys-General (SCAG) was to meet a few weeks later to discuss the review, but that meeting was postponed to November when the federal election was called.

-----

http://www.computerworld.com.au/article/364158/gillard_filter_moral_question_/?eid=-6787

Gillard: Filter is a “moral question”

Gillard continues defence of mandatory ISP-level internet filter

Prime Minister Julia Gillard yesterday took the high ground in defending Labor's mandatory internet filtering project, describing the issue of how to ensure Australians didn't get access to the wrong content as a "moral question".

Both the Coalition and the Greens have confirmed plans to block legislation associated with the controversial project when it hits parliament, leading many Australians to believe the project is dead in the water due to a lack of support in the Senate.

However, Communications Minister Stephen Conroy has vowed to push on with the project, and Australian Sex Party President Fiona Patton has warned the Coalition's policy may not be rock solid.

-----

http://www.computerworld.com.au/article/363763/12_reasons_try_ubuntu_10_10_sunday/?eid=-219

12 reasons to try Ubuntu 10.10 on Sunday

Have you been wanting to give Ubuntu a test drive? With the debut of user-friendly Maverick Meerkat, there’s no better time.

As Ubuntu 10.10, or "Maverick Meerkat," hits the streets this Sunday, it's a pretty safe bet that legions of existing Ubuntu users will be updating to the new release. After all, it looks to be Canonical's most user-friendly Ubuntu Linux yet, and many of the new features promise to be must-haves.

For those in the business world who haven't yet tried Ubuntu, however, the reasons to download and give it a whirl are even more compelling. Here are just a few of them.

1. Speed

Ubuntu 10.10 is fast -- darn fast. Even the beta version could boot in as little as 7 seconds, according to reports. Who has time to wait around for Windows when there's work to be done?

-----

http://www.computerworld.com.au/article/364363/top_5_mistakes_made_by_linux_first-timers/?eid=-219

Top 5 mistakes made by Linux first-timers

Are you new to Linux? Then don’t let these common missteps spoil your first experiences.

With the arrival of Ubuntu 10.10, the list of reasons to try Linux for your business just got a little longer. The free and open source operating system is now more user-friendly than it's ever been before while still offering the many security and other advantages it has over its competitors.

If you're among the legions of new Linux users out there, congratulations on making a smart move! Now that you're on your way to a lifetime of freedom from high costs, vendor lock-in, constant malware attacks, and the many other disadvantages associated with Windows and Mac OS X, you should be aware of some of the classic mistakes Linux newcomers sometimes make.

None of these should be deal-breakers, by any means. Nevertheless, an early heads-up can help prevent unnecessary frustration. Without further ado, here are five key things you should avoid when starting out with desktop Linux.

-----

Enjoy!

David.

Saturday, October 16, 2010

This Seems to be An Emerging Trend - Smartphones, iPads and E/M Health.

The following appeared a few days ago.

Telecom apps take the Hippocratic Oath

Diagnostic medicine is increasingly going mobile, but path isn’t smooth

By Kim Hjelmgaard, MarketWatch

LONDON (MarketWatch) — At home. On the go. During a meeting. Take your pick. The good doctor gets around these days.

If you have diabetes, asthma or heart disease, there’s almost certainly an elegant smartphone interface at your disposal.

If you’re overweight or if it’s the scourge of meningitis you fear — or even if you simply don’t know where to look for judicious diagnostic advice and treatment — the wireless medical world is at hand.

The iStethoscope app for the iPhone

The iStethoscope app turns your iPhone into a stethoscope, allowing you to listen to your hearbeat. Check out the demo.

Personal devices have, in fact, never been so personal, and developers, doctors, companies and health-care providers are all scrambling to figure out how to best harness the increasing convergence of the mobile and the medical.

Still, while consumer interest in the idea of mobile-health services, or mHealth, is growing, the industry itself is beset with a range of issues from privacy to regulation to standards and even to a common sense of where best to focus efforts.

Most in the industry agree that mHealth is first and foremost about chronic-disease management, but there is real divergence over how mobile phones fit within the fragile mHealth ecosystem, if at all.

On issues such as selection, security, platform, connectivity strategies and a whole host of other coordination-sensitive systems, consensus has yet to emerge — with respect to applications for consumers, but also more broadly for devices and software aimed at the professional health-care market.

“The mobile phone, like your wallet and keys, is the one thing you don’t leave home without,” said Brian Dolan, editor and co-founder of mobihealthnews.com, a web portal that tracks the wireless-medical world.

“The U.S. medical system is an overtaxed system and we need to extend the reach of health-care providers,” added Dolan. “The way to do this is to add connectivity to the patient, no matter where they might be. We need to take advantage of the technology people are already using today — the mobile phone.”

As smartphones move ever closer to PCs, one area where consumers are displaying an interest is in medical-related apps for mobile phones that can be purchased at online destinations such as Apple Inc.’s (NASDAQ:AAPL) App Store. But these new offerings are also leaving consumers in something of a never-never land when it comes to making informed decisions.

“There is a huge amount of interest in this area,” said Peter Bentley, creator of the iStethoscope, an app that transforms Apple’s iPhone into a stethoscope, thus permitting monitoring of the heartbeat in just about every conceivable setting (save for extremely noisy ones).

“But regulators are still trying to figure out the blurred distinctions between apps and medical devices,” said Bentley, a computer-science professor at University College London, and “the more established doctors may find the new technology somewhat baffling.”

Smartphones and tablets may not be ready to replace hospital devices just yet, but it’s safe to say that looking ahead, “the marketplace will be dramatically different,” said Joseph White, a U.S.-based medical doctor with an interest in mHealth issues.

“Bedside EKG, ultrasound, pulse oximetry, blood-pressure monitor, glucose monitor — doctors will eventually have access to these types of monitoring capabilities when they visit patients at home.”

For now, though, apps on “the consumer side that are genuinely finding adoption are fitness-related,” said Dolan.

Heaps more here:

http://www.marketwatch.com/story/this-mobile-app-could-save-your-life-2010-10-05?siteid=nwhwk

When such stuff hits the commercial news sites you know something is going on. A trend to keep a close eye on indeed!

David.

Friday, October 15, 2010

Weekly Overseas Health IT Links - 14 October, 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://www.mayoclinicproceedings.com/content/85/8/704.full

Pilot Study of Providing Online Care in a Primary Care Setting

  1. Steven C. Adamson, MD, and
  2. John W. Bachman, MD

Abstract

OBJECTIVE: To study the use of e-visits in a primary care setting.

PATIENTS AND METHODS: A pilot study of using the Internet for online care (“e-visits”) was conducted in the Department of Family Medicine at Mayo Clinic in Rochester, MN. Patients in the department preregistered for the service, and then were able to use the online portal for consultations with their primary care physician. Use of the online portal was monitored and data were collected from November 1, 2007, through October 31, 2009.

RESULTS: During the 2-year period, 4282 patients were registered for the service. Patients made 2531 online visits, and billings were made for 1159 patients. E-visits were submitted primarily by women during working hours and involved 294 different conditions. Of the 2531 e-visits, 62 (2%) included uploaded photographs, and 411 (16%) replaced nonbillable telephone protocols with billable encounters. The e-visits made office visits unnecessary in 1012 cases (40%); in 324 cases (13%), the patient was asked to schedule an appointment for a face-to-face encounter.

CONCLUSION: Although limited in scope, to our knowledge this is the largest study of online visits in primary care using a structured history, allowing the patient to enter any problem, and billing the patient when appropriate. The extent of conditions possible for treatment by online care was far-ranging and was managed with a minimum of message exchanges by using structured histories. Processes previously given as a free service or by nurse triage and subject to malpractice (protocols) were now documented and billed.

-----

http://www.itworldcanada.com/news/the-electronic-health-record-meets-the-ipad/141650

The electronic health record meets the iPad

By: Grant Buckler On: 05 Oct 2010 For: CIO Canada

The Ottawa hospital's CIO sees an opportunity to extend the benefits of his e-health efforts by adding mobile computing technology from Apple into the mix. Why iPhones will be the next step

Early in 2009 Dale Potter, chief information officer at the Ottawa Hospital, asked physicians how much of the information they needed in their work was available in the hospital’s electronic health record. On average they said about 30 per cent of it was. When he asked again at the beginning of this year, all but two respondents said everything they needed was there.

“I was quite proud of that statistic,” says Potter, who became the hospital’s CIO in fall 2008 after stints as a private-sector IT boss at Alcan Engineered Products and Bombardier Transportation. The improvement resulted largely from Potter’s efforts to address what he sees as a serious lag in the health-care sector’s adoption of information technology.

But when Potter tagged along on clinical training unit rounds, his pride in getting all that medical information online was somewhat dented.

-----

Epic, Cerner Dominated CIS In 2009

A KLAS report finds that almost 70 percent of Clinical Information System purchases by 200-bed and larger hospitals were from one of the two vendors.

By Anthony Guerra, InformationWeek

Oct. 4, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=227600114

Nearly 70 percent of CIS purchases in 2009 by hospitals over 200 beds were an Epic or Cerner integrated solution, according to a new KLAS report, "CIS Purchase Decisions: Riding the ARRA Wave."

Although they came from about five organizations, Cerner had a solid year with 31 hospital signings. "This is a pretty good stake in the ground for Cerner," said KLAS general manager of clinical research Jason Hess. "I think people recognize that ARRA and Meaningful Use is all about interoperability and integration, and you look at who the two truly notable integrated vendors are -- its Epic and Cerner. Certainly this is kind of a two-horse race as we watched it in 2009, and then the others are kind of at a distant third."

In 2009, Eclipsys, GE, McKesson Horizon and QuadraMed all lost more hospitals than they gained, according to the Orem, Utah-based company.

-----

http://www.abiresearch.com/press/3517-Personal+Robotics+Market+to+Top+$19+Billion+in+2017

Personal Robotics Market to Top $19 Billion in 2017

NEW YORK - September 29, 2010

While many consumers’ current interaction with robots is limited to those that clean their floors, pools or gutters, ABI Research, in its new market study “Personal Robotics,” forecasts that the personal robotics market will grow to more than $19 billion in 2017, driven in large part by sales of telepresence and security robots featuring high-quality cameras, microphones and processors that allow the robots to serve as interactive substitutes for human beings.

The modern robotics market has existed for nearly 30 years, but within the last decade, substantial improvements in overall functionality, levels of control, and cost structures have been achieved. While many of the advancements in robotics have been achieved in military and industrial markets where higher amounts of spending have allowed the development and commercialization of highly technical, yet costly, robots, many of the lessons learned are quickly trickling down to other market segments, including health care, business and commercial markets, and personal robotic devices.

-----

http://www.healthleadersmedia.com/content/TEC-257305/5-EHR-Myths-Busted.html

5 EHR Myths, Busted

Gienna Shaw, for HealthLeaders Media , October 5, 2010

The best physician can make a mistake when writing a prescription, the best nurse can fail to remove a catheter on time, the most organized medical records staff can misplace a file, and even top hospitals have areas of waste and inefficiency. But electronic health records systems are supposed to make all that go away, right?

Well, not exactly.

Whatever you may hear from Washington policy-makers, EHR is not going to solve all of healthcare's quality and patient safety problems. HIM professionals at last week's meeting of the American Health Information Management Association in Orlando made that much clear.

-----

http://www.aishealth.com/Bnow/hbd100410.html

Audits of Electronic Health Records Cloning Reveal Documentation Problems That Put Compliance at Risk

Reprinted from REPORT ON MEDICARE COMPLIANCE, the nation's leading source of news and strategic information on false claims, overpayments, compliance programs, billing errors and other Medicare compliance issues.

By Nina Youngstrom, Managing Editor (nyoungstrom@aishealth.com)

Electronic health records (EHR) are a double-edged sword. They can reduce the time it takes physicians to document patient encounters, allow real-time access to medical records and promote legibility. But CMS and Medicare contractors are wary of classic EHR physician documentation shortcuts — cloning (cut and paste), macros and templates — and audits are bearing out their concerns.

“EHRs are a great invention as long as they are carefully used and reviewed,” said Kathleen Enniss, compliance analyst at UW Medicine Compliance, part of the University of Washington School of Medicine in Seattle, which includes three hospitals. “Each note should contain individualized data that supports the medical necessity of the visit or procedure.” When Enniss audited EHRs, she found problems stemming from use of documentation shortcuts.

-----

http://blogs.wsj.com/health/2010/10/05/doctors-launch-thenntcom-to-give-treatment-info/

October 5, 2010, 4:36 PM ET

Doctors Launch ‘TheNNT.com’ to Give Treatment Info

Conveying how well a therapy works — and doing so in understandable terms — isn’t easy, but a group of physicians is trying to change that.

Their new website, TheNNT.com, looks at a stat called the “number needed to treat,” which it defines as “a measurement of the impact of a medicine or therapy [that estimates] the number of patients that need to be treated in order to have an impact on one person.” (Here’s the new site’s explanation of the NNT. We’ve mentioned the metric before in a post about gauging heart risk.)

The site summarizes the evidence (taken mostly from systematic reviews like those from the Cochrane Collaboration) behind a range of treatments and therapies, including the Mediterranean Diet for post-heart attack care and antibiotics for ear infections. It also includes, when appropriate, the “number needed to harm,” which indicates how many people you’d have to treat before one is harmed by the intervention. Both stats are presented as a proportion — i.e. one in 42 people will have his or her life saved by taking aspirin after a major heart attack (an NNT of 42), and one in 167 will have non-dangerous bleeding (a NNH of 167).

A perfect NNT would be one — treat one person, and one person benefits. The higher the NNH, the better.

-----

http://fcw.com/articles/2010/10/01/hhs-framework-health-it-standards.aspx

HHS works on framework for health IT standards

Framework will include standard vocabularies for electronic medical records

The next stage of federal efforts to spur adoption of electronic health records will involve a framework for standards and interoperability, according to a senior Health and Human Services Department official.

The goal is to build on the current foundation and develop “progressively more rigorous electronic health information exchange requirements,” David Blumenthal, HHS’ national coordinator for health IT, told the House Science and Technology Committee’s Technology and Innovation Subcommittee Sept. 30.

Blumenthal updated lawmakers on what's happening with the $20 billion in economic stimulus funding designated for promoting physician and hospital investments in health IT. HHS issued three sets of regulations in recent months to define how physicians and hospitals can become eligible for reimbursements by installing and meaningfully using the record systems.

-----

http://www.ihealthbeat.org/perspectives/2010/making-meaningful-use-meaningful-for-patients-and-health-care-providers.aspx

Wednesday, October 06, 2010

Making 'Meaningful Use' Meaningful for Patients and Health Care Providers

HHS recently released a package of regulations clarifying the definition of achieving "meaningful use" of electronic health record systems. Eligible providers and hospitals must meet the meaningful use criteria to qualify for government incentives and bonus payments for the adoption of EHR systems. The regulations signify a milestone accomplishment in moving forward our nation's commitment to the universal adoption of EHRs.

Each day, the American health care system conducts more transactions than the New York Stock Exchange, most of them on paper and at risk of human error. The Institute of Medicine estimates there are between 44,000 and 98,000 deaths attributed to medical errors each year, and while not all errors can be precluded by the adoption of EHRs, there is no question that standardized, interoperable systems will move us in the direction of improved quality and efficiency and reduced errors and waste.

-----

http://www.ehealtheurope.net/news/6290/romania_to_implement_health_card_in_2011

Romania to implement health card in 2011

04 Oct 2010

The Romanian government has announced that electronic health insurance cards will be rolled out nationally at the start of next year.

The cards will be separate to the European Health Insurance Card, and will hold personal information, proof of health insurance payments, applications for medical services, information on life-threatening medical diagnoses, and the cardholder's blood type.

Health Minister Attila Cseke, said: "By introducing the national health insurance cards, we make an important computerisation step. We can cut red tape to prove the identity of the insured."

-----

http://www.ehealtheurope.net/news/6283/czech_republic_registers_2m_for_ehr

Czech Republic registers 2m for EHR

01 Oct 2010

The IZIP electronic health record programme in the Czech Republic has hit its target of registering 2m users by the end of the summer 2010.

More than a fifth of the country’s population is now using the eZK (electronic health record) that allows patients to access their own health information - including information on visits, results and prescribed drugs - via a web based electronic health record.

The records are provided free to those insured by the VZP, the largest state owned health insurer in the Czech Republic. They also used by more than 15,000 practitioners to share information with each other, when given consent.

-----

http://www.modernhealthcare.com/article/20101006/NEWS/310069961

ONC lists all certified EHRs on website

By Joseph Conn / HITS staff writer

Posted: October 6, 2010 - 11:30 am ET

The Office of the National Coordinator for Health Information Technology at HHS has opened the official federal website for listing health IT products that have been independently tested and certified as eligible for incentive payments under the American Recovery and Reinvestment Act of 2009.

-----

http://www.modernhealthcare.com/blogs/it-everything/20101006/310069963

No unemployment here

The nation is suffering from the highest unemployment rates in almost 30 years, and yet healthcare industry IT leaders are worried that workforce shortages may jeopardize their hospitals' chances at obtaining federal IT incentive payments.

One out of 10 chief information officers responding to a recent survey indicated that workforce shortage "definitely would affect" their chances to implement electronic health-record systems and qualify for federal IT reimbursements. Just over half—51%—of CIOs predict that staff shortages possibly would put their health IT projects at risk, according to a membership survey by the College of Healthcare Information Management Executives.

----

http://www.healthleadersmedia.com/content/NRS-257294/Scanning-Medication-Reduces-Errors-Hospital-Says

Scanning Medication Reduces Errors, Hospital Says

Briefings on The Joint Commission, an HCPro publication , October 5, 2010

In April 2008, Baystate Medical Center (BMC), a 653-bed teaching hospital in Springfield, MA, began implementation of its Bar Code Point of Care technology to positively impact medication administration in reducing errors.

In the early pilot programs, BMC reported a 50% bedside scanning rate for all medications and a medication error rate of 1.2 errors per 1,000 patient days.

Following the implementation of an organization-wide bar code scanning process in September 2008, BMC improved its medication scanning rates to 87%—90%. The medication error rate also decreased to 0.3 errors per 1,000 patient days, a 75% reduction.

-----

http://www.ehiprimarycare.com/news/6298/ehi_awards_2010:_the_winners

EHI Awards 2010: the winners

07 Oct 2010

A system that lets paramedics hand over patient details to A&E staff has electronically scooped the top prize in the E-Health Insider Awards 2010 in association with BT.

The cab-based terminal developed by the Scottish Ambulance Service was judged the overall winner at the awards at the Grand Connaught Rooms in central London last night, having earlier won ‘best use of mobile technology in healthcare’.

The healthcare IT champion of the year award, which is decided by EHI readers, went to John Thornbury, ICT director at Worcestershire Acute Hospitals NHS Trust.

Jon Hoeksma, editor of EHI, said: “The awards are a bellwether for the health and vitality of this important sector and they show that healthcare IT is still producing great innovation and excellent work by teams and individuals.

-----

http://www.modernhealthcare.com/article/20101007/NEWS/101009973

Groups push infection-prevention framework

By Maureen McKinney / HITS staff writer

Posted: October 7, 2010 - 11:30 am ET

A coalition of infectious-disease groups are calling for the widespread adoption of a new prevention framework that they say can eliminate healthcare-associated infections. The groups outlined the framework in a white paper (PDF) that appeared Thursday in the American Journal of Infection Control and the journal Infection Control and Epidemiology.

The key elements of the framework are data collection, evidence-based practices, system-wide infection-prevention strategies and enhanced medical knowledge, according to the paper’s authors, who include representatives from the Centers for Disease Control and Prevention, and the Society for Healthcare Epidemiology of America.

-----

http://www.cbc.ca/canada/toronto/story/2010/10/06/health-drug-records-ehealth-study.html

E-health drug data saves $436M: study

Last Updated: Wednesday, October 6, 2010 | 9:11 AM ET

CBC News

Canada is seeing e-health gains in the area of medication, with an estimated $436 million in cost savings and efficiencies this year, a report released Wednesday says.

Drug information systems, which are hooked up now mainly in the western provinces and Prince Edward Island and to a lesser extent elsewhere, allow pharmacists and health-care providers to electronically access records of a patient's prescription medications.

And they provide a full and accurate medication history so that potential drug interactions or allergies can be caught before they happen.

The $436-million tally and report were compiled by Deloitte for Canada Health Infoway, a federally funded organization that was founded in 2001 and charged with helping provinces and territories to adopt electronic health-record projects.

-----

http://govhealthit.com/newsitem.aspx?nid=74774

ONC studying risks of de-identified patient records

By Mary Mosquera

Friday, October 01, 2010

The Office of the National Coordinator has begun a study on how to overcome the privacy and security risks of using health information that otherwise has been stripped of its personal identifiers such as a patient’s name and address.

One danger is that the data might be able to be re-identified through the use of additional records publicly available on the Internet, according to Dr. David Blumenthal, the national health IT coordinator.

But health care experts say that the use of de-identified data is critical for tracking population health over time and for research purposes.

-----

http://www.govhealthit.com/GuestColumnist.aspx?id=74755

Guest Columnist

Approaches to statewide patient identification: pros and cons

By Dr. Scott Schumacher

Thursday, September 30, 2010

Determining the best way to identify patients statewide or nationally is one of the hottest topics of debate within today’s health IT community.

We all agree on the importance of identifying patients – of ensuring that information about a patient is accurate and accessible regardless of where that patient is being treated.

We also agree on the importance of eliminating risks and securing patient information – of maintaining patient privacy and securing their protected health information (PHI).

What we cannot seem to agree on is the best way to achieve successful patient identification while eliminating risk.

-----

http://www.who.int/goe/ehir/2010/5_october_2010/en/index.html

E-Health Intelligence Report

5 October 2010

Scientific Articles

:: Effectiveness of telemedicine: A systematic review of reviews

International Journal of Medical Informatic. 2010

A review of systematic reviews of telemedicine interventions was conducted. Interventions included all e-health interventions, information and communication technologies for communication in health care, Internet based interventions for diagnosis and treatments, and social care if important part of health care and in collaboration with health care for patients with chronic conditions were considered relevant.

:: 10 Years Experience with Pioneering Open Access Publishing in Health Informatics: The Journal of Medical Internet Research (JMIR).

Stud Health Technol Inform. 2010;160:1329-33.

Traditional medical informatics journals are poorly cited and the visibility and uptake of articles beyond the medical informatics community remain limited....The paper summarizes some of the features of the Journal, and uses bibliometric and access data to compare the influence of the Journal on the discipline of medical informatics and other disciplines.

-----

http://www.govhealthit.com/newsitem.aspx?nid=74753

States ramping up encounter data reporting

By Kathryn Foxhall

Thursday, September 30, 2010

The largest collection of hospital all-payor, multi-year, encounter-level data is now more usable due to state-level efforts to provide better information faster, Agency for Healthcare Research and Quality experts said Wednesday.

AHRQ’s “Healthcare Cost and Utilization Project,” (HCUP) collects hospital administrative data on hospital inpatient, emergency department and ambulatory surgery care.

Much of the information is now available much sooner, “because states have been very innovative in turning around their databases,” said Dr. Claudia Steiner, a research medical officer within AHRQ who has worked on HCUP for a number of years.

-----

http://www.ehiprimarycare.com/news/6286/connelly_outlines_nhs_info_%E2%80%98revolution%27

Connelly outlines NHS info ‘revolution'

01 Oct 2010

The NHS' director general of informatics, Christine Connelly, has outlined an information revolution for the health service to match the root and branch reform promised by the Conservative-Liberal Democrats government.

“The model for healthcare in its entirety is being redesigned and recast. Given this change we need to re-design the model for informatics in step," Connelly told a conference in central London.

“We need to start to design that now. What does a commissioning world look like? What does a provider world look like?”

She said that the government was planning “very new kinds of structures and organisations, and a new approach to information is needed to build bridges to connect the different parts."

-----

http://www.modernhealthcare.com/article/20101007/NEWS/310079961

Only 1 in 15 docs e-mails with patients: study

By Andis Robeznieks / HITS staff writer

Posted: October 7, 2010 - 11:30 am ET

Despite indications that e-mail access to physicians increases patient satisfaction, only 6.7% of office-based physicians routinely use e-mail to communicate with their patients, according to a report from the Center for Studying Health System Change. The report is based on a 2008 survey of 4,258 physicians (anesthesiologists, pathologists, radiologists, and residents and fellows were excluded).

Only 34.5% of survey respondents said their office was equipped to handle electronic communication about clinical issues with patients, and among them, only 19.5% reported e-mailing with patients routinely.

-----

http://www.healthleadersmedia.com/content/FIN-257433/Comparative-Effectiveness-Could-Save-Medicare-Billions-Study-Says

Comparative Effectiveness Could Save Medicare Billions, Study Says

Roxanna Guilford-Blake for HealthLeaders Media , October 7, 2010

The "comparative effectiveness" of different treatments for the same medical condition became a hot-button issue in the healthcare reform debates. But despite federal funding for research into how to compare various treatments, the Affordable Care Act limits the abilityof the federal government to draw on comparative effectiveness research to determine what can be covered under Medicare.

Politics aside, using such research to determine how much to pay for newly covered services could yield billions of dollars in savings without threatening patient choice, according to a paper in the October issue of Health Affairs.

-----

http://www.healthleadersmedia.com/content/TEC-257332/Riverside-Monitors-Patient-Portal-Efficiency

How to Evaluate Patient Portal Efficiency

Carrie Vaughan, for HealthLeaders Media , October 5, 2010

When Riverside Health System implemented its EMR in 1996, the idea was that it would be able to use the data to help drive improvements in care.

"We thought we'd have all of the data fields in our notes," says Charles Frazier, MD, vice president of innovation. "Everybody thinks we'll get all this data and be able to do all of this stuff with it, but it is a difficult thing."

After 10 years, the Richmond, VA-based health system—which consists of four acute care hospitals, rehabilitation and long-term care facilities, and the Riverside Medical Group, a 350-member multispecialty physician practice—was still working on problem lists, lab values, medications, and elements such as gender and age. Today, the health system is still continually trying to improve how it puts information into the EMR, Frazier says.

-----

http://www.marketwatch.com/story/this-mobile-app-could-save-your-life-2010-10-05?siteid=nwhwk

Telecom apps take the Hippocratic Oath

Diagnostic medicine is increasingly going mobile, but path isn’t smooth

By Kim Hjelmgaard, MarketWatch

LONDON (MarketWatch) — At home. On the go. During a meeting. Take your pick. The good doctor gets around these days.

If you have diabetes, asthma or heart disease, there’s almost certainly an elegant smartphone interface at your disposal.

If you’re overweight or if it’s the scourge of meningitis you fear — or even if you simply don’t know where to look for judicious diagnostic advice and treatment — the wireless medical world is at hand.

-----

http://www.healthcareinfosecurity.com/articles.php?art_id=2973

PHR Privacy Report a Work in Progress

Federal Officials to Hold Event to Gather Ideas

October 4, 2010 - Howard Anderson, Managing Editor, HealthcareInfoSecurity.com

Federal officials are still months away from submitting an overdue report to Congress on privacy and security requirements for personal health records vendors, which are not covered by HIPAA.

Section 13421 of the HITECH Act called for the Department of Health and Human Services to submit a report by last February on the requirements for PHR vendors and others not covered by HIPAA. But the report has been delayed while the Department of Health and Human Services' Office of the National Coordinator for Health Information Technology worked on other projects, says Joy Pritts, ONC's chief privacy officer. She expects the report to be completed early in 2011.

Personal health records are initiated and maintained by patients. They can include information entered by patients as well data from other sources, such as a doctor's electronic health records.

-----

http://www.nytimes.com/2010/10/04/technology/04pad.html

October 3, 2010

2 Brothers Await Broad Use of Medical E-Records

By STEVE LOHR

There is no silver bullet for reforming America’s health care system, but medical experts have long agreed that digital patient records and electronic prescribing can help improve care and curb costs.

It seems straightforward. Just combine technology skills with investment money, and then develop innovative products. But to date, the push for a digital revolution in doctors’ offices has brought mostly frustration for the many companies big and small that are trying to conquer the field.

Just ask the Doerr brothers — John Doerr, the well-known venture capitalist who was an early backer of Google and Amazon, and Dr. Tom Doerr, a physician and software designer.

-----

http://www.healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=AE93323850224247BE35138E7BAA25A6

Data Virtualization Interest Is On the Rise

A recent survey suggests data virtualization may make inroads in healthcare applications

By John DeGaspari A survey conducted by Composite Software, Inc., San Mateo, Calif., a supplier of data virtualization products, has found increasing interest in the use of data virtualization as part of enterprise-wide data integration strategies. Robert Eve, executive vice president, says the findings are pertinent for large enterprises, such as healthcare providers, which have various sources of data.

Eve describes data virtualization as a way of pulling together data from multiple sources. He says it is a lower cost alternative to data warehousing. In his view, data virtualization is especially useful for “wide, shallow” types of queries, such as requesting a single patient’s information across various sources.

The results of the survey are based on the replies of 143 respondents, including CIOs, business intelligence consultants, database administrators and developers. About 10 percent of the respondents were involved in some way with the healthcare industry. Overall, 47 percent of all respondents expressed interest in using data virtualization in their organizations; those involved with the healthcare industry were in line with that figure, Eve says.

-----

http://healthcareitnews.com/news/hies-show-their-value-community-physicians

HIEs show their value to community physicians

October 01, 2010 | Patty Enrado, Special Projects Editor

SAN FRANCISCO – Trying to build a critical mass of physicians to adopt electronic health records (EHRs) and participate in health information exchanges (HIEs) is one of the more difficult tasks for HIEs and regional health information exchanges.

Three executives offered up their best practices at Axolotl's 9th Annual Customer Conference in San Francisco on Sept. 30.

Quality Health Network, a nonprofit quality improvement collaborative based in Grand Junction, Colo., has achieved an 88 percent adoption rate among physicians in its region. One of the reasons QHN achieved such a high adoption rate is that it built a governance infrastructure that included many local stakeholders, who were then responsible for making critical and often tough decisions, said executive director Dick Thompson.

-----

http://www.modernhealthcare.com/article/20101004/NEWS/310049976

Telemedicine aids early diagnosis: study

By Shawn Rhea / HITS staff writer

Posted: October 4, 2010 - 11:45 am ET

A new telemedicine study has found that review of electronically transmitted heart images by remote specialists allowed for earlier diagnosis and treatment of pediatric heart problems.

The study was conducted by researchers at Children’s Mercy Hospital and Clinics in Kansas City, Mo., and presented at the American Academy of Pediatrics national conference, which runs through Tuesday in San Francisco. For the study, researchers looked at 905 first-time pediatric echocardiograms performed at St. John’s Regional Medical Center in Joplin, Mo., between April 1998 and October 2009 and transmitted to pediatric heart specialists at Children’s Mercy.

-----

http://www.healthleadersmedia.com/content/TEC-257163/IOM-to-Launch-HIT-Study

IOM to Launch HIT Study

John Commins, for HealthLeaders Media , October 4, 2010

The Institute of Medicine will conduct a one-year study to determine if health information technology will achieve its full potential for improving patient safety in healthcare. The study will be carried out under a $989,000 contract from the federal Office of the National Coordinator for Health Information Technology.

"Since 1999, when the IOM published its ground-breaking study To Err Is Human, the Institute has been a leader in the movement to improve patient safety," said David Blumenthal, MD, national coordinator for HIT. "This study will draw on IOM?s depth of knowledge in this area to help all of us ensure that HIT reaches the goals we are seeking for patient safety improvement."

-----

http://www.fiercehealthit.com/story/pharmacies-sue-cvs-caremark-over-privacy-issues/2010-10-04

Pharmacies sue CVS Caremark over privacy issues

October 4, 2010 — 2:33pm ET | By Neil Versel

Patient and physician privacy apparently are being compromised in all kinds of ways in Texas. In just the past few days, we've learned that:

* The Texas Department of State Health Services (DSHS) has sold or given away hospital patient data on more than 27 million hospital stays since 1999, according to a report by the Austin Bulldog, an investigative journalism nonprofit organization.

* The Texas Tribune reports that former state Rep. Bill Zedler (R-Arlington) "used his legislative authority to obtain a series of confidential records from the Texas Medical Board." Zedler reportedly reviewed files on five physicians, at least two of whom contributed to his campaign fund.

* A group of six independent pharmacies in the Lone Star State have sued CVS Caremark, charging that the company's Caremark pharmacy benefits management arm engaged in racketeering and violated HIPAA by gaining too much control over patient data and squeezed competition out of the retail pharmacy market.

-----

http://www.hospitalimpact.org/index.php/2010/09/29/title_23

Factors to consider when designing HIE networks

September 29th, 2010

by Paul Abramson, MD

What will it take to create local health information exchange (HIE) systems that fit in with the federal government's vision of local, regional and national health information exchange networks based on standards defined by the Nationwide Health Information Network (NHIN)? The fragmentation of the efforts of groups involved in the actual HIE implementation at the community, local and regional levels is just one of many challenges and obstacles facing those who are trying to meet the government's meaningful use criteria. Here are some others.

Data Models: A technical issue with security implications

Theoretically, health information exchange can be accomplished in a number of different ways. One common model is the central repository, where everyone's health information in a given city or region is cached on a central "health exchange server" which can be queried by individual entities.

Another design is the federated model, where a central "master patient index" is used to match user requests with health data residing in the electronic health records systems of individual hospitals, labs, and doctors' offices. There is a corresponding trade-off between speed and reliability with the central repository model, and potentially greater security and access control with the federated model. In practice, most HIEs will likely use some hybrid of central and federated models in order to achieve a workable compromise.

-----

Enjoy!

David.