The question was:
Will Anything Useful Come from The Proposed Government E-Health Summit?
You Bet!
- 1 (4%)
Possibly
- 5 (20%)
Maybe
- 8 (33%)
No Way
- 10 (41%)
Votes 24
I think there is a fair degree of scepticism much good will come from this! We shall all have to wait and see.
I wonder are we going to see information released in the next week or two to explain just what is to be discussed?
Again, many thanks to those that voted!
David.
The following appeared a day or so ago.
By John Pulley 11/03/10 03:33 pm ET
Exactly how electronic health records will affect workflow in outpatient settings remains unclear, according to a new report.
Studies to date have been "anecdotal, insufficiently supported, or otherwise deficient in terms of scientific rigor," according to the report, prepared by the Agency for Healthcare Research and Quality by the Center for Quality and Productivity Improvement at the University of Wisconsin-Madison.
Notwithstanding those deficiencies, previous studies found that EHR implementation resulted in "nearly universal" increases in workload for physicians, according to the report submitted to the AHRQ. Workflow can include activities by patients, clinic providers or clinic staff, exchanges between organizations or work that happened during or between clinic encounters, the researchers said.
The report found that:
And a range of other issues:
Read the full list here:
http://healthitupdate.nextgov.com/2010/11/ehrs_time_savers_or_time_wasters.php?oref=latest_posts
Here is how the report is described by the AHRQ.
AHRQ released a new summary report, Incorporating Health IT into Workflow Redesign (PDF, 1.37 MB), prepared by the University of Wisconsin-Madison's Center for Quality and Productivity Improvement (CQPI). The report summarizes existing research and evidence related to the impact of health IT on workflow in outpatient settings. Key information obtained from the research will be incorporated into a toolkit to assist small and medium-sized practices in workflow analysis and redesign before, during, and after health IT implementation. The toolkit, Workflow Assessment for Health IT, is expected to be available in January 2011.
Download the Incorporating Health IT into Workflow Redesign Summary Report (PDF, 1.37 MB) and the associated Appendix, Incorporating Health IT Into Workflow Redesign Summary Report Appendix F: Tool Compendium (PDF, 1.43 MB) PDF Help.
This is the page where this and a heap of other stuff is found:
http://healthit.ahrq.gov/portal/server.pt/community/ahrq_national_resource_center_for_health_it/650
Important stuff and well worth a read!
David.
This popped up a day or two ago.
November 02, 2010
The fervor and buzz around electronic health records is mounting as federal legislation threatens fines for non-compliance by 2016. Ironically, the EHR adoption rate for medical practices remains relatively low, especially among practices with fewer than 50 physician providers.
The barriers in part are due to an abundance of myths and misinformation that lead to errors along the implementation path and drive runaway costs for EHR projects.
With thousands and even millions of dollars at stake for providers, we debunk 12 common myths that may doom your EHR efforts.
Myth #1 – EHR projects are IT projects
Implementing EHR is not a project for the IT department alone. EHRs are an enabling technology that is part of a larger initiative designed to help physicians demonstrate the improved value of the services they deliver by improving clinical quality and economic efficiency. This involves a cross-department effort. Healthcare providers who can successfully and demonstrably supply services of greater value to patients and other consumers of healthcare services will be in a better competitive market position. They can use this improved position to take advantage of government incentives, avoid government penalties, access pay-for-performance programs and gain market share.
Myth #2 – EHR software is useful out of the box
EHRs are usable, but not useful “out of the box.” Like all large scale software products, they require some end-user modification and customization. Providers need to pay particular attention to customizing certain visit templates, building useful patient registries and chronic disease management flow sheets, adding evidence-based decision support features and creating custom reports. Furthermore, in order to meet the challenge of building a health information exchange, the EHR must be customized to interface with other systems.
Myth #3 – EHR vendors will provide all the project management and assistance I need
EHR vendors may claim to provide “end-to-end” solutions. However, EHR vendors will typically use this term in reference to their specific area of expertise. In reality, there are numerous aspects of an EHR project that fall outside the purview of the vendor.
Read the other nine here:
The webinars offers with this are also useful:
For more details regarding how to avoid the common pitfalls of EHR implementation, watch the following pre-recorded webinars from Ms. Waltko and Dr. Sprowl:
Part I : https://www1.gotomeeting.com/register/805140696
Part II : https://www1.gotomeeting.com/register/297403248
The registration only requires an e-mail address and name and the content seems pretty sound to me.
Well worth some of your time.
David.
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.
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http://www.ihealthbeat.org/features/2010/health-it-key-to-patientcentered-medical-homes.aspx
Friday, October 29, 2010
The patient-centered medical home concept has been around since 1967, when it was first introduced by the American Academy of Pediatrics. More than 40 years later, widespread implementation has yet to occur, but the health reform law and the "meaningful use" incentives have given the concept new legs.
The patient-centered medical home model aims to improve consumer access to primary care services and increase care coordination. Advocates say such a team-based care model can reduce costs, prevent unnecessary hospitalizations and improve population-based health.
According to Paul Keckley, executive director of the Deloitte Center for Health Solutions, the patient-centered medical home "is an advancement in the design, delivery and payment for health care services that leverages emergent characteristics of a transformed health system -- shared decision-making with patients, multidisciplinary teams where all participate actively in the continuum of care, incentives for adherence to evidence-based practices and cost efficiency, and health information technologies that equip members of the care team and consumers to make appropriate decisions and monitor results."
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http://hitechwatch.com/blog/are-ehrs-already-obsolete
By Jeff Rowe, Editor
Providers and policymakers working hard to transition the healthcare sector to EHRs might not want to think about this, but at least one longtime observer of HIT is suggesting that EHRs have already had their day and it’s time to move on to something new.
After a brief overview of the development and introduction of electronic health records, he turns the corner and declares, “It’s time to forget and rethink the model.”
It’s not that he thinks EHRs don’t provide significant value; it’s that “new approaches” to healthcare delivery, such as patient-centered medical homes (PCMH) and accountable care organizations (ACOs), “require a different toolset than traditionally has been available to the healthcare market. EHRs, while evidence of technological progress in the industry, were designed to support a provider- and hospital-centric approach to care. As such, they are not fully equipped to catapult the industry towards the collaborative strategy preferred today. ACOs, PMHCs and other approaches will rely upon a platform that facilitates collaboration beyond the enterprise and across the community to achieve multidisciplinary care coordination.”
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More than half of U.S. medical offices affiliated with large healthcare groups have implemented electronic health records, ahead of the U.S. average of 39%.
By Nicole Lewis, InformationWeek
Oct. 26, 2010
URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228000059
Medical offices owned by hospitals and health systems saw the biggest jump in electronic health record (EHR) adoption rates between January and October 2010, according to the latest results of an ongoing survey released Monday by SK&A, a provider of healthcare information solutions and research.
The latest findings from the biannual survey, "Physician Office Usage of Electronic Healthcare Records Software," show EHR adoption at hospital-owned offices grew from 44.1% to 54.9%, a 10.8% increase. Adoption at heath-system-owned offices grew from 50.2% to 61.2%, an 11% increase. Overall, U.S. medical office EHR adoption has grown from 36.1% to 38.7%, a 3% increase.
SK&A's report is an ongoing study that tracks EHR adoption data and summarizes market research from 213,500 medical offices representing 643,000 physicians.
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Health 2.0 initiatives reduce medical expenses while improving the quality of care, finds Healthcare Performance Management Institute study.
By Nicole Lewis, InformationWeek
Oct. 27, 2010
URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228000138
Social media initiatives that help physicians, patients, and the medical research community share patient information will drive down healthcare-related costs while improving the quality of care, a report concludes.
The report, "Healthcare Performance Management in the Era of 'Twitter,'" was published this week by the Healthcare Performance Management Institute. Drawing on a number of case studies across the country, the report gives examples of how social media and other Health 2.0 initiatives are transforming the healthcare marketplace to promote a cost-efficient interactive healthcare system that provides better patient outcomes.
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http://www.healthcareitnews.com/news/it-helps-care-coordination-heart-disease-prevention-program
October 25, 2010 | Molly Merrill, Associate Editor
DENVER – An intensive population management program that matches heart disease patients to personal nurses and clinical pharmacy specialists is able to save lives, reduce hospital visits and drive down costs, according to a new study from Kaiser Permanente Colorado.
Researchers in the study examined healthcare expenditures in two populations of patients with heart disease: a group of 628 people enrolled in the Kaiser Permanente Collaborative Cardiac Care Service (CCS), a population disease management program, and 628 matched patients receiving standard care. The goal of the study was to determine if an intensive disease management program could provide more value than usual care.
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http://www.e-health-insider.com/news/6356/dh%27s_info_revolution_is_%27fantasy%27
28 Oct 2010
Analysts and professional bodies have expressed concern about the government’s ability to bring about an information revolution without additional funding or detail on how the change will be led in a period of NHS reform.
Experts contacted by E-Health Insider for their reaction to the government’s consultation on an NHS information strategy, also queried the lack of focus of the IT required to deliver the records that lie at the heart of many of its proposals.
Jonathan Edwards, Gartner’s research vice president for health, told EHI that without funds and a focus on the practical details of delivery many statements in the document were “little more than fantasy.”
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http://www.e-health-insider.com/comment_and_analysis/649/october_revolution
28 Oct 2010
Experts have not been fired with enthusiasm by the government’s ideas for an information revolution. In fact, analysts and professional bodies are asking where the commitment, money and practical details have got to. Sarah Bruce reports.
In opposition, health secretary Andrew Lansley promised NHS staff and patients an “information revolution” to support quality, promote choice and deliver accountability.
July’s white paper, ‘Equity and excellence: Liberating the NHS’, said an information strategy would be published to help to bring the revolution about.
Last week, a 68 page consultation emerged from the Department of Health. Yet analysts and professional bodies are struggling to find anything terribly revolutionary about it.
There is also considerable skepticism about whether its proposals can be carried through. A major cause of concern is that there will be no funding for any of the initiatives proposed.
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http://www.fierceemr.com/story/vas-baker-modernize-rather-replace-vista/2010-10-28
October 28, 2010 — 10:56am ET | By Neil Versel
The Department of Veterans Affairs won't be trying to replace VistA anymore, but instead will be looking for ways to improve the powerful EMR system via open-source collaboration with the private sector.
"Let's be clear, in my view, VA over the last 10 years has tried to replace VistA. I don't think that's possible. It would be like Microsoft trying to replace Windows with not an evolutionary product, but with something brand new, but it has to come out and it has to be better the day it's introduced," VA CIO Roger Baker says in a in-depth interview with FierceGovernmentIT. "That, basically, was the criteria for what VA was trying to do. That program was called HealtheVet. I have stepped VA away from HealtheVet, and what we're now looking at is how do we continue the evolution of VistA.
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http://www.modernhealthcare.com/blogs/it-everything/20101028/310289956
In medias res is a narrative device that begins a story by plunging a reader or viewer into the middle or near the story's chronological end.
Think of the opening scene in Sunset Boulevard and the disembodied voice of William Holden explaining why Joe Gillis is taking such a long soak in Norma Desmond's pool.
In medias res is what a policy committee of the federal government is doing just now, seeking public comment on how to govern a proposed network for health information exchange, development of which is already well under way.
A federal proposal to develop what was then called a National Health Information Network dates to 2004 and David Brailer, the first National Coordinator for Health Information Technology at HHS. And work began that year, funded by the Markle and Robert Wood Johnson foundations, on what would become Markle’s "Common Framework," a set of policy and technical guidelines for the NHIN.
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http://www.e-health-insider.com/features/isoftRT-sep2010/
At the end of September 2010, eHealth Insider hosted a roundtable on the future of IT in primary care, sponsored by ISOFT.
The debate took place just a few weeks after the launch of the white paper, ‘Equity and excellence: Liberating the NHS’, but before the publication of the information strategy that will support it. So there was much discussion of the many details of future policy that are still unknown.
Despite this, the participants agreed that information for both clinical decision making and commissioning will become ever more important - and that more information will need to be shared with other providers and with patients as well.
They also agreed that online services and telehealth will become more widely used and influential. And that future IT developments will need to be moulded around the needs of clinicians and the patients they serve.
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http://www.computerworld.com/s/article/9193130/Digital_divide_plagues_slow_e_health_records_rollout
Lucas Mearian
October 27, 2010 (Computerworld)
The digital divide is alive and well when it comes to health care technology.
Although President Barack Obama has made it a priority to have medical facilities deploy electronic health records (EHR) over the next four years, the people most likely to benefit -- those in poor and minority communities -- are unlikely to see them anytime soon.
Physicians' practices and small clinics, where most doctors work, don't have the money to implement the technology, which can cost tens of thousands of dollars.
In an open letter to IT vendors, David Blumenthal, National Coordinator for Health IT, asked that they do what they can to improve health care for low-income and minority communities to prevent health disparities caused by a "digital divide."
EHRs, which can help ensure that medical best practices are followed and aid in tracking illnesses by geographic regions, can mean the difference between life and death.
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http://www.fiercehealthit.com/story/telemedicine-adoption-picks-costs-fall-quality-rises/2010-10-25
October 25, 2010 — 12:13pm ET | By Neil Versel
With costs falling and video quality rapidly improving, more healthcare providers are taking a serious look at videoconferencing for telemedicine, helping to standardize the field while also extending the reach of healthcare professionals, according to a report from Frost & Sullivan. However, factors including staff training and lack of third-party reimbursement are holding back wider growth, the London-based research firm says.
"The costs of telemedicine videoconferencing systems and transmission service are not a major barrier to their deployments any more," Frost & Sullivan research analyst Iwona Petruczynik says in a press release. "In the last two years, there has been a significant reduction in prices of equipment and a substantial improvement in endpoint functionality, especially video quality."
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ClearPractice's Nimble e-health record product running on the iPad has convinced some nervous doctors that digital charts aren't so bad after all.
By Marianne Kolbasuk McGee, InformationWeek
Oct. 26, 2010
URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=227900734
The iPad in healthcare has a lot of potential to be a preferred device for clinical applications, including e-health records. Not only is the device mobile and affordable, its ease of use could be just the thing to hook physicians who are otherwise scared of trading in their paper charts for digital records.
At least that's the thinking of Joel Andersen, president of ClearPractice, a vendor that offers web-based, software-as-a-service e-medical record, e-prescribing and practice management applications for physician practices that have 10 or fewer clinicians.
Last month, the company introduced its newest offering, Nimble, an EMR for the iPad.
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http://www.washingtonpost.com/wp-dyn/content/article/2010/10/25/AR2010102503199.html
By LAURAN NEERGAARD
The Associated Press
Monday, October 25, 2010; 4:02 PM
WASHINGTON -- Think you entered the digital health age when your doctor switched from paper charts to computerized medical records? Think again: An e-chart stored in one doctor's computer too often can't be read by another's across town.
Now the country's largest network for paperless prescribing is poised to help tackle that hurdle. Surescripts is expanding so that doctors around the country can choose to share medical reports, X-rays and other health data over its network much as they send e-prescriptions to drugstores today, regardless of what competing brand of computerized health records they use.
"What doctors would like to do is share comprehensive information with each other - give me the whole file as opposed to writing me a note," says Surescripts executive vice president Cris Ross. "No other industry would stand for that level of clumsy communication."
With 200,000 doctors already using Surescripts for e-prescribing, the move is among the largest of a growing number of efforts to connect electronic medical records - including work to link Veterans Affairs hospitals with private physicians in certain cities, and half a dozen soon-to-start pilot projects in a government-industry partnership.
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http://blogs.wsj.com/health/2010/10/21/joint-commission-hospital-collaboration-targets-hand-offs/
Last year the Joint Commission, which accredits hospitals, said its new Center for Transforming Healthcare would collaborate with hospitals and health-care systems to help them fix some of the most serious problems in patient care.
The center started with handwashing, the seemingly straightforward hygiene measure that health-care workers often fail to take. Today the Joint Commission gave an update on a project targeting the miscommunication that can happen when a patient is handed off from one caregiver to another. (Other ongoing projects tackle surgical-site infections and wrong-site surgery.)
The Joint Commission said that the ten hospitals and systems that volunteered to collaborate on the issue initially found that hand-offs were defective 37% of the time. That’s important, because those crossed signals are estimated to be associated with 80% of serious medical errors, the commission said.
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http://healthcareitnews.com/news/patient-monitoring-market-pegged-4b-2017
October 22, 2010 | Bernie Monegain, Editor
VANCOUVER, BRITISH COLUMBIA – Fueled by efforts to reduce acute and long-term care costs, the U.S. patient monitoring market is expected to reach almost $4 billion by 2017, according to a new report by iDataResearch, a global research and consulting firm.
Multi-parameter vital-sign devices represented the majority of the patient monitoring market in 2010, with the home telehealth segment growing more than 17 percent in 2010 and the hospital wireless telemetry monitoring segment growing at high double-digit rates. The second largest segment of this market was pulse oximetry, which is expected to exceed $934 million by 2017.
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http://www.modernhealthcare.com/article/20101026/NEWS/310269996/
By Joseph Conn / HITS staff writer
Posted: October 26, 2010 - 10:45 am ET
The Obama administration is forming a work group focused on online privacy, but the group's work, which could affect the privacy of millions of Americans online, possibly including health information, will be conducted mostly in private.
The Subcommittee on Privacy & Internet Policy will include a representative from HHS as well as other Cabinet-level departments—Justice, Homeland Security, Commerce, Energy, Education, State, Transportation and Treasury. Its membership also will draw from national intelligence and national security agencies under the executive branch, including the National Security Staff Cybersecurity Directorate and the National Security Council, whose members include the defense secretary, the chairman of the Joint Chiefs of Staff, the director of national intelligence and the assistant to the president for national security affairs.
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Funding available for swift implementation: Minister
October 26, 2010 (Winnipeg, MB) - More Manitoba physicians will be able to make use of electronic medical records (EMR) to better manage patient information with the support of a new funding program, Health Minister Theresa Oswald announced today.
“Patients will receive faster access to better quality care with more doctors implementing electronic medical records,” said Oswald. “Together with Canada Health Infoway, we are making it easier and more affordable for family doctors to modernize their practices with electronic medical records.”
The electronic medical record is a system used within primary and specialist-care clinics to improve the management of patient information and care. EMRs contain information that is specific to the care a patient receives from a clinician or group of clinicians usually within one clinic or facility, such as diagnostic images like X-rays, prescriptions and medications, patient recalls and reminders and appointment scheduling.
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http://www.healthdatamanagement.com/news/ehr-cuts-long-term-operating-costs-41218-1.html
HDM Breaking News, October 25, 2010
A report from the Medical Group Management Association, based on a survey of 1,324 primary care and specialty practice members, finds significant financial benefits to using an electronic health records system.
Englewood, Colo.-based MGMA reports that independent practices had a median of $49,916 more revenue after operating costs per full-time physician in 2009 than paper-based practices. Hospital- or delivery system-owned multi-specialty practices with an EHR had a median operating margin in 2009 of $42,042 more than paper-based practices.
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http://www.modernhealthcare.com/article/20101025/NEWS/310259909
By Gregg Blesch / HITS staff writer
Posted: October 25, 2010 - 12:01 am ET
The American Medical Association has a solution for physicians put off by the quickly evolving and high-stakes marketplace for health information technology.
Specifically, the association has a doorway to other people's solutions and is going to sell tickets for entry.
Over the past several months, the organization has announced partnerships with a handful of technology companies that have signed on as participants in this new online platform, including NextGen Healthcare Information Systems and CareTracker, which offer integrated electronic health-record and practice management applications.
The AMA and other national physician groups generally have steered clear of endorsing any particular product or vendor, choosing instead to be counselors and resource libraries to members attempting to understand a complex and quickly evolving marketplace before investing tens of thousands of dollars and untold hours into a product.
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http://online.wsj.com/article/SB10001424052702304180804575188402688763416.html
JAMES YANG
One Saturday night, Michael Adamik, a retired engineer, was recording his weight and blood pressure when he discovered a startling gain of nine pounds from the day before. Sudden weight gain for someone who has congestive heart failure, as Mr. Adamik does, could indicate the condition is worsening.
So the Cleveland Clinic, where Mr. Adamik is a patient, asked him to sign up for Microsoft HealthVault, an online personal health record, or PHR. Now the 66-year-old from Brecksville, Ohio, enters his daily numbers directly into the online tool, which the clinic monitors in real time. If Mr. Adamik is in any danger, the clinic contacts him immediately.
"The biggest benefit" of the service, he says, "is that it takes the decision away from a non-medical person."
With people over 50 increasingly focused on ways to monitor and measure their health, PHRs are drawing more attention. In addition to Microsoft Corp.'s product, other well-known PHRs include Google Inc.'s Google Health and WebMD Health Manager from WebMD Health Corp. These tools can store your entire health history, saving you from chasing medical details spread over countless slips of paper from pharmacies, doctors and laboratories.
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http://www.thespec.com/news/local/article/270368--prognosis-is-finally-good-for-e-health
A regional version of e-Health is taking shape and giving doctors access to most of a patient’s record from almost any hospital in the Local Health Integration Network (LHIN).
Although out-of-hospital records such as private lab test results and prescriptions are unavailable, Hamilton Health Sciences (HHS) wants people to know an electronic patient information system is closer than most would think.
It is still in a rollout phase, but “we have 3,000 physicians and clinicians (out of 15,000) enrolled and we continue to add hospitals onto the system,” said Mark Farrow, HHS assistant vice-president of information and technologies. The Hamilton Niagara Haldimand Brant LHIN e-health version, spearheaded by HHS, will also tap into the Wellington Waterloo LHIN’s hospitals.
Provincially, Ontario’s e-Health Program will standardize and connect all such versions for province-wide access.
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http://www.e-health-insider.com/news/6348/wrightington_finalises_cambio_contract
25 Oct 2010
Wrightington, Wigan and Leigh NHS Foundation Trust has completed the sign-off of its contract with Cambio Healthcare Systems for a new hospital information system.
As first reported by E-Health Insider last month, the trust has awarded the Swedish company the ‘multi-year’ contract for a patient administration system, A&E functionality and e-prescribing.
The award followed a comprehensive tendering process that began in January. Speaking to E-Health Insider after finalising the contact, Stephen Dobson, head of IM&T at the trust, said it selected Cambio out of 25 competitors for “numerous reasons.”
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http://www.modernhealthcare.com/article/20101022/NEWS/101029992
By Joseph Conn
Posted: October 22, 2010 - 11:30 am ET
When it comes to privacy, the Obama administration is like a distracted student with a lot on his plate.
Obama's grades, while not terrible, have fallen off somewhat for 2010 as compared with 2009, according to a report card (PDF) released by the Electronic Privacy Information Center, a 16-year-old public interest research organization based in Washington.
EPIC, as the organization is more commonly known (it is not related to Epic Systems Corp., the Verona, Wis.-based health information technology developer), has filed numerous Freedom of Information Act requests to obtain information about the federal government's warrantless wiretapping and Total Information Awareness fiber-optic-network computer surveillance programs.
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http://govhealthit.com/newsitem.aspx?nid=74897
By Mary Mosquera
Tuesday, October 19, 2010
Federally funded “beacon” communities are tackling the problem of hospital readmissions and other tough health care challenges by testing the effectiveness of multiple treatment strategies simultaneously instead of taking the traditional approach of testing one treatment at a time, according to the program’s director.
The model communities, which have already embraced electronic health records and information exchange, are working to determine which specific treatments best improve patient outcomes for their region’s healthcare goals. They would then share for those results that they can share with other communities.
“No one specific intervention in each community is designed to be the thing that will lead to improved health goals,” said Aaron McKethan, director of ONC’s Beacon program in the Office of the National Coordinator.
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Enjoy!
David.
This excellent brief article appeared last week
October 25, 2010 | Jamie Thompson, Web Editor
Peggy E. Delany, MBA, CHBC, CEO, DR Management, LLC, Member of the National Society of Certified Healthcare Business Consultants (NSCHBC), and Thomas S. Nelson, CIO, COO, DR Management, LLC, shared the following six best practices for hospitals and medical groups when implementing electronic health records.
1. Tailor your EHR to fit within staff workflows
"You cannot implement the system to meet 100% of each individual’s needs, but neither can you implement in a generic manner and assume that everyone will adjust," Delany and Nelson emphasized. But it is important to determine which aspects can be adapted to work on an individual basis, and which aspects can work across a wider spectrum. Securing the opinions and recommendations of the staff - as well as their cooperation and commitment - are crucial to making sure the EHR will work for everyone.
2. Identify ways the EHR could potentially fail in order to prevent problems in the future
Gather input from stakeholders to pinpoint ways the EHR could fail, and use that knowledge to determine what it will take for the EHR to be successful. "Remember that you are dealing with huge amounts of data. Be sure to allow for enough storage and fast enough computers to quickly access the data," said Delany and Nelson.
3. Don’t rush implementation, take time to train
"Train for every step of the process and do several short training sessions," advised Delany and Nelson. They also stressed that beginning with the basics is important, and to follow a planned-out procedure so as to ensure the accuracy and efficiency of implementation.
The other three best practices are here:
http://healthcareitnews.com/news/six-best-practices-ehr-implementation
This sentence especially struck a chord with me:
‘"You cannot implement the system to meet 100% of each individual’s needs, but neither can you implement in a generic manner and assume that everyone will adjust," Delany and Nelson emphasized.’
What logically flows if this is true - and I believe it is - is that there must be discussion and negotiation with those on the ground in each site and workplace as to what will work for them and what won’t. This is just the total opposite to the centrally imposed one size fits all approach that has been adopted - with considerable pain and anguish - in some State jurisdictions.
To not proceed in this sensible fashion is something as complex as e-Health implementation is really a very bad idea I believe.
Indeed I would suggest that there really needs to be much more focus in general in making solutions work for the Health Sector broadly - rather than what we frequently seem to see coming from policy makers and bureaucrats - where somehow the impacts of their grand designs don’t quite seem to work out when implementation is attempted.
Six points worth sticking on the war room wall!
David.
The following article popped up late last week on ZDNet. It is a very interesting summary of a 30 minute or so podcast.
By Phil Dobbie, ZDNet.com.au on October 28th, 2010
Some of the major benefits to society from a ubiquitous broadband network will come from government services, including health and education. That means access to these services needs to be free, so everyone is able to make use of the channel, thus displacing other, more costly, ways of interacting.
This isn't a new notion. Economist Joshua Gans raised it over a year ago at a Senate Select Committee hearing in Melbourne. He suggested the government provides free access to a basic internet service that included public services.
Industry analyst Paul Budde agrees that we should be working towards a free government network, available to all households through the National Broadband Network. For example, e-health services could be available to all, without needing to connect to a commercial retail service provider.
Simon Hackett, managing director of Internode, is less convinced about the idea of a direct connection for government services. He says we only have one network in the home, which means only one connection to the NBN.
Paul Brooks from Layer 10 Advisory disagrees, arguing that we have multiple networks into the home — television, our phone, internet. A government-provided network could be another one.
This week I ask whether we need free government services for everyone to realise meaningful benefits from the NBN and, if so, why is no one doing anything about it?
More here:
http://www.zdnet.com.au/free-broadband-will-help-the-nbn-s-case-339306899.htm
You can play the podcast (narrated by Phil Dobbie of ZDNet's Twisted Wire and his guests) here:
The key issue from the e-Health perspective is that to date there has been very little recognition of the whole ‘digital divide’ issue - where the old and the poor frequently lack any internet access and so cannot utilise things such as the proposed PCEHR etc.
The discussion provides some useful insights to the possibilities that may be explored.
It also points out that for some reason these ideas are not really being discussed much in the halls of power. That indeed is a pity if true.
David.
The following appeared on the weekend:
A BRAVE new world of public hospital transparency seemed to be on the horizon following the election of the Rudd government in 2007.
A perception that was encouraged by Labor's most senior figures.
Truculent states would have their heads knocked together, seemed to be the message; and they were required for the first time to divulge information that would allow an unprecedented level of scrutiny of public hospital performance.
In exchange for getting their hands on hundreds of millions of dollars in extra cash to tackle soaring waiting lists, public hospitals would have to level with the public about how they were performing across a range of measures.
Federal Health Minister Nicola Roxon warmed to this theme, telling a Consumers Health Forum event in October 2008 that the Rudd government had a "big focus on improving accountability and transparency", and work on performance indicators for public hospitals was "well advanced".
"Transparency and accountability create strong advantages for consumers, both as people who use health services and as taxpayers," she said. "For example, comparable data on quality of care, like adverse events or infection rates for superbugs such as MRSA [methicillin-resistant Staphylococcus aureus], will allow consumers to legitimately distinguish between effective and less effective providers of health care, [allowing] them to make informed decisions."
However, nothing emerged until July this year when, 24 hours before the federal election was called, Roxon said the government would launch its MyHospitals website the following month. The task of completing the launch was given to the Australian Institute of Health and Welfare, but no launch occurred in August and no new date has been offered.
The AIHW was this week referring all inquiries about the website to Roxon's office.
Even when it does start, it will be a shadow of the service Labor promised three years ago.
It will offer comparisons between what services are provided, how many beds a hospital has and how it compares with the national average in terms of waiting times for elective surgery and emergency department care.
But there will be no information about infection rates or other adverse events, at least in the near future, and much of the information may not be up to date: it is likely to reflect the most recent available data, which at present is often at least two years out of date.
Roxon defends progress on the initiative, telling Weekend Health the government believes the public has "a right to know" how its health services are performing, and the government is "not just handing over a blank cheque and wishing for the best".
Much more here:
You can see how progress is happening by going to www.myhospitals.gov.au
The most helpful thing you get at present is the advice to call 000 in an emergency!
I did mention this planned site, and suggest this was harder than you might think, in a previous blog which you can browse here:
http://aushealthit.blogspot.com/2010/08/and-just-where-will-reliable.html
In this blog I also point out just how hard reliable information on which to base more than basic bed number statistics will be.
To this we now have the added to issue most quality measures will be very hard to gather and we will find the information pretty out of date.
Maybe DoHA should contract Healthgrades in the US to assist them to develop the site they want.
Have a look here to see what is possible.
It really is a shame this is all taking so long as there is no doubt that if proper comparable data can be provided and made available to the public there should be a positive impact on safety and quality.
This page reports the astonishing differences between the best and worst in the US and shows just how helpful the information can be.
http://www.healthgrades.com/business/study/quality.aspx
At the very worst those who are careful would be able to find out what places to avoid if DoHA and AIHW were to get this sorted and going as was promised in the election campaign!
David.
Late Update 9am Nov 2.
Computerworld is reporting the site will be available in December 2010 with very routine data only and no indicators of clinical quality and safety.
The question was:
Do You Think Our Politicians and Bureaucrats Understand What is Needed in E-Health In Australia?
Very Deeply and Effectively
- 0 (0%)
They Have Considerable Insight
- 1 (3%)
Not Really
- 13 (40%)
They Are Clueless
- 18 (56%)
Votes : 32
Well that is as clear as it gets. Those running e-Health are not credible and need to work out how to connect with the Health Sector. Can you imagine that happening? They better or they will be history!
Again, many thanks to those that voted!
David.
