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."

Monday, February 07, 2011

Weekly Australian Health IT Links – 07 February, 2011.

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:

There has been essentially no progress that anyone can detect in the National E-Health scene. We still have no HI Service Implementation Plans and no public release of how the PCEHR is to actually work.

On the broader front, with the Coalition now running Victoria and WA and about to take over in NSW both the Financial Review and The Australian are reporting we are about to see some major changes in the National Health Reform Proposals:

See here for example:

http://www.theaustralian.com.au/national-affairs/julia-gillard-to-junk-kevin-rudd-health-reform/story-fn59niix-1226000488507

Julia Gillard to junk Kevin Rudd health reform

  • EXCLUSIVE Sean Parnell and Dennis Shanahan
  • From: The Australian
  • February 05, 2011 12:00AM

JULIA Gillard is preparing to dump Kevin Rudd's plan to make the commonwealth the dominant funder of hospitals, favouring an alternative model so unpopular among states that any hope of reaching a national health reform agreement appears lost.

After 12 months of wrangling with the states and the signing of a historic health funding agreement in Canberra last year, the federal government is developing a new model to deliver its funding directly to hospitals, and without the states receiving promised funds for expenditure growth and capital works.

In an attempt to finalise the new health funding agreement before the meeting of state and federal leaders in Canberra on February 14, the federal government has put forward a tough new proposal from Treasury and Prime Minister and Cabinet.

----- End Extract.

We are also seeing some concern about the so called ‘Medicare Locals’ which I wrote about last year:

http://aushealthit.blogspot.com/2010/11/medicare-locals-and-e-health-does-it.html

According to the AMA they have gone rather off the rails, with clinician roles being downgraded in Hospitals etc.

http://ama.com.au/node/6350

Lead Clinician Groups discussion paper an insult to clinicians

AMA President, Dr Andrew Pesce, said today that the Government’s proposed Lead Clinician Groups are doomed to fail if arrangements set out in a recently-circulated discussion paper are to proceed.

Dr Pesce said the fact that the discussion paper - Lead Clinicians Groups: enhancing clinical engagement in Australia’s health system - was circulated to stakeholder groups after business hours on the eve of Australia Day suggests there is some nervousness within the Government and the bureaucracy about the proposed arrangements.

“The discussion paper is an insult to clinicians. It proposes that doctors’ input to decision making would be limited to clinical practice issues, not overall hospital and health service management,” Dr Pesce said.

“This is contrary to the intended clinician role announced by former Prime Minister Rudd in a speech to the AMA National Conference in May last year.

“Mr Rudd said that Lead Clinician Groups would also guide Local Hospital Networks in ‘service planning and the most efficient allocation of clinical services …’ and ‘developing innovative solutions that best address the needs of local communities’.

“The paper sets out ways to suppress and limit clinician engagement in decision making, not enhance it – it is a plan for lead clinicians not to lead.

“It appears that all the advice from the AMA and other medical groups has been completely ignored.

----- See more at the link above:

The AMA is also not happy about the Medicare Locals consultation process. See here:

http://ama.com.au/node/6226

So we seem to have all sorts of forces wondering if what Mr Rudd planned is still appropriate and if there are other ways forward. It looks to me that the COAG Meeting, on February 14 I believe, might be pretty important in working out what will happen! There are some pretty concerned major stakeholders out there.

-----

http://www.abc.net.au/health/thepulse/stories/2011/02/03/3129119.htm

An app a day to keep bad health away

by Suzannah Lyons

Could the path to a healthier, more active you be as close as your mobile phone?

Want to record how many steps you take, keep track of your blood glucose levels, or know when you need sun protection?

Then look no further than your mobile phone.

Our love of ever more sophisticated smartphones has the potential to turn what used to be 'just a phone' into an essential tool for good health, as a growing number of us use our mobiles to access specialised health and fitness apps (short for applications).

And research suggests how we currently use our phones as health tools is only the beginning.

A report released last November found there were 17,000 mobile phone health apps available for both consumers and healthcare providers in major app stores.

The report's authors, market research firm research2guidance, also predicted that 500 million people globally, out of a total of 1.4 billion smartphone users, will be using health apps by 2015.

-----

http://www.computerworld.com.au/article/375578/connectivity_remains_key_telehealth_success/?fp=4&fpid=5

Connectivity remains key to telehealth success

Broadband, technical support shortages likely to hamper telehealth, say industry stakeholders

The Federal Government must focus on providing suitable broadband connectivity and technical capability to general practitioners and other healthcare providers in order to ensure the success of telehealth services in rural Australia, health professionals have warned.

The scheme, first announced by Prime Minister Julia Gillard during the 2010 federal election, offers $402.2 million in government funding over four years to provide Medicare rebates for some 495,000 online consultations to patients in rural, remote and outer metropolitan areas. The funding will also provide financial incentives and training to health professionals to encourage take-up of the scheme, and $50 million in funding to provide online triage and basic medical advice through videoconferencing.

In a discussion paper released in November last year, the Department of Health and Ageing identified financial incentives and procurement models as some of the obstacles to be addressed ahead of implementation.

-----

http://www.medicalnewstoday.com/articles/215669.php

GP Health Summaries - Clear Guidelines Needed To Ensure Consistency, Australia

04 Feb 2011

A need to clearly define the key elements of the GP health summary and its application in an electronic health record has prompted the Royal Australian College of General Practitioners (RACGP) to develop a set of seven factsheets to provide advice to general practice and their teams.

The 4th edition of the RACGP Standards for general practices requires that practices can demonstrate that at least 75 percent of their active patient health records contain a current health summary (criterion 1.7.2). To meet the requirements for a satisfactory summary, elements such as allergies and adverse reactions, current medicines list, current health problems, relevant past health history, health risk factors, immunisation, relevant family history and relevant social history need to be included. But what does 'current' or 'relevant' mean?

RACGP e-health spokesperson Dr Chris Mitchell said that there is a need to clearly define the core elements of the GP health summary as health information available through an accurate and current health summary will ensure safe and high quality care for patients.

-----

http://www.zdnet.com.au/act-health-loses-cio-looks-for-new-one-339308854.htm

ACT Health loses CIO, looks for new one

By Suzanne Tindal, ZDNet.com.au on January 31st, 2011

in brief Australian Capital Territory Health has put out feelers for a new chief information officer to head up the organisation's information services branch.

The position has previously been held by Owen Smalley, who has now resigned, according to the Office of the Deputy Chief Executive.

-----

http://www.zdnet.com.au/act-health-looks-into-tablets-339308909.htm

ACT Health looks into tablets

By Marina Freri, ZDNet.com.au on February 1st, 2011

ACT Health this week revealed it was investigating the potential use of tablet devices in Canberra Hospital, an initiative that will involve examining Apple's hyped iPad device and other platforms.

Although denying any official trials of the iPad, acting chief information officer Judy Redmond said the department had just initiated a project to examine the functionality of tablet devices both for clinical and administrative use.

She said the iPad was just one of the options available and that ACT Health would be investigating and trialling a number of different tablet devices. Redmond said introducing tablets in an enterprise environment was a challenging practice that involved managing security and updates, workflow changes and the cost of data usage.

-----

http://www.medicalobserver.com.au/news/ehealth-evaluation-plan-govt-priorities-questioned

E-health evaluation plan: Govt priorities questioned

1st Feb 2011

Caroline Brettingham-Moore

After ongoing criticism of its slow progress on the rollout of the personally controlled electronic health record (PCEHR), the Federal Government has now come under fire for “jumping the gun” with a tender process to find an independent evaluator for the project.

The criticism is the latest blow to the $467 million project, with Medicare recently forced to revise Individual Healthcare Identifier contracts with medical software providers after they were deemed unworkable.

Despite Health Department claims that an evaluation framework was crucial during the program’s development, Health IT consultant Dr David More questioned the logic behind commencing an assessment when the PCEHR remained far from completion.

-----

http://www.australiandoctor.com.au/articles/d9/0c06e8d9.asp

Patients get ’appy over iPhone apps

3-Feb-2011

By Michael East

TWO iPhone applications have been launched to help patients find GPs in their area or when they are on the move.

Last week, the WA Government launched a new iPhone application to help patients find after-hours general practices in the state.

The application allows users to find their nearest after-hours practice and contains opening hours and contact details.

Once patients find their nearest after-hours practice, they can save the practice details into their phone contacts.

-----

http://www.computerworld.com.au/article/375510/tablets_double_edged_sword_mater_health_services_cio/?eid=-6787&uid=25465

Tablets a 'double edged sword': Mater Health Services CIO

Desktop virtualisation of 3500 PCs also underway

While some Australian hospitals have embraced tablet PCs, one major health services provider is holding off deployment until improvements are made in the form factor.

According to Brisbane-based Mater Health Services' CIO, Malcolm Thatcher, weight and battery life issues with tablet PCs, such as the Apple iPad, are a major drawback. The CIO also cites voice recognition as a much needed addition, among others.

“We have trialled some various form factors including tablets and mobile devices such as smartphones," Thatcher told Computerworld Australia.

-----

http://www.theaustralian.com.au/australian-it/government/nehta-scores-385m-for-e-health-record-rollout/story-fn4htb9o-1225998925462

NEHTA scores $38.5m for e-health record rollout

  • Karen Dearne
  • From: Australian IT
  • February 02, 2011 5:49PM

THE federal Health department has released $38.5 million to the National E-Health Transition Authority for the next stage of the $467m personally-controlled e-health record rollout.

Under the six-month contract to June 30, NEHTA will provide management support services as private-sector partners are hired for four key roles: a national infrastructure partner; a change and adoption partner; a benefits realisation partner and an external assurance adviser.

Bidders are currently being sought for the benefits realisation partner, whose brief is to monitor and measure progress through an analytical and evaluation framework. The tender deadline has been extended a week to February 18, after potential candidates called for more information on the PCEHR program. Bidders seek details.

-----

http://www.zdnet.com.au/nehta-given-38-5m-in-e-health-funding-339308953.htm

NEHTA given $38.5m in e-health funding

By Josh Taylor, ZDNet.com.au on February 3rd, 2011

in brief The National E-Health Transition Authority (NEHTA) has been handed $38.5 million in funding for e-health records from the Federal Government as part of the Gillard Government's $466.7 million investment in e-health.

The funding was first revealed by The Australian today and has been allocated to NEHTA by the Department of Health and Ageing as part of the government's two-year investment in e-health.

-----

http://www.newsmaker.com.au/news/7159

Decrease in Medication Errors at Dunedin Hospital after iSOFT Medication Management Implementation

Wednesday, February 02, 2011 - iSOFT Group

Three months after implementation of the iSOFT Medication Management solution (formerly known as MedChart), Dunedin Hospital of Otago on New Zealand’s South Island has seen a reduction in medication error and an increase in staff efficiency. In two wards, incorrect or missing information was reduced from 82% down to zero.

Staff support for the electronic prescribing system has been strong, with one charge nurse reported as saying there “would be a riot” if the wards reverted to the old system.

The results at the Dunedin hospital, which introduced the electronic medication chart system on 14 October 2010, are in line with a study presented at the 2010 Health Informatics Conference by Professor Johanna Westbrook, Director of the Centre for Health Systems and Safety Research, University of New South Wales, in August of last year.

-----

http://www.telegraph.co.uk/technology/8303547/Patient-privacy-is-just-one-problem-for-the-NHS-IT-plan.html

Patient privacy is just one problem for the NHS IT plan

Our report today about criticism of the privacy standards of the Secondary Uses Service (SUS) - the NHS' new system for sharing medical records with researchers - is the latest of many controversies to hit the National Programme for IT.

The massive project, conceived under Labour as the world's largest public sector IT project, is already years behind schedule.

Medical staff have been among the strongest critics of NHS IT plans

Several major suppliers have dropped out, one of the principal software designers, iSoft, nearly went bust, and many doctors and nurses remain to be conviced the National Programme for IT will deliver clinical benefits in return fot the massive outlay by taxpayers. Despite cuts by Labour and the coalition - which also dropped its name - it is set to cost more than £11bn.

-----

http://www.theage.com.au/victoria/staff-chaos-hits-hospitals-20110201-1acfh.html

Staff chaos hits hospitals

Julia Medew

February 2, 2011

THOUSANDS of Victorian health professionals are either unable to work or are doing so illegally this week after missing a registration deadline set by Australia's new trouble-plagued health practitioner regulation agency.

An update provided by the organisation yesterday said that 5029 Victorian nurses, dentists, physiotherapists, optometrists, osteopaths, pharmacists, podiatrists and psychologists had not renewed their registration to practise with the national body by Monday's deadline.

Some hospitals, including the Royal Melbourne and Monash Medical Centre, yesterday said they were changing their rosters because of unregistered nurses who couldn't work.

-----

http://www.theaustralian.com.au/national-affairs/health/roxon-steps-in-over-health-register-bungles/story-fn59nokw-1225999806193

Roxon steps in over health register bungles

FEDERAL Health Minister Nicola Roxon has been forced to intervene to ensure the patients of up to 10,000 physiotherapists, health workers and doctors can claim Medicare rebates after bureaucratic bungling left the professionals unable to practise.

However, the patients of the health workers and doctors may still be unable to claim private health insurance rebates and they could be left without medical indemnity coverage because of teething problems with a new national medical registration system.

The health workers failed to gain medical registration under a scheme introduced in July as the under-resourced Australian Health Practitioner Regulation Agency struggled with the task of registering 290,000 practitioners.

Some of them continued to work because they were unaware their registration had lapsed.

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http://www.mjainsight.com.au/view?post=Govt+should+subsidise+prescribing+resources+&post_id=2674&cat=news-and-research

Govt should subsidise prescribing resources

MEDICAL leaders want electronic prescribing resources for doctors to be subsidised and regularly updated as the federal government puts more emphasis on e-health initiatives.

Professor Jon Emery, professor of general practice and head of the school of primary, Aboriginal and rural health care at the University of Western Australia, said quality use of medicines was an important issue and the federal government should look at ways to make the Australian medicines handbook (AMH) freely, or at very least more cheaply, available to all GPs.

The AMH currently costs $160 for an annual online subscription.

-----

http://www.pharmacynews.com.au/news/Guild-gets-free-access-to-eMIMS-for-interns

Guild gets free access to eMIMS for interns

Interns taking part in the Pharmacy Guild of Australia’s clinical training program will get free access to MIMS Australia.

The deal between the Guild and MIMS means pharmacy interns who choose the Guild as their training provider will be able to use the eMIMS program, which has been available to pharmacy students and interns on the Pharmaceutical Society of Australia (PSA) program.

David Bryant, a Guild spokesperson, welcomed the agreement, describing MIMS as a vital text for those coming out of university courses.

-----

http://www.theaustralian.com.au/australian-it/digital-magnetic-resonance-scanner-will-aid-researchers/story-e6frgakx-1225997708573

Digital magnetic resonance scanner will aid researchers

RADIOLOGISTS are hoping the first fully digital broadband magnetic resonance imaging system will soon find a home in Australia.

Philips unveiled its Ingenia MR unit at the Radiological Society of North America conference in Chicago late last year, but the product is undergoing regulatory approval processes and is not yet available in the US.

Australian Diagnostic Imaging Association president Ron Shnier said the technology offered enormous potential for new forms of medical research, based on high-quality data obtained from clinical use.

-----

http://ehealthspace.org/news/enrico-coiera-affirms-ehealth-support

Enrico Coiera affirms ehealth support

It was the late 1980s and one of the hottest topics in health informatics was artificial intelligence.

One day soon, the thinking went, a clinician would enter a patient’s conditions into a computer and a diagnosis would spit out the other end. As a recent medical graduate, AI was a field that inspired Enrico Coiera. So he started a PhD in artificial intelligence and computer science at the University of New South Wales.

“Back in those days expert systems were hot,” laughs Professor Coiera. “I went from doing my PhD and moved to the UK for ten years, where I was a senior scientist at HP Research, in Bristol.”

When 1999 rolled around Prof. Coiera decided that the time was right to move back to Australia. He was appointed foundation professor of health informatics at UNSW and, along with colleague Branko Celler, now at the University of Western Sydney, co-founded the Centre for Health Informatics.

-----

http://www.theage.com.au/technology/security/900m-internet-explorer-users-vulnerable-to-datastealing-hack-20110201-1abmd.html

900m Internet Explorer users vulnerable to data-stealing hack

Asher Moses

February 1, 2011 - 10:29AM

Microsoft has warned that the 900 million users of its Internet Explorer browser are at risk of having their computers hijacked and their personal information stolen by hackers.

The company has yet to develop a permanent fix for the security hole but users are being told to apply a temporary fix that prevents hackers from exploiting a hole to install malicious scripts. Users could be targeted simply by visiting an infected website.

In a security bulletin, Microsoft said the flaw affected all versions of Windows and although it had yet to encounter "indications of active exploitation of the vulnerability", the flaw was serious and it was aware of proof-of-concept code exploiting the issue.

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http://www.zdnet.com.au/no-ad-hoc-biometrics-sharing-privacy-chief-339308954.htm

No ad hoc biometrics sharing: privacy chief

By Suzanne Tindal and Colin Ho, ZDNet.com.au on February 3rd, 2011

Australian Privacy Commissioner Timothy Pilgrim has warned pubs and clubs collecting biometric information from their patrons not to "automatically" share that information with other clubs unless they have notified their patrons.

This week the news emerged that the collection of personal information such as biometrics and driver licence details by pubs and clubs has soared. Clubs and pubs use the information to reduce the risk of violence by pinpointing offenders and banning them from venues.

"The office is aware of the use of this technology by some organisations. Any pubs and clubs using this technology should be aware that under the Privacy Act, organisations must provide individuals with notice of what will happen to the collected information," Pilgrim said.

------

http://www.cio.com.au/article/374422/open_source_ready_enterprise_ovum/?eid=-601&uid=25465

Open source 'ready for the enterprise': Ovum

ESR to provide greater options for IT managers

Open source software has been found to be functionally sufficient across most organsations and its advancement enables IT managers to choose from a variety of options, according to Ovum.

A new report, Enterprise Search and Retrieval: Exploiting all of the organisation’s information assets, by Ovum analyst, Mike Davis, found that the development of open source software has provided IT managers with more options.

“Free-to-use open source enterprise search and retrieval (ESR) solutions are now ready for the enterprise,” he said in a statement.

-----

http://www.smh.com.au/technology/sci-tech/nasa-spots-54-potentially-lifefriendly-planets-20110203-1aeaf.html

NASA spots 54 potentially life-friendly planets

February 3, 2011

An orbiting NASA telescope is finding whole new worlds of possibilities in the search for alien life, spotting more than 50 potential planets that appear to be in the habitable zone.

In just a year of peering out at a small slice of the galaxy, the Kepler telescope has discovered 1235 possible planets outside our solar system. Amazingly, 54 of them are seemingly in the zone that could be hospitable to life — that is, not too hot or too cold, Kepler chief scientist William Borucki said.

Until now, only two planets outside our solar system were even thought to be in the "Goldilocks zone". And both those discoveries are highly disputed.

-----

Enjoy!

David.

AusHealthIT Poll Number 56 – Results – 07 February, 2011.

The question was:

Will NEHTA, DoHA and The Implementation Partners Successfully Deliver a Fully Operational and Functional PCEHR?

The answers were as follows:

For Certain

- 3 (5%)

Yes - With a Few Problems Along The Way

- 11 (18%)

It Will Probably Get Cancelled A Year or So From Now

- 17 (28%)

Not a Snowflakes Chance In Hell

- 28 (47%)

Well that is pretty clear. Readers reckon the PCEHR is a doomed dud! Good to see so many votes!

Votes : 59

Again, many thanks to those that voted!

David.

Sunday, February 06, 2011

The PCEHR Seems To Be Something that Needs A Lot More Than 16 Months To Deliver!

In case you were wondering what a the PCEHR System NEHTA has in mind is conceived to be I provide a brief extract from the late November, 2010 Concept of Operations.

On page 50 (as numbered) we read:

5.7 PCEHR-conformant repositories

The PCEHR system will consist of a range of PCEHR-conformant repositories operated at the national and regional level by a mix of public and private organisations. The PCEHR system capability will transition over time to provide access to richer clinical data stored in a range of PCEHR-conformant repositories.

The PCEHR system will consist of:

• A nationally operated repository, designed to provide a distributed set of secure highly available repositories for PCEHR records on a national basis.

This PCEHR-conformant repository will be used to ensure that there is a minimum level of health information available nationally and to support the sharing of critical health information when there is no other suitable repository available locally. It is likely that the national repository will be used to store health summaries and discharge summaries.

• Other PCEHR-conformant repositories will be accessible over time. These

repositories will typically be multi-purpose repositories that may have been designed for other purposes and now include new features to allow it to become conformant with the PCEHR system. Potential candidates include, but are not limited to:

– state, territory and regionally operated SEHRs (e.g. NT SEHR, NSW SEHR);

– Medicare Australia operated repository (e.g. for ACIR and Organ Donor Information);

– privately operated diagnostic services (e.g. repositories operated for/by Pathology and Diagnostic imaging companies);

– other sources including Australian Childhood immunisation register (ACIR), Adverse Drug Event Reporting (ADRAC), implant registers, cancer registries, breast screen registries, etc; and

– commercially operated PHRs (although this is subject to further policy review).

----- End Extract.

From other sources we know there will be an record indexing service, access control services and a template service (whatever that actually is).

What is not clear to me are the following:

1. Where are the health summaries and discharge summaries going to be sourced from?

2. Who will be accountable - and presumably paid - for keeping them current even after they have been uploaded?

3. Who will be accountable for errors in the summaries?

4. How will other non-government entities be paid for their time and trouble to populate the proposed repositories?

5. Who will fund the update of all the affected systems?

6. Who will train and support all the new e-Health users?

7. What happens if your GP does not want to share his records with the Government?

8. More important has anyone actually thought about any of this?

I note the RACGP has come out with some suggestions on e-Health Summaries. This is found here:

http://www.racgp.org.au/ehealth/summary

GP e-health summary

The RACGP is working closely with the National e-Health Transition Authority (NEHTA) to further define the core elements of the GP health summary and its application in an electronic health record. This will provide clinicians with key health information when providing care. Health information obtained through an accurate and current health summary will ensure safe and high quality care is delivered through access to the e-health summary in an electronic health record. Software specifications need to be developed to ensure the design is technically robust. The RACGP has established a group of GPs to work with NEHTA to ensure that electronic health records are integral to the management of patient care and the treatment of patients across the health sector.

Related files

Fact sheet - Allergies and adverse reactions (PDF 191KB)

Fact sheet - Health risk factors (PDF 186KB)

Fact sheet - Immunisations (PDF 186KB)

Fact sheet - Medical history (PDF 186KB)

Fact sheet - Medicines list (PDF 186KB)

Fact sheet - Relevant family history (PDF 186KB)

Fact sheet - Social history (PDF 184KB)

These are worth a browse - if only to see just how much information is envisaged in being shared. and the possible risks of sharing any of this information with anyone without explicit patient consent - which does not actually seem to get a major mention.

The College Standards make it clear that clear consent, beyond just consent for treatment, is required for clinical information to be transferred to third parties:

See pages 12, 29 and 93 among others.

The document is found here:

http://www.racgp.org.au/Content/NavigationMenu/PracticeSupport/StandardsforGeneralPractices/Standards4thEdition.pdf

This caution should have been included at the header of these summaries I reckon.

I wonder how this is actually going to managed and signified. In the UK this has been a major issue which is still not actually resolved as far as I know.

It is also clear the College sees some other issues:

http://www.medicalnewstoday.com/articles/215669.php

GP Health Summaries - Clear Guidelines Needed To Ensure Consistency, Australia

04 Feb 2011

A need to clearly define the key elements of the GP health summary and its application in an electronic health record has prompted the Royal Australian College of General Practitioners (RACGP) to develop a set of seven factsheets to provide advice to general practice and their teams.

The 4th edition of the RACGP Standards for general practices requires that practices can demonstrate that at least 75 percent of their active patient health records contain a current health summary (criterion 1.7.2). To meet the requirements for a satisfactory summary, elements such as allergies and adverse reactions, current medicines list, current health problems, relevant past health history, health risk factors, immunisation, relevant family history and relevant social history need to be included. But what does 'current' or 'relevant' mean?

RACGP e-health spokesperson Dr Chris Mitchell said that there is a need to clearly define the core elements of the GP health summary as health information available through an accurate and current health summary will ensure safe and high quality care for patients.

----- End Extract.

There is a good way to go in sorting out content, accuracy, sharing and consent at the very least!

As for paying for all this some of the issues are flagged here!

www.gp10.com.au/slides/thursday/slide30.pdf

If ever there was something that was not yet properly thought through, seems to not have absorbed lessons from overseas and needs a lot more consultation and work this PCEHR is it!

Time to swallow the pride and start really consulting! As the poll that will report tomorrow shows very few reckon this project - as presently conceived - is a goer of any sort.

David.

Saturday, February 05, 2011

Here Is A Different Perspective on Person Centred Health Information Management. Might Be A Better Approach Than NEHTA’s - If We Knew What That Was!

The following appeared a few days ago:

Thursday, February 03, 2011

Person-Centered Health Data Management Systems: Key to Sustainable U.S. Health Care

The U.S. health care system is a $2.5 trillion industry comprising multiple powerful stakeholder groups, often with competing interests. It is therefore crucial to identify guiding principles and priorities by which all stakeholders may be held accountable. For example, there is broad consensus for the following two mandates:

  • The U.S. health care system needs to function to provide the best possible quality of care and service for the patient (i.e. become more patient-centered).
  • The U.S. health care system needs to deliver higher value care in order to improve long-term access and achieve financial sustainability.

Engaging individuals as informed and empowered participants in their health, as well as discerning consumers of health care is essential to achieving these goals.

Person-centered ("person" because we are not all patients) health information management systems -- IT solutions that put individuals in control of their health data, allow them to share their data and communicate with anyone who is involved in their health, and provide them with the information and tools they need to improve their health and health care -- will emerge as powerful solutions that will be critical to the long-term performance of the U.S. health care system.

In an era where clinical and non-clinical digital health information is proliferating, the only way to achieve a truly patient-centered health care system is to aggregate and exchange this information at the point of the patient. Doing so will accelerate efforts aimed at achieving comprehensive patient health records, health information exchange and coordinated care, thus improving care quality and eliminating waste.

Why Are Person-Centered Health Information Management Systems Needed?

The prevalence of largely preventable, lifestyle-related chronic conditions continues to soar, now accounting for an estimated three-quarters of health care spending. Americans need to become more informed, engaged and empowered to improve their daily health behaviors, and, in doing so, stem the rising tide of chronic disease-driven demand for care. Person-centered health information management systems that combine clinical and non-clinical data, mobile capabilities, devices that track behaviors and biometrics, and personalized incentives will become a cost-effective method to achieve population wide health behavioral change.

More here with links:

http://www.ihealthbeat.org/perspectives/2011/person-centered-health-data-management-systems-key-to-sustainable-us-health-care.aspx

As I see it this article is talking about a rather different take on the personal involvement in their Health Information that the one outlined by the still secret (and outrageously so) Concept of Operations for the PCEHR.

I am told NEHTA might be about to issue some tenders for the other partners in implementing the PCEHR while the public still does not know what they are actually up to.

Bluntly this is just outrageous and unacceptable.

David.

Friday, February 04, 2011

Weekly Overseas Health IT Links - 04 February, 2011.

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://govhealthit.com/newsitem.aspx?nid=76064

Health data exchange still a challenge, Blumenthal says

By Mary Mosquera

Friday, January 21, 2011

The Office of the National Coordinator for Health IT is heavily involved in ongoing work with vendors and standards organizations to enable the exchange of health information, something that remains a challenge, according to Dr. David Blumenthal, the national health IT coordinator.

“We don’t believe that standards development stopped in July 2010,” when the Centers for Medicare and Medicaid Services and ONC published their final rules for meaningful use, he said. “We are actively developing new implementation specifications in collaboration with health IT vendors, standards development organizations and industry in a wiki-style process, such as has been done with the Direct Project.”

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http://www.healthleadersmedia.com/content/TEC-261894/EvidenceBased-Care-Gaps-Pervasive-Researchers-Say

Evidence-Based Care Gaps Pervasive, Researchers Say

HealthLeaders Media Staff , January 28, 2011

Healthcare systems around the world are failing to use evidence obtained through research, according to Sharon E. Straus, MD, MSc, FRCPC, a geriatrician and director of knowledge translation at St. Michael's Hospital in Toronto. The result: reduced length and quality of life, she and her colleagues write in a recent paper.

Straus was the guest editor of the January issue of the Journal of Clinical Epidemiology, which featured articles on knowledge translation. Knowledge translation is the term for closing the gap between evidence and data obtained through research and healthcare practice and policy.

More simply, it addresses the gap between what we know and what we do.

Failure to use research-based evidence to inform healthcare decision making are is prevalent among patients, caregivers, managers, and policymakers across all disciplines and in developed and developing countries, she and her colleagues note in one of the articles.

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http://www.govhealthit.com/newsitem.aspx?nid=75973

ONC will simplify guides for establishing exchange standards

By Mary Mosquera

Tuesday, January 18, 2011

The Office of the National Coordinator for Health IT plans to develop a clearer set of technical descriptions for establishing the standard clinical document formats for exchanging summary information as patients move across settings of care.

ONC will also consolidate into a consistent template-based guide the advice offered by multiple organizations for implementing the standard document formats used to share data about patients’ medications and problems.

These are among the first projects that ONC has launched for its Standards & Interoperability Framework, which will tackle persistent challenges that healthcare providers face in successfully exchanging information in order to meet meaningful use requirements of electronic health records (EHRs), according to Dr. Doug Fridsma, director of ONC’s Office of Standards and Interoperability.

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http://www.modernhealthcare.com/article/20110125/NEWS/301259986/

Stanford researchers find EHRs don't boost care quality

By Joseph Conn

Posted: January 25, 2011 - 11:15 am ET

A pair of researchers at Stanford University, Palo Alto, Calif., has released results of a three-year study that indicates EHRs did little to improve the quality of care.

"There's a lot of enthusiasm and money being invested in electronic health records," senior author Dr. Randall Stafford said in a news release. "It makes sense, but on the other hand it's an unproven proposition. When the federal government decides to invest in healthcare technology because it will improve the quality of care, that's not based on evidence. That's a presumption."

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http://www.healthleadersmedia.com/print/TEC-261743/5-Ways-to-Engage-Patients-in-PHRs

5 Ways to Engage Patients in PHRs

Gienna Shaw, for HealthLeaders Media , January 25, 2011

One of the "five pillars" of meaningful use is to engage patients and their families in electronic health data. But engaging patients and families with electronic health data isn't just about HITECH requirements and stimulus money - - it's also a way to foster collaborative decision-making between provider and patient, which, in turn, improves the patient experience, leads to better outcomes, and can reduce readmissions.

Americans pay more attention and become more engaged in their health and medical care when they have easy access to their health information online, according to a 2010 California HealthCare Foundation survey. For example, patients who use a personal health record say they take steps to improve their own health, know more about their healthcare, and ask their doctors questions they say they would not otherwise have asked.

But consumer adoption is still low—just 7%, according to the survey. The questions facing the healthcare industry are how best to get those numbers up and whose job it is to do so.

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http://www.miller-mccune.com/health/your-next-m-d-might-be-a-pda-26777/

Your Next M.D. Might Be a PDA

Handheld sensors using specialized — and relatively cheap — biosensors may deliver an instant diagnosis of diseases, contaminated water and biological attacks.

Your doctor has a hunch that your respiratory infection and fever are caused by bacteria (and should be treated with antibiotics), but it might instead be a simple virus, which should be allowed to run its course.

Today, lab tests could take several days to complete, but in a couple of years a handheld device called an acoustic wave biosensor might sample a droplet of your saliva to reveal within seconds whether your doctor’s hunch was correct.

Just three of these biosensors, developed by the University of New Mexico Health Sciences Center and Sandia National Laboratories, exist at the moment. But the invention has been licensed for development, garnering enough buzz to have made R&D Magazine’s Top 100 list for 2010.

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http://europa.eu/rapid/pressReleasesAction.do?reference=SPEECH/11/43&format=HTML&aged=

eHealth: an answer to EU healthcare and demographic challenges

ETNO Innovation Day 2011

Brussels, 25 January 2011

Ladies and Gentlemen,

I am delighted to be here this afternoon. Telecoms operators have not had a long history in eHealth, but I want to do everything in my power to work with you to change that. You have a critical role in our society enabling so many different types of relationships and transactions. And you run the essential infrastructure – broadband, other communications networks – which can revolutionise how health is managed.

As you are well aware, demography is not on our side. More than 30% of Europeans will be 65 or over in 2025. Chronic conditions are going up just as a shortage of specialists and carers emerges. This will become a huge care gap unless technology fills it. It means our systems are guaranteed to collapse if we do not make radical changes. When I hear information like the Spanish Government's estimates that health professionals are spending between 30 and 50 per cent of their time on administrative tasks, it is even clearer that innovation cannot come soon enough!

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http://www.healthleadersmedia.com/content/TEC-261901/GOP-bill-puts-meaningful-use-HITECH-Act-in-peril

GOP Bill Puts Meaningful Use, HITECH Act in Peril

HDM Breaking News, January 27, 2011

Legislation introduced in the U.S. House and initially sponsored by nearly three-quarters of the Republican caucus clearly appears to seek repeal of the Medicare/Medicaid electronic health record meaningful use incentive payment programs. But whether the bill also would repeal all of the HITECH Act within the economic stimulus law is unclear.

The bill also would prohibit appropriations of funds to carry out any programs under the health care reform law, and a related law designated to "fix" components of the reform law.

The bill is H.R. 408, the Spending Reduction Act of 2011, and sponsored by Rep. Jim Jordan (R-Ohio) along with, at this juncture, 174 other GOP members. The House has 242 Republicans, far above the 218 votes needed for passage in the chamber. The bill seeks to cut $2.5 trillion in federal spending during the next decade. It includes an extensive list of existing government programs that would be repealed, along with other provisions to cut spending, including extending the federal employee pay freeze and limiting the number of civilian employees in the Executive Branch.

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http://www.modernhealthcare.com/article/20110128/NEWS/301289950

Use health IT to tailor treatments: Brookings

By Rich Daly

Posted: January 28, 2011 - 11:30 am ET

Outdated healthcare policies are keeping physicians and hospitals from providing personalized treatments tailored to individuals' genetic structures, according to a new paper (PDF) by the director of governance studies at the Washington-based Brookings Institution.

The healthcare reform law could use health IT to help overcome these barriers, Brookings scholar Darrell West writes.

Specifically, West urges the CMS to use some of the $10 billion in the Patient Protection and Affordable Care Act for "innovation" pilot projects to test the ability of health IT to allow personalized medicine. Additionally, the National Institutes of Health could use its substantial research budget to fund new projects aimed at reducing policy barriers to broad adoption of personalized medicine, according to West.

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http://www.post-trib.com/news/3041464,methodist-ptb-0127.article

Hospital wants its $16M back from failed computer system

January 27, 2011

BY TERESA AUCH SCHULTZ, (219) 648-3120

The Methodist Hospitals claims in a federal lawsuit that the company it hired in 2006 to help steer it out of a financial mess instead directed it to a new computer system that wasted $16.6 million.

The computer system opened up almost half of Methodist's computers to a virus attack and messed up patient information to the point that doctors and nurses had to abandon the system altogether, according to the lawsuit filed Wednesday in the U.S. District Court in Hammond.

The lawsuit names as defendants FTI Cambio, a Tennessee company, and HealthNET and Medical Information Technology Inc., both based in Massachusetts.

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Healthcare Software Development Exposes Security Risks

Many organizations are lax in protecting patient data during development and testing, finds Ponemon Institute study.

By Nicole Lewis, InformationWeek

Jan. 26, 2011

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=229100300

According to a survey of IT managers at health delivery organizations, 51% of respondents said they don't protect patient data used in software development and testing.

Released on Tuesday, the findings come at a time when the healthcare industry is transferring medical records from paper-based systems to digitized medical records, which calls for more development and testing of software in healthcare environments.

The report, "Health Data at Risk in Development: A Call for Data Masking," also revealed that lost patient information can go undetected. A full 78% of respondents said they are not confident or else are undecided as to whether their organization could even detect the theft or accidental loss of real data in development or testing.

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http://healthcareitnews.com/news/obama-gives-hit-nod-state-union-speech

Obama gives HIT the nod in State of the Union speech

January 26, 2011 | Diana Manos, Senior Editor

WASHINGTON – In a broad State of the Union speech Tuesday night, President Obama hailed the information age in America and the need for the federal government to support IT innovation.

"In America, innovation doesn’t just change our lives, it’s how we make a living," he said. "Our free enterprise system is what drives innovation. But because it’s not always profitable for companies to invest in basic research, throughout history our government has provided cutting-edge scientists and inventors with the support that they need. That’s what planted the seeds for the Internet. That’s what helped make possible things like computer chips and GPS."

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http://www.ama-assn.org/amednews/2011/01/24/bise0125.htm

Men, chronically ill embrace virtual medical visits

A survey finds 78% of all respondents open to the idea of remote monitoring of their health care.

Men and chronically ill patients are the most likely to support remote monitoring and virtual visits as part of their health care. But a large majority of the public is at least willing to give it a try, according to a new survey.

Euro RSCG Tonic, the New York-based consumer health and wellness arm of the marketing and communications firm Euro RSCG, conducted an Internet survey of 1,000 adults in mid-November 2010, and found that nearly half are receptive to virtual visits to save time and money, and 78% would be willing to give it a shot. Twenty-three percent said they would never consider a remote visit with a doctor.

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http://govhealthit.com/newsitem.aspx?nid=76122

ONC adds $80M to extension centers, HIEs and workforce programs

By Mary Mosquera

Thursday, January 27, 2011

The Office of the National Coordinator for Health IT has awarded a total of $80 million more for its regional extension center, state health information exchange and community college workforce programs to boost their support of providers becoming meaningful users of electronic health records.

More funds will strengthen the momentum of these programs, which ONC launched last year, as physicians and hospitals begin to register for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs.

For extension centers (RECs), which offer local technical assistance to individual physicians and small practices, ONC has provided $32 million in additional funds. The money will accelerate outreach to providers to encourage their registration in the EHR incentive program and to direct more staff in the field as providers adopt health IT in their practices, said Dr. David Blumenthal, the national health IT coordinator, in a Jan. 27 letter announcing the program awards.

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http://www.healthdatamanagement.com/news/himss-pcast-universal-exchange-language-41793-1.html

HIMSS: Obama Advisors On Wrong Track

HDM Breaking News, January 26, 2011

Inaccurate patient identification methods could sink the vision of the President's Council of Advisors on Science and Technology for establishment of a "universal exchange language" to accelerate health information exchange, according to the Healthcare Information and Management Systems Society.

In a comment letter, Chicago-based HIMSS expresses concern that the council's report issued in December "continually states that there is no role for universal patient identifiers, but does not offer a detailed approach as to how the healthcare community will achieve error-free patient identification across healthcare organizations."

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http://www.fierceemr.com/story/cios-need-consider-new-course-promote-emr-adoption/2011-01-27

CIOs need to consider new course to promote EMR adoption

January 27, 2011 — 2:22pm ET | By Janice Simmons - Contributing Editor

CIOs will need to think and act far differently than in past years to successfully drive the use of and implement EMRs, according to an Accenture survey of CIOs who already have achieved advanced use of EMRs within their hospitals and health systems.

Less than 1 percent of health systems have achieved "mature use" of EMRs in 2009, Accenture estimated. However, at the same time, nearly half of all U.S. hospitals could have trouble meeting federal EMR meaningful use requirements by 2015, according to Accenture's new report, "Secrets of Success on the EMR Journey to Meaningful Use: Leading Hospital CIOs Reveal Key Lessons Learned."

"From strategic planning, staffing and adoption, health systems are integrating technology at a previously unprecedented level, but many health systems are lagging and at risk of facing penalties," said Mark Knickrehm, global managing director, Accenture Health Practice, in a statement.

One of the survey's key findings is that most major health systems are underestimating the time and cost associated with implementing advanced EMR functions.

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http://seattletimes.nwsource.com/html/localnews/2014036271_swedish26m.html

Software glitch shuts down Swedish medical-records system

A four-hour shutdown of Swedish Medical Center's centralized electronic medical-records system Monday morning was caused by a glitch in another company's software.

Seattle Times health reporter

A four-hour shutdown of Swedish Medical Center's centralized electronic medical-records system Monday morning was caused by a glitch in another company's software, said Swedish chief information officer Janice Newell.

The system, made by Epic Systems, a Wisconsin-based electronic medical-records vendor, turned itself off because it noticed an error in the add-on software, Newell said, and Swedish was forced to go to its highest level of backup operation. That allowed medical providers to see patient records but not to add or change information, such as medication orders.

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http://healthcareitnews.com/news/ehrs-cpoe-featured-top-10-healthcare-predictions-2011

EHRs, CPOE featured in top 10 healthcare predictions for 2011

January 25, 2011 | Bernie Monegain, Editor

FRAMINGHAM, MA – New reiumbursement models driven by healthcare reform tops the list of the top 10 healthcare provider predictions from IDC Health Insight analysts Judy Hanover and Lynn Dunbrack.

IDC Health Insights' top 10 healthcare provider predictions identify major trends that will impact the U.S. provider IT landscape in 2011.

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http://www.who.int/goe/ehir/2011/january_25_2011/en/index.html

E-Health Intelligence Report

January 25, 2011

Publications

  • Standards and eHealth
  • ITU - January 2011
  • Electronic health (eHealth) systems continue to hold great promise for improving global access to healthcare services and health informatics, particularly in the developing world
  • Mobile e-Health Solutions for Developing Countries
  • ITU - 2010
  • The report highlights the role of mobile telecommunication technology in health care by offering at a distance the medical consultation and administration of patient treatment.
  • Creative Economy Report 2010: A Feasible Development Option
  • UNCTAD - December 2010
  • Chapter 7: Technology, connectivity and the creative economy. Improved broadband connectivity can help to achieve education and health targets set out in the Millennium Development Goals (MDGs).

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http://www.mitwa.org/sites/default/files/files/MITEF%20NW%20Boomers%20Technology%20and%20Health%20Report.pdf

Baby boomers’ demand for wireless and mHealth products to hit $12 billion by 2020

Aging, tech-savvy baby boomers who want to retain control over their own lives will lead to a near-tripling of their adoption of wireless and mobile health (mHealth) products by 2020, according to a study by the Massachusetts Institute of Technology (MIT) Enterprise Forum of the Northwest.

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http://www.healthdatamanagement.com/news/certification-meaningful-use-ehr-cchit-41780-1.html

Beth Israel's In-House EHR Certified

HDM Breaking News, January 24, 2011

Beth Israel Deaconess Medical Center in Boston is the first hospital to have its in-house developed electronic health records system certified as meeting meaningful use under a new program from the Certification Commission for Health Information Technology.

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http://www.ehealthinitiative.org/ehealth-initiative-reports-projects.html

eHealth Initiative Reports & Projects

eHealth Initiative and Thomson Reuters Report: Governance Models for HIE NEW

Top Eleven Trends for 2011: Report from eHealth Initiative and GE Healthcare

Planning for Adoption: The Early Direction of Regional Extension Centers

The State of Health Information Exchange in 2010: Connecting the Nation to Achieve Meaningful Use (2010)

National Progress Report on eHealth (2010)

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http://www.healthleadersmedia.com/print/TEC-261672/OCR-Patient-Data-Breach-List-Hits-Milestone

OCR Patient Data Breach List Hits Milestone

Dom Nicastro, for HealthLeaders Media , January 24, 2011

The number of entities reporting breaches of unsecured protected health information (PHI) affecting 500 or more individuals has hit 225. The web site was born out of HITECH and has been live since February 2010.

OCR says the breach reports date back to September 2009. Hence, it's been about 17 months since OCR has accepted the reports. It amounts to about 13 reports filed per month, or 0.44 per day.

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http://healthitupdate.nextgov.com/2011/01/adopting_advanced_electronic_medical_records.php?oref=latest_posts

Health IT Takes Time and Money

By John Pulley

Adopting advanced electronic medical records takes longer and costs more than most hospitals imagine, warn hospital IT executives who have already trod that path.

IT operating expenses spike by 80 percent during the transition to an EMR system, chief information officers of 15 major U.S. hospital systems told researchers from Accenture, a management consulting, technology services and outsourcing company. Looking ahead, finding IT personnel who are qualified to handle the installation and implementation of the sophisticated technology will be tough, the CIOs predict -- and hospitals will have to ante up plenty of cash to attract top IT talent.

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http://www.modernhealthcare.com/article/20110124/blogs02/301249999

Not-so-rosy numbers

Last week, Dr. David Blumenthal announced the results of two surveys funded by the Office of the National Coordinator for Health Information Technology on hospital and physician participation in the federal electronic health-record incentive programs.

But Dr. B left out a few numbers in going over the results of the survey of office-based physicians conducted by the National Center for Health Statistics. On request, the ONC and NCHS released those missing numbers.

Docs were asked: "Are there plans to apply for Medicare or Medicaid incentive payments for meaningful use of health IT?" Blumenthal reported on their answers in part, noting that 41.1% indicated "yes" and 14% said "no." However, a 44.9% plurality, which he did not mention, chose "uncertain whether we will apply."

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http://www.fiercehealthit.com/story/providers-struggle-fill-clinical-it-positions/2011-01-24

Providers struggle to fill clinical IT positions

January 24, 2011 — 3:30pm ET | By Dan Bowman

St. Luke's Health System in Sioux City, Iowa may recently have been able to fill its need for a clinical informatics specialist, but that doesn't mean other hospitals in similar positions nationwide will have the same luck, according to a new Hay Group study.

The global consulting firm found that 47 percent of healthcare organizations have struggled when trying to fill, or retain talent for, newly created clinical informatics positions. Ultimately, it comes down to supply and demand, with such talent now in high demand but low supply thanks to the recent emphasis on health IT, highlighted by the Healthcare Information Technology for Economic and Clinical Health Act, which is part of the American Recovery and Reinvestment Act of 2009.

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http://www.fiercehealthit.com/story/health-it-still-has-many-detractors-healthcare/2011-01-24

Health IT still has many detractors in healthcare

January 24, 2011 — 1:02pm ET | By Ken Terry - Contributing Editor

Despite the government-led explosion of activity in the health IT field, physician and hospital leaders remain deeply divided about the value of information technology in patient care.

The latest reminder of this came in a Thomson Reuters survey of nearly 3,000 physicians. Asked whether electronic health records would help patients, 39 percent of the doctors said they would; 37 percent said there would be no effect; and 24 percent said EHRs would have a negative impact on care.

In a broader survey of physicians and healthcare executives, 80 percent of the respondents said they thought the widespread adoption of health IT would improve the quality of care and organizational efficiency. But Jim Cramer, CIO of Scottsdale (Ariz.) Healthcare and an advisor on the report, said that many of his peers have doubts about the use of health IT in complex medical situations.

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http://www.ihealthbeat.org/features/2011/conference-offers-look-at-health-it-landscape.aspx

Monday, January 24, 2011

Conference Offers Look at Health IT Landscape

"Welcome to the era of meaningful use." That's how National Coordinator for Health IT David Blumenthal greeted attendees at the eHealth Initiative annual conference last week.

He noted that as of Jan. 3, it became possible for health care providers to register for meaningful use incentive payments and that Kentucky and Oklahoma already have doled out Medicaid incentive payments under the program.

Blumenthal highlighted all of the progress that's been made in the health IT sphere, from the establishment of 62 regional extension centers to the launch of 84 community college health IT training programs to an electronic health record certification process. However, he noted that there's still much work to be done.

Blumenthal said, "The age of meaningful use is not the end of our vision or the end of our journey, it is the beginning. We still have an enormous amount of work to do and an enormous amount of education to do."

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Enjoy!

David.