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."

Saturday, April 02, 2011

Weekly Overseas Health IT Links - 02 April, 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.

-----

http://healthcareitnews.com/news/emrs-help-boost-hiv-care-developing-countries

EMRs help boost HIV care in developing countries

March 22, 2011 | Bernie Monegain, Editor

INDIANAPOLIS – Electronic medical records improve the quality of care in developing countries, according to a new study conducted by researchers from the Regenstrief Institute and the schools of medicine at Indiana University and Moi University in Eldoret, Kenya.

The study is one of the first to explore and demonstrate the impact of electronic record systems on quality of medical care in a developing country.

In a paper published in the March 2011 issue of the Journal of the American Medical Informatics Association, Martin Chieng Were, MD, assistant professor of medicine at the IU School of Medicine and a Regenstrief Institute investigator, and his colleagues report that computer-generated reminders about overdue tests yielded nearly a 50 percent increase in the appropriate ordering of CD4 blood tests. CD4 counts are critical to monitoring the health of patients with HIV. The tests help guide treatment decisions.

-----

http://www.fierceemr.com/story/emrs-found-improve-care-quality-countries-limited-resources/2011-03-22

EMRs found to improve care quality in countries with limited resources

March 22, 2011 — 6:35pm ET | By Janice Simmons

A new comparative study in Sub‑Saharan Africa using computer‑generated clinical reminders--within electronic medical records (EMRs)--found significantly improved clinician adherence to blood testing guidelines used for monitoring patients with HIV.

The study, conducted by researchers from the Regenstrief Institute and the schools of medicine at Indiana University and Moi University in Kenya, is one of the first ever to examine and demonstrate the impact of EMRs on quality of medical care in a developing country. The comparative study used clinical summaries with computer‑generated reminders.

-----

Clinical Workflow Integration Tops Health IT Priorities

Telemedicine and collaborative tools are also high on health IT professionals' project lists, reports Avaya survey.

By Nicole Lewis, InformationWeek

March 21, 2011

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=229301328

During the next three years, 95% of healthcare IT professionals believe that communication and workflow integration into healthcare information systems will be a very important issue to address as healthcare delivery organizations prepare to meet meaningful use and accountable care requirements.

The findings come from a survey conducted by Avaya, which interviewed 130 healthcare IT professionals in February at the Healthcare Information and Management Systems Society (HIMSS) conference in Orlando, Fla.

The survey results, which were released March 14, also showed that 74% of respondents listed automated patient follow-up applications, and 64% rated voice, video, and text collaborative tools as important technologies that will impact their work during the next three years.

-----

http://www.cnbc.com/id/42166000

RI lawmakers take on illegible writing by doctors

Published: Saturday, 19 Mar 2011 | 9:37 AM ET

PROVIDENCE, R.I. - Some Rhode Island lawmakers are looking to outlaw illegible writing by physicians.

Doctors and other medical professionals who continue to handwrite notes and records would face a fine under legislation sponsored by five state senators. Instead, physicians would have to type all their notes, records and files.

-----

http://healthcareitnews.com/news/telemedicine-holds-promise-patients-after-major-disaster

Telemedicine 'holds promise' for patients after major disaster

March 22, 2011 | Molly Merrill, Associate Editor

NEW YORK – More effective use of information technology after a major disaster could significantly improve patient outcomes, according to a study by researchers at Weill Cornell Medical College and the University of California, Davis.

A control tower-style telemedicine hub that can manage electronic traffic between first responders and remote medical experts could boost the likelihood that critically-injured victims will get timely care and survive, according to the research team's computer simulation model.

"Since its introduction in the 1970s, telemedicine – the electronic linkage of healthcare providers and recipients – has held promise for improved disaster response outcomes," said the study's senior author, Nathaniel Hupert, associate professor of public health and medicine at Weill Cornell Medical College and co-director of the Cornell Institute for Disease and Disaster Preparedness. "As information technology becomes pervasive, we want to ensure that systems are in place to fully realize its potential for helping patients – particularly for emergency response."

-----

http://www.modernhealthcare.com/article/20110323/NEWS/303239956

IOM offers standards for clinical practice, comparative effectiveness

By Jessica Zigmond

Posted: March 23, 2011 - 12:15 pm ET

The Institute of Medicine has issued eight recommended standards to develop trustworthy clinical practice guidelines and 21 recommended standards for systematic review of the comparative effectiveness of medical or surgical interventions. The IOM also said it encourages HHS' Agency for Healthcare Research and Quality to pilot-test the standards and assess their reliability and validity. “If guideline users had a mechanism to immediately identify high quality, trustworthy clinical practice guidelines, their health-related decisionmaking would be improved—potentially improving both healthcare quality and health outcomes,” the IOM wrote in a description of its report Clinical Practice Guidelines We Can Trust, which outlines eight standards that address issues including transparency, conflict of interest and external reviews.

-----

http://www.ihealthbeat.org/features/2011/mental-health-community-wants-in-on-meaningful-use-program.aspx

Thursday, March 24, 2011

Mental Health Community Wants In on Meaningful Use Program

Last week, Sen. Sheldon Whitehouse (D-R.I.) introduced the Behavioral Health Information Technology Act of 2011 (S 539) to expand eligibility for meaningful use incentive payments to include behavioral health, mental health and substance misuse treatment professionals and facilities.

Under the 2009 federal economic stimulus package, hospitals and eligible professionals who demonstrate meaningful use of electronic health records can qualify for Medicare and Medicaid incentive payments. Under the current law, most mental health providers and facilities are excluded from the health IT incentive payments.

-----

EHR Adopters: Confident, Or Cocky?

Healthcare providers have an almost singular focus on putting electronic records in place this year and are highly optimistic about getting it done.

By Marianne Kolbasuk McGee, InformationWeek

March 19, 2011

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=229301224

Healthcare providers are doing whatever it takes to deploy electronic health record systems and all the related technology they'll need to qualify for a share of the $27 billion in U.S. federal stimulus funds set aside to encourage investment in health IT. Their top priorities this year all relate in some way to the government's financial incentive program, including meeting regulatory requirements, managing digital patient data, improving care, reducing costs, and increasing efficiencies.

It's not surprising that providers are focused on grabbing those subsidies. But it is surprising how confident they are that they'll be able to handle the task ahead.

Nearly six in 10 healthcare organizations still need to buy an EHR system or upgrade an existing one to qualify for the federal funds, according the InformationWeek Analytics' Healthcare IT Priorities Survey of 357 business tech- nology professionals at healthcare providers. And 62% of respondents who have EHRs or are planning them say they'll spend more than 20% of their annual IT budget on EHR projects this year. In other words, there's still a lot of heavy lifting for U.S. hospitals and doctors' practices to deploy systems that comply with federal guidelines.

-----

http://www.healthdatamanagement.com/news/acquisition-walgreens-drugstore-web-online-pharmacy-42190-1.html

Walgreens to Buy drugstore.com

HDM Breaking News, March 24, 2011

Drug store chain Walgreens has signed a definitive agreement to acquire drugstore.com Inc. for $409 million, gaining access to more than 3 million online customers and adding about 60,000 new products along with new vendor partners to Walgreens' online product portfolio.

-----

http://www.fierceemr.com/story/penny-wise-or-pound-foolish-montana-ehr-debate/2011-03-24

Penny wise or pound foolish: The Montana EHR debate

March 24, 2011 — 9:26am ET | By Janice Simmons

Montana is known for many things--its Big Sky beauty, its national parks, and its rough and tumble history. But this month it is standing out over what has become a battleground over the funding of electronic health records (EHRs).

On March 14, the GOP-led state legislature passed House Bill 2, which denied the state's Department of Public Health and Human Services the authority to accept $35 million in federal meaningful use incentive payments for hospitals to adopt EHRs.

While many state governors and legislators are faced with considering belt-tightening strategies in a weakened economy, this has become a polarizing issue between the Montana legislative and executive branches. And, it has become a challenging issue for healthcare providers and patients as well who are being inserted into the middle of this debate.

-----

http://www.fierceemr.com/story/patient-advocates-harness-potential-emrs/2011-03-24

Patient advocates harness the potential of EMRs

March 24, 2011 — 4:10pm ET

With the advent of EMRs and the government's stimulus benefits, doctors are slowly but surely incorporating them into their practices. The government has increased the benefit this year to encourage more physicians to jump on the bandwagon. Currently only 30 percent of primary-care physicians and 20 percent of hospitals have installed some form of electronic medical records.

-----

http://hitechwatch.com/blog/completing-hit-transition-correctly-more-important-completing-it-quickly

Completing the HIT transition correctly more important than completing it quickly

By Jeff Rowe, Editor

Policymakers are currently discussing how much of last year’s report from the President’s Council of Advisors on Science and Technology (PCAST) can be incorporated into Stage 2 MU requirements.

But while the consensus seems to be that the PCAST report has several recommendations worth heeding, policymakers are pointing to the overall MU schedule as the reason why most of the recommendations will have to wait.

According to this report, ONC “could include in the requirements for the next stage of meaningful use some functions that would build toward the comprehensive information exchange system that (PCAST) recommended last year.

-----

http://healthaffairs.org/blog/2011/03/25/health-information-technology-the-work-is-only-beginning/

Health Information Technology: The Work Is Only Beginning

March 25th, 2011

by Mark Frisse

Editor’s Note” As David Blumenthal prepares to step down as the National Coordinator for Health Information Technology, where does the United States stand in the continuing effort to promote widespread adoption of electronic health records? What are the challenges that the next health IT coordinator will face? Health Affairs Blog asked two leading experts to address these questions: Mark Frisse does so below, and Carol Diamond provides her analysis in another post.

You can find more on the adoption and impact of electronic health records in the current issue of Health Affairs, which contains articles by Melinda Buntin, Brian Bruen, and Neil Fleming (and colleagues in each case). These articles were discussed at the release event for the issue, which you can listen to on the Health Affairs website.

Dr. David Blumenthal’s tenure at the Office for the National Coordinator for Health Information Technology (ONC) is without precedent. Never in American history has the public experienced such an aggressive and deliberate effort to introduce health information technology (HIT) into clinical settings with such a deliberate goal of producing a safer, more efficient, more reliable, and more effective health care delivery system. Following the script of the HITECH Act of 2009, Blumenthal’s ONC implemented: consensus-building processes to develop financial incentives for EHR adoption (Meaningful Use); more flexible EHR certification methods; regional extension centers to support EHR adoption; HIT workforce training and education programs; state-level health information exchange programs; simpler and more widely accepted communication standards; new health information technology research grants; and many other initiatives fostering widespread HIT adoption. Through ONC, HITECH has evolved from a stage of words and ideas to a time of action. Appropriated funds have been spent. A massive machine has been set in motion. And all has taken place over only two years.

-----

The EHR and the dare; What should be done when patients can access their raw test results electronically before their doctor has seen them?

(canadianhealthcarenetwork.ca)

MARCH 24, 2011

TIM WILSON

The issue of patient anxiety about what they find when they access their personal medical information has come up in a number of interviews I’ve conducted over the past few years. In all instances, the answers from experts have been fuzzy, but the general view is clear enough: “Don’t worry, we’ll find the right way to control access to electronic health records (EHRs), and we won’t be facing an anxiety-ridden population stressing over incomprehensible medical data.”

The reason? It will first be filtered. It will be well-explained. The medical community will stand in front of the results as benevolent explicators, and individuals will not suffer the distress of being exposed to raw, unfiltered data.

It’s as if the tortoise is convinced it can simply tell the hare to slow down.

-----

http://govhealthit.com/newsitem.aspx?nid=76761

HHS publishes strategy to improve national healthcare quality

By Mary Mosquera

Monday, March 21, 2011

The Health & Human Services Department has released the National Strategy for Quality Improvement in Health Care to promote quality health care focused on the needs of patients. At the same time, it wants to make the health care system work better for physicians and other healthcare providers, through such things as reducing their administrative burdens and helping them collaborate more to improve care.

The HHS strategy includes calls for the increased adoption of electronic health records (EHR), which are a foundation for many of the projects that will realize HHS goals.

The national quality strategy was required under the health reform law, the Affordable Care Act, and is the first effort to create national aims and priorities to guide local, state, and national efforts to improve healthcare quality.

-----

http://www.ehi.co.uk/news/acute-care/6746/birmingham_patients_get_records_access

Birmingham patients get records access

24 March 2011 Sarah Bruce

Patients at the University Hospitals Birmingham NHS Foundation Trust are being given access to their own online medical records.

Twelve liver patients at the Queen Elizabeth Hospital Birmingham will begin trialling the myhealth@qebh system next week.

It will enable them to view documents about their care, such as details of past and future appointments, medications, diagnosis and test results online.

James Ferguson, consultant hepatalogist at the trust who pioneered the idea, told eHealth Insider: “A lot of patients come a long distance and have a number of clinicians looking after them.

-----

http://www.healthdatamanagement.com/blogs/EHR_health_care_technology_news-42174-1.html

The High Price of Progress

Gary Baldwin

Health Data Management Blogs, March 18, 2011

Often, while talking to industry experts for a certain topic, I uncover an entirely new story. And lately, that emerging story is one of fatigue. For recent articles, I’ve reported on 5010, ICD-10 and meaningful use. Conversations that drill down into these topics increasingly begin with the phrase, “We have a lot on our plate.”

Simply put, providers are starting to reel under the weight of these multiple—and concurrent—federal mandates and programs. There are more than these three—there’s also the looming specter of health reform, with its accountable care organizations, adoption of more uniform HIPAA transactions and potential expansion of the insured Medicaid pool. There are looming payment audits under Medicare, whose RAC program is an after-the-fact effort to reclaim inappropriately paid claims, and commercial carriers likely will launch similar audits. As federal officials ramp up privacy and security enforcement, providers will have to enhance their protection of health information. To top it all off, there are some serious labor shortages among the key personnel needed to cope with these programs.

-----

http://www.modernhealthcare.com/article/20110322/NEWS/110329993/

Computerized systems reduce psychiatric drug errors: study

By Andis Robeznieks

Posted: March 22, 2011 - 12:00 pm ET

The rate of medication errors dropped 87.7% in an 88-bed psychiatric unit at Johns Hopkins Hospital in Baltimore after computerized provider order-entry and error-reporting systems were implemented, according to a report in the March issue of the Journal of Psychiatric Practice.

Researchers randomly selected 42 medical charts from 2003 and 40 each from 2005 and 2007, and collected data on the number and types of medication errors reported. Medication administration records were also examined to detect nonreported errors.

-----

http://www.techworld.com.au/article/380503/study_virtual_medicine_effective_physical_doc_visits/

Study: Virtual medicine as effective as physical doc visits

Webcam doctor visits called convenient and save time and money

Results of a five-year study on telemedicine showed that patients can be treated virtually by physicians as effectively as if the patients made physical visits to the doctor's office. In another finding, the remote treatment also improved doctor-patient communications.

The study highlighted the efforts of Hospital Clinic of Barcelona to treat 200 HIV-infected patients remotely through its "Hospital VIHrtual" telemedicine program. The program used virtual consultations through videoconferencing and delivery of medications to a patient's home. The telemedicine program does not replace the traditional face-to-face visits between doctor and patient but complements and enhances them, the hospital said. The study results were published in the peer-reviewed journal PLos One.

-----

http://www.healthleadersmedia.com/content/MAG-263727/Patient-Portals-A-Look-Forward

Patient Portals: A Look Forward

Gienna Shaw, for HealthLeaders Media , March 16, 2011

If you have a patient portal, chances are you aren’t using it to its full potential. And if you don’t have one, you’re missing out on benefits from increased efficiency to improved patient satisfaction to an edge in the marketplace. And, experts predict, the capabilities of patient portals are only going to increase over the next few years. What remains to be seen is whether all this innovation will have an impact on market share and quality of care and whether significant numbers of consumers and providers will embrace them.

A January HealthLeaders Media Intelligence Report found that only 25% of physician practices with an EHR have patient portals and only 21% of hospital-based systems have them. And those that do have them aren’t exactly thrilled. Only 12% and 9% of physician practice- and hospital-based respondents, respectively, said they’re strongly satisfied with their patient portal’s capabilities.

-----

http://www.healthleadersmedia.com/content/TEC-263973/Patient-Portals-Get-Social.html

Patient Portals Get Social

Gienna Shaw, for HealthLeaders Media , March 22, 2011

The patient portal of today has some neat features that are convenient for patients and save time and money for providers—online appointment scheduling and lab results for example. But what will the portal of the future look like?

Well, it might have a social media vibe, according to providers and experts I interviewed for a story on patient portals in this month's issue of HealthLeaders Magazine.

"The future of the patient portal is unlimited at this point," said Barbara Fahl-Watkins, administrator of the Heart & Vascular Center of Arizona. "I feel like we are just scratching the surface in finding new ways to communicate more thoroughly and efficiently with patients."

-----

http://www.fiercehealthit.com/story/hospitalization-predictions-worth-3m-managed-care-firm/2011-03-17

Hospitalization predictions worth $3M to managed care firm

March 17, 2011 — 4:42pm ET | By Ken Terry

The Heritage Provider Network, a managed care company that contracts with several medical groups in southern California, is launching a contest to develop the best algorithm for predicting which patients are most likely to be hospitalized within a year. The two-year competition begins in April, with a prize of $3 million. Contestants will be provided with a batch of de-identified claims to play with.

-----

http://www.fiercehealthit.com/story/zynx-thomson-reuters-partner-reference-content/2011-03-15

Zynx, Thomson Reuters partner for reference content

March 15, 2011 — 4:45pm ET | By Ken Terry

Zynx Health, the largest source of prebuilt order sets for computerized physician order entry systems, has agreed to incorporate the reference content of Thomson Reuter's Micromedix subsidiary in its ZynxOrder solution. Micromedix offers evidence-based reference materials for medication management, disease and condition management, toxicology, and patient education.

The integration of the two product lines pushes Micromedex's information to the point of care, giving physicians access to comprehensive drug information and disease protocols from their ZynxOrder evidence-based order set.

-----

http://www.fiercehealthit.com/story/predictive-modeling-good-care-coordination-better/2011-03-19

Predictive modeling is good, but care coordination would be better

March 19, 2011 — 11:17am ET | By Ken Terry

In the past week, two organizations in different parts of the country announced efforts to harness information technology to improve predictive modeling. The Heritage Provider Network in southern California is offering $3 million to whoever comes up with the best algorithm for predicting which patients will be hospitalized. And a healthcare system in the Dallas-Fort Worth area is testing a new IT tool that forecasts which patients with congestive heart failure (CHF) are most likely to be readmitted within 30 days of hospital discharge.

In each case, there's an economic motive behind the search for a reliable method of forecasting illness. Heritage is a managed care company that takes financial risk for care, so it wants to be able to manage that risk better. And hospitals are facing new Medicare regulations that will penalize them financially for excessive readmissions, starting in October.

-----

http://www.healthdatamanagement.com/news/connect-free-open-source-hie-software-aurion-42176-1.html

Free Software Builds on Federal HIE Initiative

HDM Breaking News, March 21, 2011

Two leaders of the federally-funded CONNECT initiative to develop open source, downloadable health information exchange software now head a new foundation created to take the lead in promoting and expanding use of the technology.

Three companies working under a federal contract developed CONNECT in 2008 and early 2009, and it was released in April 2009 to the open source community.

While there has been some acceptance of CONNECT in the health care industry--by such organizations as HealthBridge, Regenstrief Institute, Thayer County Health Services in Nebraska, and Redwood MedNet in California--federal agencies have adopted the software more readily than the private sector. Some software vendors also have developed commercial products based on CONNECT technology.

-----

http://e-caremanagement.com/electronic-health-information-exchange-way-more-complicated-than-getting-money-from-an-atm/#more-1908

Electronic Health Information Exchange — Way More Complicated Than Getting Money from an ATM

Posted by Vince Kuraitis on · Filed in EHRs/PHRs, Information & Communication Technologies (ICT) · Comments

“If banks can exchange funds electronically through the ATM system, why can’t my doctor and hospital exchange information electronically?”

Keith Boone’s concise article “A Doctor is Not a Bank” explains why this conclusion about healthcare interoperability is overly-simplistic.

-----

http://www.ctv.ca/CTVNews/Health/20110318/surgeons-kinect-110318/

Ont. surgeons bring video game technology to the OR

The Canadian Press

Date: Friday Mar. 18, 2011 7:50 AM ET

TORONTO — Doctors at a Toronto hospital are banking on video game technology to save time and prevent contamination in the operating room.

A team at Sunnybrook Hospital has started using the Xbox Kinect, a hands-free gaming console equipped with a motion sensor, to virtually manipulate key medical images during surgery. The doctors use hand gestures to zoom in and out of the images or freeze a particular shot without leaving the operating table.

Surgeons typically have to leave the sterile field around the patient to pull up images such as MRI or CT scans on a nearby computer.

-----

http://www.upi.com/Health_News/2011/03/17/Online-messaging-effective-for-patients/UPI-14741300410445/

Online messaging effective for patients

Published: March. 17, 2011 at 9:07 PM

SEATTLE, March 17 (UPI) -- Follow-up online messaging by trained nurses resulted in less depression among patients being treated for depression, U.S. researchers say.

Dr. Gregory E. Simon, a Group Health psychiatrist and Group Health Research Institute senior investigator, says the study involved a randomized controlled trial of 208 Group Health patients. Half had three online care contacts with a trained psychiatric nurse, and were significantly more likely to feel less depressed, take their antidepressant medication as prescribed and be more satisfied with their treatment for depression.

-----

http://govhealthit.com/newsitem.aspx?nid=76748

Meaningful use could include steps toward PCAST exchange goals

By Mary Mosquera

Friday, March 18, 2011

The Office of the National Coordinator for Health IT could include in the requirements for the next stage of meaningful use some functions that would build toward the comprehensive information exchange system that a presidential commission recommended last year.

These functions could include a patient’s ability to download information to a personal health record (PHR), simple search by providers and sharing immunization data, according to an advisory panel that is examining the report of the President’s Council of Advisors on Science and Technology (PCAST).

Meaningful use in 2013 could promote the use of patient portals, which give individuals access to their electronic health records. Patients could then send or “push” their information or specific data elements to their PHR, which they control, said William Stead, co-chair of the Health IT Policy Committee’s PCAST work group.

-----

http://www.cmio.net/index.php?option=com_articles&view=article&id=26812&division=cmio

EMR report: No leader, lots of contenders

Written by Editorial Staff

March 20, 2011

No company has emerged as frontrunner in the EMR market, but there is a lead pack, according to a report from Kalorama Information, which valued the EMR market at $15.7 billion in 2010.

The report, “EMR 2011: The Market for Electronic Medical Record Systems,” said that revenue comes from a wide variety of vendors including hospital IT vendors and small web-based companies' offerings, the New York City-based healthcare market research firm stated.

-----

http://www.healthcareitnews.com/news/kalorama-no-clear-emr-leader

Kalorama: No clear EMR leader

March 17, 2011 | Molly Merrill, Associate Editor

NEW YORK – There is still no one company that dominates the market for electronic medical records, according to market research firm Kalorama Information.

Kalorama's most recent report valued the market for EMR at $15.7 billion in 2010.

"You still have no one company that is the leader in EMR, but there is a clear pack of competitors now," said Bruce Carlson, publisher of Kalorama Information. "There are still opportunities for new entrants, but this may not be the case for long as the competitive picture is more defined than it was."

-----

http://www.healthcareitnews.com/news/medical-identity-theft-rise

Medical identity theft on the rise

March 15, 2011 | Mike Miliard, Managing Editor

IRVINE, CA – A new study from the Ponemon Institute, sponsored by Experian, finds that almost 1.5 million Americans are victims of medical identity theft – an increase from last year. While consumers grasp the importance of protecting their medical and personal information, it reports, few take the precautions to avoid medical ID theft.

The study also found that the average cost to resolve a case of medical identity theft stands at $20,663 – up from $20,160 in 2010.

-----

Enjoy!

David.

Friday, April 01, 2011

And Who Has a Plan To Reduce Health IT Workflow Integration - NEHTA Maybe?

The following report of a US Survey appeared a little while ago.

Clinical Workflow Integration Tops Health IT Priorities

Telemedicine and collaborative tools are also high on health IT professionals' project lists, reports Avaya survey.

By Nicole Lewis, InformationWeek
March 21, 2011
URL:
http://www.informationweek.com/story/showArticle.jhtml?articleID=229301328

During the next three years, 95% of healthcare IT professionals believe that communication and workflow integration into healthcare information systems will be a very important issue to address as healthcare delivery organizations prepare to meet meaningful use and accountable care requirements.

The findings come from a survey conducted by Avaya, which interviewed 130 healthcare IT professionals in February at the Healthcare Information and Management Systems Society (HIMSS) conference in Orlando, Fla.

The survey results, which were released March 14, also showed that 74% of respondents listed automated patient follow-up applications, and 64% rated voice, video, and text collaborative tools as important technologies that will impact their work during the next three years.

According to Bruce Wallace, Avaya's healthcare practice leader, the discussions his company has had with its healthcare customers reveal that clinicians want to more efficiently collaborate with each other around the care process as they seek to improve decision support for their patients.

"Healthcare is a service delivered by a team, and increasingly the team cannot easily meet face to face, whether because of the size of a single hospital, or the multisite nature of hospital systems, or the need for care to be provided across large distances," Wallace told InformationWeek in an interview. "The shift towards accountable care organizations, enabled by the meaningful use of the electronic medical records (EMRs), is only going to expand this need."

More at the URL in the text.

What this survey shows is that clinicians have a pretty low tolerance for workflow disruption and workflow support - as well as I am sure ease of use - are vital in successful systems.

It seems to me this sort of issue is at least a substantial part of the issues identified a week or so back by Prof. Jon Patrick here:

http://aushealthit.blogspot.com/2011/03/professor-jon-patrick-refines-and.html

The point is that change is always difficult and the more change you expect and the harder you make it the less likely you are to succeed.

NEHTA and DoHA are very likely to discover these truths too late, unless they radically re-design their workflow hostile PCEHR plans.

David.

Thursday, March 31, 2011

Minister Roxon Really Wants To Share the Possible PCEHR Pain Around. Everyone Gets a Mention.

I wandered along to the Commonwealth Health Department Site earlier today and was greeted with a blizzard of press releases on the Wave 2 projects.

There is no doubt the Government is keen to play up just how wonderful they are for providing $55 Million for what are really glorified pilots and little else.

Here is the e-Health list:

29 March 2011

Brisbane leads the way as e-health super site

Brisbane will the lead the way as an Australian e-health ‘super site’ following new e-health projects announced as a part of national health reform.

29 March 2011

E-Health benefits spread as Canberra team chosen to lead roll-out

Aged and palliative care patients in the ACT will benefit from better integrated and safer care through e-health systems developed by a team from Canberra that has been chosen as one of nine new projects to lead the roll-out of e-health records.

29 March 2011

E-Health Benefits Spread as Nine New Sites Start Work

Mothers and new born babies, Australians suffering from chronic disease and patients in aged and palliative care are some of the first groups set to benefit from national health reform as nine new locations have been selected to lead the roll-out of e-health records.

29 March 2011

E-Health benefits spread as Sydney team chosen to lead roll-out

Patients are set to benefit from a better, safer and more integrated medical records system to be developed by a consortium of Sydney health providers that have been chosen as one of nine new projects to lead the roll-out of e-health records.

29 March 2011

E-Health benefits spread into Western Sydney

Mums and bubs, Indigenous Australians and aged, chronic and complex disease patients in Western Sydney are set to benefit from a new e-health project.

29 March 2011

Territory to Lead E-Health Records for Indigenous Australians

Northern Territorians will be one of the first groups of Australians to have access to e-health records thanks to a new national health reform e-health project announced on 29 March.

28 March 2011

E-Health benefits spread as Geelong team to lead roll-out

Patients are set to benefit from a better and safer medication system to be developed by a team from Geelong that has been chosen as one of nine new projects to lead the roll-out of e-health records.

28 March 2011

Tasmanian aged and palliative care to lead e-health roll-out

Aged and palliative care patients and their families in North West Tasmania will be one of the first groups of Australians to have access to e-health records thanks to a new national health reform e-health project announced on 28 March 2011.

----- End List.

This is certainly ‘bang for the buck’ for a quite small funding announcement in terms of the number of press releases!

I just love the way suddenly local members like Sid Sidebottom, Darren Cheesman, Ed Husic and Peter Garrett are spruiking the benefits of these funds to their local communities as though they are experts on the topic!

It is also fun to see how Mr Abbott gets a kicking in each release.

Most interesting is a paragraph found at the bottom of a few of the releases:

Media note:

All nine organisations were selected following a competitive process by the Department of Health and Ageing and National E-Health Transition Authority. All organisations managing these projects will now develop their final plans over the next eight weeks to ensure their work programs clearly meet national objectives before receiving final payments to implement the projects.

I only have one question. Just where can we read these ‘national objectives’ so we can all be sure that our taxpayers funds are not just vanishing into thin air. And I wonder what happens in the plans don’t pass muster!

It seems to me, reading about each of these that either we really are setting up a ‘playpen’ and that nothing more permanent will come from these pilots or we are trying to meet some ‘national objectives’ in which case there needs to be enough consistency and standardisation around what is done that the work is re-usable and replicable.

If it is to be the second - the deadlines are really too tight and there are going to be all sorts of issues around the ownership if the various software components that may be employed. From an IP sense this could get very messy indeed! Once a pilot is deemed a success how is it then procured nationally?

Enquiring minds would like to know.

Another issue is to wonder if these plans will actually see the light of day in eight weeks - with the associated objectives so we can see if they have been met?

I will take a small wager that will NOT be the case!

David.

Wednesday, March 30, 2011

This Really Is a Dreadful Story of Government Mismanagement. Maybe The NSW Election Result Can Help?

The following dreadful story appeared a few days ago.

Consumers 'ignored' in e-health policy, says privacy foundation

  • Karen Dearne
  • From: Australian IT
  • March 24, 2011 7:00PM

THE Australian Privacy Foundation has accused Health Minister Nicola Roxon of reneging on her promise to consult with consumers over the design and operation of the $467 million e-health record project.

APF chair Roger Clarke said that given the advanced state of the project, with work already under way at lead implementation sites, "we are raising a necessarily urgent concern about the governance of this major initiative".

"Unless you take action right now, key decisions will be made in an unsatisfactory manner, without consumer advocacy involvement," he said in letters to Ms Roxon published on the APF website.

Mr Clarke said 20 days had lapsed since the letter was sent to Ms Roxon and 16 days after a follow-up, there was still no word from the minister.

"We seek your urgent attention to the matter, in order to avoid such an outcome. If you decline to do so, then, far from fixing the problem, you would be breaching the undertaking you gave three months ago, and endorsing the exclusion of effective consumer consultation," he wrote.

At the National e-Health Conference in Melbourne on November 30, Ms Roxon said the Health Department would "take the lead role in ensuring comprehensive stakeholder engagement across the program".

"The arrangements that we are putting in place will ensure there are robust assurance and governance provisions around the implementation of the program," the minister said.

"And yes, that governance will include consumers. We will work with all parties to ensure that a strong governance framework is in place ahead of the national system being delivered."

Dr Clarke descirbed the whole process as a "travesty".

"The National e-Health Transition Authority ran a loosely-structured roundtable in November, and three sessions in January and February," he said.

"But despite requests from participants, those events concluded without a permanent group being established. The department, meanwhile, has done nothing to ensure that the group's expertise and commitment is utilised."

Dr Clarke said the advocacy groups had deep knowledge of the needs of various categories of healthcare consumers, and the practicalities and subtleties involved in sharing medical data.

"The complexities of the health sector are so great that the general public will not get down to the devil in the details," he said. "Ongoing engagement with consumer advocates is therefore critical to the PCEHR's success."

Ms Roxon's office has declined to comment on the issues raised by the APF. Nor has the minister responded to The Australian's recent requests for further information on the consultation process.

In January, Ms Roxon promised to release a public discussion paper on the PCEHR, but this is yet to be published.

At the time NEHTA was holding the consumer reference group sessions, chief executive Peter Fleming told The Australian a consultation process was being established with the Consumers Health Forum -- now a corporate entity in receipt of government funding for a range of consultations, including the PCEHR.

Health gave the CHF a $10,000 grant to hold a members-only workshop in mid-February to work out how NEHTA should engage with consumers.

The Deloitte report on the outcomes of the Melbourne e-health conference is also yet to released - three months after the event.

More here:

http://www.theaustralian.com.au/australian-it/government/consumers-ignored-on-e-health-says-privacy-foundation/story-fn4htb9o-1226027637719

I raised this issue a while ago in this blog:

http://aushealthit.blogspot.com/2011/02/time-has-come-for-some-light-to-be.html

and essentially nothing seems to be changing.

Just why this is, is very hard to understand. I would have thought we might just have some more hope with the dramatic way in which an incumbent government has just been thrown out in NSW.

It might just be that those in DoHA and NEHTA might just realise that their political cover might be a good deal more flimsy than they had previously believed. It seems at least possible that with new directions from their political masters now being delivered to their NEHTA Board Members in NSW and Victoria we could see a demand for more accountability and transparency.

This has certainly been a mantra for the Liberal / Nationals in NSW.

If I was new Health Minister in NSW or Victoria I would be keen to ensure that what is going on in my name in NEHTA were things I was comfortable with. My view is that they should be alarmed, very alarmed at the way things are being conducted at present! If they don’t act reasonably soon they become complicit through inaction.

Proper consultation and proper transparency are vital in e-Health. They are not being delivered at present and really need to change, and fast! What has gone on with the most recent PCEHR release (Wave 2) only confirms that view to me. I hope the NSW Government is not going to pretend extending the failed HealtheLink Project as part of the PCEHR is a good idea!

On the NSW Election I see there is some e-Health comment.

e-health back in the spotlight for NSW

Telehealth technology centre at Nepean Hospital one of the first priorities for Coalition

Health services in NSW have been in limbo pending the outcome of the election, but the landslide victory by the Barry O’Farrell-led Coalition is likely to precipitate a frenzy of activity as the new government looks to implement its e-health policies.

Jillian Skinner will take on the role of Health Minister within the new government. During the election campaign, the NSW Coalition’s policies focussed on health issue prevention, openness, better management of chronic disease and increased community involvement in the running of the NSW public health system.

Now, the industry is beginning to call on the government to make good on its promises.

The world's largest health systems integrator, CSC, was quick to issue a statement welcoming the election result — and remind the new government of the Council of Australian Governments (COAG) and Federal Government’s plans for personally-controlled electronic health records.

More here:

For interest the full Health Policy is here:

https://www.nsw.liberal.org.au/policies/health

Interesting browse, as I suspect they will be around for a while!

David.

Looks Like iSoft is Really Gone!

The following appeared a few hours ago.

Dream ends for iSoft with $300m buyout

WHEN Gary Cohen's IBA Health agreed to buy troubled British group iSoft in 2007, he had visions of creating one of the largest healthcare information technology providers in the world.

Cohen, who was ousted last year from the company now called iSoft, is infamous for dreaming big but delivering little.

What followed was years of underperformance that has left the share price at 5c, compared with the $1.21 it closed at on the day IBA announced its agreement with iSoft, and debt of about $260 million -- more than four and a half times its current market capitalisation.

This week, the UBS-advised iSoft is poised to be bought out by the New York-listed CSC.

It's believed IT services giant CSC, which is iSoft's biggest customer, could finalise a more than $300m takeover deal for the company as early as today. ISoft is a major supplier to the British government, which is in the midst of a pound stg. 12.7 billion ($20bn) overhaul of the National Health Service's IT systems. (CSC subcontracted iSoft to carry out the work before the IBA buyout.)

More here:

http://www.theaustralian.com.au/australian-it/dream-ends-for-isoft-with-300m-buyout/story-e6frgakx-1226030527556

This sounds like the end. Banks get paid, little shareholders dudded and CSC gets a revenue stream and some OK software. Pretty typical in this sort of collapse!

At least the users will have continued support from a reasonably competent organisation that knows e-Health.

Sad loss for Australia, but it really was a rather large ask in retrospect.

David.

Are We Just Kidding About Or Serious About E-Health? Who Knows. It Seems We Are Building a Playpen!

The following appeared in today’s Age On-Line. The paragraph in bold says it all!

Electronic health records planned

Kate Hagan

March 30, 2011

UP TO half a million patients, including the chronically ill, will be the first to receive electronic health records under Labor's radical plan to overhaul the way medical data is kept.

Federal Health Minister Nicola Roxon yesterday announced $55 million for nine projects, to be run by various groups including pharmacists, general practitioners and hospitals.

.....

The federal government's clinical adviser on e-health, Dr Mukesh Haikerwal, described the projects as "a playpen to see how these things could work".

Full article here:

http://www.theage.com.au/national/electronic-health-records-planned-20110329-1cexj.html

I am just awed that half a billion dollars can be spent on a “playpen”.

There are plenty of examples overseas about what works - a playpen is not needed. Some competence, leadership and governance are!

David.

Tuesday, March 29, 2011

Ms Roxon Has Just Administered A Severe Shotgun Wound To Her Very Own Foot!

We have just has the announcement of the additional Wave 2 Personally Controlled EHR Sites Announced.

There is coverage here:

Nine new e-health pilots, but doubts linger

A further nine new e-health pilot sites and projects have been announced (link) by health minister Nicola Roxon, who says they will bring the personally controlled e-health record a step closer to reality.

The new pilot sites include GP divisions and hospitals, with Brisbane becoming an ‘e-health super site’, as most of the citiy’s divisions and the Mater Hospital involved, the minister says.

“Our 12 e-health lead implementation sites are aiming to have more than half a million Australians enrolled before the national launch of e-health records next year,” Ms Roxon said.

Medibank Private will also be involved in the pilot scheme, with a portal that allows members with chronic diseases to enter data into a ‘Health Book’ that will be shared with health providers. Medibank’s e-health project will also offer electronic health management plans, test results and appointment reminders.

More here:

And here already.

DoHA announces second wave e-health sites

The latest nine sites include maternity at the Mater Hospital, sites in North and South Brisbane and sites across NT, SA and the ACT

The Department of Health and Ageing (DoHA) has unveiled the second wave of e-health implementation sites to deploy and trial specific aspects of the Gillard Government’s $466.7 million personally controlled electronic health records (PCEHR) initiative.

Minister for Health and Ageing, Nicola Roxon, said the announced e-health implementation sites, to join the initial three sites in Brisbane, the Hunter Valley and Melbourne East, was the next step in the Federal Government’s health reform project.

“In these nine projects we can see practical examples of how e-health can improve heath care for patients,” Roxon said in a statement.

The announced sites, include both North and South Brisbane and the maternity unit at the Mater Hospital, as well as sites across the Northern Territory, South Australia and the ACT. The sites will receive a share of $55 million from the project for implementation.

Each site will focus on a particular demographic identified as a high priority for e-health records. Those in the Northern Territory, Western Australia and South Australian will focus on indigenous populations, chronic disease patients will be the focus in western Sydney while the aged care and palliative care patients will become priority at those sites in NSW, the ACT and Tasmania.

“With more than 90 applications received, it’s clear there is a high level of support for e-health," Roxon said.

According to Roxon, the total 12 e-health sites will be aiming to have in excess of half a million Australian enrolled before the national launch of the electronic health records on 1 July 2012.

More here:

http://www.cio.com.au/article/381341/doha_announes_second_wave_e-health_sites/

The full list of sites and the technologies is found on the blog here:

http://aushealthit.blogspot.com/2011/03/wave-2-sites-for-pcehr-program-here-is.html

Or at the first link above.

Why is this all just an utter fiasco? It is easy.

After careful checking with a range of NEHTA insiders and sources it is now clear a national integration architecture and strategy does not exist.

Worse some sources have suggested that NEHTA has a consultant working away on a ‘Standards Gap Analysis’ due in May which will be a first step towards working out how these pilots - which by then are meant to have developed their implementation plans - are to be forged into a coherent national system.

Anyone with any clue knows that all this work has to be done first - and not as an afterthought.

I challenge NEHTA and DoHA to show I am wrong by releasing the already developed plans that are going to result in any form of coherent national PCEHR system. They won’t and can’t because they simply does not exist.

Half a billion dollars will go largely down the gurgler as these idiots utterly fail to get even the basics of large project delivery 101 right.

This will see the Minister lose her portfolio when the public realises just how badly this has been done and how political deadlines have utterly overwhelmed common sense.

Not only is the design of the PCEHR a disaster but this will now be compounded by implementation of island like pilots which will really struggle to ever talk to each other.

Just amazing! Incompetence on this scale just defies belief.

David.