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."

Wednesday, December 21, 2011

Weekly Overseas Health IT Links - 21th December, 2011.

Note: Each link is followed by a title and few paragraphs. 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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HIEs 2016: Through A Cloudy Crystal Ball

For better or worse, no crystal ball exists to see into the future of health IT.  Especially not when it comes to health information exchanges (HIEs).  Attention has been focused around health information exchanges since the HITECH Act, because of widespread recognition that the ability to exchange health data is necessary to improve care coordination and efficiency.  Since the promise of ARRA stimulus money began, several segments of the health information exchange landscape have accelerated at an unprecedented pace.  Private HIEs connecting elements within delivery networks are growing at a rapid clip for those systems progressive or wealthy enough to afford them.  Another segment of public-private, community-focused health information exchanges funded primarily by government grants, seeks to form the regional backbone of “inter-health system” data exchange.
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GOVERNMENT NEWS

R.I. statewide HIE offers patient record locator service

Written by Luke Gale   
December 12, 2011
The nation’s smallest state is making big health IT moves. At its Dec. 8 Health IT Expo, the Rhode Island Quality Institute (RIQI) demonstrated a new data locator feature available on the statewide health information exchange (HIE), which RIQI operates.
A panel of RIQI employees appeared before a room full of local providers to provide an update on currentcare, the staewide HIE operated by RIQI, and to show off its brand new Patient Record Inquiry Service (PRIS), which allows providers to search the HIE database for longitudinal clinical records on their patients via web portal.
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5 mobile trends for 2012

December 13, 2011 | Michelle McNickle, Web Content Producer
At the third annual mHealth Summit in Washington D.C., major players in the mobile arena noted the impact mobile phones and other devices have and will continue to have both in the US and across the globe. Paul Jacobs, chairman and CEO of Qualcomm, the closing keynote speaker at the mHealth Summit, predicted nearly 4 billion smart phones would be sold between now and 2014.
“The mobile device in your hand gives you access to all of humanity’s collective knowledge," he said. "We’re going to see the full computer environment coming over. Over the next year, really cool stuff is coming.”
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Epic tops 2011 Best in KLAS Awards

December 16, 2011 | Mike Miliard, Managing Editor
OREM, UT – KLAS has unveiled its annual "Best in KLAS Awards" for software and professional services in 2011, ranking the best-performing healthcare IT vendors in more than 100 market segments based on ratings from over 18,000 interviews with healthcare providers.
Epic was the top-ranked overall software vendor with a score of 87.1 out of 100. MaxIT Healthcare garnered top ratings for professional services, with an 88.7 score.
Previously known as "Top 20 Best in KLAS," the research firm has renamed the awards "Best in KLAS," and surveyed new market segments in the report, including clinical decision support products, self-service patient kiosks and more.
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IDC: Increasing demand for mobile health IT products

Written by Luke Gale
December 14, 2011
The importance of a clinical team’s ability to quickly access and communicate information has led to increased use of mobile technologies, but recent IDC Health Insights research suggested a demand for more advanced mobile technologies and predicted a growing market for products that service this need.
“Increasingly, clinicians are turning to a range of mobile point-of-care (MPOC) devices, such as purpose-built devices, smartphones and tablets to access clinical information systems and document care at the patient bedside or in the exam room,” authors of the December report wrote.
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As Doctors Use More Devices, Potential for Distraction Grows

By MATT RICHTEL
Published: December 14, 2011
Hospitals and doctors’ offices, hoping to curb medical error, have invested heavily to put computers, smartphones and other devices into the hands of medical staff for instant access to patient data, drug information and case studies.
But like many cures, this solution has come with an unintended side effect: doctors and nurses can be focused on the screen and not the patient, even during moments of critical care. And they are not always doing work; examples include a neurosurgeon making personal calls during an operation, a nurse checking airfares during surgery and a poll showing that half of technicians running bypass machines had admitted texting during a procedure.
This phenomenon has set off an intensifying discussion at hospitals and medical schools about a problem perhaps best described as “distracted doctoring.” In response, some hospitals have begun limiting the use of devices in critical settings, while schools have started reminding medical students to focus on patients instead of gadgets, even as the students are being given more devices.
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Friday, December 16, 2011

Kenya Has Mobile Health App Fever

Nairobi startup's health app surges; Safaricom gives subscribers links to experts for two cents a minute.
Mobile health platforms are fast emerging in Kenya, where one startup's newly launched mobile health platform is attracting nearly 1,000 downloads daily, and the dominant telecom, Safaricom, has forged a partnership that will give its 18 million subscribers access to doctors.
A World Bank official sees significant promise from such efforts, pointing to the fact that 50 percent of all Kenyan banking is already done on mobile phones—suggesting that the population is ready to go mobile with health care, too.
"In terms of providing basic services through mobile phones on the continent, Kenya is in the lead in many ways, and showing the way," says Elizabeth Ashbourne, director of global health information forums at the World Bank in Washington, D.C. "Local applications in the health space are absolutely frontier activities."
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December 15, 2011

Direct Project Connect-A-Thon: Pushing the line forward

On December 8th, I again had the privilege to organize and host a Direct Project virtual connect-a-thon. This was the fifth virtual connect-a-thon held by the Direct Project reference implementation workgroup, and the second time we’ve hosted it at Cerner. As an indication of Direct’s increasing momentum, this was the largest connect-a-thon to date, consisting of more than 20 companies, with 13 actively participating HISPs. These connect-a-thons offer opportunities to validate the latest enhancements and fixes to the Direct Project reference implementation source tree, while ensuring interoperability across multiple HISP deployment models and implementers. The outcome of this event will lead to another production release of the .Net and Java reference implementations by the end of the year.
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Community Hospitals Ramp Up Health IT Adoption

Regional and critical access hospitals implement clinical information systems; EPIC, Cerner reap benefits, reports KLAS.
Community hospitals, which have traditionally lagged behind in automating their clinical data, picked up the pace in 2010 with 52% reporting they contracted with a clinical information system (CIS) vendor to install systems where none existed, a recently published KLAS study revealed.
The KLAS report, Community Hospitals Accelerating CIS Adoption: Community Hospital Clinical Market Share Report 2011, also noted that an additional 36% of respondents said they are purchasing a system from a different vendor after retiring their legacy system.
"Cerner is seeing a lot of critical access and community hospitals go to market for a new healthcare IT partner," observed Eric Geis, managing director of CommunityWorks for Cerner.
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AHRQ releases online EHR troubleshooting guide

December 15, 2011 — 11:36am ET | By Marla Durben Hirsch - Contributing Editor
Concerned that your hospital or health care organization may run into issues when implementing and operating an electronic health record system? The Agency for Healthcare Research and Quality (ARHQ) now is offering a free online guide to help providers with the unintended consequences of EHRs.
The tool--called the "Unintended Consequences Guide"--is designed to give providers practical advice and tips for dealing with the unanticipated problems sometimes associated with EHR systems, noting that "unintended consequences can undermine provider acceptance, increase costs, sometimes lead to failed implementation, and even result in harm to patients."
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CfH works on PACS framework for 2012

13 December 2011   Shanna Crispin
NHS Connecting for Health says it will have a framework to help trusts re-procure picture archiving and communications systems established by the end of 2012.
The national local service provider contracts for PACS - signed as part of the National Programme for IT in the NHS - are due to expire over the next three years.
CfH has issued a briefing note to the chief executives of the 127 trusts receiving PACS under the national contracts urging them to prepare for the contract expiration.
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Technology at heart of NI shake-up

14 December 2011   Lyn Whitfield
A new model for Northern Ireland’s health and social care services has been unveiled that mirrors many of the reform plans for the NHS in England over the past decade.
The model, unveiled by health minister Edwin Poots at the end of an independent review, calls for the individual to be put “at the centre” of care and for a significant shift of services from hospitals to nursing homes, social and community services and GP practices.
The model sees a significant role for technology in the changes, and describes it as “a key enabler of the delivery of the new model of care.”
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NHS IT programme software 'three times market price'

Committee member says trusts being vastly overcharged by BT and CSC

NHS trusts are paying three times the market price for systems under the failed National Programme for IT (NPfIT), according to an MP on the Public Accounts Committee.
While NPfIT was supposed to deliver complex but standardised systems at an affordable price, hospitals are spending much more with suppliers BT and CSC than by buying elsewhere, said Richard Bacon MP, an expert on the programme.
Bacon took the figures from written parliamentary answers, National Audit Office reports, and the suppliers' regulatory filings.
North Bristol NHS Trust has paid BT �29 million over seven years for the Cerner Millennium patient administration system.
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Costco Enters Electronic Health Record Business

Discount retailer offers cloud-based Allscripts EHR for small medical practices.
Costco has entered the health IT business with a nationwide rollout of a cloud-based electronic health record (EHR) designed for small physician practices.
Following a successful pilot in a few regions, the giant price club is offering Allscripts' MyWay EHR through a value-added reseller, Etransmedia, just as a lot of small practices are finally jumping into the market to take advantage of government EHR incentives.
Costco is pricing its MyWay package at $599 per doctor per month, or $499 for physicians who become "executive members" of Costco. The package encompasses not only the EHR, but also an integrated practice management system, a patient portal, training, implementation, maintenance, and claims submission. Hardware is not included, but the remotely hosted software does not require an onsite server.
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5 mobile trends for 2012

December 13, 2011 | Michelle McNickle, Web Content Producer
At the third annual mHealth Summit in Washington D.C., major players in the mobile arena noted the impact mobile phones and other devices have and will continue to have both in the US and across the globe. Paul Jacobs, chairman and CEO of Qualcomm, the closing keynote speaker at the mHealth Summit, predicted nearly 4 billion smart phones would be sold between now and 2014.
“The mobile device in your hand gives you access to all of humanity’s collective knowledge," he said. "We’re going to see the full computer environment coming over. Over the next year, really cool stuff is coming.”
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Stress Testing Health Information Management and Governance

Linda L. Kloss
HDM Breaking News, December 14, 2011
In the engineering field, stress analysis is a discipline that determines whether materials and structures can safely withstand a range of forces or loads. Evidence is mounting that current structures and methods for managing health information are under stress and not adequate for the digital era. Each week brings new reports signaling systemic deficits in information stewardship, integrity, and life cycle management. Anecdotal evidence from health care organizations underscores the need for new approaches to enterprise information management (IM). 
Enterprise IM and information governance are essential strengthening strategies to address a range of information stressors. This article offers a framework that can be used to take stock of which stress fields are currently under reasonable control in your organization and which will benefit from more targeted attention.  It challenges organizations to approach IM and information governance from the perspective of asset management focusing on gaining real value from investments in EHRs and other information and communication technologies.  
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KLAS: Cloud computing must mature for providers to adopt

Written by Luke Gale   
December 12, 2011
Market researcher KLAS spoke with 97 providers to develop a general sense of healthcare professionals’ perceptions of cloud computing and found that those utilizing other technologies were skeptical of web-based data storage even though 58 percent said that they were considering cloud systems.
“Fifty-eight percent of respondents are considering using cloud computing,” report author Erik Westerlind wrote. “However, only 35 percent who expressed interest in the cloud have any solid plans to adopt it, showing that providers do not have aggressive cloud implementation timelines.
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Docs Have iPad Fever: Is There A Cure?

Clinicians are excited about what iPads can do for practices. But if you're shopping for a medical tablet, dispassionate analysis is in order.
In case you're questioning reports of a tablet epidemic in healthcare, take a look at stats from a QuantiaMD survey. Thirty percent of doctors use a tablet device, compared with just 5% of U.S. consumers, the online physicians' forum said. Of tablet-using physicians, two-thirds, equivalent to 19% of all physicians, use their tablet in a clinical setting. Another 35% of doctors surveyed say they're "extremely likely" to use a tablet in the next few years to help their practice. That sounds like a fever to me.
It's probably no surprise to most health IT managers to hear that Apple's iPad tops the list of tablets that clinicians want to use. But if your clinicians are hot for an iPad, my advice is take two aspirins and call me in the morning.
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Virginia offers residents free advance directive registry

December 12, 2011 | Mary Mosquera, Senior Editor
The Commonwealth of Virginia has launched a statewide Advance Health Care Directive Registry (AHCDR), which securely stores documents that detail healthcare wishes when a patient is unable to speak for themselves. These documents include medical power of attorney and do-not-resuscitate orders.
An advance directive lets family members and physicians know the extent and types of medical care that patients want and do not want if they are unable to express it, such as breathing machines and feeding tube. 
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Dossia health management system spurs engagement

December 12, 2011 | Mike Miliard, Managing Editor
CAMBRIDGE, MA – Dossia, the open-source personal health record service developed by a group of Fortune 500 employers, announced Monday that the Dossia Health Management System has been deployed at six of its founding member companies – leading to sharp uptick in patient engagement.
Dossia is a nonprofit organization consisting of several large U.S. companies seeking to help their employees to make more informed decisions about their healthcare. The Dossia Founders group includes AT&T, Applied Materials, BP America, Cardinal Health, Intel, NantWorks, Pitney Bowes, sanofi-aventis, Vanguard Health Systems and Walmart.
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myhealthlondon GP compare site launched

8 December 2011   Rebecca Todd
A new website showing performance and patient satisfaction levels at London’s GP practices is being launched today.
The myhealthlondon website brings together data on a set of 22 standards developed by NHS London with Londonwide Local Medical Committees.
Patients will be able to see how their practice performs against national standards such as childhood immunisations and cervical screening, as well as how they compare with other London practices.
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TPP users switch on SCR viewer

8 December 2011   Rebecca Todd
TPP has switched on a new integrated Summary Care Record viewer at a GP practice and an out-of-hours provider using its SystmOne software.
TPP says it is the first systems supplier to offer an integrated SCR viewer to primary care providers.
It allows SystmOne users to view the SCR of any patient who has had a summary record uploaded to the NHS Spine and who gives their consent.
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Healthcare IT

Hong Kong launches public consultation on e-health records

The Hong Kong government yesterday (12 December 2011) launched a two-month long public consultation to solicit views on the legal, privacy and security framework for electronic health record (eHR) sharing.
 “We understand that data privacy and system security are of paramount importance to the development of the eHR Sharing System. To this end, the Government endeavours not only to deploy the appropriate technologies to safeguard system security, but also to formulate a Legal, Privacy and Security Framework for eHR sharing with reference to views of various stakeholders as well as local and overseas experiences, so as to provide legal protection for the privacy of patients’ health data and system security,” said York Chow, Secretary for Food and Health.
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6 new HIT positions in 2012

December 09, 2011 | Michelle McNickle, Web Content Producer
By now, we know health IT professionals will need certain skills to make it big in 2012. But according to Guillermo Moreno, vice president of recruiting firm Experis, new positions springing up in health IT are calling for an even broader range of talents and abilities.
From social media gurus to CKOs, certain positions not commonly seen in the market will make a bigger impact in the year to come. Moreno spotlights six HIT positions to watch in 2012.
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Canadians with chronic illness find it tough to get care

December 12, 2011 | Bernie Monegain, Editor
TORONTO – The use of electronic health records, telemedicine and e-visits are key ways to provide chronically ill Canadians the care they need, a new report based on a Commonwealth Fund survey recommends. Results from the survey reveal that sicker Canadians struggle to gain access to care.
The Health Council of Canada on Dec. 12 released the results from the 2011 Commonwealth Fund International Health Policy Survey. The bulletin, "How Do Sicker Canadians with Chronic Disease Rate the Health Care System?" compares experiences of sicker Canadians with chronic conditions to those of the general public.
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After surgery, a robot may be at your side

In quest for efficiency, savings, hospital is testing at-home mechanical monitors

Globe Correspondent / December 12, 2011
When Erin Tally took Aidan, her 2-year-old son, home from Children’s Hospital Boston on the day after his urinary surgery, she brought along a new friend: a 4-foot-6, 17-pound, two-wheeled robot that would help deliver care to her recovering child.
Over about two weeks that included five video consultations, the robot, made by Vgo Communications Inc., of Nashua, eliminated the need for Tally to drive Aidan into Boston every three days for post-surgical checkups.
With cameras, advanced audio gear, and a video screen on its “face,’’ the robot allowed Aidan and his parents to talk with nurses and doctors in Boston. They could see and communicate with Aidan and his parents, take close-up photos of his surgical scars for doctors to review, and help determine what type of medications he needed.
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DH launches 3m lives telehealth campaign

6 December 2011   Shanna Crispin
The Department of Health has launched a campaign to use telehealth to improve the lives of 3m people over the next five years.
The launch came as the DH simultaneously published a review of innovation in the NHS and the ‘early headline findings’ from its Whole Systems Demonstrator programme.
The WSD randomised controlled trial was launched in May 2008 to assess the benefits and impacts of telehealth and telecare technology on the NHS and social care services.
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ONC pushing for standards to increase interoperability

December 9, 2011 — 1:33pm ET | By Ken Terry
The Office of the National Coordinator for Health IT (ONC) is pushing hard for universal adoption of standards that will increase the interoperability of health IT applications, according to Doug Fridsma, director of ONC's Office of Standards and Interoperability.
Writing on ONC's Health IT Buzz blog, Fridsma explained why these standards should not be optional. "Reducing optionality improves interoperability and lowers the cost for vendors to implement," he said, "thus lowering the cost for health care providers as well."
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KLAS: CDS tools need to integrate into physician workflow

December 6, 2011 — 10:44am ET | By Ken Terry
Clinical decision support (CDS) tools are starting to have a real impact on healthcare providers, but still have some kinks to work out, according to a new report from KLAS.
The researchers looked at hospitals' use of several kinds of CDS solutions, including care plans, diagnostic decision support, disease reference, drug databases, order sets and surveillance software. Most respondents were unable to quantify the clinical outcomes that resulted from using these applications. Still, they indicated that some solutions--such as those for order sets and care plans--made it easier standardize care processes. Fully adopted order sets, disease/drug reference tools and surveillance tools--used for early identification of patients who have developed complications--had the highest impact on clinical decision making.
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Despite mHealth's growth, device maturation still needed

December 11, 2011 — 11:26am ET | By Ken Terry
Many articles about the current explosion of mobile health apps, including those for healthcare professionals, presume that this is a new phenomenon. But a decade ago, there were so many mobile applications for physicians to select from--roughly 500 or 600 of them--that the sheer volume of choices overwhelmed doctors. Among those programs were drug references, standard clinical texts, electronic prescribers, medical calculators, coding and billing software, patient and procedure trackers, and evidence-based medicine databases.
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The 7 critical healthcare systems IT must protect

December 07, 2011 | Bob Gast, IT industry analyst, Vision Solutions
The coupling of modern technology with medical research has greatly increased longevity and improved the quality of life for countless patients. Technology utilized in day-to-day operations has revolutionized the receiving, storing and accessing of healthcare information. With automation throughout the healthcare industry becoming standard, along with compliance requirements necessitating sophisticated backup and recovery systems, healthcare organizations are challenged to deliver quality healthcare while maintaining up-to–date technology.
Yet, as healthcare moves in a direction where Health Information Technology (HIT) and electronic health records (EHR) are ubiquitous, questions regarding the reliability of automated IT systems arise. In a nutshell, critical healthcare systems can’t afford to go down. In fact, IT analyst group Gartner suggests that every healthcare organization’s systems need to have some level of formal high availability (HA) solution to provide at least 99.99 percent uptime. In addition, the College of Healthcare Information Management Executives (CHIME) emphasizes that HA should be a primary concern when rolling out clinical automation systems.
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Surgeon General steps into health app challenge fray

December 09, 2011 | Mary Mosquera
U.S. Surgeon General Regina Benjamin is challenging mobile health application developers to come up with technology tools that are not only creative but also easy and enjoyable for Americans to use in their everyday lives to encourage healthy behaviors.
The Surgeon General's Healthy Apps challenge, announced during her Tuesday morning keynote at the mHealth Summit, is designed to develop handy tools with tailored information that will encourage those "who may not be tech savvy and who wouldn't ordinarily want to get involved to become healthy and fit, and to make it easy and fun."
The app will also be aimed at individuals who live in communities that are hard to reach or underserved by healthcare providers.
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3M, Berkeley Research Target Preventable Hospital Readmissions

Companies join forces to tackle two major pain points for U.S. hospitals: unacceptably high readmission rates and preventable complications.
As hospitals increasingly focus attention on reducing patient readmission rates and related costs, 3M Health Information Systems and Berkeley Research Group's (BRG) Health Analytics Practice have come together to provide consulting services and software to address the underlying issues.
BRG will conduct pilot projects at select hospitals using 3M's Potentially Preventable Complication (PPC) and Potentially Preventable Readmission (PPR) software, as well as advanced patient classification systems that connect with hospital claims data. These tools will identify process and performance issues that contribute to post-admission complications and patient readmissions.
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Monday, December 12, 2011

Million Hearts Initiative Offers Health IT Opportunity, but Challenges Remain

This past September, HHS launched the Million Hearts initiative, a new public-private partnership aimed at preventing one million heart attacks and strokes across the next five years. Million Hearts will pursue this prevention goal through a focus on ABCS: Aspirin for people at risk, Blood pressure control, Cholesterol management and Smoking cessation.   
Early statements and policy decisions indicate that health IT will play a vital role in this initiative. Indeed, HHS' official announcement contained a telling line: "Ongoing HIT improvements will increase focus on cardiovascular prevention and give providers improved tools for their delivery of lifesaving ABCS care." 
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Enjoy!
David.

Tuesday, December 20, 2011

Just Why Have Medicare Not Got The Abuse Of Their Systems Under Control? Firm Penalties Are Vital.

The inadequacy of the present legislation protecting personal information held by Government agencies is made very clear in the following report.

Centrelink cracks down on misconduct

A CENTRELINK employee was sacked after accessing records belonging to customers and co-workers on 124 separate occasions, and misusing the agency's IT systems to benefit the people concerned.
The 26-year Centrelink veteran was terminated in early 2010, after an investigation into the many "unauthorised accesses” between January 2007 and January 2010.
The outcome is one of 14 cases of suspected breaches of the Australian Public Service code of conduct investigated by Centrelink over recent years; the heavily redacted findings have been published under Freedom of Information laws.
The staff member accessed one customer’s records on 61 occasions, and also a co-worker’s customer record on 61 occasions.
An investigation revealed that on three further occasions, unauthorised accesses to a former co-worker’s records resulted in alterations awarding benefits the individual was not entitled to receive.
The investigating professional standards officer dismissed the employee, saying "Centrelink takes these types of situations seriously".
Detecting and disciplining data snoops is a key priority for federal government agencies, with a number of high-profile data sensitive projects in train, including the merger of Medicare, Centrelink and Child Support and the creation of a national Healthcare Identifier database for the upcoming personally controlled e-health record system.
In the published sample cases, nine other Centrelink employees were found to be searching customer records of family members and acquaintances through the Income Support Information System or OnLine Search facility, incurring penalties of an average $50 to $100 per breach.
More examples of bad behaviour are found here:
With the Government planning to hold all our health records in data-bases managed by either Medicare Australia or a contract partner it seems clear the penalties are simply not adequate at present.
For me proven deliberate access without a proper reason should result in a no questions asked instant dismissal and if there has been any harm caused by the breach there should be serious fines of $20,000+. For breaches for profit etc. jail time should be a serious option.
It is only with dis-incentives of this level, clearly communicated to staff, will the problem be substantially addressed.
The Explanatory Memorandum for the PCEHR Bills (page 35 on) makes it clear that civil penalties for abuse of the PCEHR information (with some more draconian Crimes Act provisions available for serious criminal activities) will be enacted and this is a good thing - as long as all involved know how seriously such offenses will be taken and that the penalties handed out are really substantial to act as a proper incentive to do the right thing.
The first time a $110 fine is handed out will be the last time the penalty regime is taken seriously.
You can access the Explanatory Memorandum here:
We really need very powerful dis-incentives and comprehensive education to make this work - given the Medicare experience among others.
David.

Monday, December 19, 2011

Weekly Australian Health IT Links – 19th December, 2011.

Here are a few I have come across this week.
Note: Each link is followed by a title and a few paragraphs. 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

Clearly the big news this week has been the appointment of a new Federal Health Minister.
To date I have not heard of any comments from the new Minister on e-Health. If you spot some comments it would be useful for us all to know!
Under the covers we are seeing things starting to ease off a bit but we still see some new documents being released for the PCEHR.
Also we have interesting news from South Australia and their hospital systems this week and a range of smaller announcements - along will all sorts of security / privacy issues seeming to come out of nowhere!
All in all quite lively for the week before Christmas.
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Roxon passes Health Minister role to Plibersek

Ms Roxon who has been Health Minister for four years will move to become the country’s first Attorney-General, as part of a cabinet reshuffle expected to be announced today by the Gillard government.
During her reign in the top spot, Ms Roxon has overseen a range of health reforms including the creation of Medicare Locals and the start of e-health with the personally-controlled electronic records.
She has faced criticism from GPs with her push for Super Clinics and the After Hours GP helpline as well as the recent cuts to the Medicare rebates for mental health items.
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All eyes on new Health Minister Tanya Plibersek

  • by: Karen Dearne
  • From: Australian IT
  • December 13, 2011 12:00AM
OUTGOING health minister Nicola Roxon's elevation to top legal officer has a bitter sting in the tail for health consumer and privacy advocates she will take on "additional responsibility for Privacy and Freedom of Information".
Prime Minister Julia Gillard has, however, seen fit to remove cyber security policy from the new Attorney-General’s portfolio, while responsibility for national security research and innovation will move from the PM’s purview to Defence.
Ms Gillard’s cabinet reshuffle may allow the government to sidestep an embarrassing failure of Ms Roxon’s $500 million personally controlled e-health record system, due for launch next July 1.
With just six months to go, key specifications are undecided, key components – notably the National Authentication Service for Health transactions – are years from completion, while construction is yet to start on the core infrastructure.
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Plibersek acknowledges GPs’ role

13th Dec 2011
NEW Health Minister Tanya Plibersek, already swamped with demands from GP, consumer, pharmacy and industry groups, has acknowledged the central role of general practice in Australian healthcare.
“Every Australian needs to be able to see a doctor at the right time in the right place when they need to [and we are] making sure that we have the workforce in place to do that [and] making sure that we've got the physical services located on the ground,” she said.
Yesterday’s cabinet reshuffle saw former Health Minister Nicola Roxon appointed Attorney General, the elevation of Mental Health Minister Mark Butler to Cabinet and the creation of a Disability Reform portfolio to be headed by Jenny Macklin.
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Drug interaction alerts could be better - GPs

GPs want to see drug interaction alerts in their clinical software more relevant to clinical practice, with better information on how severe an interaction could be, a survey has found. 
A survey of more than 300 Australian GPs and pharmacists who were questioned about the drug interaction alerts they receive through their clinical software, revealed the majority want to see improvements in the system.
GPs want to see the alerts better presented, according to the survey, carried out by NPS and published in the MJA, (link) with the information formatted using headings with one or two succinct bullet points of information under each.
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eHealth technologies in primary health care: current strengths and limitations

eHealth aims to improve the quality and safety of Australia's health system by introducing a more efficient way to collect and share information such as prescriptions and test results.1 The primary health care sector could benefit substantially from the widespread use of eHealth technologies.2 The National E-Health Transition Authority is currently working with numerous stakeholders, including GPs and allied health professionals to develop an eHealth uptake plan.2 This RESEARCH ROUNDup focuses on the use of eHealth technologies in primary health care, by exploring the benefits and current limitations of a number of eHealth tools.
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Facebook aims to help prevent suicide

A program launching will instantly connect users with a crisis counsellor through Facebook "chat"
  • AAP (AAP)
  • 14 December, 2011 08:49
Facebook is making it easier for people who express suicidal thoughts on the social networking site to get help.
A program launching on Tuesday enables users to instantly connect with a crisis counsellor through Facebook's "chat" messaging system.
The service is the latest tool from Facebook aimed at improving safety on its site, which has more than 800 million users. Earlier this year, Facebook announced changes to how users report bullying, offensive content and fake profiles.
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SA govt kicks off $408m e-health roll-out

By Suzanne Tindal, ZDNet.com.au on December 14th, 2011
The South Australian government is getting ready to roll out a $408 million state-wide e-health system to metropolitan hospitals and rural hospitals and services.
The Commonwealth Government has provided $90 million for the project under the Council of Australian Governments National Health Reform funding to improve elective surgery and emergency-department funding, with the South Australian government contributing $318 million over 10 years.
The product to be implemented for the project is from Allscripts Healthcare Solutions, which has previously completed large-scale roll-outs in the US, Canada and Singapore. Allscript's system will be installed in metropolitan hospitals and services, as well as at the Glenside Hospital, the new Royal Adelaide Hospital, South Australian Ambulance headquarters, GP Plus Health Care centres, GP Plus Super clinics, Mount Gambier Hospital and Port Augusta Hospital.
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South Australia launches its first paperless health plan

  • by: Michael Owen, SA political editor
  • From: The Australian
  • December 15, 2011 12:00AM
THE first step towards a paperless national health system in which patient records can be shared electronically has been taken.
A $408 million e-health program was launched in Adelaide yesterday.
While South Australia was busy rolling out its advanced e-health plan, other states were still planning their own different systems - raising doubts about a national strategy to ultimately link electronic records across all hospitals in every jurisdiction.
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SA GPs to plug into e-health

15th Dec 2011
SOUTH Australian GPs will soon plug into a $408 million electronic record system that will provide real-time patient information, while experts have urged the rest of Australia’s GPs to prepare now for the national e-health rollout in July.
The enterprise patient administration system (EPAS) will see more than 3500 computers installed at bedsides in SA public hospitals, allowing doctors to access real time medical information about emergency patients, monitor progress of patients and exchange secure messages.
GPs with admitting rights to SA hospitals will have access to the new EPAS Clinician Portal, where they will be able to view patient information, test orders and medicines and review results.
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Queensland Ambulance Service to get new patient transport system

New transport system will help manage 20,000-plus medically authorised non-urgent patient transfers a month
  • Tim Lohman (Computerworld)
  • 15 December, 2011 11:47
Growing demand from an ageing population has prompted to Queensland Ambulance Service (QAS) to begin the search for a new ambulance transport request and scheduling system.
According to the agency, some 20,000 medically authorised non-urgent patient transfers are provided per month, and demand for these services is on the rise due to demographic and population health factors.
To help meet the data collection, resource utilisation, and reporting required to manage the demand for the transport service, QAS is now investigating available options.
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More funds for NSW Health Oracle project

  • by: Karen Dearne
  • From: Australian IT
  • December 15, 2011 6:13AM
THE cost of NSW Health's Oracle human resources information system has increased by almost $35 million and will not be complete until 2013, as a result of massive scope changes arising from the state’s restructure of health districts.
NSW Auditor-General Peter Achterstraat said the HRIS will now cost $94.3m and take two more years to address the extra configuration and development issues.
In January, the O’Farrell government established 15 local health districts to replace eight former area health services, to bring the state into line with National Health Reform arrangements.
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Breaking Victoria’s IT fail cycle: First steps to take

analysis Several weeks ago the Victorian Ombudsman handed down one of the most damning assessments of public sector IT governance in Australia’s history, noting total cost over-runs of $1.44 billion, extensive delays and a general failure to actually deliver on stated aims in 10 major IT projects carried out by the state government over the past half-decade.
Shortly after the report landed, Delimiter published an analysis of what the state should avoid doing next. Gershon-style reviews, super-chief information officers being flown in to take charge, focusing on shifting everything into IT shared services centres; analysts agreed that these sorts of quick fix solutions would just lead to more of the same problems that Victoria has already been experiencing.
With these obvious wrong turns out of the way, the focus today turns to some positive thinking. What are the steps which the Victorian State Government should be taking decisively forward at this point? Where can it look to for inspiration and a roadmap to better IT governance?
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Electronic health records – handle with extreme care

No matter which side of politics you support, and to the many in the “neither” camp, it is fair to say that the Federal government has had some unfortunate outcomes with the delivery and implementation of, what many see to have been, meritorious policies and ideas. The implementation of the pink bats and school halls schemes were marked by numerous controversies and, on occasions, subject to the processes of trial and error.
Most people seem to agree that the introduction of electronic health records (EHR) is both a good idea and good policy. People may argue about whether consumers should opt out rather than in, and its cost. But its stated objective of overcoming the fragmentation of health information, improving the availability and quality of health information, reducing the occurrence of adverse medical events and improving the coordination and quality of health care provided by different health care providers is difficult to criticise.
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UK report indicates telehealth can reduce mortality rates by 45%

The U.K. Department of Health report “Whole System Demonstration Programme: Headline Findings—December 2011” said that early findings from the demonstration project involving 3,030 people with diabetes, heart failure or chronic obstructive pulmonary disease show that “if used correctly telehealth can deliver a 15% reduction in A&E (accident and emergency) visits, a 20% reduction in emergency admissions, a 14% reduction in elective admissions, a 14% reduction in bed days and an 8% reduction in tariff costs. More strikingly they also demonstrate a 45% reduction in mortality rates.” Authors also indicate that at least 3 million people with long-term conditions or social care needs could benefit from telehealth and telecare.
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Blue Mountains to trial e-discharge

General Practitioners in the Blue Mountains West of Sydney will trial an e-discharge scheme that electronically notifies them when a patient is discharged from hospital.
The trial site is one of twelve locations around the country testing ehealth records standards and specifications ahead of the rollout of the PCEHR in 2012. The scheme is due to begin operating within the next few months.
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Medicare Local flexible funding guidelines revealed

Medicare Locals are to be given flexible funding arrangements that will allow them to channel savings from efficiencies and underspends into other areas, according to funding guidelines (link), released this week.
The new $1.5 billion funding system known as “Regionally Tailored Primary Health Care Initiatives through Medicare Locals Fund” will consolidate the 159 existing health and ageing programs into 18 larger, flexible funds from 1 July 2012, according to the blueprint released for consultation.
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Clinical E-Newsletter

December 9, 2011
Welcome to another clinician e-newsletter brought to you by the Clinical Unit of the National E-Health Transition Authority (NEHTA) providing information on key issues and current events related to eHealth in Australia.
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Centrelink cracks down on misconduct

A CENTRELINK employee was sacked after accessing records belonging to customers and co-workers on 124 separate occasions, and misusing the agency's IT systems to benefit the people concerned.
The 26-year Centrelink veteran was terminated in early 2010, after an investigation into the many "unauthorised accesses” between January 2007 and January 2010.
The outcome is one of 14 cases of suspected breaches of the Australian Public Service code of conduct investigated by Centrelink over recent years; the heavily redacted findings have been published under Freedom of Information laws.

Privacy czar investigates Telstra

  • by: Andrew Colley
  • From: Australian IT
  • December 12, 2011 1:01PM
THE Australian privacy commissioner has formally started its investigation of Telstra after it left details of around 800,000 customers exposed on the web.
The details were exposed on a search page used by Telstra customer service agents that was discovered unprotected and openly accessible on the web.
Privacy Commissioner Timothy Pilgrim said that he asked the carrier for a detailed report on the incident following a briefing early today.
Mr Pilgrim said Telstra had given him assurances that the "immediate problem" had been rectified.
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NSW Privacy Commissioner investigates USB key auction

RailCorp sent a series of questions to find out what steps were taken prior to the auction
The lost property auction of more than 50 USB keys by RailCorp in Sydney has prompted an investigation by the NSW Privacy Commissioner into possible breaches of privacy laws around use and distribution of personal information.
The keys, which were acquired at the auction by security vendor Sophos, were all unencrypted with 33 of the keys containing malware. Tax deductions, photo albums and Web source codes were just some of the kinds of personal information Sophos found.
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Scientists close to finding God particle

Deborah Smith
December 13, 2011
AFTER a 50-year hunt, scientists at the world's largest atom-smasher are closing in on their prey - an elusive subatomic particle called the Higgs boson.
At a seminar in Geneva tonight, researchers are expected to release data that will provide the first hint of the existence of the boson, known as the God particle because of its importance.
It is a final piece; the last undiscovered particle of the many predicted to exist by the standard model of particle physics.
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Enjoy!
David.

AusHealthIT Poll Number 101 – Results – 19th December, 2011.

The question was:
Will The Appointment of a New Federal Health Minister Improve the Future of E-Health In Australia?
For Certain
- 2 (7%)
 Probably
 - 1 (3%)
Possibly
-  6 (22%)
Probably Not
 - 11 (40%)
No It Will Proceed Unchanged
 - 7 (25%)
Votes 27
It appears that 65% of readers don’t have much confidence the new Minister will make a difference. Sad reflection on the new Minister I fear. Or is it that people think Ms Roxon could not be improved on?
Again, many thanks to those that voted!
David.

Sunday, December 18, 2011

The Year In Retrospect - What Was Most Read for the Year? And What Next?

With the year winding down I thought it would be fun to look back at the most popular posts for the year.
Here are the top six in terms of numbers of pageviews as of today December, 18, 2011
Sep 13, 2011, 15 comments - 1,071 Pageviews
Jan 18, 2011, 40 comments - 701 Pageviews
Mar 7, 2011, 26 comments - 627 Pageviews
Jul 20, 2011, 7 comments - 620 Pageviews
Dec 20, 2010, 12 comments - 598 Pageviews
Jan 11, 2011, 26 comments - 579 Pageviews
It does seem the most interest is generated by comments regarding Government efforts and in particular NEHTA.
For me the major theme for the year has been to try and get the PCEHR program to just take a breath and see if with a little more time spent - and possibly an architectural re-think - maybe something really good could flow from the investment that is being undertaken.
From all the feedback I get it does seem there are many in the Industry, and indeed within NEHTA itself, who would really like to see the change of Health Minister as an opportunity to call a ‘time-out’ to reassess and re-calibrate what is planned.
This is certainly the view expressed here:

All eyes on new Health Minister Tanya Plibersek

  • by: Karen Dearne
  • From: Australian IT
  • December 13, 2011 12:00AM
OUTGOING health minister Nicola Roxon's elevation to top legal officer has a bitter sting in the tail for health consumer and privacy advocates she will take on "additional responsibility for Privacy and Freedom of Information".
Prime Minister Julia Gillard has, however, seen fit to remove cyber security policy from the new Attorney-General’s portfolio, while responsibility for national security research and innovation will move from the PM’s purview to Defence.
Ms Gillard’s cabinet reshuffle may allow the government to sidestep an embarrassing failure of Ms Roxon’s $500 million personally controlled e-health record system, due for launch next July 1.
With just six months to go, key specifications are undecided, key components – notably the National Authentication Service for Health transactions – are years from completion, while construction is yet to start on the core infrastructure.
But Ms Roxon has been sniping at largely volunteer groups for months over their demands for proper consultation over the PCEHR project, while critical technical and clinical safety concerns have been brushed aside.
Lots more here:
There is no doubt this opinion piece has certainly got the paid NEHTA bloggers all in a lather! To me it is simply expressing the same sentiments I expressed just before the official announcement last week.
See here:

Monday, December 12, 2011

Big Changes For Health Ministry Coming Is The Rumour. Might Change The E-Health Game.

It seems Plibersek, The Hon Tanya, Member for Sydney is about to replace Ms Nicola Roxon as the Health Minister.
The implications of this may very well be to get DoHA / NEHTA out of a very big hole with an excuse to now change strategy, objectives and timelines in the e-Health space.
Surely Minister Plibersek will take a golden opportunity to sort out a potential festering mess. Time will tell.
David.
What I said then still stands and it would be good to see something come in the next month that clarifies if sanity will prevail or the madness is to continue! A lot of careers, jobs and people’s lives rest on the right decision
David.