Quote Of The Year

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

or

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

Monday, April 23, 2012

Weekly Australian Health IT Links – 23rd April, 2012.

Here are a few I have come across the last week or so.
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

The MJA Articles on the safety of the NEHRS (PCEHR) and mobile health tools and apps were the big news of the week. Both articles were covered on Monday here:
and here:
Other than that the news flow has focussed on the continuing countdown to the launch of a patient registration scheme for some future NEHRS.
The next couple of weeks will be dominated by Budget Speculation. The Budget is released on May 8 and it will be very interesting to see just what is announced in terms of base NEHRS funding and in practitioner involvement incentives. It is only about 2 weeks away and I am sure this Budget will be pivotal to the future - see recent blog
At a general level the Government announcements on Aged Care for the future where also pretty important. This link provides discussion and background.
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Doctor shopper scheme praised

17 April, 2012 Sarah Colyer
A new opioid script-tracking website is making it easier for GPs to identify patients who genuinely need emergency painkillers, according to early trials of the system.
In a new push to tackle doctor-shoppers, the Federal Government recently committed to expanding the technology from Tasmania to the rest of Australia from July this year.
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Plibersek defends script alert system

  • by: Karen Dearne, IT writer
  • From: The Australian
  • April 21, 2012 12:00AM
HEALTH Minister Tanya Plibersek has dismissed a Victorian coroner's concerns that a proposed $5 million electronic system to alert doctors and pharmacists to prescription-shoppers is flawed.
This is despite the fact that e-prescription software and exchange services offered by independent providers such as MediSecure and Pharmacy Guild-owned eRX can provide instant reporting.
Earlier this year, Plibersek promised to establish a national electronic recording and reporting of controlled drugs system to combat abuse of prescription medications.
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GPs want more money for e-health

  • by: Karen Dearne
  • From: Australian IT
  • April 20, 2012 7:01AM
THE peak GPs' body has restated its funding position on the Gillard government’s personally controlled e-health records system, following confusion over whether doctors will be paid to establish and maintain electronic health summaries for their patients.
"General practice is in an ideal position to be at the forefront of e-health and implementation of the PCEHR," the Royal Australian College of General Practitioners says in a statement released this week.
"Funded and protected time for data cleansing and data quality improvement will ensure that the patient record is accurate and current.
"This will require an ongoing business investment by general practice, not just a one-off payment.
"With more than 125 million GP consultations taking place annually in Australia, and 83 per cent of the population consulting a GP at least once a year, the flow-on to the whole health sector will be substantial."
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‘False optimism’ over e-health funding

The Federal Health Minister has been accused of creating “false optimism” by declaring GPs could claim MBS items to fund their role in creating e-health summaries for patients.
Last month, both the RACGP and the AGPN gave an enthusiastic welcome to a speech by Tanya Plibersek where she “confirmed” that level B, C and D items could be used by doctors “creating or adding to a shared health summary, which involves taking a medical history as part of a consultation”.
It emerged later, however, that doctors were being asked to absorb the costs of setting up the personally controlled e-health record summaries, with the government offering no new money to fund the additional workload.
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Roxon flags online identity checks

  • by: Karen Dearne
  • From: Australian IT
  • April 20, 2012 2:40PM
THE Gillard government is looking at introducing a real-time identity verification system, Attorney-General Nicola Roxon told the Commonwealth Lawyers Association regional conference in Sydney.
"Document verification may not sound particularly sexy, but it is now a critical tool to control the validity of online transactions," she said this morning.
"Just think of how your personal and financial security is reliant on secure transfer and validation of information from our banking and finance sectors, Australia's large superannuation sector and maritime and aviation security.
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Amplilatwatja health records go online

Posted April 17, 2012 13:43:36
The health centre at the remote central Australian community of Amplilatwatja has become the first in Australia to adopt a new e-health system.
The system will place patient health records online so that health professionals are able to access information remotely.
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Govt should fund e-health: Psychologists add their voice

19th Apr 2012
PSYCHOLOGISTS have joined GPs and physiotherapists in calling on the government to fund the administration of e-health records, estimating the cost of setting up the necessary software alone at $3000 per provider.
Australian Psychological Society (APS) executive manager of professional practice David Stokes said allied health professionals, including psychologists, needed assistance to help ensure the viability of the personally controlled health care record (PECHR) system.
Mr Stokes, who was also a NEHTA clinical lead representing allied health, said the whole initiative “is underpinned by the idea that relevant health service providers can access the system to upload reports or letters at their patient’s request and review relevant information to enhance care”.
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The connective tissue of modern health

17 April, 2012
David Ramli
As patients enter Melbourne’s Western Hospital, it’s probably impossible for them to spot the electronic heart that helps them be treated.
They are greeted by a triage nurse who judges the severity of injuries and decides how soon they’ll see a doctor. As the process progresses, they’re cared for by medicos who ask questions about allergies and monitor conditions, moving between scores of beds, as they have for decades.
But just below the surface of all these interactions sits up to $10 million of electronic health technology designed to reduce errors and boost the chances of patients surviving.
Western Health’s executive director of information and communications technology, Jason Whakaari, said the upgrade started as a way to cut down on paper records and cope with rapidly rising patient numbers.
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NSW Health eyes cloud in data centre reform

Recruitment points to long-awaited action.

NSW Government plans to consolidate its 130-odd data centres appear to have borne fruit, with several developments suggesting its largest Departments - Health and Education - have agreed to participate.
NSW Health has advertised for a director of data centre reform to lead the consolidatation of three existing data centres into two, "enabling their use of ... cloud technologies while maintaining service availability".
The NSW Government started scoping a whole-of-government data centre reform project in 2009, based a review of data centre capacity a year earlier.
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Time is key to specialist buy-in to PCEHR, not money

By Professor Martin Culwick
In general, anaesthetists are early adopters of technology and we work under a considerable time pressure. This is partly because in hospitals, patients are admitted on the same day of surgery and we have between five and fifteen minutes to assess them.
How we assess them can be the difference between life and death.
Obviously that assessment depends on the information, so the quality of the information is a very important safety factor. This is why we are very interested in the PCEHR.
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Privacy concerns over mobile apps

DOCTORS using clinical software on their smart phones or tablet computers may be inadvertently putting patient confidentiality at risk, according to a privacy expert.
Dr Juanita Fernando (PhD), part of the mobile health research group at Monash University, told MJA InSight she had been contacted by several patients who had suffered “direct dire consequences” as a result of privacy breaches after doctors used clinical apps on their mobile devices.
She cited the case of a doctor who had updated and uploaded a patient record at home using a clinical app. This was then cached by a metasearch engine, effectively publishing the data in the public domain.
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Apps pose medicolegal risks

17 April, 2012 Sophie Cousins
Clinical software being used by doctors on their smartphones and tablets could be putting patient privacy at risk and threatens the reliability of medical information, a leading academic warns.
In an article in the Medical Journal Australia online, Dr Juanita Fernando (PhD) of the Australian Privacy Foundation warns of the medicolegal risks of doctors using apps, amid the proliferation of programs such as iStethoscope and MedCalc.
Some applications alter the protective settings on the user's smartphone or tablet "threatening the reliability and so security, of medical information read on these," she said.
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Doctors' health apps pose a security risk

THERE's an urgent need for government regulation of clinical software being used by doctors on their smartphones and tablets, according to Juanita Fernando, from Monash University's Mobile Health Research Group.
Doctors using apps like iStethoscope, Flipboard and MedCalc on a wide range of personal mobile devices face liability and security risks not addressed in current legislation, Dr Fernando warns in a Medical Journal of Australia article published today.
"Risks include transmission of user log-ons and address-book details, message interception and activity tracking," she says.
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Safety warning on "unregulated and unmonitored" e-health

16th Apr 2012
Experts have called for an independent monitor of e-health clinical safety and governance to mitigate the patient harm they say will inevitably result from use of the personally controlled e-health record system (PCEHR).
Centre for Health Informatics director Professor Enrico Coiera told MO while the PCEHR system rollout was getting headlines, e-health also included “every GP's desktop, every pharmacy and hospital that has software installed which is currently uncertified”.
Professor Coiera, Flinders University Professor Michael Kidd and NEHTA national clinical lead Dr Mukesh Haikerwal have used an article in the Medical Journal of Australia to underscore the seriousness of the issue, warning “e-health in Australia is unregulated and unmonitored”.
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Dangers of proposed e-health system: Expert warning

Published on April 17, 2012 at 6:26 PM
By Dr Ananya Mandal, MD
Experts warn that patient safety can be in jeopardy under the proposed Australian electronic health records system. The electronic health record scheme, due to start on July 1, is yet to provide safeguards to prevent mistakes with doctors software.
Three experts including Chief clinical adviser to the e-health transition agency Mukesh Haikerwal warn the lack of a national clinical safety system to deal with computer glitches, and electronic devices means that “it is not yet possible to make any definitive statement about whether the personally controlled electronic health record is safe or not.”
The new system has been subject to growing criticism on concerns of privacy and security attributable to the unreliable performance of the National e-Health Transition Agency NEHTA, responsible for the e-Health rollout. Complaints have come from industry, “ranging from accusations of ineffective oversight and failure of administrators to acknowledge design flaws, to warnings that the system will not succeed because its implementation has been ill-considered and rushed.” This comes from an analysis by the Parliamentary Library.
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E-health safety protocols off to a shaky start

Broadcast:
Monday 16 April 2012 6:20PM (view full episode)
Electronic health records have been billed as a way to cut through red tape and improve the level of care that we all receive.
But a group of experts have warned that arrangements need to be made to ensure that our very personal records don't become compromised in any way.
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Concerns raised about e-health records

Updated April 18, 2012 09:36:00
Concern has been raised in the Medical Journal about the move toward electronic health records in Australia.
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Experts warn against E Health

Updated: 08:55, Tuesday April 17, 2012

Patient safety under the proposed electronic health records system cannot be guaranteed, warn experts.
The electronic health record scheme, due to start on July 1, is yet to provide safeguards to prevent mistakes with doctors software.
Three experts including Chief clinical adviser to the e-health transition agency Mukesh Haikerwal warn the lack of a national clinical safety system to deal with computer glitches, and electronic devices means that 'it is not yet possible to make any definitive statement about whether the personally controlled electronic health record is safe or not.'
The E Health scheme has been subject to growing criticism on concerns of privacy and security attributable to the unreliable performance of the National e-Health Transition Agency, responsible for the e-Health rollout.
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Experts warn about e-health safety

E-HEALTH experts have called for safety arrangements to minimise harm caused by health IT initiatives like the Gillard government's personally controlled e-health record system.
While e-health systems can foster safer care, an editorial published in today's Medical Journal of Australia warns that problems in design or operation can also lead to patient harm or death.
"The handful of local studies on e-health safety all point to clear evidence of past harms and future risks," says Enrico Coiera, director of the University of NSW's Centre for Health Informatics, along with co-authors executive dean of Flinders University's Faculty of Health Sciences Michael Kidd and National E-Health Transition Authority clinical lead Mukesh Haikerwal.
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Concern for patient safety with e-records

Mark Metherell
April 16, 2012 - 12:07AM
PATIENT safety under the proposed electronic health records system cannot be guaranteed less than three months before it is scheduled to start.
Safeguards to prevent and correct snafus with doctors' software, such as medication mistakes, have yet to be provided for in the national e-health scheme beginning on July 1.
The warning has come from three experts, including Mukesh Haikerwal, chief clinical adviser to the e-health transition agency.
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E-health policing plan pulled

13 April, 2012 Sarah Colyer  
The Department of Health and Ageing has been forced to pull a "shocking" draft plan giving bureaucrats powers to search general practices and scrutinise their records.
Under the draft proposals GPs wanting to take part in the personally controlled electronic health records (PCEHR) scheme being rolled out from July 1 would have had to sign a contract allowing the department search and seizure powers under the proposal.
A leaked draft of the contract stated that the system operator - currently the department of health - "may at reasonable times on giving reasonable notice to you: access your premises; access your information technology systems; require the provision by you of records and information;… inspect and copy documentation;… interview and require a meeting with any of your employees."
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Aussies Consider Date of Birth on Guard IDs ‘Excessive Personal Information’

By Carlton Purvis
04/16/2012
The overhaul of identification cards for security personnel in New South Wales in December came after complaints that information on current IDs violated privacy statutes, according to recently released documents.
Early last year, a person only identified as a member of the New South Wales security industry made a complaint to the NSW Office of the Privacy Commissioner about the requirement for security personnel to wear and display license cards while on duty. The complainant expressed concerns about physical and financial safety because of the amount of information listed on the cards and said ID cards showing names and birthdate violated NSW privacy laws, according to recently released investigation report by the privacy commissioner.
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NBN blowout is inevitable, warns analyst

  • by: Annabel Hepworth, Mitchell Bingemann
  • From: The Australian
  • April 19, 2012 12:00AM
THE furore over the National Broadband Network has intensified amid fresh claims that the $36 billion project is 15 months behind schedule because of "fundamental" shortcomings in Labor's policy and that cost blowouts are inevitable.
Telecommunications analyst Kevin Morgan argues that, while delays in the multi-billion-dollar deal between the Gillard government, NBN Co and Telstra have been blamed for missed targets
on the NBN rollout, the main reason has been "fundamental shortcomings and miscalculations" in the policy behind the NBN.
Mr Morgan, who served on Keating government communications minister Kim Beazley's committee on telecom reform on behalf of the ACTU, says these miscalculations included a $43bn "guesstimate" of the cost to build the NBN in 2009 that had led to "unreasonable" expectations about the price that should be paid to contractors.
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Scientist beams up a real 'Star Trek' tricorder

April 16, 2012 - 8:26AM
A scientific measurement device based on Star Trek's "tricorder" handheld, used by characters in the series as early as 1966 for data sensing, analysis and recording
Starships, warp speed, transporters, phasers. Think Star Trek technology is only the stuff of fiction? Think again.
Dr. Peter Jansen, a PhD graduate of the Cognitive Science Laboratory at McMaster University in Hamilton, Ontario, Canada, has developed a scientific measurement device based on the tricorders used by Captain Kirk, Spock, Dr. McCoy and other space adventurers on the classic TV series that has spawned numerous spin-offs in more than 45 years.
"Star Trek inspired me to be a scientist" said Jansen, who has been formally working on his tricorder prototypes since 2007, but toying with the idea of making a functioning device since he was "a kid in high school."
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Space mining start-up set for launch in US

Published 11:21 AM, 21 Apr 2012
AAP
A corporate start-up evidently devoted to mining asteroids for metals is to make its public debut on Tuesday in the US northwest city of Seattle.
X Prize founder Peter Diamandis and a former NASA astronaut are slated to unveil Planetary Resources, which boasts an impressive list of backers including Google co-founder Larry Page and famed film-maker James Cameron.
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Enjoy!
David.

AusHealthIT Poll Number 118 – Results – 23rd April, 2012.

The question was:
Is NEHTA Providing Sufficient Transparency On What It Is Doing Regarding Patient Safety In Its Programs?
Yes - Just Great
- 3 (8%)
Yes - But Might Do A Little Better
- 1 (2%)
No - Are Being Too Opaque
- 7 (20%)
No - They Are Being Obstructive And Secretive
- 23 (67%)
Votes 32
A pretty clear outcome and it is really just not good enough!
Enough said.
Again, many thanks to those that voted!
David.

Sunday, April 22, 2012

The 2012 Budget Will Be Critical for E-Health. What Will Happen Is Anyone’s Guess.

The Federal Budget for 2012/2013 is due to be released in May 8, 2012. That is just 15 days away.
There are a number of reasons why it will be critical for e-Health going forward.
As background we know.
1. The Government is desperate to achieve a Budget Surplus and this will mean about $40 Billion in savings are needed as opposed to 2011/2012.
2. This is a fiscal contraction of the order of 2% of GDP and so it will hurt - no matter how executed and what attempts are made to diminish the impact.
3. There are a lot of smart economists that it might be more sensible to say just bring the deficit down to $20 Billion this year and then finish the job the year after to avoid too much pain.
From a specific e-Health perspective we know.
1. Funding for the NEHRS comes to a sudden end June 30, 2012 unless renewed.
2. Funding for associated infrastructure, the wave sites and so on has the same drop dead date.
3. NEHTA’s annual budget of about $100 Million also stops at June, 30, 2012 unless renewed.
4. At the last Council of Australian Government meeting a week or two back there was no mention of e-Health or NEHTA.
Here are the links to what was decided:

Council of Australian Governments Meeting - 13 April 2012, Canberra

COAG Communiqué

Related Documents

Themes of Strategic Importance

Skills Reform

Progress on Seamless National Economy Reforms

Mental Health Reform

Remote Service Delivery National Partnership Annual Report

Review of National Agreements and National Partnership Agreements

Last Updated:  16 April, 2012
This is the web site:
Simply not a mention of e-Health or anything even close. Given there seem to be only 2-3 meetings a year which could fund NEHTA (It is a joint State / Federal effort) the signs for June 30 can’t be seen as great unless NEHTA is suddenly going to be transferred to the Federal Budget.
It seems to me that to have the basic infrastructure work continue (Identifiers, NASH, SNOMED, AMT, Supply Chain etc.) that $50-100 million p.a. is needed.
To press on with the NEHRS (Wave Sites, Clinician Incentive Payments, Software Vendor Payments, NASH Tokens and so on) there has to be another $100 million +.
To see an overall $200 million p.a. being provided - without business cases and any evidence of the e-Health program having actually made a difference - in these difficult times seems a pretty big ask.
Frankly I don’t think it will happen. What do others think?
David.

Saturday, April 21, 2012

Weekly Overseas Health IT Links - 21st April, 2012.

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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5 keys to IT and the physician-patient relationship

By Michelle McNickle, Web Content Producer
Created 04/12/2012
As the concept of patient-centered care continues to evolve, a key to its success is the relationship between physician and patient. But factor in all the technologies springing up left and right, and finding the perfect balance between patient engagement and new IT initiatives can be tricky.
"Focusing specifically on the physician-patient relationship – it's behind the rest of the world," said Steve Wigginton, CEO of Medley Health, a medical practice marketing and communication services company. "But there are a lot of benefits to be had. More information is readily available to physicians as a result of IT, and therefore, it's easier for them to keep track of what's going on with their patients."
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Patients Make Poor Health-Care Consumers, Says Quest Diagnostics’ CMO

Are patients good consumers of healthcare?
Nope, says Jon Cohen, a vascular surgeon and chief medical officer at Quest Diagnostics. The average American spends twice as much time before buying a TV as they do looking for a doctor, he told participants today at TEDMED in Washington.
“Consumer-driven healthcare doesn’t work because people don’t want health care,” he said.
The three main factors that drive consumers to make a choice: price, quality and desire, said Cohen. When it comes to health care, however, price doesn’t correspond with quality, so going to a more expensive doctor doesn’t guarantee better treatment.
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Do We Need Doctors Or Algorithms?

Vinod Khosla
Tuesday, January 10th, 2012
Editor’s note: This is Part II of a guest series written by legendary Silicon Valley investor Vinod Khosla, the founder of Khosla Ventures. In Part I, he laid the groundwork by describing how artificial intelligence is a combination of human and computer capabilities. In Part III, he will talk about how technology will sweep through education.
I was asked about a year ago at a talk about energy what I was doing about the other large social problems, namely health care and education. Surprised, I flippantly responded that the best solution was to get rid of doctors and teachers and let your computers do the work, 24/7 and with consistent quality.
Later, I got to cogitating about what I had said and why, and how embarrassingly wrong that might be. But the more I think about it the more I feel my gut reaction was probably right. The beginnings of “Doctor Algorithm” or Dr. A for short, most likely (and that does not mean “certainly” or “maybe”) will be much criticized. We’ll see all sorts of press wisdom decrying “they don’t work” or “look at all the silly things they come up with.” But Dr A. will get better and better and will go from providing “bionic assistance” to second opinions to assisting doctors to providing first opinions and as referral computers (with complete and accurate synopses and all possible hypotheses of the hardest cases) to the best 20% of the human breed doctors. And who knows what will happen beyond that?
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5 keys to EHRs supporting next-generation business models

By Michelle McNickle, Web Content Producer
Created 04/11/2012
With the rise of accountable care organizations (ACOs) and patient-centered medical homes (PCMH), the spotlight has been put on IT to help make a smoother transition to those new care models. And although the partnership between patient and EHR plays a critical role in their success, Shahid Shah, software analyst and author of the blog The Healthcare IT Guy, believes EHRs have a long way to go before they can take on the full responsibility of supporting these organizations.
"Today's reality of patient management is 'disjointed care,' and most of the collaborators in a patient's care team don't know what each other is doing for the patient in real time," he said. 
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EHRs a major cause of patient info breaches

By mdhirsch
Created Apr 12 2012 - 9:27am
The "aggressive" adoption of electronic health records is one of the biggest reasons for the rise in security breaches of patient records, according to HIMSS' latest analytics report [1] on the security of patient data.
The report, commissioned by Kroll Advisory Solutions, noted that with the move to patient records in electronic form, the data is more vulnerable since it's more accessible and mobile. Of the respondent hospitals that have reported a security breach of patient information, 22 percent reported that the data compromised had been in electronic form--such as a computer or mobile device--double the amount reported in 2010. Most of the breaches involved theft or loss.
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New Patient Safety App Challenge from ONC

APR 11, 2012 4:27pm ET
The Office of the National Coordinator for HIT has launched a new challenge for development of a specific health information technology application.
The Reporting Patient Safety Events Challenge seeks an application to facilitate reporting of safety incidents in hospital and ambulatory settings.
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By Joseph Conn

Breaches, hackers and the wisdom of encryption

The recent breach of patient-identifiable healthcare records in Utah is unusual, but not unique, in that it reportedly involved the work of hackers and the extent of the exposure was not immediately known.
According to the publicly available segment of the 410 major breach reports collected by HHS' Office for Civil Rights, 24 (not quite 6%) were the result of hacking, primarily of computer servers. Those 24 breaches exposed 550,083 patients' records, or just 3% of the nearly 19.2 million records involved in all 410 reported incidents involving more than 500 patient records.
So far, the Utah breach, at the latest report could involve as many as 780,000 beneficiaries of the state's Medicaid and Children's Health Insurance Program participants. That would make it the single-largest breach involving hacking since the civil rights office began collecting breach reports in September 2009 under a congressional mandate.
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Fierce Q&A: Data governance plan crucial for winning providers' trust

By danb
Created Apr 12 2012 - 12:55pm
A clear data governance plan that includes how data will be collected, maintained and protected is a must for any hospital planning on pushing a big-data initiative, Computer Sciences Corporation senior research analyst Jared Rhoads writes in the company's latest whitepaper, "Transforming Healthcare Through Better Use of Data [1]."
According to Rhoads, such a plan is crucial to winning providers' trust.
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New electronic medical record system to further enhance exchange of vital patient information at Group Health Centre in Sault Ste. Marie

April 12, 2012 (Sault Ste. Marie, ON) - Canada Health Infoway Inc. (Infoway) and the Group Health Centre (GHC) today launched a new $3.3-million initiative, the Group Health Centre Ambulatory EMR and Hospital Information System Connect Project. This project will revitalize GHC's I.T. infrastructure and integrate it with local hospital and provincial electronic health record (EHR) systems to enhance quality of care and share information between healthcare settings. Alignment with provincial and national EMR and EHR initiatives are critical elements of the project.
GHC's existing EMR has been used by local clinicians to store and share information amongst authorized healthcare providers for more than 15 years. While this system has helped position GHC as an EMR leader, the time has come to replace the existing EMR solution with the next generation of EMR.
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Thursday, April 12, 2012

New Leader, New Plan, New EHR Initiative for Cal eConnect

Laura Landry has worked at Cal eConnect since it was formed by the state two years ago, but she looks at the organization a little differently now. After spending the last six months as interim CEO, Landry was officially named CEO on March 19.
Her new position gives her a different perspective -- the overview.
"I think we're on the verge of a breakthrough," Landry said. "People talk about making changes at the speed of trust, and we're at the point where we've engaged stakeholders ... and now we're giving them the things that they need to get things done. We're right on the cusp of making health information easier, making it easier to do health information."
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Blog Explains Direct Project Secure Messaging

APR 10, 2012 11:56am ET
Greg Meyer, a director and principal architect at Cerner Corp., has written the first of three blogs that are a plain English tutorial of the government-funded Direct Project secure messaging service.
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Utah Breach Shows Vulnerability of Health Records

By NICOLE PERLROTH
 April 10, 2012, 10:29 am
Eastern European hackers have stolen personal records for 780,000 people in the breach of a computer server in Utah.
The list of victims include recipients of Medicaid and a health care program for low-income children in Utah, officials at Utah’s Department of Health said in a statement. Hackers were able to breach the servers by exploiting a technician’s weak password. On March 30, they downloaded 24,000 files to computers in Eastern Europe. Each file contained records for hundreds of recipients.
Utah’s Department of Health has updated the number of victims three times. It initially said 24,000 people were affected but by Monday evening, the list had expanded to include 780,000. Of those, the department said 280,000 had their Social Security numbers stolen, according to the revised statement.
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Epic “ready for NHS”

Two of the senior executives at Epic talk to EHI editor Jon Hoeksma about why “the Epic way” may be the way forward for some trusts in the NHS.
4 April 2012
Author: Jon Hoeksma
The chief operating officer of US electronic patient record vendor Epic says the firm is ready for the NHS, is optimistic about its chances and sincerely hopes it will win the high-profile Cambridge procurement.
In an exclusive interview with eHealth Insider at HIMSS12, Las Vegas, Carl Dvorak, executive vice president, Epic, and Leslie Karls, who is leading on the NHS, said the company had first started engaging with the NHS in England in the mid 2000s, at the request of NHS Connecting for Health.
“Six or seven years ago we decided the NHS market wasn’t right for us, but we’ve been keeping watch of developments and been getting more enquiries from the UK.”
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HIMSS: Hospitals must be more 'proactive' about data breach prevention

By danb
Created Apr 11 2012 - 1:48pm
Hospitals and health organizations need to be more proactive about preventing health data breaches, concluded the authors of the recently released "2012 HIMSS Analytics Report: Security of Patient Data." The report [1] said most facilities are too wrapped up in compliance issues to focus on keeping patient data protected.
"While increased regulation and better-articulated guidance have led to increases in privacy and security measures within hospitals, they also have contributed to a false sense of security within organizations that comply with these mandates," the report's authors wrote. "Despite the increase in the number of breach incidents reported, most hospitals continue to believe that if they are more prepared, they are more secure."
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Breaches epidemic despite efforts at compliance, says Kroll

By Mike Miliard, Managing Editor
Created 04/10/2012
NEW YORK – A new study from HIMSS Analytics and Kroll Advisory Solutions shows that, a diligent focus on security compliance notwithstanding, healthcare providers are still badly lacking when it comes to privacy protections. In fact, data breaches have only increased in recent years.
According to the 2012 "HIMSS Analytics Report: Security of Patient Data," increasingly stringent regulatory activity with regard to reporting and auditing procedures – and increased compliance from providers – haven't done anything to prevent an uptick in breaches over the past six years.
The report is the third iteration of Kroll’s biannual survey of healthcare providers nationwide.
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Civil liberties group criticizes health information exchanges over privacy

A lack of standards on sharing data could put patient records at risk, according to a report.

By Pamela Lewis Dolan, amednews staff. Posted April 10, 2012.
A report by the New York Civil Liberties Union examining health information exchanges in the state questioned the legalities of the patient privacy policies in place and criticized the exchanges for not doing enough to protect patients.
The findings are applicable to health information exchanges across the country, the report’s author says, because there are no established best practices for the sharing of data through HIE organizations. New York is often viewed as a leader in such exchanges, as it had some of the first ones in the nation.
Corrine Carey, assistant legislative director of the NYCLU and author of the report, said because information can be uploaded to an HIE without patient consent, the NYCLU and other patient privacy groups have argued that these policies are not consistent with state law, which requires physicians to get consent from a patient before transferring records to a third party. Patients do, however, have to give consent before those files can be accessed by another physician, which makes the policies consistent with the law, according to the New York State Dept. of Health.
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April 10, 2012

EHR Study Update: Top reasons for implementing EHR

By Michael McBride
When asked what their top reasons were for implementing an electronic health record (EHR) system, 95% of the EHR Study's participating physicians listed "to achieve meaningful use" as the primary motivation. For 53% of the doctors polled, "to improve patient quality of care" came in at a distant second-place motivation.
Clearly, complying with the government's mandate motivates more primary care physicians to adopt EHRs in their practices than other, more fundamental healthcare motivations.
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Oregon Health Network's 12 HIT best practices, part 4: Implementation

By Greg Fraser, CMIO, WVP Health Authority
Created 2012-04-09 09:49
Implementation – answering the question of “how” – is #4 on the list of Health Information Technology Best Practice Areas. Having been involved with electronic health record implementation in the ambulatory environment for six years, I can validate some universal truths about implementation and what it takes for a health care organization to successfully navigate its way from a paper to electronic environment. Why do some organizations succeed while others fail? Why do some successful organizations struggle much more than others?
The Buddhist aphorism applies: “Pain is inevitable; suffering is optional.”
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Telemedicine becoming the new house call

The Atlanta Journal-Constitution
6:57 p.m. Monday, April 9, 2012
Travis Proctor logged onto his computer, turned on his new webcam and clicked his mouse.
Within seconds, the 42-year-old father of three was face to face with Dr. Kelvin Burton, his primary care physician.
Just months ago, Proctor would have had to drive for nearly an hour round-trip from his home in Powder Springs to Burton’s Douglasville family care practice just for a checkup.
Not anymore.
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ICD-10 Would be Delayed One Year Under HHS Proposal

Andrea Kraynak, for HealthLeaders Media , April 9, 2012

HHS released a proposed rule Monday announcing a one-year delay of the implementation of ICD-10-CM/PCS. If finalized, ICD-10 would become effective October 1, 2014.
"Many provider groups have expressed serious concerns about their ability to meet the Oct. 1, 2013, compliance date. The proposed change in the compliance date for ICD-10 would give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition to these new code sets," according to an April 9 press release.
"This is what I expected," says Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CPC-I, CCDS, director of HIM and coding at HCPro, Inc., in Danvers, Mass. "But I am happy to hear that they didn’t seem to consider bypassing ICD-10 and going right to ICD-11. This goes to show that they do see the value in the system."
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Patients Take Back Control with Technology

Scott Mace, for HealthLeaders Media , April 10, 2012

Technology can be a wonderful thing. It can also be a cold and dehumanizing thing.
Unfortunately, in medicine, that often happens with one and the same device.
The very instruments that diagnose and treat us can often make us feel more like test subjects than patients receiving care. Anyone who's ever had an MRI knows the device that can find what's ailing us is also oppressively big and noisy. Woe to you if you're claustrophobic.
But technology is now being applied in the interests of healing the entire patient—mind, body, and soul.
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7 types of security features for your tablet

By Michelle McNickle, Web Content Producer
Created 04/06/2012
With the release of the "new" iPad, an increased focus has been placed on how to protect sensitive information. And although there are a myriad of basic ways to safeguard your device, certain security features have become necessary to take tablet protection one step further.
"Clearly, healthcare is a vertical that is more concerned, or needs to be more concerned, about security, more so than any other vertical because of the personal info they're dealing with," said John Bischof, executive director of sales operations for Lenovo Americas. 
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CMS Posts Details on Stage 2 Clinical Quality Measures

APR 9, 2012 11:42am ET
The Centers for Medicare and Medicaid Services has posted on its Web site the complete set of clinical quality measures in the proposed rule for Stage 2 electronic records meaningful use starting in 2014.
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States wrestle with prescription data to curb abuse

By gshaw
Created Apr 9 2012 - 12:58pm
Access to drug prescription databases could curb abuse of pain pills, says a Colorado payer--but the state's pharmacy board is having none of it.
Rocky Mountain Health Plans, along with Colorado Medicaid officials, sought access to the database in order to curb doctor-shopping and pharmacy hopping, according to [1] the Denver Post.
But board members said state law allows access only to those providing direct care or dispensing direct prescriptions, and told both organizations they could not conduct wider reviews, according to the paper.
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Adaptive clinical decision support improves patient risk estimation

By danb
Created Apr 9 2012 - 1:34pm
Clinical decision support could become more personalized, if the results of a study [1] recently published in the Journal of the American Medical Informatics Association are any indication. Researchers determined that a new data-driven and adaptive approach to CDS was found to be more reliable than some existing methods.
The new approach--dubbed ADAPT--does not use training data, and instead relies on confidence intervals (CIs) drawn from individuals. Each model uses different features, parameters and samples, according to the study's authors.
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Health privacy issues can be resolved without obstructing care

By kterry
Created Apr 9 2012 - 7:10am
At times, it seems like concerns about the security and privacy of healthcare data have catapulted into overdrive: For instance, it recently was predicted that healthcare spending on security would hit $70 billion a year [1] by 2015--enough to cover the majority of the uninsured. Sure, there are plenty of security breaches--some of them serious enough to attract public attention. But as a few recent cases show [2], universal encryption of data (some forms of which may soon be required under the latest HIPAA rules [3]) could eliminate the biggest source of security breaches. Also, with the advent of virtual desktop infrastructure, there's no reason to store any personal health information on end-user devices.
As for hacking, the Eastern European thieves who are suspected of hacking into Utah's Medicaid system [4] recently were not after the details of Aunt Tilly's hip operation; they wanted her Social Security number. The only cure for that--regardless of how much is spent on security--is to replace the "social" with a national patient identifier. Unfortunately, that's still the impossible dream [5], ironically because of privacy concerns.
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Time To Rethink EMR Design And User Interface

04/06/2012 By Dale Sanders
Dale Sanders, Senior VP, Healthcare Quality Catalyst
There’s a great new article in the March 2012 issue of The American Journal for Managed Care, “IT-Enabled Systems Engineering Approach to Monitoring and Reducing ADEs.” You can find it here. The point I’m trying to make in this blog, by drawing attention to this article, is this: it’s time for EMR vendors to rethink the fundamental design and user interface of their products.
They’ve been basically unchanged for 10 years at least, supporting the same concept of encounter-based care that itself goes back at least 50 years. EMR vendors need to stop thinking of patient care as short-term encounters with a clinician and start thinking of patient care as long-term project management with a team of care providers. EMR user interfaces need to look more like a project management tool that enables social collaboration, task assignment and follow-up, and the collective wisdom of the care team, including the patient’s wisdom, more effectively.
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Monday, April 09, 2012

Moving Federal Health Care Targets Becoming a Way of Life

Moving targets are a challenge in skeet shooting; for health care providers, they are becoming a way of life.
Health care organizations are facing a variety of looming federal deadlines, ranging from implementing electronic health records to adopting new transaction standards. These deadlines -- carefully tracked by health care organizations and professional associations such as the College of Healthcare Information Management Executives -- are intended to put pressure on the industry to stay the course.
But recently some federal deadlines have been pushed back in response to evidence that the industry as a whole is not ready to meet them. For example, the Oct. 1, 2013, deadline for use of ICD-10 codes was postponed in February, and most recently, the deadline for enforcing use of ASC X12 Version 5010 and NCPDP Version D.0 was pushed back for a second time, to June 30, 2012.
These reprieves draw sighs of relief from some industry segments, while evoking frustration from others that have invested time, money and staff to meet the original deadline.
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Gingrich Health IT Think Tank Goes Bankrupt

Center for Health Transformation played major role in promoting health IT to Congress and the healthcare industry.
By Ken Terry,  InformationWeek
April 09, 2012
The Gingrich Group, which includes Newt Gingrich's think tank, the Center for Health Transformation (CHT), has filed for Chapter 7 bankruptcy. Gingrich severed ties with CHT when he began seeking the Republican presidential nomination in May 2011, and a Gingrich campaign spokesman told the Wall Street Journal that CHT's bankruptcy is a result of its founder's departure.
CHT was a major promoter of health IT both before and after the passage of the HITECH Act, part of the 2009 stimulus law that established the government incentive program for "meaningful use" of electronic health records. AdTech Ad
Back in 2007, when Allscripts and several other technology companies formed the National e-Prescribing Patient Safety Initiative (NEPSI), which offered free e-prescribing software to physicians, Gingrich appeared at the press conference. "In the 21st century, the legibility of a doctor's handwriting should not determine whether a patient lives or dies," said the former Speaker of the House of Representatives in urging widespread adoption of e-prescribing. Later, Gingrich wrote the introduction to a book on the topic entitled Paper Kills, which was edited by CHT project director David Merritt and published by CHT press.
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Kenya's Startup Boom

Local programmers and homegrown business models are helping to realize the vast promise of using phones to improve health care and save lives.
Erick Njenga, a 21-year-old college senior wrapping up his business IT degree at Nairobi's Strathmore University, has a gap-toothed grin and a scraggly goatee. A mild-mannered son of auditors, he didn't say much as we tucked into a lunch of grilled steak, rice, and fruit juice at an outdoor café amid the din of the city's awful traffic. But his code had done the talking. Last year Njenga and three classmates developed a program that will let thousands of Kenyan health workers use mobile phones to report and track the spread of diseases in real time—and they'd done it for a tiny fraction of what the government had been on the verge of paying for such an application. Their success—and that of others in the nation's fast-growing startup scene—demonstrates the emergence of a tech-savvy generation able to address Kenya's public-health problems in ways that donors, nongovernmental organizations, and multinational companies alone cannot.
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Information Integrity: A High Risk, High Cost Vulnerability

APR 1, 2012
Accuracy and validity of data are persistent concerns for those who use it and are the subject of that data. And the concerns are well founded. Data error is a risk to patient safety.
Distrust of data can stop or delay action on a performance improvement agenda and it's very difficult to overcome that distrust. Tracing and correcting errors is costly and often imperfect. The amount of operational inefficiencies due to data quality issues, such as untangling an error in patient identification, is legend.
In short, problems in data accuracy and validity can impair the value of the information that health care is investing so much to digitize.
The Data Warehousing Institute estimates that poor data quality costs U.S. businesses $600 billion a year. There's no estimate of the cost of data quality problems in health care-but even the most conservative guesses for quality problems in the nation's largest industry would indicate there's real money at stake here.
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Enjoy!
David.