This Is An Astonishing and Just Unsupportable Piece Of Nonsense. A Fraud On The Populace Is My View.

This astonishing document appeared a few days ago.

Expected benefits of the national PCEHR system

Printable version of Expected benefits of the National PCEHR System (PDF 71 KB)

Based on economic modelling work undertaken in 2010-2011

Overview of the national PCEHR system

The national PCEHR system will comprise a secure network of systems enabling access to consolidated and summarised health information drawn from multiple sources across the Australian health sector.

Summary of expected benefits

The net direct benefits of the national PCEHR system estimated by Deloitte are expected to be approximately $11.5 billion over the 2010 to 2025 period. This comprises approximately $9.5 billion in net direct benefits to Australian governments and $2.0 billion in net direct benefits to the private sector, where the private sector includes households, GPs, specialists, allied health clinics, private hospitals and private health insurance providers.

Economic modelling was undertaken from the commencement of investment in the PCEHR in 2010 and considered benefits that would be accrued over the 15-year period to 2015. The economic modelling considered both the benefits that accrue from the direct investment in the national PCEHR system as well as the benefits that accrue from investment by the broader health sector that is catalysed by the Commonwealth Government’s investment in the national PCEHR system.

Expected net benefits

Deloitte has categorised the expected benefits and costs of the national PCEHR system as follows:

• Public – The benefits and costs of the national PCEHR system to the public sector, which consists of the Commonwealth and State and Territory Governments
• Private – The benefits and costs of the national PCEHR system to the private sector, which consists of households, GPs, specialists, allied health clinics, private hospitals and private health insurance providers.
• Community – The combined benefits and costs across both the public and private sectors.

Table 1 below shows the sum of future net benefits of the national PCEHR system over the 2010-2025 period.

Table 1 – Expected total net benefits of the funded national PCEHR system (2010-2025)

Benefit	Expected total net benefits (2010-2025) ($M)
Public benefits	$13,121
Public costs	$3,614
Net public benefit	$9,507
Private benefits	$7,594
Private costs	$5,555
Net private benefit	$2,038
Total community benefits	$20,715
Total community costs	$9,170
Net community benefits	$11,545

Benefit contribution to priority health activities

The benefits of the national PCEHR system accrue from two key areas:

Reduced avoidable hospital admissions and GP visits due to more effective medication management

With more complete information about a patient at the time of prescribing — independent of location or time constraints — prescribing errors and adverse drug events (ADEs) in both acute care settings and in the community can be reduced. The national PCEHR system will enable this outcome through giving health providers access to clinical documents that contain concise medication information for a patient, such as Shared Health Summary, Discharge Summary and Event Summary documents.

Improved continuity of care
Reducing the time consumers and care providers spend repeating and sharing information across the health sector will improve the effectiveness and efficiency of healthcare delivery. The national PCEHR system will enable this outcome through enabling health providers to contribute patient health information to their PCEHR in the form of PCEHR-conformant clinical documents. Other health providers can then access and view this information for the same patient thereby reducing the need for consumers and the original care provider to repeat the same information. For example, a Shared Health Summary document will summarise the current health status of a patient so that this can be accessed by other health providers involved in their care, such as outpatient clinics and allied health professionals.

Table 2 below shows the benefits for priority health activities which the national PCEHR system is expected to deliver over the 2010-2025 period based on available global research.

Table 2– Benefits of the national PCEHR system for priority health activities

Priority health activities	Benefits of national PCEHR system (2010-2025) ($M)*
Reduced avoidable hospital admissions and GP visits due to more effective medication management	$10,237
Improved continuity of care	$1,308
Total net community benefits (as per figure stated in Table 1)	$11,545

* The allocation of benefits across the priority health activities is an estimate based on their proportional contribution to overall benefits modelled for the period 2010-2015.

Table 3 below provides a break-down of the above benefits for the national PCEHR system by care setting.

Table 3– Breakdown of PCEHR benefits by care setting

Priority health activities	Care setting	Benefits of national PCEHR system (2010-2025) ($M)*
Reduced avoidable hospital admissions and GP visits due to the more effective medication management	Community setting	$9,228
	Aged care setting	$603
	Acute care setting	$405
	Subtotal	$10,237
Improved continuity of care	Community setting	$1,254
	Acute care setting	$55
	Subtotal	$1,308
	Total	$11,545

* The allocation of benefits across the priority health activities is an estimate based on their proportional contribution to overall benefits modelled for the period 2010-2015.

Approach to modelling

The economic impact assessment undertaken by Deloitte focused on identifying the incremental health and economic benefits that could be realised from the implementation of a national PCEHR system as distinct from the benefits of other eHealth investments occurring in the Australian landscape, such as:

• The core standards and eHealth foundational infrastructure being developed by the National E-Health Transition Authority
• Investments that have already been proposed or implemented by Australian governments, such as the implementation of Electronic Medical Records, ePrescribing, eDiagnostics and Care Plan capabilities
• Investments that have already been proposed or implemented by commercial providers, such as commercially available ePrescribing solutions.

To identify the incremental costs and benefits associated with the national PCEHR system as compared with other eHealth investments that would be expected to be made independent of the national PCEHR system, two scenarios were developed:

• The Base Case investment scenario In this scenario, where no national PCEHR system is developed, a cost-benefit model was developed that identified the range of eHealth capabilities that would be expected to come online regardless of whether a national PCEHR system was developed. The assumptions underpinning the expected costs and the timing of new capabilities coming on-line was estimated based information gathered from the broader health sector.
• The PCEHR investment scenario In this scenario, where a national PCEHR system is developed, a cost-benefit model was developed that identified the additional eHealth capabilities that would be expected to be either specifically delivered or brought forward as a direct result of the implementation of a national PCEHR system. As in the Base Case, the assumptions underpinning the expected costs and the timing of new capabilities coming on-line was estimated based on information gathered from the broader health sector. The benefits estimates were based on a literature review of the likely improvements in safety, quality or efficiency of care associated with each capability, with the PCEHR cost benefit model identifying the additional benefits that would be unlocked as a result of the national PCEHR system being developed.

By comparing the benefits that would be realised for different technologies in the PCEHR scenario with the Base Case scenario the analysis is able to identify the benefits associated with the national PCEHR system.

Base assumptions

In modelling the scenarios for the national PCEHR system, five key assumptions about the operating environment of both scenarios were made:

• Privacy legislation and all necessary regulation is expected to be implemented
• Available bandwidth exists to support the information sharing across patients, care providers and governments
• Basic carer provider infrastructure, such as computers and access to internet where relevant, is available
• Technology change is steady
• Current health sector funding and governance remains unchanged.

To calculate the benefits of the national PCEHR system over time, Deloitte made assumptions regarding the take-up of the system among consumers and the health sector. An overview of these assumptions is provided below.

Provider take-up assumptions

With the scope of the change and adoption strategy focused towards eHealth, a nationally uniform rate of technology take-up is not expected. It is expected that there will be a faster rate of adoption and take-up within eHealth Site regions, and a slower rate of take-up in the rest of the country. It has also been assumed that there will be comparatively higher rates of take-up by GPs, hospitals, pharmacies and aged care providers, with lower rates among specialists and allied health providers.

Consumer take-up assumptions

The national PCEHR system will be based on an opt-in participation model. This means that the extent to which benefits are generated as a result of the PCEHR will be dependent on the rate of participation by consumers. The consumer participation rate was based on two key assumptions:

• A percentage of consumers will, for a variety of reasons, never choose to register for a PCEHR
• The rate of participation by consumers will lag the aggregate participation rate for healthcare providers.

You can find the page here:

www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/content/pcehr-benefits

Just as a small sanity check:

From this reference found here we hear the Adverse Drug Events cost the Community $660 million per year.  So the cost over 15 years is $9.9 billion.

See here:

http://pharmacistsforhealth.com.au/wp/wp-content/uploads/2011/06/PCHR_fact_sheet.pdf

The reference cited is:

6. Easton K, Morgan T, Williamson M.  Medication safety in the community: A review of the literature. National Prescribing Service. Sydney, June 2009.

You can grab the paper from here:

http://www.nps.org.au/__data/assets/pdf_file/0008/71675/09060902_Meds_safety_June_2009.pdf

So what we are being told is that introduction of the PCEHR will save essentially every cent of cost incurred in the community with no help from e-prescribing, GP and Pharmacist automation and the like.

Also this must assume 100% adoption from day one etc, etc. And I just love how they can estimate to five significant figures 15 years out. This is NASA like futurology!

The utter lack of supporting detail and references is, of course, an insult to anyone interested in the area. The arrogance here is really spectacular. DoHA are saying 'We will make it up as we go along, put it on a government web site and you will believe it" Sorry, it just does not work like that.
Whatever these people are smoking I want some. It must make reality a very distant concept.
It is this sort of rubbish that gives economists credibility in getting their predictions right!

David.
Addendum June 5, 2012: Please Note: I have no real criticism of what Deloittes have done - which I am sure is has been undertaken competently and properly. My criticism is of DoHA who simply don't release enough information to allow any one to form a view, on the evidence provided, on the actual conclusions reached! They are just too secretive and un-transparent.
D.

Weekly Overseas Health IT Links - 2nd June, 2012.

Here are a few I have come across last week.

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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http://www.washingtonpost.com/blogs/ezra-klein/post/what-could-revolutionize-health-care-this-database/2012/05/21/gIQAjUdEfU_print.html

What could revolutionize health care? This database.

By Sarah Kliff, Published: May 21

Think of it as a health policy wonk’s dream: Football stadium after bigstockphoto One insurance company’s data could fill 60 million of these. football stadium packed to the brim with...health insurance claims data.

An odd dream, to be sure. But health insurance data is crucial to understand how health care dollars get spent. It shows how people use health care, what’s changing and, in some cases, why. Health insurers, however, have tended to keep that data private, as it could tip competitors off to how they handle business.

That all, however, changes today. This morning a new nonprofit called the Health Care Cost Institute will roll out a database of 5 billion health insurance claims (all stripped of the individual health plan’s identity, to address privacy concerns).

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Kaiser Permanente CEO: Health IT Must Focus On Quality

KP CEO George Halvorson says too many organizations approach IT projects from the wrong angle. Start with the health care issues and savings will follow, he says.

By Neil Versel,  InformationWeek

May 23, 2012

URL: http://www.informationweek.com/news/healthcare/leadership/240000533

Health systems and policymakers mustn't lose sight of the big picture when discussing IT strategy and goals, believes the leader of the largest private healthcare delivery organization in the United States.

"The goal is the care," advised Kaiser Permanente president and CEO George Halvorson. "The technology is a tool."

"A lot of people put medical records in place but don't have a goal, don't have a particular strategy to use them, and if you just put the medical record in place and don't use it for anything, care doesn't get better," Halvorson told InformationWeek Healthcare in an exclusive interview. The Kaiser leader keynoted at the pan-European World of Health IT conference in Copenhagen, Denmark, this month, then spoke to InformationWeek Healthcare at the official residence of the U.S. ambassador to Denmark, Laurie Fulton.

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http://www.healthcareitnews.com/news/6-things-patients-want-social-media

6 things patients want from social media

By Michelle McNickle, Web Content Producer

Created 05/24/2012

NEW YORK – On the second and last day of the Connecting Healthcare + Social Media Conference in New York this past week, Jessie Gruman, president of the Center of Advancing Health, took the stage to present an honest and point-blank keynote on what she, and a majority of patients, ultimately want to see from an organization's social media efforts.

"I speak as someone who's been diagnosed four times with cancer," she said. "I'm a frequent user of healthcare, and I draw on my experiences to inform my own work … many of us personally know healthcare is a delicate balance between the cognitive and emotional, the subjective with objective and individuals with populations. Websites are an ever-changing puzzle, and as we become more familiar with looking for health things online … social media makes this puzzle less puzzling for us."

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http://www.healthdatamanagement.com/blogs/blog-obama-govenrment-data-access-analytics-44513-1.html

Realism: The Other Side of Obama’s Data Plan

By Robert DeFazio

MAY 25, 2012 10:42am ET

President Obama’s directive to made federal data more accessible and useful is a nice idea. But clearly, he doesn't have the slightest idea of what it takes to create digital interfaces to data that can work all the time across multiple platforms and without glitches.

Just as a simple example: a major bank for which I do contract work had paid a group of programmers to create an accounting program. After three years and having spent several million dollars, they fired the group because the software still didn't work. Creating digital tools, applications, and interfaces is not easy work. If it were, everyone would be doing it.

More importantly, doing something that presents a uniform face to the information-consuming public requires cooperation in the design and implementation of proposed solutions. This is something for which government is not known. Departments sequester information often for no other reason than simply to show that they have the power to do so. To expect the floodgates of Christian charity to open wide to usher in a new age of interdepartmental cooperation and goodwill is tantamount to believing in the tooth fairy.

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http://www.fiercehealthit.com/story/ccd-could-be-boon-public-health-agencies/2012-05-25

Continuity of care document could be boon to public health efforts

May 25, 2012 | By Ken Terry

The Continuity of Care Document (CCD), a standardized format for clinical summaries that can be exchanged between disparate electronic health record systems, could greatly advance public health initiatives, according to a new paper in the American Journal of Public Health.

Among the public health areas that the CCD could benefit, the paper said, are public health agencies' efforts to help reduce the burden of chronic diseases; the improvement of clinical detail in death certificates to identify dangerous trends; and the improvement of biosurveillance to detect disease outbreaks.

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http://www.fiercehealthit.com/story/fcc-oks-channel-wearable-monitors/2012-05-25

FCC approves channel for wearable monitors

May 25, 2012 | By Susan D. Hall - Contributing Writer

The Federal Communications Commission yesterday voted to approve a channel to accommodate wearable electronic devices that will free patients now tethered to hospital beds.

New rules will allow healthcare providers to use wireless spectrum for "medical body area networks"--or MBANs--which can transmit information from, and between, mobile medical devices both in the hospital and at home. FCC Chairman Julius Genachowski predicted last week that the expansion will allow providers to monitor patients vital signs throughout the continuum of care, prevent adverse events and hospital readmissions, and ultimately lower healthcare costs.

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http://www.healthcare-informatics.com/news-item/report-consumer-self-monitoring-will-drive-wireless-health

Report: Consumer Self-Monitoring Will Drive Wireless Health

May 23, 2012

A recent report from Englewood, Colo.-based research firm, IMS Research, is predicting that medical devices utilized by the consumer to self-monitor their health, rather than those used in managed telehealth systems, will be the biggest opportunity for wireless technologies in healthcare over the next five years. In the report, “Wireless Opportunities in Health and Wellness Monitoring – 2012 Edition,” IMS Research forecasts that more than 50 million wireless health monitoring devices will ship for consumer monitoring applications during the next five years, with a smaller number being used in managed telehealth systems.

According to the IMS report, medical devices bought by the consumer to self-monitor their health will account for more than 80 percent of all wireless-enabled consumer medical devices in 2016. The researchers say the demand for consumers to self-monitor their health is growing much faster than the market for telehealth implementation. The report states consumers will want to be able to monitor and manage their own health at home, even if they don’t belong to a healthcare systems that is adapted for this. The researchers expect a proportion of wireless devices used in managed telehealth programs to increase from five percent in 2011, to 20 percent in 2016.

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http://www.ehi.co.uk/news/EHI/7767/final-death-knell-for-healthspace

Final death knell for HealthSpace

22 May 2012   Lyn Whitfield

The NHS’ own health organiser, HealthSpace, has been confirmed as an unlikely casualty of the NHS information strategy, published earlier this week.

In a speech today, Dr Charles Gutteridge, the national clinical director for informatics at the Department of Health, confirmed that HealthSpace would cease to exist in the next 12 months.

Even though the strategy makes giving patients access to their records a key part of its vision for improving access to information, and HealthSpace was developed to give patients access to their Summary Care Record, Dr Gutteridge said he could not make the technology work.

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http://www.healthcareitnews.com/news/ge-brings-emrs-analytics-london-2012-olympics

GE brings EMRs, analytics to London 2012 Olympics

By Mike Miliard, Managing Editor

Created 05/24/2012

COLORADO SPRINGS, CO – For the first time ever, the United States Olympic Committee will use electronic medical records rather than paper charts to manage care for more that 700 athletes at the summer games.

The USOC announced Thursday that it will deploy GE’s Centricity Practice Solution, which integrates EMR with practice management technology, to manage the care of more than 700 American athletes competing in the London 2012 Olympic and Paralympic Games, and for 3,000 additional records maintained by USOC staff.

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http://www.fiercehealthit.com/story/telemedicine-market-hit-25b-2018/2012-05-24

Telemedicine market to hit $2.5B by 2018

May 24, 2012 | By Marla Durben Hirsch

The telemedicine market is expected to achieve "significant" growth in the next few years, from $736 million in 2011 to $2.5 billion in 2018, according to a new study by WinterGreen Research.

Telemedicine and home telehealth monitoring will increasingly be used to treat people with chronic conditions and reduce readmissions by using diagnosis support tools and treatment support tools, according to the study. It is being recognized as an effective way to keep patients healthy and thus cheaper for payers.

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http://www.fiercehealthit.com/story/facebook-personal-health-information-storage-bad-idea/2012-05-24

Facebook and PHI storage: A bad idea

May 24, 2012 | By Dan Bowman

Could Facebook succeed as a platform for personal health record storage? Not likely, says Healthcare Technology Online's Ken Congdon, who cites the company's business model and its infamous privacy policy problems as reasons why healthcare providers shouldn't even consider the thought.

Facebook's recent IPO means that the company now has a lot more incentive to use the personal data it has collected on its 900 million-plus users, Congdon says. He writes that, were the company to get into the protected health information business, it could decide to offer that information to pharmaceutical companies looking to market specific drugs to specific patients.

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http://www.fiercehealthit.com/story/diagnostic-coding-sets-snomedct-versus-icd10-/2012-05-23

ICD-10 and SNOMED-CT: Better together?

May 24, 2012 | By Ken Terry

A funny thing happened on the way to ICD-10: Suddenly, there's talk of using the Systemized Nomenclature of Medicine--Clinical Terms (SNOMED-CT) in place of or in conjunction with the controversial diagnostic coding set. The American College of Physicians (ACP) and the Texas Medical Association (TMA) have both taken this position, although in different ways.

In a May 17 letter, ACP told the Department of Health and Human Services that it supports the proposed implementation of ICD-10 by Oct. 1, 2014; a year later than the current deadline.

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http://www.stripes.com/blogs/the-ruptured-duck/the-ruptured-duck-1.160117/va-dod-promise-online-lifelong-military-medical-records-by-2017-1.177960

VA, DOD promise online, lifelong military medical records by 2017

By Leo Shane III

Published: May 22, 2012

WASHINGTON – The departments of defense and veterans affairs plan to fully merge their health care records systems in the next five years, with the goal of giving troops and veterans a single, seamless system to track medical care throughout their lifetime.

President Barack Obama touted the idea of a lifelong electronic military medical record in April 2009, as part of dramatic improvements to veterans health care. But during a joint appearance in Illinois on Monday, Defense Secretary Leon Panetta and VA Secretary Eric Shinseki announced they hope to put the single system in place in 2017, creating what would be the world’s largest electronic health record system.

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http://www.healthcare-informatics.com/article/breaking-2012-healthcare-informatics-100-released

BREAKING: The 2012 Healthcare Informatics 100 is Released

May 21, 2012 by The Editors of Healthcare Informatics

Largest vendors maintain their rankings from last year

Healthcare Informatics, a New York City-based magazine providing leadership and strategy for healthcare IT leaders, is proud to officially announce the 2012 version of its unique industry offering: the Healthcare Informatics 100, a compilation of the top health IT companies based on HIT revenues from the most recent fiscal year. For this year’s list, McKesson Technology Solutions (Alpharetta, Ga.) was the top ranked company, marking the fifth year in a row that the diversified healthcare IT software solutions vendor has sat atop the list.

The HCI 100 is a complete look at the top 100 revenue-earning companies in the industry, eligible to any company that can identify HIT-based revenues. On the list, along with the company’s revenue, is a look at detailed information including a brief description of each company’s activity, its past revenues, recent acquisition information, and more.

Here’s a full look at this year’s HCI 100. 

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http://www.ihealthbeat.org/perspectives/2012/govt-promotes-consistent-approaches-to-consumer-and-health-data-privacy.aspx

Thursday, May 24, 2012

Gov't Promotes Consistent Approaches to Consumer and Health Data Privacy

by Deven McGraw

In the first quarter of 2012, two important reports on consumer privacy were issued in Washington: In February, the White House laid out a "Consumer Privacy Bill of Rights" and in March the Federal Trade Commission followed with its report, "Protecting Consumer Privacy in an Era of Rapid Change." Both documents acknowledge that most federal data privacy laws apply only to specific sectors of the economy, such as health care, education, communications and financial services. Both reports call on Congress to enact baseline consumer privacy legislation to fill the gaps and, in the interim, urge companies to voluntarily adopt best practices or model codes of conduct based on fair information practice principles. 

Unfortunately, because most health care system entities -- chiefly health care providers and payers -- already are required to comply with baseline health privacy regulations enacted under HIPAA, these reports received little attention from the health care industry. 

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E-Prescribing Reaches Tipping Point

Surescripts survey finds 58% of office-based physicians now issue prescriptions electronically. Meaningful Use e-prescribing requirements have played a large role in the technology's adoption.

By Nicole Lewis,  InformationWeek

May 22, 2012

URL: http://www.informationweek.com/news/healthcare/CPOE/240000804

New figures from Surescripts reveal that at the end of 2011, 58% (or 317,000) of office-based physicians were using e-prescribing tools to fill prescriptions, versus only 36% (190,000) in 2010.

"The National Progress Report on E-Prescribing and Interoperable Healthcare, Year 2011," which examined actual adoption and use of e-prescribing nationwide, also found that smaller practices led the way. Among practices with six to 10 physicians, 55% adopted the technology, as did 53% of practices with two to five physicians. The most significant growth in physician adoption of e-prescribing occurred among solo practitioners: from 31% in 2010 to 46% in 2011.

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http://www.ehi.co.uk/insight/analysis/896/joe%E2%80%99s-view:-of-rating-epr-suppliers

Joe’s view: of rating EPR suppliers

A test drive, a check against standard criteria, and lots of user reviews. Joe McDonald knows what a good test of EPR systems should look like. Now, he just needs a supplier to step forward...

23 May 2012

My first column compared services that allow patients to rate the healthcare they have received.

I allocated stars to the various services in what I admit was a fairly crude way of representing their relative merits (not least because they were awarded in a somewhat arbitrary way, with a large dollop of personal preference).

The column generated a fair amount of debate and that debate was generally good natured. Even better, the providers of feedback services covered themselves in glory by responding positively to criticism.

Patient Opinion, NHS Choices, and iwantgreatcare all offered to up their game in a variety of different ways. So could the same approach drive improvement in electronic patient record systems? Or would I merely generate a law suit from system providers?

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http://www.fiercehealthit.com/story/iehr-roll-out-2017/2012-05-23

iEHR to roll out in 2017

May 23, 2012 | By Susan D. Hall - Contributing Writer

Much work remains on the joint integrated electronic health record system being created by the Departments of Defense and Veterans Affairs, Defense Secretary Leon Panetta and VA Secretary Eric Shinseki told reporters earlier this week at Chicago's James A. Lovell Federal Health Care Center, Nextgov reports. The full system, Shinseki said, is not due out until 2017, though a preliminary version will roll out at medical facilities in San Antonio and Hampton Roads, Va., in 2014.

"We'll go as fast as we can without accepting risk that's not tolerable," Shinseki said. "[Q]uality and safety are the standards we measure ourselves by."

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http://www.fiercehealthit.com/story/telehealth-cuts-readmission-rates-earns-system-speedy-return-investment/2012-05-23

Telehealth cuts readmission rates, earns system a speedy return on investment

May 23, 2012 | By Ken Terry

Saint Vincent Health System in Erie, Pa., reports that using telemedicine technology has reduced readmissions in its 26 Pennsylvania facilities--and also netted a 100 percent return on investment in just two months.

St. Vincent's success story echoes the findings of Geisinger Health Plan's two-year study of home telemonitoring. That trial showed a 44 percent drop in readmissions among the monitored patients compared to a control group.

The Geisinger study looked at the use of an interactive voice response system for monitoring patients with congestive heart failure. The IVR system enabled the patients to report their weight and answer a series of questions about their symptoms. 

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http://www.healthcare-informatics.com/news-item/report-mobile-technology-represents-risk-health-data

Report: Mobile Technology Represents Risk to Health Data

May 21, 2012

According to a report by the Department of Homeland Security, the increased use of mobile health technology opens up a world of vulnerability to patients and medical facilities. The report, "Attack Surface: Healthcare and Public Health Sector" says since IT networks are remotely available through medical devices, there is a rising concern that these devices will fail toprotect against theft of medical information and malicious intrusion.

The report states, “These vulnerabilities may result in possible risks to patient safety and theft or loss of medical information due to the inadequate incorporation of IT products, patient management products and medical devices onto Medical IT Networks.”

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http://health-information.advanceweb.com/Features/Articles/Improving-Efficiency-With-EMRs.aspx

Improving Efficiency With EMRs
Flattening the healthcare cost curve cannot be achieved without total hospital efficiency.

By Amanda Mewborn, RN, PMC, CPN, CPHIMS, DSHS

It is no surprise that as the complexity of healthcare has increased, so too have the demands placed on today's clinicians.

With the widespread implementation of health information technology (HIT) rapidly proceeding and the reengineering of service delivery being initiated because of health reform, nurses are being asked to perform more critical tasks in an environment that is changing more rapidly than any time in the last several decades.

Because this amounts to "trying to build a plane while flying it," hospitals need to consider taking a step back and maximizing the efficiency of their current processes before tackling these enormous new undertakings.

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http://www.govhealthit.com/news/reducing-healthcare-inefficiencies-big-data

Reducing healthcare administrative inefficiencies with big data

By Roger Foster, Senior director, DRC’s high performance technologies group, and advisory board member of the technology management program at George Mason University

While it is true that organizations across all industries experience a certain degree of inefficient administrative processes, the size and the cost of the problem in the US healthcare industry is colossal.

Indeed, administrative system inefficiencies have been estimated in the range of $100-150 billion annually, and the actual costs could be even higher. According to a position paper by the Medical Group Management Association, “simplifying our healthcare system’s administration could reduce annual healthcare costs by almost $300 billion.”

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http://www.healthleadersmedia.com/print/TEC-280401/Ebook-Revolution-Changes-Challenges-Healthcare

E-book Revolution Changes, Challenges Healthcare

Scott Mace, for HealthLeaders Media , May 22, 2012

If you've flown lately, you've seen them everywhere: e-books, running on Kindles, on iPads, on any number of tablet devices. Get ready to see them a lot in healthcare too.

Prompted by an announcement that yet another standard desk reference had been released in e-book form, I wonder if we've reached a tipping point yet where the standard nurse or doctor's desk reference on paper has gone the way of the telephone book.  I normally recycle these phone company dinosaurs as soon as they land on my doorstep.

Think of the upside. E-books are fully indexed. Any occurrence of a word is searchable with a touch. Paper-based indexing systems just can't compete.

Publishers can update e-books as often as necessary. Paper-based desk reference books are still updated at least (and often, at most) once a year.

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http://www.healthdatamanagement.com/news/Hubble-data-cleansing-mammograms-44487-1.html

Data Cleansing is a Life Saver

Jim Harris

MAY 21, 2012 11:20am ET

When it comes to data quality best practices, it’s often argued, and sometimes quite vehemently, that proactive defect prevention is far superior to reactive data cleansing. Advocates of defect prevention sometimes admit that data cleansing is a necessary evil.  However, at least in my experience, most of the time they conveniently, and ironically, cleanse (i.e., drop) the word necessary.

Therefore, I thought I would share a story about how data cleansing saves lives, which I read about in the highly recommended book “Space Chronicles: Facing the Ultimate Frontier” by Neil deGrasse Tyson. “Soon after the Hubble Space Telescope was launched in April 1990, NASA engineers realized that the telescope’s primary mirror – which gathers and reflects the light from celestial objects into its cameras and spectrographs – had been ground to an incorrect shape. In other words, the two-billion dollar telescope was producing fuzzy images.  That was bad. As if to make lemonade out of lemons, though, computer algorithms came to the rescue. Investigators at the Space Telescope Science Institute in Baltimore, Maryland, developed a range of clever and innovative image-processing techniques to compensate for some of Hubble’s shortcomings.”

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http://www.ehi.co.uk/news/primary-care/7760/new-nhs-information-strategy-unveiled

New NHS information strategy unveiled

21 May 2012   Jon Hoeksma

The new NHS information strategy, published today, urges health and social care services to make full use of online technologies to put patients in control of their health and health records.

The strategy puts a particular emphasis on the creation of portals for patients, health professionals, commissioners and researchers, in a series of moves that health secretary Andrew Lansley says will free up the "power" of information.

A national ‘portal’ will be created as the definitive source of trusted information on health and social care by 2013. The NHS portal will inform patients’ decisions on selecting treatments and providers.

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http://www.fiercehealthit.com/story/telemonitoring-effect-diabetes-outcomes-long-lasting/2012-05-22

Telemonitoring effect on diabetes outcomes long-lasting

May 22, 2012 | By Dan Bowman

Telemonitoring had a sustained positive impact on outcomes for diabetes patients, even as the intensity of the monitoring decreased, according to a Journal of the American Medical Informatics Association study.

The study examined veterans who participated in The Diabetes Telemonitoring (DiaTel) Study, which compared active care management that included home telemonitoring to monthly care coordination efforts via telephone calls. The initial study ran from January 2005 to November 2007.

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http://www.govhealthit.com/news/measures-top-10-hhs-it-projects-obamas-2013-budget

Measures: Top 10 HHS IT projects in Obama's 2013 budget

By Andrea Falciani, Research Analyst, Suss Consulting

President Obama's IT budget for the Department of Health and Human Services (HHS) totals $7.1 billion for fiscal year 2013, marking a 3 percent increase from FY12.

The IT budget request covers a variety of business functions and plays a pivotal role in supporting the Department’s overall mission to protect the health of all Americans and provide essential human services, especially for those who are least able to help themselves.

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http://www.healthcareitnews.com/news/oregon-implement-new-hie

Oregon to implement new statewide HIE

By Erin McCann, Associate Editor

Created 05/21/2012

SALEM, OR – The state of Oregon is joining the burgeoning number of health information exchanges across the country, with the implementation of CareAccord, a statwide HIE officials say will promote improved communication between care providers, reduce duplicate orders and facilitate implementation of meaningful use requirements.

The Oregon Health Authority (OHA), which will administer CareAccord, has selected Harris Corporation – the international IT company whose HIE projects include implementations for the State of Florida and the Department of Veteran Affairs – for Direct Secure Messaging, a point-to-point communications system that enables registered providers to exchange information, including attachments containing patient data, using any device with Internet access.

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http://www.healthdatamanagement.com/news/ahrq-health-information-technology-workflow-toolkit-physicians-44489-1.html

AHRQ Seeks Improvements to I.T. Workflow Toolkit

Joseph Goedert

MAY 21, 2012 12:22pm ET

The Agency for Healthcare Research and Quality reminds ambulatory practices of the availability of its free Workflow Assessment for Health IT Toolkit and is working to make it more useful to small- and mid-size physician practices.

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http://www.healthdatamanagement.com/blogs/dental-Xrays-danger-of-perfunctory-medicine-44486-1.html

The Perils of Perfunctory Medicine

By Greg Gillespie

MAY 21, 2012 11:06am ET

I recently took my four-year-old son into the dentist for a teeth cleaning, and the first thing that happened, per usual, is that a technician came into the room and said it was time for X-rays. That’s just a given during a trip to the dentist; has been since I was a kid and had to be dragged to the dentist in chains (just hated getting my teethed cleaned, almost as much as I disliked brushing them, or so I’m told).

This time I was a little leery of doing business as usual. It was the fourth time in the past year my son was going to get a full set of X-rays. A while back he managed to shatter a tooth, which had to be yanked out old school with a pair of pliers and a dental hygienist and me sitting on top of him. That triggered a couple extra trips, and a couple more sets of X-rays to check for complications.

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http://www.fiercehealthit.com/story/patients-taking-smartphone-pics-ban-or-not-ban/2012-05-21

Cell phone pics in the doc's office: To ban or not to ban?

May 21, 2012 | By Dan Bowman

Ten years ago, most patients wouldn't have even considered bringing a camera into their doctor's office. The advent of smartphones, however, has changed that. So much so, in fact, that an article published this week in American Medical News asks if doctors should ban patients from taking cellphone pictures in their offices.

New York-based attorney Andrew Blustein told amednews that doctors need to take every precaution they can think of to prevent such uncomfortable situations. For instance, he said, doctors should post signs making it clear to both patients and employees that picture taking is banned throughout their facilities--including in the waiting area and in exam rooms--no matter what. In addition, a doctor needs to make sure that his or her entire staff is trained in knowing and enforcing the facility's chosen privacy policy, Blustein said.

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http://www.fiercehealthit.com/story/rise-physician-tablet-use-means-less-meets-eye/2012-05-21

Rise in physician tablet use means less than meets the eye

May 21, 2012 | By Ken Terry

Sixty-two percent of physicians--nearly double the number a year ago--now use computer tablets, according to FierceMobileHealthcare reports. That report makes it appear as if iPads and other tablets will inevitably take over medicine. In fact, Monique Levy, director of research for Manhattan Research, told eWeek that all physicians will eventually adopt these gadgets.

That would certainly affect healthcare, but perhaps not as much as one might expect.

For one thing, only half of the current tablet owners have ever used them at the point of care. That's still a lot of physicians, but they're mostly using their iPads to read medical news, access drug information and e-prescribe. In other words, they're doing the same stuff they used to do on PDAs and smartphones, only on a larger screen.

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http://www.ihealthbeat.org/features/2012/high-court-ruling-not-expected-to-impair-health-it.aspx

Monday, May 21, 2012

High Court Ruling Not Expected To Impair Health IT

by Paula Blasi, iHealthBeat Editor

Back in March, crowds of people gathered outside the Supreme Court building to proclaim their support for or opposition to the Affordable Care Act.

Stakeholders on one side of the political spectrum touted the law's current and future benefits, while stakeholders on the other side called for a complete repeal of the legislation.

But despite the heated rhetoric, experts note that one component of the health reform law has had a steady stream of support from across the political spectrum: health IT.

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Enjoy!

David.

Portal Security May Be A Bigger Issue Than We Have Recognised. This May Be An Issue For The NEHRS (PCEHR).

The following article appeared a few days ago.

Proposed NHS portal raises questions about data security

Dan Raywood

May 25, 2012

The new NHS information strategy is to allow patients, health professionals, commissioners and researchers to access their records easily.

The national ‘portal' will allow all NHS patients to be able to have secure online access, where they wish it, to their personal health records by 2015. According to E-Health Insider, this will fit with the central theme of shifting to a sharing of information within and between health and social care providers, and capturing data just once at the point of care.

David Harley, senior research fellow at ESET and former director of the NHS Threat Assessment Centre, looked at the plan and said he felt it read more like an extended mission statement than a real strategy document.

He said: “Even the polysyllabic version seems to me to say, basically, that the security of an individual's data will depend on the data being handled responsibly by medical professionals; and on the sharing of such information by the individual only with appropriate people.

“The security model of the central repository isn't defined, even in the main document. Instead the emphasis is on the need to share the data with the subject of the data, with professionals treating the subject and the agencies who would make use of the anonymised/sanitised data.”

Harley said that the model described doesn't sound like it has been changed significantly from the NHS National Programme for IT (NPfIT) model, as the central agencies under control of the Department of Health are focusing on central security.

“I'd be willing to place a small bet on the implementation continuing to rely on external providers rather than in-house expertise and a lot of responsibility devolved to ‘the local level',” he said.

“The emphasis on better data sharing with the data subject, however desirable in principle, does increase the attack surface – even if the central resource is soundly protected, it seems to me that how local services and data subjects access data is likely to be highly dependent on local conditions. We're already all too aware that security awareness across the many individual units that make up the NHS is highly variable.”

Marc Lee, EMEA sales director at Courion, said: “Giving all NHS patients secure online access to their records by 2015 is hugely ambitious.

Lots more here:

http://www.scmagazineuk.com/proposed-nhs-portal-raises-questions-about-data-security/article/242804/

Clearly a very similar portal - conceptually at least - is to be a major component of the proposed NEHRS (PCEHR). The logistics of what the NHS is proposing seem even more daunting that the proposed secondary system that is the NEHRS. Access to primary systems will be even more complex - although we know at a local level some of their major vendors already have operational systems that get pretty close to what is envisaged.

Again we have the issue of just additional functionality beyond look up of information is to be enabled. This will be the major determinant of the level of use I believe.

And in late breaking news we now have news of the Government E-Health Information Portal Site being attacked and defaced by hackers.

Official Australian e-health info page defaced

infEktard by anti-government, anti-monopoly protestors.

• Liam Tung (CSO Online (Australia))
• — 30 May, 2012 11:41

An apparent trio of ‘hackers’ operating under the LatinHackTeam banner has claimed the Australian Government’s Department of Health and Ageing eHealth education site as its 13,789th ‘defacement‘ victim.

The group’s latest record on Zone-H, a site that archives website vandalisations, is the department’s eHealth education site, publicleanring.ehealth.gov.au.

The site is a learning portal aimed at preparing consumers and healthcare professionals for the July 2012 launch of eHealth records in Australia.

“infEkt”, “Adminp4nic” and “eCore” apparently do their homework, claiming to have targeted the site because they were “Against government corruption !!”

More here:

http://www.cso.com.au/article/425982/official_australian_e-health_info_page_defaced/

Oh dear, oh dear!

David.