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, July 16, 2012

Weekly Australian Health IT Links – 16th July, 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

A week late, but we were able to register this week for a NEHRS / PCEHR and it seem we now have 1/10000 individuals registered. It will take a good while before the ‘network effect’ kicks in and the record is actually useful at this rate.
Otherwise the announcement on mental e-health is really a good thing at the top level. I hope the implementation is also well conducted.
Many other topics covered - with some very interesting information on a e-Health system is Israel.
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2022 people register for PCEHR

Almost two weeks into the PCEHR, and just over 2000 individuals have registered for a personally controlled electronic healthcare record, up from around 800 at the beginning of this week.
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PRODUCTIVITY SPECTATOR: Your money and your life

Jackson Hewett
Published 7:33 AM, 9 Jul 2012 Last update 7:33 AM, 9 Jul 2012
Three hundred and six.
That’s the number of people who signed up last week to the government’s new program to slash the cost of our medical spending.
It was a very soft launch for the Personally Controlled E-Health Record but the motivation behind it is right. An easily accessible database that ensures medical professionals have access to all of our medical activities should, if utilised correctly, reduce the enormous amount of waste and duplicate activities that drain federal and state health budgets. It also should help reduce mistakes caused by patients forgetting what previous symptoms they’ve had or drugs they’ve taken.
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Slower than predicted start for personal e-health records

Date July 9, 2012 - 1:38PM
Only 320 people signed up for an electronic health record five days after the Federal Government's much anticipated July 1 e-health launch.
With numbers like this, the Personally Controlled Electronic Health Record project, which aims to streamline patient medical records to facilitate treatment, is unlikely to meet its own target of registering 500,000 users by July 1 next year.
Australians wanting to consolidate their health records including medications, allergies, immunisations, doctors’ and hospital notes and prescriptions, can apply online at ehealth.gov.au.
A slow, incomplete start was predicted in May for Australia's most ambitious e-health project to date.
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E-health security concerns blight launch

9 July, 2012 Kate Newton
The Federal Government’s e-health records system came under renewed last week as it launched to the public, with patients struggling to sign up and critics questioning its security.
The first stage of the personally controlled electronic health record — or PCEHR — began on 1 July, with people able to register for their own record.
GPs and other health providers cannot access the records yet as it will still be months before their software is compatible.
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Steve Hambleton: Jumping the e-health gun

THE Personally Controlled Electronic Health Record was launched last week. It is probably the softest launch of a major government initiative in Australian political history.
Why? Because it is not ready. Not by a long shot.
For months, the AMA has been warning the government that the PCEHR is not ready. Patients are not ready. Doctors and other health professionals are not ready. Hospitals are not ready. The health system is not ready.
I was one of a group of GP leaders who met with Health Minister Tanya Plibersek just before the launch to explain in person our concerns about the lack of readiness for the PCEHR.
We told her we want the PCEHR to work. We want it to work for our patients and for ourselves. We see the electronic health record as a key productivity tool in health.
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No apostrophe name glitch hits e-health portal

IT'S a new, electronic portal where Australians can sign up to keep records of their medial history online - but not if your surname is O'Reilly, M'Gregor or D'Angelo.
The federal government owned up to an embarrassing blunder that blocks people with apostrophes from signing up to their new e-health service.
It follows concerns that people with other special characters in their names are also being refused access due to a glitch in the system.
A spokeswoman for the Department of Health and Ageing said staff were aware of the problem with apostrophes but denied there had been issues with other special characters like hyphens.
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Auditor-General must audit e-health: Coalition

  • by: Karen Dearne and Fran Foo
  • From: The Australian
  • July 10, 2012 12:00AM
PRESSURE is building for the Auditor-General to examine the cost and performance of parties involved in the Gillard government's personally controlled e-health record program after a dismal launch last week.
Opposition e-health spokesman Andrew Southcott said that given "almost $1 billion of taxpayers' money has been spent or allocated for this in the past two years, it would be prudent for the Australian National Audit Office to examine the PCEHR program".
IT projects were "notorious for costing a lot more than expected and delivering a lot less than expected, and this seems to be in that category".
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Call for secure messaging as Coalition demands e-health audit

10th Jul 2012
The government has been urged to focus its attention on developing secure messaging systems for GPs and other doctors in the wake of last week’s jittery e-health records system launch.
Shadow parliamentary secretary for primary healthcare Dr Andrew Southcott told MO the government should have spent the past two years developing secure messaging and other “incremental steps” rather than going for the “big bang, blockbuster approach” by launching e-health records.
Dr Southcott said he would write to the Attorney General to ask that the Australian National Audit Office examine how the government had spent “almost $1 billion” developing the records system.
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NEHTA knew of PCEHR delays

  • by: Karen Dearne
  • From: Australian IT
  • July 11, 2012 12:00AM
ALMOST all the functionality of the new personally controlled e-health record system is delayed until at least August, the National E-Health Transition Authority's head of the PCEHR program admitted four days before the go-live.
"At the moment, we are in the final stages of the production build-out and final verification testing," Andrew Howard told a vendors' webinar on June 27.
"Everything is on track for a successful launch (of the consumer portal and online registration system) over the weekend."
But Mr Howard said plans for the release of the provider portal were not yet settled.
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Sideshow obstructs e-health traffic

THERE is a truck trundling across Australia that should be pulled over and its owners charged with false and misleading advertising.
It's the Model Healthcare Community Roadshow, and it claims the Gillard government's $1 billion personally controlled e-health record guarantees "your health e-info travels with you".
Although that is indeed the aim of modern electronic health systems, the PCEHR is a repository containing a static, point-in-time medical summary uploaded by your GP, and possibly a few "event summaries" from other practitioners.
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The conversation is starting....just4docs

13 July, 2012 Dr Kerri Parnell
Australian Doctor is developing a new online community exclusively for doctors called just4docs.
Many of you already comment on the Australian Doctor website or talk about our stories with colleagues. In the near future you will be able to continue that dialogue on a secure social network called just4docs.
Over recent months, a small group of GPs has been helping this secure doctor-only community take shape. The time has now come to widen the conversation and if you want to be the first in line to join, we would love you to register your interest.
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Interaction beyond the e-health record

9 July, 2012 Kate Newton
Israel's largest health provider offers e-health services to 3.8 million users, giving patients and doctors the opportunity to interact.
While the Federal Government struggles to get its e-health service off the ground, a similar service in Israel is treating over a million people each month.
Clalit, Israel’s largest provider of health services, launched its e-health wing in 2009, with patients and doctors able to interact through multiple layers of online services.
The service gives Clalit’s 3.8 million patients access to their full medical record — including diagnoses, lab results with simple explanations, and current prescriptions — and allows doctors to easily share those records with specialists and other health professionals.
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GP creates Skype site for telehealth consults

12th Jul 2012
A MELBOURNE GP, fed up with not being able to find a specialist to conduct telehealth consultations, has launched a free website designed to connect doctors via the Skype video-conferencing program.
The website allows practitioners interested in telehealth to register their specialty, location and Skype address; search the resulting database for others to connect with; browse registered practitioners with an interactive map; and features a forum and instant messaging.
The creator, Dr Jonathan Brown, said he had received dozens of registrations in the first week and he hoped the site would help other GPs struggling to make telehealth consultations.
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The eyes have it for disabled gamers

  • From: AFP
  • July 13, 2012 10:49AM
RESEARCHERS in Britain had built a device using mass-produced video gaming equipment that lets disabled people control a computer with just their eyes -- with a price tag of under $US30 ($29.60).
The gadget comprises two video game console cameras, costing less than $US10 apiece, attached outside the line of vision to a pair of ordinary glasses, reported the team from Imperial College London.
The cameras relay the eye's movements to an ordinary computer, wirelessly over WiFi or via USB, and used one watt of power, they wrote in the Journal of Neural Engineering
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Evolving eHealth

eHealth is finally making its way out of the realm of imagination and into reality. But is the hype surrounding eHealth justified?
Often viewed as a pipedream, eHealth is finally making its way out of the realm of imagination and into reality. But is the hype surrounding eHealth justified? PATRICK BUDMAR finds out.
As advancements continue to be made with computer technology, and the Internet becomes more commonplace in our daily work and private lives, transformation is expected to occur in many traditional work sectors.
For example, the retail industry underwent some growing pains in recent years as it was pulled into the digital age, along with the music and film industry. Another sector that is expected to follow in their footsteps is the healthcare industry under the oft quoted “eHealth” moniker.
Comment: Note that the article really does not answer the question it poses as far as I can tell.
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Springborg springs motion on health payroll cabinet documents

HEALTH Minister Lawrence Springborg has ambushed Queensland's Labor Opposition on the floor of parliament, demanding it authorise the release of confidential Cabinet documents.
Former Liberal National Party leader Mr Springborg called a snap motion this morning, calling for Opposition leader Annastacia Palaszczuk to hand over legal advice to the government assessing potential financial recovery options for the health payroll debacle before the next parliamentary sitting.
The motion was passed using the LNP's huge majority.
The previous Bligh government obtained legal advice on its options over the botched implementation of the IBM-WorkBrain payroll system, which the Auditor-General last year deemed the worst state government failure he had reported.
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e-Mental Health gets a new plan and $110 million in funds

The federal government has announced it will invest $110.4 million over the next four years to build a “mature online mental health care environment” as part of its new E-Mental Health Strategy.
The strategy, released in conjunction with the launch of the e-mental health website mindhealthconnect, outlines the government’s approach to e-mental health and its main areas of investment.
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Smartphone stethoscope in with a chance

Date July 8, 2012

Tim Barlass

A MEDICAL device that could saves the lives of millions of Third World children is the Australian entry in an international competition to find software solutions to global problems.
The digital stethoscope is attached to a smartphone, which listens to and digitises a pneumonia patient's breathing sounds and patterns. Those patterns are then compared against a medical database using cloud technology to deliver an automated diagnosis and treatment plan via an app on the smartphone.
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Queensland Institute of Medical Research seeks data centre services

New facility will house hierarchical storage management offering and servers
The Queensland Institute of Medical Research (QIMR) is seeking a data centre construction partner to build a new facility as it prepares for increased storage needs, according to a request for information.
The new data centre will house a hierarchical storage management (HSM) offering and server infrastructure. According to tender documents, a suitable room has been found at QIMR but a fit out is needed to turn the room into a data centre.
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'Most embarrassing' blunder: government contractor paid $1m for e-security alerts service loses 8000 subscribers' personal information

Date: July 9, 2012 - 10:21AM

Ben Grubb

Deputy technology editor

A federal government contractor paid more than $1 million to deliver e-security alert services to Australians has lost 8000 subscribers' personal information in the postal system.
AusCERT, which was paid $1,199,484.52 by the federal government to run staysmartonline.gov.au between July 18 2008 and June 30 2011* lost subscribers' data after posting it to the Department of Broadband, Communications and the Digital Economy (DBCDE) on April 11 when its contract to run the alerts service ended.
In an email to the site's 8000 subscribers sent at about 6pm on Friday, the "Stay Smart Online Team" said information that had "gone missing" on the DVD included subscribers' user names, email addresses, memorable phrases and passwords, which it said were "unreadable" (stored as a cryptographic hash).
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TECHNOLOGY SPECTATOR: Time for a Big Data diet

Supratim Adhikari
Published 11:04 AM, 12 Jul 2012 Last update 11:19 AM, 12 Jul 2012
The current buzz around ‘big data’ is almost enough to give the ‘cloud’ a run for its money but amid the grand promises that seem to accompany every piece of technology a clear definition of just what makes data ‘big’ can be hard to find.
Well, the simplest description would be that if the amount of data that you need to process exceeds the capability of your database systems, you’ve got big data. This may seem a tad simplistic but it is accurate. Volume is really the name of the game given the massive amount of data generated and collected by organisations every day.
This volume is closely aligned to the other two Vs in this equation – velocity and variety. Velocity refers to the speed at which the data can be analysed and variety points to the multitude of data points from where the information is flowing in.
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Government defends web spy powers

Date: July 13, 2012

Dylan Welch and Ben Grubb

THE Gillard government has defended a plan to force telcos to store the internet and phone data of all Australians for up to two years, saying it is needed to allow our intelligence and police agencies to effectively target organised criminals and terrorists.
''In this day and age, an age where governments all around the world are grappling with the challenges of terrorism and organised crime, it is important that our relevant agencies have access to the information that they need,'' the assistant Treasurer, David Bradbury, said.
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Enjoy!
David.

AusHealthIT Poll Number 130 – Results – 16th July, 2012.

The question was:
Now We Have Seen The NEHRS / PCEHR Do You Believe The Australian Public Has Received Value For Its Money ($500m+ so far)?
Most Definitely
-  3 (6%)
Probably
-  1 (2%)
Probably Not
-  4 (8%)
No Way
-  38 (82%)
Votes : 46
A very clear response with 90% or so saying we had not had value for the funds expended.
Again, many thanks to those that voted!
Please note : Suggestions for future polls always welcome.
David.

Sunday, July 15, 2012

It Really Looks Like The Right and Left Hands Of E-Health Have Not Co-Ordinated The Story. They Have No Explicit Plan And Are All Over The Place.

The following very long piece appeared in the Saturday Health Section of the Australian yesterday.

Sideshow obstructs e-health traffic

THERE is a truck trundling across Australia that should be pulled over and its owners charged with false and misleading advertising.
It's the Model Healthcare Community Roadshow, and it claims the Gillard government's $1 billion personally controlled e-health record guarantees "your health e-info travels with you".
Although that is indeed the aim of modern electronic health systems, the PCEHR is a repository containing a static, point-in-time medical summary uploaded by your GP, and possibly a few "event summaries" from other practitioners.
It's unclear how a hospital will upload a discharge summary after surgery or a visit to an emergency department, just as it's uncertain how specialists will contribute their summaries.
That's so as each person's record is supposed to be "curated" by a single, nominated provider, usually their GP.
It's also unclear how long it will take to update individual records. It's certainly not in real time.
Doctors have made very plain their concern they will be unable to rely on the PCEHR as accurate, up-to-date and complete.
The last point is certainly tricky as it's impossible to ascertain that every healthcare provider you encounter has the capacity or the will to contribute to your record. It's a voluntary system for providers as well as patients.
Take, for example, an emergency admission following a sudden collapse. You're fortunate enough to land in a hospital with good internal e-health systems and a specialist who is already communicating electronically with their colleagues and local doctors through secure messaging systems.
How will the PCEHR help in this situation? It won't.
When you arrive in emergency the receiving doctors will be able to access only a brief health summary from your most recent GP visit, perhaps six months or a year ago.
What about the "X-rays, pathology, scans" proudly emblazoned on the truck's side, implying they too can be uploaded to your record? They can't.
Efforts to provide access to diagnostic imaging through the PCEHR are yet to begin. Work on creating the technical standards and processes for handling diagnostic images, reports and requests is scheduled to start sometime next year.
Worse, it appears the initial versions will provide images in the PDF format only. That's better than nothing but unlikely to please medical professionals already exploring new worlds of computer-assisted technologies as well as those doing 3-D modelling of surgery plans for patients.
And what about pathology? Again the best doctors can expect is a summary of test results, in static form. That means doctors won't be able to dynamically monitor variations.
Instead, they will need to open each result separately, perhaps print out the report, and then work out the changes and trends themselves, much as they do at present.
Pathologists warn that the summary nature of PCEHR information poses particular challenges, as pathology results need to be interpreted in the context of other test results, both normal and abnormal, with a normal result just as important as an abnormal one.
Any omission of results from the record may inadvertently lead to wrong conclusions and wrong diagnoses, thereby compromising patient care.
Lots more here:
The second half of the article then goes on to explain how systems which are in-place, proven and working are being harmed and replaced by the push from a presently worse than useless system ‘from the Government’.
One colleague had the following reaction.
“It's a pretty powerful and very provocative article. I'm sure it will be widely circulated electronically in addition to all the hard copy readers. It could have the effect of dramatically slowing down the e-Health momentum OR it could act as a real wake-up call to the Minister to exercise real leadership and employ some common sense thinking about how best to fix the PCEHR fiasco.”
My feeling is that no one is taking any account of the harm the PCEHR Program is doing to our current e-Health providers and worse that the messaging about e-Health is now hopelessly confused. We have the wandering truck promising the earth while down on Planet Earth it is well known this is all going to take years to make any difference - and the Minister and other senior people are all saying just that.
Again we have an excessive simplification of a debate which is not all that simple. Simply saying ‘e-Health’ is good and opposing ‘e-Health’ is bad misses the point that there is good evidence based e-health and what is going on with the PCEHR which is the extravagant opposite in every sense. I strongly support the former and oppose the latter - despite what you might read elsewhere.
What is missing in all this is the Government actually levelling with stakeholders and providing a real plan of what is foreshadowed over the next few years and the business case and evidence to support that plan.
Dream on David I guess.
David.

It Seems The PCEHR Is Not Handling Things All That Well. I Just Had Another Look And Found It Was Not Working Properly.

Since it was a week since I had signed up - I thought - time to have another look and see if anything has changed. (About 1.00pm AEST)
Well it has and not in a good way.
When I had a look at my Personal Summary all seemed well. Self-entered data present and correct. All good so far.
Then I decided to click on Medicare Services Overview.
The last time I tried this - I was given a list of the four data categories (PBS Information, Medicare Claims etc.) and told that there was no information yet available on each.
This time I got the little ‘whirling starburst’ which then kept going and going. After an age (30+ seconds at least I got the following:
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Error Details
An error has occurred processing your request.
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Well it seems that something is being tweaked, changed or whatever - but the error message is hardly useful! No idea about if the error was known about, was being fixed and when things might be fixed.
At least the system didn’t totally crash! Not a good look for all this money.
Will try again next week and report back.
David.
Addendum - Checked at 6.35pm. No change so bug fixing seems to be on Public Service hours.
D.

 

Saturday, July 14, 2012

Weekly Overseas Health IT Links - 14th July, 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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The human side of developing integrated electronic health records

By Bob Brewin July 6, 2012
As the Defense and Veterans Affairs departments work to develop an integrated electronichealth record the concept is simple—streamline the military health care system for active-duty service members, veterans and retirees—but getting there is not. The two departments will not deploy the system until 2017, eight years after President Obama kicked off the project in April 2009.
The interagency program office managing the iEHR wasn’t set up until October 2011, and its director wasn’t appointed until April 2012. That gives VA and the Pentagon five years to develop what Defense Secretary Leon Panetta dubbed the world’s largest electronic health record system, which would serve 9.7 million active-duty and retired military personnel and their families, and 7.8 million veterans.
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Study: Clinical Trial Alerts in EHRs Have Limitations

JUL 6, 2012 12:07pm ET
Physicians using electronic health records that give alerts about appropriate clinical trials experience alert fatigue but rates of response remain relatively high, according to a new study. Still, overall results are mixed.
Researchers for 36 weeks documented the response patterns of 178 physicians receiving alerts for an ongoing clinical trial, collecting data on response rates to the alert and patient referral rates. Response rates declined over time, but even after 36 weeks remained in the 30 to 40 percent range, concludes the study.
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Opt-In Policy Best For HIE Patient Privacy

John Halamka, CIO for Beth Israel Deaconess Medical Center, believes health information exchanges should use an 'opt-in to disclose' policy to safeguard patient data.
Healthcare providers have yet to agree on the best way to protect the privacy of personal health information (PHI) in health information exchanges (HIEs), but John Halamka, MD, has an opinion.
As CIO at Beth Israel Deaconess Medical Center (BIDMC) in Boston, Halamka recently announced in a blog post that BIDMC will have all of its 1,800 affiliated ambulatory care providers ask their patients to "opt in for data sharing among the clinicians coordinating their care." This would allow data exchange, not only within BIDMC, but also with outside clinicians who provide care for those patients. The patients who opt in now will still be able to opt out later. AdTech Ad
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Avoid common pitfalls of healthcare website design

July 6, 2012 | By Dan Bowman
Looking to attract new patients and improve your facility's reputation with a new website or redesign? Be sure to have both a goal and a budget in mind, according to an article published this week in Medscape Business of Medicine.
The article outlines several potential pitfalls of healthcare website design.
Too often, when busy providers create websites they  become an afterthought, according to author Morgan Lewis, when a thoughtful approach is more likely to increase business.
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EHR disaster prep should be a priority, not an afterthought

July 3, 2012 | By Marla Durben Hirsch
One of the first announcements our regional power company made after vicious storms swept through the Washington, D.C., region last weekend was that power had been restored to local hospitals. Now, the company said, it could turn to the restoration of electricity to homes and businesses.
Of course the restoration of power to hospitals and other vital entities should be a priority. But hospitals always have an obligation to engage in disaster planning, and that includes protection of their electronic health records and other patient records.
EHRs generally are protected during disasters, as such data is stored both on a hospital's emergency power system and at a backup offsite storage location. But what happens to the data if those options also are knocked out?
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The Promise and Pitfalls of Population Health

JUL 1, 2012
Heath care is personal, but in the eyes of the industry and its federal overseers, the fundamental mission of clinical care needs to broaden its horizons.
The Centers of Medicare and Medicaid Services forecasts that national health expenditures, tagged at $2.6 trillion in 2010, will continue to rise faster than inflation, indeed, from 2010 to 2020 to grow by 5.8 percent annually, outpacing the average annual growth in the overall economy by 1.1 percentage points (4.7 percent). By 2020, national health spending is expected to be $4.6 trillion and comprise 19.8 percent of Gross Domestic Product (from the current 17.6 percent).
That's not encouraging, nor is the frightening spike in chronic diseases. The Centers for Disease Control and Prevention notes that chronic diseases-heart disease, stroke, cancer, diabetes, obesity and arthritis, among others-are among the most costly and maddeningly preventable conditions the health care industry deals with.
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Cerner questions Epic win for Cambridge patient records

Short-listed supplier queries trust over procurement process for multi-million pound software deal
Patient record supplier Cerner has written to Cambridge University Hospitals foundation trust over its recent award of a major software tender to Epic, Government Computing understands.
The letter, understood to be from Cerner's European managing director Alan Fowles to the trust's interim chief executive Dr Karen Castille, questions the scoring of the rival bids; apparent changes to the procurement process while it was running; and the relative prices of the three short-listed bids from Allscripts, Cerner and Epic.
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Cerner challenges Cambridge EPR decision

5 July 2012   Jon Hoeksma
Cambridge University Hospitals NHS Foundation Trust has been challenged by clinical IT vendor Cerner over its recent eHospital electronic patient record procurement, in which Cerner was beaten by US arch rival Epic.
The firm accuses the high-profile trust of failing to conduct a fair and transparent tender process and of picking a winner in advance - which it then rigged the tender process to deliver - ignoring considerations of price and proven product.
Cerner calls for the trust to re-tender, a suggestion that Cambridge has given short-shrift.

Insider view: Jon Hoeksma

Cerner’s decision to challenge the decision by two Cambridge trusts to award an eHospital EPR project to Epic looks like sour grapes; but it may serve the NHS IT market, says EHI editor Jon Hoeksma.
5 July 2012
Cerner’s decision to accuse two Cambridge trusts of rigging their eHospital electronic patient records procurement in favour of Epic is a serious charge.
It will be seen by many as being motivated by a serious case of sour grapes from a supplier smarting after losing out to its arch rival.
The trust flatly denies the accusations and it is to be hoped that the lawyers don’t get involved (although a letter seen by eHealth Insider suggests that they are already on board). So this is a high risk move for Cerner. Why do it?
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EHealth Initiative: ONC approach would hamper info exchange

Posted: July 3, 2012 - 3:15 pm ET
The not-for-profit eHealth Initiative is rejecting what it calls a "heavy regulatory approach" in a proposed federal framework for governing the Nationwide Health Information Network.
The initiative, in an 23-page letter (PDF) dated June 26 but released along with a prepared news statement on Tuesday, took issue with much of the direction of a formal request for information issued May 15 by HHS' Office of the National Coordinator for Health Information Technology.
That request included 66 specific questions that ONC wanted answered about who should participate in the proposed network as well as who would decide who can join and under what rules. The ONC proposed creating a category of nationwide health information network validated entities, or NVEs, for eligible participants, and conditions for trusted exchange, or CTEs, as criteria for eligibility.
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VA wants advanced clinical decision support for iEHR

By Mary Mosquera
The Veterans Affairs Department wants industry help to describe standard technical specifications for services that are needed for clinical decision support that could be incorporated in its integrated electronic health record (iEHR) with the Defense Department.
Clinical decision support (CDS) is currently linked with specific vendor electronic health record software and modules. The Interior Department’s National Business Center, which is working on behalf of the VA, wants to develop CDS functionality as a service.
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Research Highlights Growth in Healthcare Cloud Computing

July 3, 2012
According to new research from MarketsandMarkets, the global healthcare cloud computing will be worth $5.4 billion by 2017. The report which studied the cloud computing market over the five year period from 2012 to 2017, found that in healthcare it will grow at an annual compounded rate of 20.5 percent in that time period.
The global cloud computing market revenue is expected to increase from $1.77 billion in 2011 to $5.4 billion by 2017. The report says that North America will be the largest contributor to this market as a result of various changes such as the conversion from ICD-09 to ICD-10 clinical diagnosis codes and meaningful use rules of American Recovery and Reinvestment Act (ARRA) and Health Information Technology for Economic and Clinical Health Act (HITECH), which mandate the adoption of electronic medical records.
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dm+d made 'fundamental standard' for NHS

3 July 2012   Lyn Whitfield
The Information Standards Board for Health and Social Care has approved the NHS dictionary of medicines and devices as a fundamental standard for the NHS.
The move means that the dictionary - which is better known as the dm+d - should be used across the NHS and by its suppliers when referring to medicines.
In a statement, the ISB said the move would improve the exchange of clinical information and improve the safety of prescribing.
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Cerner at odds with hospital over installation of system

By MARK DAVIS

The Kansas City Star

Cerner Corp. and a small Kansas hospital have become embroiled in a dispute over failed attempts to install an electronic medical records system.
Girard Medical Center, a critical-access hospital northwest of Pittsburg, Kan., had sued the North Kansas City-based supplier of information technology to hospitals, doctors and others in health care.
Their quarrel is now in arbitration under an order issued in U.S. District Court in Kansas City, Kan.
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Patient Engagement Requires Right IT Tools

Federal and private policy makers are insisting that healthcare providers get patients more involved in their own care, but that's not going to happen without a careful analysis of your IT strategy.
Health IT managers could learn a lot from my car mechanic. Mike once explained the difference between "parts changers" and real mechanics--those who are skilled diagnosticians. Parts changers will look at your ailing engine, make a snap judgment about what's wrong, replace the part he suspects is at fault, and hope for the best. A good mechanic, on the other hand, works through a diagnostic process, looking for subtle clues, and bringing his in-depth understanding of the internal combustion engine to bear to find the root cause of your problem.
As most healthcare providers know, the federal government is insisting that hospitals and practices improve their e-patient engagement strategy in order to meet Stage 2 Meaningful Use criteria. Private insurers are already going down this same path. When faced with such mandates, health IT executives and clinical leaders can take the parts changer's approach to patient engagement, or do a deeper root-cause analysis to find the best technology to address the issue. AdTech Ad
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5 keys to the legal issues of social media in healthcare

By Michelle McNickle, New Media Producer
Created 07/02/2012
Social media is without a doubt playing a major part in patient engagement, marketing efforts, and an overall sense of communication within the industry. Yet with the growth of these tools come other issues to keep in mind — like the legal ramifications of using outlets like Twitter, Facebook, and LinkedIn within a healthcare setting.
"These social media sites have moved beyond the novelty stage and into the mainstream," read a recent whitepaper by Actiance. "They have become so pervasive that they have emerged as effective tools within the corporate setting as well. The line separating the recreational use of these tools from legitimate business purposes has become increasingly blurred."
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After SCOTUS decision, health IT orthodoxy worth rethinking

By John W. Loonsk, MD, CMO CGI Federal
Created 07/03/2012
Now that the Supreme Court has upheld the substance of the Affordable Care Act (ACA), a collective sigh can be heard, of relief by some and frustration by others, but certainly of avoided tumult.
The focus of ACA attention will turn to results or repeal. And while a different decision could have had ACA become a weight on HITECH and health information technology (HIT), the principally bi-partisan nature of the HIT agenda should now refocus attention almost exclusively on results for it.
It is from this latter perspective, though, that there may still be HIT tumult to come. HITECH was constructed from a health IT orthodoxy (set of tightly-held, common beliefs) that has shown a few cracks of late. And some of these cracks have to do directly with the population health IT needs of health reform from a program (HITECH) that is principally built around individual patient transaction technology.
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Report: Digital health firm investments skyrocketing

July 3, 2012 | By Ken Terry
Investments in "digital health" companies--including firms in the health IT and wireless spaces--more than tripled in the first six months of 2012, according to a new report from Burrill & Co., a San Francisco financial services company. Venture-capital investments in the sector soared to $499 million in 46 transactions from $156 million in 19 transactions during the first half of 2011.
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JPMorgan Chase unit to acquire M-Modal in $1.1 billion transaction

July 3, 2012 | By Ken Terry
In what is by far the biggest venture capital deal in health IT this year, One Equity Parters, the equity investment branch of JPMorgan Chase, has agreed to take M-Modal (NASDAQ:MODL) private, buying all of its shares for $1.1 billion in cash.
M-Modal, which offers a cloud-based voice recognition program that uses natural language processing (NLP), recently announced a new product that it said could convert doctors' dictation into discrete data in electronic health records. The "speech-to-text platform," called Fluency, is a refinement of its earlier NLP software.
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FDA Finally Issues Unique Device Identifier Rule

JUL 3, 2012 10:44am ET
The Food and Drug Administration has released a proposed rule to establish a unique medical device identifier, called UDI.
The long-awaited identifier, which Congress authorized in 2007 with renewed pressure from members in recent months to implement, is designed to better enable users to track devices and enable FDA to identify safety or effectiveness concerns quicker and better target recalls.
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INPS and EMIS to supply GP IT in Wales

3 July 2012   Chris Thorne
NHS Wales has agreed a framework agreement with GP practice suppliers EMIS and INPS to provide a managed IT service to the country’s GPs, EHI Primary Care understands.
The tender document says it is looking for a managed service to provide GP clinical system functionality via a central hosting arrangement with the inclusion of support services. The new framework is set to run for four years.
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That was then...

Ten years after the start of the National Programme for IT in the NHS, how do IT directors, suppliers and analysts view it? What is its legacy, and is the NHS in the right place to move forward? Chris Thorne reports.
28 June 2012
The first leader of the National Programme for IT in the NHS was the man who introduced the congestion charge to London, Richard Granger.
The programme’s failings have been well-publicised, and the scheme has often been described as a car-crash. Yet it did have some successes.
PACS was good
Paul Curley, clinical director for IT and a consultant surgeon at Mid Yorkshire Hospitals NHS Trust, believes that while it was “too ambitious” overall, it had considerable success with e-prescribing and picture archiving and communications systems.
“This is an area where NPfIT and NHS Connecting for Health [the agency set up to run the programme] have done some really useful work. This includes reviews of available systems and detailing the pros and cons – the ‘Which’ guide of pharmacy systems,” he says.
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Study: EMRs Improve Physician Compliance for Reviewing Portal Images

July 2, 2012
According to a new study, the use of an EMR for reviewing portal images dramatically improves compliance with timeliness and record keeping. The study, which appears in the July issue of the Journal of the American College of Radiology, found that portal images are used to verify the positioning of patients during daily radiation treatments to improve the accuracy of the radiation field placement, to reduce exposure to normal tissue and to deliver accurate dose to tumor volumes.
"The benefits of the implementation and utilization of an EMR have been well documented. Other studies have shown that the use of EMR's improves the quality of care, saves time and decreases cost," Andre Konski, M.D., co-author of the article, said in a statement. Konski is chief of radiation therapy at the Barbara Ann Karmanos Cancer Center; and professor and chair of the Department of Radiation Oncology at the Wayne State University School of Medicine in Detroit.
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CIOs and CMIOs Speak Their Minds about the Supreme Court Decision

Scott Mace, for HealthLeaders Media , July 3, 2012

This week, some voices of healthcare CIOs and CMIOs, speaking out about last week’s U.S. Supreme Court decision on the Patient Protection and Affordable Care Act:
Marc Probst, Chief Information Officer, Intermountain Healthcare, Salt Lake City, Utah
Bottom line is politically I don't like the ACA and the lack of financial responsibility which our country’s leaders have. In the end, the problem of "going broke" just continues to escalate. 
However, that's politics. As for us at Intermountain, the outcome of the Supreme Court ruling doesn't change at all the strategy and efforts we are pursuing. The ability for the government to pay for health care continues to diminish, therefore if we are going to be in a position to provide the high quality of care we believe we should and do it at substantially lower costs, then we need to maintain our focus on our current efficiency and accountability efforts. 
As a CIO, there is a huge responsibility to focus on cost saving workflows, better access to data and systems, and of course on using data as a strategic asset for increasing quality and lowering costs. Luckily, that has been a focus at Intermountain for many years. We have a lot to do—but the path we are on is a good one. Regardless of what the politicians do, the problem is economic. We know what it will take to be successful in the future and we know we can succeed.
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ID re-entry helps reduce wrong-patient errors

July 2, 2012 | By Susan D. Hall - Contributing Writer
Requiring providers to re-enter patient ID numbers in computerized physician order entry systems significantly reduced the number of wrong-patient orders in a study published by the Journal of the American Medical Informatics Association.
The New York-based researchers used a retract-and-reorder measurement tool to determine the reasons for wrong-patient orders, then set up a three-pronged study to look at two possible solutions compared with no intervention: a single-click confirmation of patient identity and requiring that the ID number be re-entered.
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Supreme Court decision a huge win for health IT

July 1, 2012 | By Ken Terry
Some observers say that last week's Supreme Court decision upholding most of the healthcare reform law won't really have much of an effect on health IT. The healthcare industry, these pundits point out, was already moving down the tracks to accountable care, patient-centered medical homes, and value-based reimbursement. Moreover, the main financial driver of health IT adoption is the HITECH Act's incentives for Meaningful Use of electronic health records.
This argument is partly true, but it isn't the whole truth. Let's start with Meaningful Use. Although the HITECH Act was passed before the Patient Protection and Affordable Care Act (ACA) as part of the 2009 stimulus law, the framers of the Meaningful Use regulations have made it abundantly clear that they're trying to use the incentives to steer the healthcare industry in the same direction that the ACA wants it to go: toward a high-quality, safe and efficient healthcare system.
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Hospital Association Comments on Health Information Exchanges

Written by Bob Spoerl | June 29, 2012
The American Hospital Association submitted comments in response to HHS' requests for feedback on how to govern and advance health information exchange, according to an AHA News Now report.
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Monday, July 02, 2012

Upping the Health IT Bar During Cost Containment

by Ernie Hood and Daphne Lawrence
More than ever, cutbacks and cost savings are top-of-mind priorities for health care organizations, as hospital revenue and margins continue to decline, Medicare reductions loom, case mix worsens, and increased competition and consolidations become a daily reality. Yet the need for new and often costly IT initiatives such as electronic health record implementations has not abated. The challenge to meet organizational needs for ICD-10, meaningful use, accountable care and clinical integration often is both costly and urgent.
Staying on target without compromising performance requires a careful approach to cost containment that will rely on assessing and refining existing performance measurement tools and, in many cases, initiating new ones.
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Enjoy!
David.