DoHA Has Released A Major ICT Tender - Worth Reading The Details To Understand What DoHA Has Been And Is Doing.

The following tender appeared a little while ago.

Request for Tender (RFT) for the provision of Solution Delivery Services to deliver an Aged Care Gateway system

ATM ID                      DoHA/220/1213

Agency                      Department of Health and Ageing

Category                   80101507 - Information technology consultation services

Close Date & Time          3-Apr-2013 2:00 pm (ACT Local time)

Publish Date           15-Feb-2013

Location                    ACT, NSW, VIC, SA, WA, QLD, NT, TAS

ATM Type                Request for Tender

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Multi Agency Access      Yes

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The Commonwealth Department of Health and Ageing (DoHA) seeks a contractor to provide the Services and Products necessary for the creation and operation of a solution for a new Aged Care Gateway system (Gateway) for aged care services.

The Gateway will create an identifiable entry point to the aged care system comprising several key elements:

(a) a national contact centre, including the My Aged Care website;

(b) an assessment service to identify needs based upon a nationally consistent assessment framework and standardised tools;

(c) a central client record to support appropriate information collection and sharing; and

(d) a linking service, targeting vulnerable people with multiple needs.

 Description

This RFT invites interested entities to offer the following Services and Products:

(a) Services necessary to plan, design and develop the detailed approach to operational management and service delivery for the overall Gateway (Business Design Services);

(b) Services necessary to design, build, test and deploy the Gateway and integrate the various components of technology to be used for the Gateway (some of which may be provided by DoHA or other Commonwealth agencies and/or their contracted service providers, and some of which may be provided by the Contractor or its subcontractors) into a single, fully functional technical solution for the Gateway (Technical Design and System Integration Services);

(c) Services necessary to ensure that the Commonwealth is provided with the Software or Software Services and other Products necessary for the operation of the Solution for the Gateway (Product Provision Services);

(d) Services necessary for the proper operation, maintenance and support of the Solution for the Gateway during the Term of the Contract (System Operations, Maintenance and Support Services); and

(e)  Optional Services or other Services as specified in the Contract (Optional Services).

Conditions for Participation None in addition to the Department's standard requirements

Timeframe for Delivery                June 2013 to June 2015 with options to extend

Address for Lodgement                www.tenders.gov.au

The link is here:

https://www.tenders.gov.au/?event=public.atm.show&ATMUUID=DC791DB6-C72E-F0E5-A27B5DD541C4AE07

There is a link to download the tender details once you are registered as an interested party or potential tenderer.

Among the interesting aspects that are available are the following.

1. Documentation that sets out performance and uptime characteristics that are a lot more onerous than we see with the NEHRS. I wonder has there been some attempt to learn from the NEHRS Program?

2. Requirements to integrate with the HI Service, Australian Business Number and NEHRS Systems. It seems odd we are now creating a pathway to create another client record and then tie it in with the NEHRS. One hopes as the NEHRS becomes a life-long record all the NEHRS and Aged Care information will be properly segmented. It is also interesting that another record is being created without the apparent stakeholder input that went into the NEHRS.

3. We are told of the IT Governance Principles applied by DoHA.

IT Governance Principles

The endorsed IT Governance Principles are used to guide IT decision making and sourcing.

No.	IT Governance Principle in full
ITGP.01	The department should have a consolidated IT work program based on a single set of priorities and only the agreed highest priority activities should be resourced and completed.
ITGP.02	Where possible, enterprise approaches and as a consequence enterprise systems capabilities will be developed and used instead of developing separate systems to support similar functions in different (or the same) divisions.
ITGP.03	The required enterprise systems capability requirements will be identified and choices made to either develop a new system to provide this function for the department, or to enhance an existing system to provide this for the department.
ITGP.04	The approach to provide systems support for new policy proposals (NPP) will be designed at the time of writing the NPP to enable a better approach and costing estimate.
ITGP.05	Policy and reform projects should design and deliver systems that contribute to the enterprise capabilities that can be leveraged by the department.
ITGP.06	Decisions on whether the systems development activities should be delivered using departmental capabilities or outsourced will be jointly considered with the sponsor area, the Office of the Chief Information and Knowledge Officer and other appropriate specialists.

I have to say I found these a little lacking in terms of scope and coverage.

4. The planned management of the project really takes the biscuit in terms of being baroque and convoluted. The number of Boards and Committees really takes one’s breath away. The diffusion of responsibility is a real treat to behold.

5. This all has the flavour of another very large ICT project being kicked off by Government that might suffer the fate of others we can all think of.

6. The planned rationale and benefits are interesting.

3         Programme Benefits

3.1         Key Benefits

The strategic motivation for implementing the Aged Care Gateway was described in the Living Longer Living Better aged care reform package.  The Aged Care Gateway is a response to the conclusion presented in Living Longer Living Better that “The aged care system can be very difficult for older people, their families and carers to understand. The sources of information are wide and varied, often difficult to access and understand and do not support informed decision making.”

The Living Longer Living Better aged care reform package outlined the major deliverables of the Aged Care Gateway:

• My Aged Care website
• National contact centre
• Linking service.

The likely benefits of implementing the Aged Care Gateway were briefly examined in the first pass business case, and benefits were outlined for older people, the aged care sector and the aged care system.

Now that the planning for the implementation of the Aged Care Gateway has advanced, it has been possible to examine the likely benefits in more detail. A graphical summary of the expected benefits is provided in Attachment A.

The expected benefits are clustered around these themes:

• Accessible and understandable information
• imely and consistent experiences
• Linked services.

The benefits expected of the Aged Care Gateway are documented in the following tables. The tables include information about the benefit itself, how it is to be achieved, and how the measurement of the benefit may occur.

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There seems to be a risk of some downside to all this - which we plan to ignore:

3.2.4  Disbenefits

The analysis also detected some potential disadvantages for certain parties that may arise from the implementation of the Aged Care Gateway.

• The implementation of the National Contact Centre may lead to perceptions of reduced opportunities for face-to-face service delivery and reduced access to local knowledge, especially in cases where a telephone service replaces services that were previously accessed in a face-to-face setting.
• Some providers may find that the role of the National Contact Centre may limit their ability to refer cases to themselves.
• The Aged Care Gateway will require providers to interact with new systems. This requirement may contribute to the need for providers to enhance or replace their automated business systems.
• The implementation of the Aged Care Gateway, and especially the My Aged Care website, may lead to greater awareness of entitlements and support options. This may lead to increased demand for services.

There are no plans to measure the magnitude of these consequences of implementing the Aged Care Gateway.

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And the approach to benefits is very clear - if rather brief!

4         Benefits Approach

The Aged Care Gateway Sourcing Strategy explores in great detail how the Department of Health and Ageing might strategically approach the change management aspects of delivering the Gateway.  A critical part of this change management is the delivery of the following:

• Benefits and evaluation framework – Development of a whole of program framework for the assessment and tracking of benefits in a way that demonstrates linkages between benefits and policy objectives
• Monitoring capability – delivery of monitoring services that assist the department to source, compile, review and evaluate data developed during implementation
• Evaluation services – development of an evaluation framework, and approach for monitoring and measurement of activities that inform progress and contribution of the program to the program benefits.

It is expected that a specialist Change Management partner will be able to re-use the information already established by the Gateway programme and build upon this to achieve the above outcomes.

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Why does this all just cause a sense of deja vu?

I am sure others will pick up a lot more. Really worth a browse.

David.

Weekly Overseas Health IT Links - 2nd March, 2013.

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.healthcareitnews.com/news/humetrix-unveils-improved-iblue-button

Humetrix unveils improved iBlueButton

By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT

Created 02/22/2013

The San Diego-based software company Humetrix has released a cross-platform version of its iBlueButton app that lets patients and physicians exchange medical information at the point of care with iPhones, iPads and Android smartphones.

Humetrix, which won the federal government’s Blue Button mashup innovation challenge, calls the multi-platform personal health record app the first of its kind, with secure QR-code data transfer.

"iBlueButton puts patients’ health in their own hands and, in doing so, not only solves the problem of having your health records when and where they’re needed, but dramatically improves patient-physician communication at the point of care," Bettina Experton, MD, Humetrix CEO and an adjunct professor of medicine at the University of California San Diego, said in a media release.

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http://consumer.healthday.com/Article.asp?AID=673677

U.S. Doctors Slow To Adopt Electronic Health Records

Despite incentives, just 1 in 6 uses the new technology, study finds

By Serena Gordon

HealthDay Reporter

WEDNESDAY, Feb. 20 (HealthDay News) -- Although doctors who are using electronic health records in a meaningful way are eligible for a $44,000 bonus from the U.S. government, many still haven't adopted the new technology, a new study shows.

Overall, just one in six doctors has adopted electronic health records significantly enough to qualify for the bonus, the study found.

"These are the doctors that have attested to using the electronic health records. My guess is that more people are on the journey [to using electronic records] than have attested to it. But, there are still some physicians who haven't started using electronic health records at all," said the study's lead author, Adam Wright, a senior research scientist at Brigham and Women's Hospital and an assistant professor of medicine at Harvard Medical School in Boston.

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http://www.fiercemedicalimaging.com/special-reports/4-radiology-safety-efforts-reducing-risk-improving-quality-0

Special report: 4 radiology safety efforts for reducing risk, improving quality

February 22, 2013 | By Mike Bassett

Improving the quality and safety of patient care has always been a primary concern for imaging professionals, and they often are on the lookout for technical innovations and other solutions that can help them reach that goal.

For instance, doctors at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia recently looked into how clinical decision support tools could help them to reduce unnecessary patient scans. Research presented at the Society for Academic Emergency Medicine last May found that use of such technology led to a near 10 percent decrease in the number of CT scans performed, according to Angela Mills, an associate professor of emergency medicine at the university's hospital.

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http://www.fiercehealthit.com/story/researchers-cpoe-averted-174-million-medication-errors-one-year/2013-02-22

Researchers: CPOE averted 17.4 million medication errors in one year

February 22, 2013 | By Gienna Shaw

Electronic prescribing through computerized physician order entry averted 17.4 million medication errors in the U.S. in a single year, according to researchers publishing in the Journal American Medical Informatics Association.

The authors analyzed data from 2006 to 2008, including the American Hospital Association's 2008 electronic health record adoption database to estimate the reduction in medication errors that they said could be attributed to CPOE.

"Processing a prescription drug order through a CPOE system decreases the likelihood of error on that order by 48 percent," the authors wrote. "Given this effect size, and the degree of CPOE adoption and use in hospitals in 2008, we estimate a 12.5% reduction in medication errors, or 17.4 million medication errors averted."

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http://www.ehi.co.uk/news/EHI/8395/you-don%27t-have-mail-consultations

You don't have mail consultations

21 February 2013  

The majority of UK GPs believe that email consultations are not an appropriate means of communicating with patients, and almost 80% have yet to do so.  

A survey of 1,000 GPs for eHealth Insider by doctors.net.uk shows that GPs are skeptical about the appropriateness, safety and reliability of such communications - despite official enthusiasm for the idea.

The survey suggests that much work will need to be done to convince GPs of the benefits of email consultations as one of a range of alternatives to face-to-face visits, which form a key ambition in the government’s 2012 NHS information strategy, 'The Power of Information'.

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http://www.ehi.co.uk/news/EHI/8394/gps-not-there-on-records-access---survey

GPs not there on records access - survey

21 February 2013  

The overwhelming majority of GP practices are not ready to implement the government’s flagship NHS IT pledge to give patients online access to their records by 2015.

An exclusive survey for eHealth Insider, conducted by doctors.net.uk, found that 43% of just over 1,000 GP respondents said “we haven’t started to address this yet” when asked how ready they were to facilitate patient access to records.

A further third (29%) said their IT systems still needed work or that the relevant functionality had not been switched on, and a quarter (24%) said they simply did now know how ready their practice was. Just 4% said “our IT system is ready, and is already live.”

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http://www.healthcareitnews.com/news/ecri-releases-c-suite-watch-list-top-10-hospital-technology-issues-2013-0

ECRI releases C-suite watchlist of top 10 hospital technology issues for 2013

By Diana Manos, Senior Editor

Created 02/20/2013

Healthcare reform, accountable care organizations, readmissions and reimbursement rates are just a few of the challenges facing today's healthcare leaders, according to a new report from ECRI Institute, a non-profit evidence-based practice center.

Balancing costs and savings potential for new technologies also weighs heavily on their shoulders, the Feb. 19 report says. A new Watch List from ECRI Institute provides a roadmap to 10 technology issues that healthcare leaders should have on their radar in 2013 and beyond.

ECRI Institute's "Top 10 C-Suite Watch List: Hospital Technology Issues for 2013" reflects ongoing impacts of healthcare reform initiatives and new technology developments, according to a news release by ECRI. Some of the technologies represent significant capital investments, such as PET/MR. Others, including mobile health, metabolic surgery and low-dose computed tomography lung screening, may greatly affect operations and care patterns.

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5 Ways To Improve Healthcare Information Exchanges

Define the problem you want to solve with an HIE -- and be ready for incompatibility headaches, say experts.

By Michelle McNickle,  InformationWeek
February 19, 2013
URL: http://www.informationweek.com/healthcare/interoperability/5-ways-to-improve-healthcare-information/240148735

Recent comments made by a number of leaders throughout the industry show clear discontentment with the state of health information exchanges. As William Yasnoff, MD, PhD, president of the Health Record Banking Alliance, recently pointed out, the current nationwide network of health information exchanges is an "unmitigated disaster," due primarily to obstacles in privacy, stakeholder cooperation and financial stability.

Four experts sat down to discuss current data exchange trends and best practices at the eHealth Initiative Annual Conference. Among the panelists were Chris Hobson, MD, CMO at Orion Health; Arien Malec, VP of strategy and product marketing at Relay Health; David Horrocks, president of Maryland HIE Chesapeake Regional Information System for our Patients (CRISP), and Eric Thieme, VP at the Indiana Health Information Exchange.

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http://www.healthcareitnews.com/news/ehr-users-dissatisfied-consider-switch

EHR users unhappy, many switching

By Erin McCann, Associate Editor

Created 02/19/2013

With more electronic health record systems continuing to fall short of providers' expectations, a new report by Black Book Rankings suggests that 2013 may indeed be the "year of the great EHR vendor switch." 

After polling some 17,000 active EHR adopters, report officials found that as many as 17 percent of medical practices could be switching out their first choice EHR by the end of the year. 

“The high performance vendors emerging as viable past 2015 are those dedicating responsive teams to address customers’ current demands,” said Black Book’s managing partner Doug Brown, in a news release. 

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http://www.fierceemr.com/story/will-2013-be-year-great-ehr-vendor-switch/2013-02-20

Will 2013 be the 'year of the great EHR vendor switch'?

February 20, 2013 | By Susan D. Hall

This could be the "Year of the Great EHR Vendor Switch," according to a new Black Book Rankings survey indicating that up to 17 percent of physician practices plan to ditch their current electronic health record system.

Unmet expectations in system features, implementations, deliverables and client support issues are blamed for the dissatisfaction, according to an announcement that tells of dozens, if not hundreds, of software firms underperforming badly enough to lose major market share.

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http://www.fiercehealthit.com/story/obama-administration-wants-map-human-brain/2013-02-19

Obama administration wants to map the human brain

February 19, 2013 | By Ashley Gold

With a nod toward the importance of strides in healthcare technology, the Obama administration is planning a long-term effort to examine the human brain and build a map of its activity. The project is being compared to the Human Genome Project in a recent New York Times article.

Slated to be unveiled as early as March, the project will be a collaboration of federal agencies, private foundations and neuroscientists and nanoscientists, all looking "to advance the knowledge of the brain's billions of neurons and gain greater insights into perception, actions and, ultimately, consciousness," according to the Times.

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http://www.fiercehealthit.com/story/economic-evaluations-health-it-systems-generally-positive/2013-02-19

Economic evaluations for health IT systems generally positive

February 19, 2013 | By Susan D. Hall

In the wake of reports that the push to go digital in healthcare hasn't produced the promised results, a literature review of economic evaluations of health IT systems finds an array of methods, but generally positive conclusions.

Researchers from the University of Victoria in British Columbia looked at 33 papers that sought to pin down the value the systems provided, not just the cost. Their research is published in the Journal of the American Medical Informatics Association.

The papers included 12 economic analyses, five input cost analyses and 16 cost-related outcome analyses and covered primary care electronic medical records (seven papers); six computerized provider order entry systems (six); medication management systems (five); immunization information systems (five); institutional information systems (four); disease management systems (three); clinical documentation systems (two); and one health information exchange network.

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http://www.ihealthbeat.org/features/2013/mobile-device-security-boosting-confidence-and-trust-in-health-it.aspx

Tuesday, February 19, 2013

Mobile Device Security: Boosting Confidence and Trust in Health IT

by Helen R. Pfister and Susan R. Ingargiola, Manatt Health Solutions

Mobile devices like laptops, smartphones and tablets have the potential to increase the quality and efficiency of health care by, among other things, making it easier for health care providers to access patient information when and where they need it. Because health care providers are increasingly using these devices, the HHS recently released a new set of online tools to help providers comply with their obligations under HIPAA when using mobile devices. 

HHS' tips are designed to be particularly helpful to smaller health care providers, such as independent physician offices and health centers, but they should be of interest to health care providers of all sizes.

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http://www.healthleadersmedia.com/content/TEC-289378/Connected-Health-Advocate-Seeks-Wider-Audience

Connected Health Advocate Seeks Wider Audience

Scott Mace, for HealthLeaders Media , February 19, 2013

It seems like every other physician I meet these days has a tech-powered start-up in the works, or an idea for one.

Take Joseph Kvedar, MD, profiled in our December 2012 issue as one of the HealthLeaders 20. Founder and director of the Center for Connected Health at Partners HealthCare in Boston, no sooner did that honor fall on his shoulders than he launched his start-up, Wellocracy. It's a side project while he continues as director of the Partners Healthcare nexus for all things connected health.

"For some time, I've felt like our ability to really get connected health adopted has been limited by our view of it through the lens of patient care," Kvedar told me at the 2013 International Consumer Electronics Show. "I had really thought with great interest about a way to reach consumers, so that was always in my head. And then another observation over the years was that patients, although we sometimes had to coax them to participate in telemonitoring programs, once they get on they didn't want to come off. Patients find it very comforting. They've connected in. They feel cared for."

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http://www.healthcareitnews.com/news/ecaring-taps-connected-independence

eCaring taps into seniors market

By Eric Wicklund, Editor, mHIMSS

Created 02/18/2013

Call it "connected independence" or "sustainable aging," but the impact is clear: Today's seniors are a growing population, and they're demanding more from an already-taxed healthcare system as they strive to stay in their own homes and out of the hospital.

This population represents one of the biggest markets for telehealth, serving not only the seniors but their family members and other caregivers, physicians, senior service agencies and assisted living communities. Mobile devices and platforms are giving seniors the opportunity to connect at all times with their caregivers and share health data, while allowing clinicians to monitor their patients around the clock and take action before a medical crisis occurs.

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http://www.healthcareitnews.com/news/health-technologys-essential-critic-warns-medical-mistakes

Health technology's 'essential critic' warns of medical mistakes

By Kaiser Health News

Created 02/18/2013

By Jay Hancock, KHN Staff Writer

This story was produced in collaboration with The Philadelphia Enquirer

Computer mistakes like the one that produced incorrect prescriptions for thousands of Rhode Island patients are probably far more common and dangerous than the Obama administration wants you to believe, says Drexel University’s Dr. Scot Silverstein.

Flawed software at Lifespan hospital group printed orders for low-dose, short-acting pills when patients should have been taking stronger, time-release ones, the Providence-based system disclosed in 2011. Lifespan says nobody was harmed.

But Silverstein, a physician and adjunct professor of healthcare informatics who is making a name for himself as a strident critic of electronic health records, says the Lifespan breakdown is part of a much larger problem.

 “We’re in the midst of a mania right now” as traditional patient charts are switched to computers, he said in an interview in his Lansdale home. “We know it causes harm, and we don’t even know the level of magnitude. That statement alone should be the basis for the greatest of caution and slowing down.”

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http://www.healthcareitnews.com/news/date-no-one-hie-model-fits-all

To date, no one HIE model fits all

By Patty Enrado, Special Projects Editor

Created 02/18/2013

When William Yasnoff, MD, president of the Health Record Banking Alliance (HRBA), declared that "our nationwide network of health information exchanges is an unmitigated disaster" in a NHINWatch Perspective column last month, his assessment that HIEs are failing became a hot topic of discussion. Critics and supporters weighed in. Farzad Mostashari, MD, national health IT coordinator, emphasized the return on investment of current HIEs at the Jan. 29 joint meeting of the federal advisory Health IT Policy and Standards committees.

As the debate continues, Irene Koch, executive director of the Brooklyn Health Information Exchange (BHIX), points out, "Evolution is still happening with all of the systems and the standards." Provider buy-in and a commitment to care coordination from all stakeholders (patient, provider and payer), which is critical to making health information exchange successful, regardless of model, are also in the early stages of development, she said.

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http://ehi.co.uk/news/mobile/8386/telehealth-benefits-realised

Telehealth benefits realised

15 February 2013   Lis Evenstad

A Yorkshire project proves the cost benefits of telehealth, says a report on the scheme by think-tank 2020health.

The report evaluates the Yorkshire and the Humber Telehealth Hub, which was set up in 2011 as a partnership between Airedale NHS Foundation Trust, the University of Hull and South West Yorkshire Partnership NHS Foundation Trust.

The aim was to reduce hospital admissions and prove cost benefits. Despite struggles with clinical engagement and very low uptake in some areas, more than 2,000 patients were enrolled.

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Enjoy!

David.

Interesting To See How Electronic Medication Ordering Can Reduce Errors. Seems It Really Works.

This appeared a little while ago.

Researchers: CPOE averted 17.4 million medication errors in one year

February 22, 2013 | By Gienna Shaw

Electronic prescribing through computerized physician order entry averted 17.4 million medication errors in the U.S. in a single year, according to researchers publishing in the Journal American Medical Informatics Association.

The authors analyzed data from 2006 to 2008, including the American Hospital Association's 2008 electronic health record adoption database to estimate the reduction in medication errors that they said could be attributed to CPOE.

"Processing a prescription drug order through a CPOE system decreases the likelihood of error on that order by 48 percent," the authors wrote. "Given this effect size, and the degree of CPOE adoption and use in hospitals in 2008, we estimate a 12.5% reduction in medication errors, or 17.4 million medication errors averted."

Putting a hard number on the results of any health information technology on quality improvement is a challenge--and research on the effects of HIT are often ripe  for debate.  

For example, data transfer between health IT systems can threaten patient safety perspective, according to an analysis of health IT-related safety events by the ECRI Institute Patient Safety Organization, FierceHealthIT reported earlier this month.

A breakdown of the events found that 53 percent were associated with medication management systems. Of the systems identified in such events, computerized physician order entry systems were mentioned the most (25 percent of the time).

More with links here:

http://www.fiercehealthit.com/story/researchers-cpoe-averted-174-million-medication-errors-one-year/2013-02-22

A useful one for the evidence files.

David.