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."

Saturday, April 13, 2013

Weekly Overseas Health IT Links - 13th April, 2013.

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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4 ways health IT can build trust

By Benjamin Harris, New Media Producer, Healthcare IT News
Created 04/04/2013
Medicine is a two-way street; it works best when the patient and the provider trust each other, and can work together for the best outcome. While technology can enable those outcomes, when improperly used -- consider the epidemic of patient data breaches -- it can also raise some eyebrows and scare some people away from embracing it. Scott Zimmerman, president at TeleVox Software, understands these concerns. But he sees technology offering a net gain on the road to improving patien-physician relationships and enhancing trust. He shares four ways health IT can improve the quality of care and enhance trust between the patient and the provider.
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Patients Like Online Health Records Access, Study Says

Veterans in study said the ability to view notes, lab results and other documents helped them communicate better with their doctors and led to better health.
When patients at the VA Medical Center in Portland, Ore., were given access to key parts of their electronic health records such as visit notes, lab results and discharge summaries, they believed that the ability to view their records helped them in many ways. They said they gained knowledge about their health, did a better job of taking care of themselves, had an easier time talking to their doctors and participated more fully in office visits, according to a new study in the Journal of Medical Internet Research.
On the other hand, some veterans were disturbed when they saw inconsistencies, previously undisclosed information, or derogatory language, said researchers. AdTech Ad
The study showed that common provider concerns about giving patients full access to their records appeared unwarranted. However, the authors said, record sharing "is likely to change providers' work, necessitating new types of skills to communicate and partner with patients."
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HIT Errors 'Tip of the Iceberg,' Says ECRI

Cheryl Clark, for HealthLeaders Media , April 5, 2013

Healthcare systems' transitions from paper records to electronic ones are causing harm and in so many serious ways, providers are only now beginning to understand the scope.
Computer programs truncated dosage fields, leading to morphine-caused respiratory arrest; lab test and transplant surgery records didn't talk to each other, leading to organ rejection and patient death; and an electronic systems' misinterpretation of the time "midnight" meant an infant received antibiotics one dangerous day too late.
These are among the 171 health information technology malfunctions and disconnects that caused or could have caused patient harm in a report to the ECRI Institute's Patient Safety Organization. Thirty-six participating hospitals reported the data under a special voluntary program conducted last year.
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American Academy of Pediatrics recommends electronic prescribing

April 3, 2013 | By Marla Durben Hirsch
The American Academy of Pediatrics has issued a policy statement recommending that pediatric healthcare providers use e-prescribing to improve quality and reduce costs. According to the statement, published in the journal Pediatrics, the prescription error rates for children range between 5 percent and 27 percent; moreover, these errors can create more severe complications for children because of their more narrow therapeutic profiles and the inability of some of them to communicate adverse effects.
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HIT unprepared for 'omics' onslaught

By Mike Miliard, Managing Editor
Created 04/04/2013
Data systems in healthcare are lacking when it comes to the storage and handling of increasingly complex medical information, according to a new study published in the Journal of the American Medical Association.
Physicians are moving en masse to electronic health records, but existing data systems aren't sophisticated enough to make optimal use of ever-expanding patient information, according to one of the report's authors, Justin Starren, chief of the division of health and biomedical informatics in the department of preventive medicine at Northwestern University Feinberg School of Medicine.
This problem that will only be exacerbated as data grows apace – fueled by innovations such as next-generation genomic sequencing – and becomes cheaper and more available to health care providers.
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Retrial begins for iSoft execs

3 April 2013   Central News court reporting agency
Three former senior executives of iSoft faced retrial today accused of ‘cooking the books’ to bury bad news about the company to boost its value.
Stephen Graham, Timothy Whiston and John Whelan are being retried at Southwark Crown Court after their first, four month trial ended without a verdict last August.
Patrick Cryne, a co-founder and former chief executive of the company, was not part of the first trial for medical reasons and was not before the court today.
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Why health data digitization is here to stay

April 4, 2013 | By Ashley Gold
Despite federal incentives and penalties, as well as payer demands, for health data digitization, some providers continue to resist the trend. One health policy and ethics analyst aims to address why in a recent Hospital & Health Networks article.
Emily Friedman, wondering if reluctant providers' concerns should be taken more seriously, says she can understand the resistance. She lists some of the arguments against digitization: primarily, lack of ease of use, citing a 2012 CompTIA survey that found 58 percent of respondents think systems are hard to use.

"Requiring busy people who might be technologically challenged to clamber up a steep learning curve is asking a lot, in or out of health care," Friedman writes.

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The big-data and analytics revolution in health care

Analytics is transforming many facets of the health-care industry, from drug research to patient care. “The big-data revolution in US health care: Accelerating value and innovation” traces the evolving role of analytics from retroactive reporting to prediction and intervention, and quantifies the potential benefits and organizational challenges. This article includes a video interview with McKinsey director Nicolaus Henke, who discusses the capabilities organizations will need to integrate analytics effectively.
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5 reasons to get sold on analytics

By Benjamin Harris, New Media Producer, Healthcare IT News
Created 04/02/2013
Welcome to the data world. Many secrets are hidden in big data, and now, with the computing power to unearth them, analytics promises to deliver transformative power wherever it is put to work. Still, the technology is a relative newcomer in the healthcare world. Brett Furst, CEO of Arbormetrix, says there is nothing to fear – and that analysis of clinical data has much to offer the medical world. Here, he shares his top five requirements to succeed with, or at least get excited about, the power of clinical analytics.
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President Obama’s Challenge: Map the Brain

APR 2, 2013 3:33pm ET
President Obama on April 2 launched a national public-private initiative to map the human brain, adding federal funds to private sector efforts as was done to map the human genome.
The federal government between 1988 and 2003 invested $3.8 billion into the Human Genome Project, with an economic return of $141 for every invested dollar, totaling $796 billion, the White House says.
The goal of the BRAIN Initiative is to discover new treatments, preventions and cures for such disorders as Alzheimer’s, autism, epilepsy, schizophrenia and traumatic brain injury, the President said.
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7 health technologies developed for veterans

April 3, 2013 | By Susan D. Hall
Technology has always played a big part in providing and improving healthcare for U.S. soldiers, both at home and abroad. For instance, the Blue Button, launched in 2010, initially was designed as a means for veterans to easily access and download their health information to use, as necessary. The technology, which since has been made available to non-veteran patients, as well, continues to evolve, with registration reaching one million patients last summer.
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Access to EHR data 'overwhelmingly' positive for patients

April 1, 2013 | By Marla Durben Hirsch
Providing patients with access to the information in their electronic health records "overwhelmingly" yielded positive benefits, according to a new study in the Journal of Medical Internet Research.
While patient review of their health data is an opportunity to engage them in their healthcare, some clinicians have expressed concern about such open access. The researchers, from the Veteran's Administration and elsewhere, sought to determine patients' actual experiences with such open access by studying the My HealtheVet EHR access pilot program.  They used focus group interviews conducted at the Portland Ore.-based VA Medical Center, which had the highest percentage (72 percent) of enrollees in the pilot.
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Press Ganey spotlights ways to improve the patient experience

By Diana Manos, Senior Editor
Created 04/02/2013
A new report from Press Ganey reveals the value of capturing every patient’s voice in order to focus efforts on enhancing the quality and safety of care.
The report, "2013 Strategic Insights: Targeted Performance Improvement," identifies new thinking and analytical approaches organizations can adopt to efficiently and effectively enhance performance, according to a news release. Press Ganey, a patient experience improvement firm, works with more than 10,000 health care organizations, including 50 percent of all U.S. hospitals.
“In order to continue to advance the patient experience and perform at the highest levels clinically, leadership will require continuous innovation,” according to Patrick Ryan, CEO of Press Ganey. “A new framework is needed, and every patient must be given a voice. Sustainability will require operational integration of advanced analytics to drive targeted, day-to-day improvement.”
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Study: Medication Errors in the ED Decreased With Computerized Provider Order Entry

Written by Sabrina Rodak | April 02, 2013
Computerized provider order entry systems in the emergency department can reduce medication errors, according to a study in Annals of Emergency Medicine.
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Commentary: EHR usability must amplify human potential

By Tim Andrews, Vice president, Booz Allen Hamilton
It's an exciting time for the health IT community: the wider use of electronic health records (EHRs), coupled by new integrated delivery models, clinical support systems, and mobile technology provides an amazing opportunity to dramatically improve care delivery while changing how patients and providers interact.
Unfortunately, this rapid change has wreaked a bit of havoc on health IT providers. Over the past few years, vendors have been consumed by EHR certification and support for Meaningful Use while continuing their own feature development. However, this rapid rollout of EHRs has laid a solid foundation from which we can build.
Now, I believe we need to turn our focus from critical internal development — the plumbing — to the user experience. As our healthcare system moves away from an ad hoc, fee-for-service system and towards an integrated care model, we must design and create health IT solutions that will enable and empower users — from patients to providers.
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Allscripts opens lab with Singapore IT org

By Anthony Brino, Associate Editor
The U.S. health IT company Allscripts is partnering with Singapore’s Integrated Health Information Systems (IHIS) to open a lab bringing information technologies to health systems in Singapore and possibly other Asian countries.
IHIS is an organization of the Singapore Ministry of Health’s (MOH) public holdings group, and has been helping bring IT tools to the country’s regional health systems, many also owned by the MOH.
“The joint laboratory will enable local clinicians and IT professionals to work closely with international experts to create software that will integrate seamlessly with our hospitals’ workflows and address our future healthcare challenges,” IHIS CEO Chong Yoke Sin said in a media release..
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Massive disparities in GP IT spend

28 March 2013   Rebecca Todd
Expenditure on GP IT varies enormously nationwide from between just 50p per head of population in Wiltshire to more than £10 in West Essex.
This massive disparity in spending, revealed in a Freedom of Information request to the NHS Commissioning Board, has left the board struggling to delegate GP IT funding to clinical commissioning groups.
However, enquiries by EHI reveal that for at least one primary care trust, the reported figure represents its entire IT budget rather than just money spent on GP IT.
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All change, please

At midnight, the latest reorganisation of the NHS finally took effect. Lyn Whitfield outlines the changes and their impact on NHS IT.
28 March 2013
It’s hard to believe that between 1948, when the NHS was established, and 1974, when regional and area health authorities were created, the health service was left un-reorganised.
Since then, the pace of ‘reform’ has picked up to the point where major changes, such as the introduction of general management and the internal market, can be expected every decade, and minor changes to purchaser or provider bodies can be expected every year.
Even so, the shake-up that took effect at midnight is bigger and far more hotly contested than most.
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Shaken NHS faces uncertain future

1 April 2013   Lyn Whitfield
The latest round of NHS reforms, which took effect at midnight, have been greeted with unease and concern about what they could mean for the future of the health service.
Mike Farrar, the chief executive of the NHS Confederation, which, as a management organisation might be expected to flag the more positive aspects of the changes, instead warned of the challenges ahead.
“We need to recognise the huge challenges facing the health service,” he said. “New structures alone won’t enable us to tackle these changes, and we should not see them as a silver bullet.”
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Marc Probst: Data standards, ICD-10 among healthcare's biggest hurdles

April 2, 2013 | By Dan Bowman
Among the biggest challenges currently facing the health IT industry, two in particular that stand out, according to Intermountain Healthcare CIO Marc Probst, are interoperability and ICD-10. With regard to the former, the outspoken Salt Lake City-based hospital executive, who also serves as a member of the federal Health IT Policy Committee, has made no bones about the fact that he thinks the government needs to set standards now.
"We've got to get things standardized, and it's not happening fast enough," Probst ( pictured right) told FierceHealthIT in a recent interview.
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Obama's BRAIN Initiative takes aim at Alzheimer's, Parkinson's

April 2, 2013 | By Ashley Gold
The Obama Administration's Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, first alluded to in the president's State of the Union Address in February, officially was launched by the White House this morning. In a press conference touting the announcement, Obama called the knowledge that potentially could be gained through the project's efforts "transformative."
"As humans, we can identify galaxies light years away … but we still haven't unlocked the mystery of the three pounds of matter that sits between our ears," Obama said. "The most powerful computer in the world isn't nearly as intuitive as the one we're born with."
Three organizations--the National Institutes of Health, the National Science Foundation and the Defense Advanced Research Projects Agency--will provide approximately $100 million in funding for the initiative beginning in FY 2014, according to a White House announcement. Additionally, according to the announcement, NIH will establish an academic working group to "define detailed scientific goals" of the program, as well as to create a "multi-year scientific plan" for the program.
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HL7 Makes Good on Offer of Free Intellectual Property

APR 1, 2013 4:26pm ET
Standards development organization Health Level Seven International in September 2012 pledged to offer much of its intellectual property via a free license, and that property now is available, effective April 1.
The free property includes all published standards, domain analysis models, profiles and implementation guides. HL7 also will make free other select intellectual property, such as implementation tools, on a case-by-case basis. The intellectual property will not be licensed on the open source market, under which developers may make enhancements. The freely available property means the content must be licensed for use but the license is free.
In September, HL7 CEO Charles Jaffee, M.D., said the property was being made freely available to advance interoperability across the globe and better align with other standards organizations that
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Tuesday, April 02, 2013

Could New Cancer Care Database Be a 'Game Changer' for Medicine?

by Kate Ackerman, iHealthBeat Managing Editor
WASHINGTON -- Experts say an announcement made last week by the American Society of Clinical Oncology could have significant implications for the future of health care delivery.
ASCO announced that it successfully completed a prototype of a cancer care database that leverages health IT to improve care.
CancerLinQ is a knowledge-generating computer network that will collect and analyze cancer care data from millions of patients and then combine that information with expert guidelines and other evidence to generate real-time, personalized guidance and quality feedback for doctors.
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Health IT Priorities Put Regulations Before Innovation

Implementing electronic records and meeting Meaningful Use rules are top of the list in our Health IT Priorities survey. Is there room for breakthrough technology?
The tension is palpable among healthcare IT pros, given how much change is happening at once in their industry. Lynn Witherspoon, chief medical information officer at Ochsner Health System in New Orleans, sums up the challenges: "Care delivery redesign and associated reimbursement changes, ongoing Meaningful Use and healthcare reform requirements, and the difficulty of developing new cultural norms will make next year a very busy one."
AdTech AdAnother respondent to our InformationWeek 2013 Healthcare IT Priorities Survey puts things more bluntly: "Most healthcare CIOs are supportive of the majority of the new functional requirements that are being forced on us. However, federal requirements are coming too many, too fast. … The rate of change is such that systems and changes are being implemented less than optimally."
This furious pace of change explains why tactical and regulatory objectives dominate this year's Healthcare IT Priorities Survey, just as they did last year. More than 60% of the health IT pros who responded to our survey cite managing digital patient data and meeting regulatory requirements among their top priorities, rating each a 5 on a 1-to-5 scale.
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Phishing a Real Threat to Healthcare, No Fooling

Scott Mace, for HealthLeaders Media , April 2, 2013

It was a long holiday weekend several years ago, and I received a message on Facebook from someone I trusted, a longtime acquaintance from a well-known high-tech company. He had posted something to my Facebook wall. I thought it was benign. But his Facebook account had been compromised, and now I had been phished.
I knew about phishing; essentially it's an email fraud scam or online con game. I thought I would be safe if I only opened messages from people I knew, on networks I believed to be safe. I spent the next day, however, profusely apologizing to my Facebook friends, who now had postings to their own Facebook walls, from me, inviting them to click and be sucked into the digital chaos. We all had a good non-laugh changing our passwords and apologizing on down the line.
I was lucky that the only harm I suffered was a little embarrassment. And I now I know I'm in pretty good company. Last week, we learned that Supreme Court Chief Justice John Roberts has been the victim of credit-card fraud. The court did not provide any other details, according to the Associated Press. But if you ask me, the odds are that Justice Roberts had been phished.
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Stanford researchers develop disease-detecting biological 'computer'

April 1, 2013 | By Ashley Gold
A new biological computer developed by Stanford University researchers could potentially detect disease and kill off rogue cells, according to a new study published in Science magazine.
The advancements, according to an article in the San Jose Mercury News, are described as "microscopic natural computers inside [human's] cells that could guard against disease and warn of toxic threats."
The achievement is a portent to computers inside the human body that could screen for cancer or toxic chemicals. Lead researcher Drew Endy told the Mercury News, "We're going to be able to put computers inside any living cell you want," which he said could answer any biological question within a cell, and count cells, too.
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Securing health data from hackers requires a holistic approach

April 1, 2013 | By Susan D. Hall
Though less common than breaches from lost laptops or other devices, hacking is on the rise in healthcare, experts say. Fending off cyber criminals, however, should go beyond treating security as a routine matter of protecting patient privacy, according to a recently published research report from CSC's Global Institute for Emerging Healthcare Practices.
"It needs to more of an ongoing, constant, holistic type of approach where you're looking at your systems from the perspective of someone on the outside," lead author and senior research specialist Jared Rhoads, pictured, told FierceHealthIT, speaking about the risk assessments the report recommends.
Rhoads described hacking as "still the kind of thing that statistically won't happen to you yet," but that "is happening often enough that we're taking notice of it." A recently published Wired article hypothesized that as health data increasingly is pushed online, hacking becomes less a question of "if" and more a question of "when."
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Enjoy!
David.

Friday, April 12, 2013

This Is A Really Interesting Development In Information Sharing and Interoperation.

The following appeared a little while ago.

EMIS and TPP share data

18 March 2013   Rebecca Todd
EMIS and TPP are working on a data-sharing agreement to allow clinicians to see information held in each other’s systems.
The GP IT companies plan to deliver one-to-one local health community data-sharing for clinical commissioning group areas using both EMIS and TPP systems.
The new agreement, described by the companies as “groundbreaking” and “momentous”, means clinicians using one system will be able to view patient records from the other system.
This will be subject to sharing agreements and patient consent at the point of care.
EMIS managing director Neil Laycock told EHI the two companies were working together to find pilot sites for the new data-sharing arrangement. Areas with high populations of TPP and EMIS users tended to be in the North East and South East of the country.
The functionality would then be rolled out across England.
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 “It’s fantastic that we can offer this level of integration to the NHS for free. This will transform the delivery of patient care across the NHS,” he said.
More here:
The terms used to describe this eventuality are more than reasonable - given the market position of these two players in the UK market - i.e. very large.
It might be a while before this sort of outcome can be replicated in Australia I suspect.
David.

Thursday, April 11, 2013

This Is A Useful Summary Of Where Analytics May Help To Make A Difference.

This appeared a little while ago.

5 ways hospitals can use data analytics

By Kelsey Brimmer, Associate Editor, Healthcare Finance News
Created 02/28/2013
When it comes to healthcare analytics, hospitals and health systems can benefit most from the information if they move towards understanding the analytic discoveries, rather than just focusing on the straight facts.
George Zachariah, a consultant at Dynamics Research Corporation in Andover, Mass., explains the top five ways hospital systems can better use health analytics in order to get the most out of the information.
 1. Use analytics to help cut down on administrative costs.
 “To reduce administrative costs – it’s really one of the biggest challenges we face in the industry,” said Zachariah. “One-fourth of all healthcare budget expenses are going to administrative costs, and that is not a surprise because you need human resources in order to perform.”
Zachariah suggests that hospital systems begin to better utilize and exchange the information they already have by making sure their medical codes are properly used, and thus, the correct reimbursements are received.
“Right now, with electronic medical records, you can see that automated coding can significantly enhance how we can turn healthcare encounters into cash flow by decreasing administrative costs,” he said.
2. Use analytics for clinical decision support.
Zachariah said that having all medical tests, lab reports and prescribed medications for patients on one electronic dashboard can significantly improve the way clinicians make decisions about their patients – while at the same time cutting costs for the organization.
“If all the important information is on one electronic dashboard, clinicians can easily see what needs to get done for a patient, and what has already been done. They can then make clinical decisions right on the spot,” he said. “In addition, clinicians will not be double-prescribing patients certain medications due to the lack of information they have on the patient.”
Read the other three here:
This is a very useful summary of where analytics fit. Well worth a read.
David.

Wednesday, April 10, 2013

A New Framework For Health Information Privacy - An Important Set Of Actionable Principles.

This article appeared a few days ago.

New Framework Details 15 Core Health Privacy Principles

APR 3, 2013 5:30pm ET
Advocacy organization Patient Privacy Rights has published the Privacy Rights Framework, with 15 core principals comprising more than 75 auditable criteria to measure and align privacy policies to acceptable business practices.
The Framework is designed to help measure and test whether health information systems and research projects comply with best privacy practices in such areas as whether patients have control over their protected health information, an organization obtains meaningful consent before disclosing data and obtains new consent before secondary data use occurs, patients have the ability to selectively share data, and the organization uses servers housed in the United States, among other factors.
The framework is available now for all stakeholders. However, Patient Privacy Rights will develop a system to permit licensing for entities that want to be formally approved by the organization to enable consumers “to tell the good guys from the bad guys.”
This article is found here:
The framework is available here.
The core privacy principals from the .pdf are:
Principle 1: Patients can easily find, review and understand the privacy policy.
Principle 2: The privacy policy fully discloses how personal health information will and will not be used by the organization. Patients’ information is never shared or sold without patients’ explicit permission.
Principle 3: Patients decide if they want to participate.
Principle 4: Patients are clearly warned before any outside organization that does not fully comply with the privacy policy can access their information.
Principle 5: Patients decide and actively indicate if they want to be profiled, tracked or targeted.
Principle 6: Patients decide how and if their sensitive information is shared.
Principle 7: Patients are able to change any information that they input themselves.
Principle 8: Patients decide who can access their information.
Principle 9:  Patients with disabilities are able to manage their information while maintaining privacy.
Principle 10: Patients can easily find out who has accessed or used their information.
Principle 11: Patients are notified promptly if their information is lost, stolen or improperly accessed.
Principle 12: Patients can easily report concerns and get answers.
Principle 13: Patients can expect the organization to punish any employee or contractor that misuses patient information.
Principle 14: Patients can expect their data to be secure.
Principle 15: Patients can expect to receive a copy of all disclosures of their information.
A description of the approach is here:

Trust Framework

What is the PPR Framework?

The PPR Framework is a set of 75+ auditable criteria that measure how much technology protects data privacy. It can offer ALL health care consumers the ability to control their most sensitive and sacred personal information by empowering patients to make meaningful choices about HIT systems and products based on attestation to the tough privacy principles and criteria they expect for health information.

Who developed the PPR Framework?

PPR and the bipartisan Coalition for Patient Privacy, in concert with Microsoft and PricewaterhouseCoopers (PwC), developed and tested a set of privacy principles and standards, operationalized in criteria that should be built into all electronic systems, platforms, and applications that handle personal health data in order to prove that they are worthy of trust.

What is PPR Framework based on?

The PPR Framework is grounded in American’s longstanding civil, human, and ethical rights to health information privacy. It is based on the bipartisan consumer privacy policies and principles established by members of the Coalition for Patient Privacy in 2007.

What does the PPR Framework test?

The PPR Framework tests whether health IT, platforms, applications, and research projects comply with the gold-standard privacy principles the bipartisan Coalition for Patient Privacy established in 2007-2008 over a period of 18 months. A patent is pending to assure that this system can be widely used to measure how closely systems, platforms, and applications meet patients’ expectations for control over personal data, and expectations of state-of-the art data security.

Who will benefit?

Everyone.
Developers of health IT systems, platforms, applications, and organizations that claim to be committed to privacy should be able to outwardly reflect that avowed commitment. Privacy seals could be awarded for compliance with the PPR Trust Framework and would distinguish trustworthy organizations that are truly making a full and good-faith effort to honor individuals’ right to privacy from all the rest. Patients are the greatest beneficiaries of the PPR Trust Framework. They should be able to protect themselves and easily see which electronic records systems, applications, and websites to avoid. Restoring patient control will offer consumers the ability to reap the rewards of health IT by enabling them to select systems worthy of trust.

PPR Trust Framework

Today’s data-rich networked society makes deployment of trusted electronic systems practical and painless. PPR believes organizations can earn public trust by attesting and adhering to the principles outlined in its Trust Framework and privacy certification process. In 2008, PPR, PwC, and Microsoft developed and tested this robust privacy certification program on HealthVault. Several key consumer organizations, inducing the ACLU and Consumer-Action, participated in the development and testing of the PPR Trust Framework.
PPR’s Trust Framework could be used for a formal privacy certification process. It differs from other health IT certification processes because it is designed specifically to enhance consumer engagement, education, and trust in electronic systems, platforms, and applications that hold individuals’ personal health information.
Public awareness of privacy-positive companies and organizations would be a very significant step and create pressure to restore privacy and the Constitutional liberties and freedoms that the Digital Age has violated. As more and more consumers – of healthcare and other products and services – become better educated about their privacy rights and the existing and growing threats to those rights, they will look for privacy-committed companies with which they can do business. Consumers will reward good business practices by participating in systems or projects that are publically committed to operate in compliance with the Trust Framework’s privacy principles.
The PPR Framework can play an integral role in building a vibrant, trusted research ecosystem. In general, the public is altruistic and willing to participate in research, provided that they know they have control over their information and can choose the type of research in which they participate. Furthermore, they want to know that the platforms and applications they donate their information to are trustworthy and secure. The Trust Framework offers research organizations and institutions the opportunity to demonstrate their commitment to informed consent and strong data security and data privacy protections.
Click here for a nutshell overview of Principle 1 of PPR’s Trust Framework.
Click here to read more about the Framework criteria
This page is found here:
It should be noted that the intent of these principles and the auditable points apply to all those who handle health information electronically. While I can see some obvious areas where the NEHRS may not comply it is also clear there will be many medical practices and facilities who are not quite up to scratch.
There is no doubt these requirements set a high bar - but I think we should be working towards them if we are to ensure patient trust.
David.

Tuesday, April 09, 2013

Let’s Play Spot The E-Health Spin From The Federal Health Minister. What Fun.

Health Minister Tanya Plibersek appeared on Meet the Press on the Weekend.
Here is the link to the show.
Here is an approximate transcript of what was said (E&OE).
8.49 minutes into the discussion:
 Sue Dunlevy: Have you spent a billion dollars on an ehealth system – doctors cant upload any patient records without crashing their computers in their surgeries?
Minister Plibersek : That's not right Sue.
Sue Dunlevy:  Is this not a white elephant, when will we be able to use this – I mean it was launched 9 months ago and it is still not working?
Minister Plibersek : There are 8 million records on the e-health system right now, there are 100,000 people signed up, there are about 7,000 organisations signed up, we have already got a number of hospitals doing electronic discharge summaries, we have doctors in many surgeries, in the test areas, using this very effectively but it is a huge system – this is something that will one day serve 23 million Australians. It is a big job. I have got my own  e-health record and I was able to see for the last two years everything I have been to the doctor for, every medicine I have had, I have been able to check my children’s immunisations status on line. It is a very useful thing.
Sue Dunlevy: Was that in a test situation or a clinical situation?
Minister Plibersek:  No it is mine, I sat down at my computer and typed up and I logged on and created my own record – it took me about 10 minutes
Sue Dunlevy: Has your doctor been able to update your medical records?
Minister Plibersek: I haven’t been to the doctor since then because  I am quite healthy thank you very much. But if I went to hospital and I wanted an electronic discharge summary – my own doctor could then read my own discharge summary. This is the very beginning of a massive change in health in Australia. In years to come it will make a huge difference. It will reduce prescription errors – we have thousands of people every year who are made sicker when they go to the doctor because they get the wrong medicine or too much medicine. It will mean if you have an accident and taken into hospital all the hospital staff will be able to see whether you have had any surgery in recent years, whether you are on any medications, whether you have any allergies. It will mean that if you have an x-ray or a blood test in Sydney and you get sick in Brisbane then they can have a look at your blood test or that x-ray that you had six months ago. Or six years ago. Huge savings to health and huge improvements’
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The figure that amazed me was the 8 million records in the system. That sounds pretty high to me!
While obviously well briefed I am not sure the Minister was really telling a story that reflects the actual reality of what has been achieved.
Oh well - I suppose that is pre-election politics!
David.

AusHealthIT Poll Number 162 – Results – 9th April, 2013. Extended Commentary.

The question was:

Do You Believe It Is Appropriate For DoHA To Be Spending Money Paying Staff To Aggressively Recruit Hospitalised (And Presumably Ill) Patients For The PCEHR / NEHRS?

Yes - Strike Where and When You Can 8% (4)
Probably 6% (3)
Probably Not 15% (7)
No - Potentially Invasive and Intrusive For Patient 69% (33)
I Have No Idea 2% (1)
Total votes: 48
Very interesting! A large majority seem to think there is a good deal wrong with the intrusive Government approach.
Latest news is that the effort is being ramped up with funded staff in white tee-shirts running all over Canberra government departments and in all sorts of health facilities all over the country harassing people to sign up.
I guess they have to spend the adoption budget before the Election or June 30.
The criteria that will matter is the actual usage rate of the record once people sign up. No stats are said to be available that I can find. If anyone knows of such stats please let us all know!
Again, many thanks to those that voted!
David.

Monday, April 08, 2013

Weekly Australian Health IT Links – 8th April, 2013.

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

Another quiet week with all sorts of odd places asking people to sign up for e-Health - but with nonsense being spoken as to what exactly it will all mean.
Other than that we are seeing a wait and see period leading up to the election in September.
I would expect little to happen before then.
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Telehealth for urbanites a waste: expert

4 April, 2013 Antonio Bradley
Telehealth funding is being frittered away on Australia’s urbanites and should be redirected to remote and rural areas, an eHealth leader says.
The claims, from WA rural GP Dr Trevor Lord come off the back of a study which finds telehealth may not be good value for money.
The study, published in the BMJ, found that adding telehealth services to the usual care of mainly urban patients with long-term conditions added further costs but did not significantly improve health gains.
Telehealth included giving patients remote monitoring equipment such as glucometers and pulse oximeters.
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Patients urged to sign up for digital medical records

By Georgia Kelly-Bakker

April 1, 2013, 6:43 p.m.
THE medical records of South East patients can now go online following the announcement that Mount Gambier’s Pangula Mannamurna has connected to the Federal Government’s eHealth record system.
The Aboriginal Community Controlled Health Service is the first facility outside New South Wales to offer the national system and operators are calling on all residents to get on board.
“We are trying to encourage everybody to join on to eHealth, not just our clients,” Pangula Mannamurna administration officer Stefanie Birkholz said.
“Anybody who wants our assistance in setting up their own eHealth record can do so by coming into the service.”
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Health milestone as medical records go online

WANT to gain access to and control over all your medical records?
Though it's still in the early stages of development, this is what will be available as the eHealth system of electronic medical records unfolds.
A milestone was reached in Mackay on Tuesday when the first Mackay patient's personal health summary was uploaded by a GP in Slade Point.
Townsville-Mackay Medicare Local chairman Dr Kevin Arlett said the federally-run program would be useful for a variety of reasons.
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Immunisation reminder app launched

2nd Apr 2013
GPs in NSW now have an additional ally in efforts to ensure child immunisations are kept up to date with the state’s health department launch of a new app.
NSW Health has released the Save the Date app, which calculates the next date an immunisation is due and sends parents a reminder to make the appointment.
All parents have to do is enter their child's name, birth date and GP contact details into the app. The app will then send a series of reminders to prompt the parent to call their GP to schedule an appointment for each immunisation with parents able to call their GP straight from the app.
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St Vincent's helping to create connected healthcare communities for their patients

26 March 2013. St Vincent's Hospital is situated in the heart of Sydney's busy Eastern Suburbs precinct and is one of the twelve lead eHealth sites across Australia. On average, at least ten patients per week are now presenting to St Vincent's with their personally controlled electronic health record (eHealth record) and this number is increasing.
For the majority of these patients, when they leave the hospital a Discharge Summary will go to their eHealth record. Over time as more healthcare professionals register to use the system the better connected our health system will become and when a GP opens a patient's record, they will see meaningful, clinical data.
Rachel Byrne, national eHealth record system project manager at St Vincents & Mater Health Sydney, said that only last week they had over 30 patients with a PCEHR across St Vincent's Hospital, St Vincent's Private Hospital and the private specialists in St Vincent's Clinic.
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E-health take-up 'missing its target'

  • by: SEAN PARNELL, HEALTH EDITOR
  • From: The Australian
  • April 02, 2013 12:00AM
THREE Australians have been allowed to use a fake name to sign up for an electronic health record but even taking pseudonyms into account, the federal government will fall well short of its registration target.
Little-known provisions in the Personally Controlled Electronic Health Record program allow people to register using another name for privacy reasons, for example, if they are taking extra precautions to avoid an abusive spouse or are worried their reputation will suffer if their health status becomes publicly known.
But in gaining the right to withhold their identity, the first three Australians to take up the provision for pseudonyms may have also lost the right to claim government benefits.
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E-health letter free-for-all

 Medicare Local has infuriated GPs by suggesting they tell their patients there is “no cost” for creating shared e-health summaries for the Federal Government’s national e-health system.
The summaries — listing medications, diagnoses, adverse reactions and immunisation histories — are meant to form the backbone of the billion dollar PCEHR. But there has been furious debate over the plan when it emerged the government was providing no dedicated funding to GPs to either create or update the shared summaries.
Now Tasmania Medicare Local has enraged local doctors over a letter sent to practice staff last week which tells them how to handle questions from patients about the records.
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Comment - 6Minutes - 04/04/2013

E-health letter free-for-all

Medical records are a doctor’s  records, for doctors to use and  share as they see fit.
Historically, there have been  disgraceful lapses, poor records,  false records, even funny records.  But most convey a useful message  for the next carer. Modern  professionals would agree modern  record-keeping is made easier by  computer technology.
Enter PCEHR. Confidentiality is  immediately breached. If records  are accessible to our patient  then they are accessible under  persuasion, coercion, accident or  theft to all the world.
Every practice has patients  for whom the full knowledge  of their medical records would not be in their best interest.  Even a differential diagnosis of a  temporary mental health  condition  often carries stigma, which in itself  can be harmful to the patient.
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Stoner pushes collaboration for innovation in NSW

Innovate NSW to provide grants to connect startups with researchers and top corporations.
  • Adam Bender (Techworld Australia)
  • 05 April, 2013 10:58
The New South Wales government today launched its $6.7 million Innovate NSW initiative, providing grants and other support to startups.
Through matched grants, Innovate NSW aims to spur collaboration among small to medium enterprises (SMEs), academic researchers, major corporations and end users. The NSW government announced the program in December.
“New South Wales is Australia’s innovation powerhouse,” NSW minister for trade and investment, Andrew Stoner said at a launch event in Sydney this morning. However, when it comes to collaboration the state “still has a considerable way to go,” he said.
…..
Innovate NSW will focus on e-health, advanced manufacturing, energy technology, online and interactive education and transport, logistics and infrastructure. Innovate NSW especially seeks ideas using “enabling technologies” including mobile, cloud, analytics, sensors, advanced materials and biosciences, Stoner said.
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Health-IT early adopters well-poised for big-data advances in clinical medicine

But the majority of US health providers are in smaller practices that have been slow to embrace electronic medical records
Nearly a decade after research firms predicted major cost savings and clinical benefits from the use of health-IT, adoption rates among U.S. medical providers remain sluggish, with the industry slow to embrace the big-data movement.
Electronic health record (EHR) adoption has been fastest at larger, more technology-savvy medical organizations, while smaller practitioners -- which make up the bulk of U.S. clinicians -- have been slow on the health-IT uptake for a variety of reasons, chief among them the cost, but also the training time and effort needed to make the move from paper. Those that don't adopt EHRs by 2015 face decreased government reimbursements for Medicare patients under existing law.
Questions surrounding the effectiveness and financial impact of EHRs were raised in a January report from RAND Corp., which reconsidered its 2005 prediction that health-IT, including EHRs, could save the U.S. approximately US$81 billion annually. The new report on the technology noted that health costs have increased since the 2005 research and called the clinical benefits "mixed."
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Girls' gadget keeps tabs on UV risk

Date April 2, 2013 - 9:40AM

TARYN UTIGER

Prevention is better than a cure when it comes to cancer, and two New Zealand girls have had a bright idea to protect people from the sun.
Danielle Watt and Sarah Mount of Taranaki have created a bracelet with a sensor that changes colour when the wearer needs to apply more sunscreen.
The two 17-year-olds, who both know people suffering from skin cancer, are hoping the invention helps to prevent the disease.
"We call it the Exposure Band. It has a UV monitoring face in it and it alerts you when you need to put more sunscreen on. It's going to be especially great for kids," Miss Watt said.
The wristband, which comes in seven colours and fits children and adults, has been designed by the two New Plymouth Girls' High School students during the past eight weeks.
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Doctors’ letters that have made my day

2 April, 2013 Professor Max Kamien
I have been a doctor for over five decades. During that time I have noticed no change in GPs’ complaints about specialists communications and hospital discharge letters.  
Nor have there been many reports from specialists or hospitals about any improvement in the quality of GP communications to them. But the e-health and the personally controlled electronic health record system, may, in time, render such complaints superfluous.
I can only hope that this abbreviated e-health communication will not stifle the wit and creativity of those GPs and specialists whose words have enlightened my day.  
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Obama offers $100m to map human brain

Date April 4, 2013

Nicky Phillips

Science Reporter

Over the past two centuries, modern science has charted vast quantities of our solar system and constructed detailed models of the invisible particles that make-up the world's matter.
But when it comes to understanding the human brain, a complex machine comprising 100 billion neurons that make trillions of connections, scientists have no map to guide them.
On Tuesday, President Barack Obama announced his ''Brain Initiative'', a bold new plan - with $100 million initial funding - to conquer the human body's most mysterious frontier.
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Medicare Locals to stay? Libs send mixed message

5th Apr 2013
HEALTH Minister Tanya Plibersek has launched an attack on the Opposition after a Liberal candidate appeared to break from Coalition policy by praising Medicare Locals and pledging to keep them if elected.
Shadow health minister Peter Dutton has repeatedly said he would put an end to MLs, saying the 61 new organisations formed from the 110 general practice divisions represent an unnecessary new layer of bureaucracy.
MLs have joined Labor in denying the organisations represent any additional bureaucracy and calling for the Opposition to clarify its position.
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Coalition to end the NBN monopoly

If the Coalition wins this year’s election, two things will happen to the NBN: it will no longer be a monopoly and it will become about half user pays.
I understand one of the key elements of the Coalition’s NBN policy, to be released in a few weeks, is that Telstra will be able to compete with the NBN Co as a wholesale provider of broadband internet access using its hybrid fibre-coaxial (HFC) cable.
Under the current deal between Telstra and the NBN, Telstra is to be paid for migrating customers from both the copper access network and the HFC to the NBN, other than pay TV customers.
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NBN debate full of 'erroneous' information

Date April 4, 2013 - 3:06PM

Trevor Clarke

It is only going to get worse. Ever since it was first announced more than four years ago, the national broadband network has polarised people, including those whose official public comments add considerably to the debate. Some of it is erroneous and misleading, according to the experts. And even then, experts' opinions vary.
IT Pro asked about a dozen Australian academic institutions to compile a list of statements they believe are inaccurate. Three of them responded with the following comments. You might like to add your own in the comments below.
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Healthcare analytics market to exceed $10bn by 2017

Summary: If you've been wondering where the growth is in IT, one area is healthcare. Just one segment alone, healthcare analytics, is projected to grow past $10 billion by 2017.
By Denise Amrich for ZDNet Health | March 31, 2013 -- 22:44 GMT (09:44 AEST)
With all the doom and gloom we've been reading about the PC market recently, many of you may be wondering where, exactly, the growth opportunities are in IT.
Well, wonder no more. The answer is healthcare IT. I've been talking about the growing need for electronic health records for quite some time now, and certainly EHR is a growth market.
But what can you do with all that information? How can we move from gathering information for more effective billing to gathering and processing information for more effective healthcare itself?
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PC market losing more ground to tablets: survey

Date April 5, 2013
Up and up ... 2.4 billion tablets, smartphones and PCs are expected to sell in 2013. Photo: Reuters
Sales of traditional desktop and mobile personal computers are expected to drop 7.6 per cent this year as consumers shift to tablets and other devices, a market tracker says.
The report by the research firm Gartner said all connected devices — PCs, tablets and mobile phones — are on pace to grow nine percent this year to 2.4 billion units, but that the mix is changing.
A proliferation of lower-priced tablets with increased power is accelerating the shift from PCs to tablets, said Gartner analyst Carolina Milanesi on Thursday
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Particle hunter on space station may have found dark matter

Physicists get clue to mysterious matter that may makes up a fourth of the universe
A $2 billion device attached to the outside of the International Space Station has found particles that could be the building blocks of dark matter.
CERN, also known as the European Organization for Nuclear Research, reported today that it is collecting and analyzing data that could offer the first glimpse of dark matter -- mysterious and so-far elusive matter that is thought to make up a quarter of the universe.
Scientists know that dark matter, which neither emits nor absorbs light, is there because of its gravitational influence on the rest of the universe. Beyond that, they know little about what it is.
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Enjoy!
David.

Sunday, April 07, 2013

The Next Federal Budget Is Only Six Weeks Away And The Government Is Looking For Money! What Might This Mean For E-Health?

On Friday, after a month or two of intense speculation in the lead up to the Budget, we saw the Government announce a series of changes to Superannuation for Australians - re-introducing a level of tax on superannuants in retirement (aimed at making about $10B in savings over 10 years) as well as a range of other tweaks.
It seems clear that the Government really wanted to extract a whole lot more and to announce these in the Budget in mid-May but having said (Mr Shorten set the hares running) that they were thinking of changes they made so many people anxious and unhappy with uncertainty they were forced  to move and announce a relatively limited package early.
The structural deficit the Australian budget is now in - caused I would argue as excessive unfunded spending by both sides over the last 10-15 years is - is going to need some seriously smart and doubtless painful pruning. (I hear the size of this deficient is the subject of a forthcoming report from the Parliamentary Budget Office which is due soon.)
Indeed yesterday we were told things are so bad that an actual surplus seems to be unlikely in the next 3-4 years at best - and we are meant to be in boom times from mining. See here:

No Labor surplus in foreseeable future

Laura Tingle and Jacob Greber
Federal cabinet’s expenditure review ­committee sees little chance of a forecast surplus in any of the next four years when Treasurer Wayne Swan releases the federal budget on May 14.
The government gave up any hope of being able to forecast a surplus in 2013-14 some time ago, as revenue collections have failed to meet forecasts.
Senior government sources have now confirmed that there appears little prospect of a surplus in the so-called budget “out years” of 2014-15, 2015-16 and 2016-17.
It will argue that a slump in tax ­collections is behind the failure to return the budget to surplus this financial year or to forecast such a return in the next four years.
It will argue that it would be economically irresponsible to impose savage spending cuts to offset low revenue and get back to surplus in a soft, if improving, economy .
At the same time, it will argue that the budget numbers show it ­continues to exercise spending restraint in the short term, and is finding large long-term structural savings like the superannuation changes, to fund major new spending proposals like the National Disability Insurance Scheme and the Gonski education spending increase.
Lots more here
So what we have is a Government framing what, if the pundits are correct, will be its last budget with some very large spending to lock in and dramatically falling revenue. (Note: I believe if the Liberals win they will equally struggle with this - it will need major surgery.)
Against this we have an e-Health Program which looks unlikely to provide any real benefit - economic or health outcome based - for years to come, if ever.
If I were a betting man - which I am not - I would lay long odds on pretty major cuts to the forward funding for the PCEHR and a range of other supporting programs no matter who is in power.

Medicare Locals may also find themselves struggling fundingwise I suspect.
What do you think?
David