Do have a safe and careful Easter.
David
Thursday, March 28, 2013
Wednesday, March 27, 2013
It Looks Like Telehealth In Chronic Disease May Not Be All That Useful.
This appeared a few days ago.
As "telehealth" grows, experts question cost benefits
Thu, Mar 21 2013
LONDON (Reuters) - Monitoring patients at home using modern technology, so-called 'telehealth', is tipped as the next big thing in healthcare, but a new study by British researchers suggests it may not be worth the extra expense.
The findings will fuel controversy over the economic case for telehealth, which many information technology and telecoms companies are betting on as a multibillion-dollar market opportunity.
Martin Knapp, professor of social policy at the London School of Economics, one of the leaders of the study, said the disappointing results did not mean telehealth was a waste of time but did suggest it needed to be better targeted.
In some cases, smarter technology and a scaling up of programs might help improve the outcome, he added.
"We have got to find ways of better adjusting the equipment to suit the circumstances of the individual patient," he said in an interview. "Just at the moment we don't find the advantage that people had hoped for."
Knapp and colleagues tested the cost-effectiveness of telehealth compared with standard care over 12 months in 965 patients with three long-term conditions: heart failure, chronic obstructive pulmonary disease or diabetes.
Just over half the patients received equipment to allow them to measure things like blood pressure and blood glucose levels at home. They then transmitted their readings electronically to a healthcare professional.
The pay-off, however, was marginal. The researchers found that the cost per quality adjusted life year (QALY) - a standard measure of quantity and quality of life - of telehealth when added to usual care was 92,000 pounds ($139,200).
That is well above the 30,000 pounds that Britain's National Institute for Health and Clinical Excellence (NICE) uses as a benchmark for assessing if medical interventions are worth using on the state-run health service.
Lots more here:
There is also coverage here:
Study: Telehealth not cost effective for chronic patients
March 22, 2013 | By Susan D. Hall
Telehealth failed to produce gains more cost effectively than standard care alone in a new study published at BMJ. That work comes on the heels of previous research in the journal that found telehealth produced no significant improvements in reported quality of life or anxiety or depression symptoms.
Both studies were part of the British government's Whole System Demonstrator Evaluation of telehealth. The latest study tracked 534 patients with heart failure, chronic obstructive pulmonary disease or diabetes who received telehealth services for 12 months along with usual care, and 431 who received usual care alone.
In the telehealth program, patients received equipment that enabled them to take measurements like blood pressure and blood glucose level at home and transmit readings electronically to a healthcare professional, according to Reuters.
Lots more with links and references here:
On a different tack - slightly different technology seems to be useful with early stroke treatment.
Telestroke programs significantly boost care access for rural patients
March 18, 2013 | By Ashley Gold
Researchers from the University of Pennsylvania School of Medicine have found that a telestroke program based in Oregon was able to increase access to stroke care by 40 percent in regions of the Beaver State. Their findings are being presented this week at the American Academy of Neurology's 65th annual meeting in San Diego.
According to an announcement touting the presentation, telemedicine programs in rural parts of Oregon upped the percentage of residents with access to stroke care within one hour from 54.5 percent to 80 percent. The researchers noted that in-person stoke care was crowded in urban areas, and while telestroke care was available in urban centers, it didn't reach less populated, uninsured areas quite as well.
Previous work by the same researchers published in February 2010 found that half of Americans live more than an hour away from lifesaving stroke care.
"Telestroke programs can reach patients in smaller communities and provide time-critical treatment to previously unreached people," senior study author Brendan Carr, an assistant professor of emergency medicine, surgery, & epidemiology at UPenn said. "Increasing telestroke networks gives everyone a better chance of surviving a stroke, the fourth leading cause of death in the United States."
More with links here:
All in all some useful perspectives again on what works and what doesn’t.
David.
Tuesday, March 26, 2013
AusHealthIT Poll Number 160 – Results – 26th March, 2013.
The question was:
Will The Opposition Make E-Health A Major Issue For Attack On The Government In The Health Portfolio Leading Up To The Election?
For Sure 26% (11)
Probably 17% (7)
Possibly 33% (14)
No Way 17% (7)
I Am So Sleepy I Have No Idea 7% (3)
Total votes: 42
Very interesting! A good majority seem convinced there will be some effort to exploit the perceived problems.
Again, many thanks to those that voted!
David.
The Queensland Health Payroll Enquiry Is Certainly A Gift That Keeps On Giving.
Here is the latest instalment.
Qld Health staffer accused of helping IBM
Date March 21, 2013
Petrina Berry
A Queensland Health employee involved in selecting IBM to provide a new payroll system has been accused of helping the IT giant to win the government contract.
Queensland's payroll inquiry is examining emails and meetings between Damon Atzeni, a member of the state's panel involved in the process, and an IBM contractor in the lead-up to the tender process in 2007.
The inquiry's first two weeks have focused on whether IBM had an unfair advantage in winning the contract.
In astounding developments on Thursday, counsel assisting the inquiry, Peter Flanagan SC, accused Mr Atzeni of favouring IBM in replacing the obsolete system.
''You were doing everything in your power to assist IBM to become the prime contractor because you knew that the first rollout of a human resource solution was to be Queensland Health. Yes?," Mr Flanagan asked.
Mr Atzeni denied he had been assisting IBM. However, he said he wanted Queensland Health to be made a priority over other departments because its computer systems needed to be urgently replaced.
Lots more here:
Days prior are linked here:
Read more:
- Former IBM top man showed no bias - Day 6
- Payroll consultant had a 'preconceived view' - Day 5
- Independent consultant a 'long-time IBMer' - Day 4
- Contract signed before payroll system proven to work - Day 3
- IBM not the first choice: payroll inquiry - Day 2
- Queensland Health's payroll inquiry begins - Day 1
I really hope, at some point, we move away from finger pointing and try to form a view of what actually happened so future disasters like this can be avoided.
In circumstances like this there is seldom just one person or one cause for the mess that ultimately emerges. We all need to learn from this while avoiding scapegoats unless clear malfeasance is established. Even then it is unlikely to be the whole cause of the problem. With so many people around the project there must have been many opportunities to sort things out with reasonably competent management.
David.
Monday, March 25, 2013
Weekly Australian Health IT Links – 25th March, 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
Not a very exciting week - other than the amazing goings on in Canberra. We really seem to be a rudderless ship at present. E-Health will hardly benefit from all this.
We see the Qld Payroll Enquiry drag on with blame being spread around all over the place.
Other than that the SA E-Health program seems to be slipping a little, the NBN seems to be becoming very bogged down (again with blame flowing all over) and apparently we have a big push on signing up people to the NEHRS.
My check on my NEHRS this week was uneventful but slow as usual.
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E-health system launch delayed
Date March 20, 2013 - 1:47PM
Trevor Clarke
The launch of the computer system meant to form the foundation of one of the Australia's first e-health record projects has been delayed by several months due to accounting complexity.
South Australia's electronic health record (EHR) was to be one of the first in the national push for electronic patient records, a national project already marred by delays.
SA Health's Enterprise Patient Administration System (EPAS) is made up of clinical, patient administration and billing modules. It was due to go live in the first week of March. It will form one of four projects in a $408 million upgrade of the state organisation's systems.
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2% of Dungog and surrounding area have registered for an eHealth record
21 March 2013. Dungog is a country town on the Williams River in the upper Hunter Region in New South Wales. In early 2013, the Hunter eHealth lead site (one of twelve sites across Australia) targeted the Dungog area to raise awareness of the personally controlled electronic health record (eHealth record) system and the benefits it could offer Dungog residents.
Prior to 1 January 2013, there were only nine consumers registered in the Dungog postcode (2420). Since then nearly 50 additional consumers have registered and if the other postcodes (surrounding areas) covered by this activity are included, then 2% of the local population have now registered with an electronic health record.*
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Flu jab a good time to get on eHealth records
- Peter Foley
- 21st Mar 2013 3:00 AM
WITH one of the worst flu seasons expected to hit us soon, Ipswich Mayor Paul Pisasale is leading the way by getting his flu vaccination.
The West Moreton-Oxley Medicare Local said it was also a good time for Cr Pisasale to sign up for his eHealth record.
eHealth records allow doctors to see what care patients have received, whether they have collected their prescriptions and what course of treatment they have tried in the past, even when they are away on work or holidays.
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PCEHR in for a 'big push' says DOHA Secretary
Posted Wed, 20/03/2013 - 13:57 by Fran Molloy
Launceston residents can register for the PCEHR via trained administrative staff using the new assisted registration tool from this week, with the tool to then be rolled out nationally, Department of Health and Ageing (DOHA) Secretary Ms Jane Halton said today.
The assisted registration tool is one of the final parts of the PCEHR puzzle, now that all major GP software developers have system upgrades to ensure compliance.
"From May this year we are ready for a publicity push on the PCEHR," Ms Halton said.
A slow rollout of the health record had been flagged from the outset, she said, but momentum is building and over 85,000 enrolments have been completed so far.
Of these, around 90 per cent have been done online rather than through a Medicare office or via the Medicare-staffed hotline.
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Qld Health staffer accused of helping IBM
Date March 21, 2013 - 5:04PM
Petrina Berry
A Queensland Health employee involved in selecting IBM to provide a new payroll system has been accused of helping the IT giant to win the government contract.
Queensland's payroll inquiry is examining emails and meetings between Damon Atzeni, a member of the state's panel involved in the process, and an IBM contractor in the lead-up to the tender process in 2007.
The inquiry's first two weeks have focused on whether IBM had an unfair advantage in winning the contract.
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Payroll consultant had 'preconceived view'
Date March 19, 2013
Petrina Berry
A consultant who played a major role in the Queensland government adopting IBM's flawed health payroll system had preconceived views before the tender process, an inquiry has heard.
Queensland's Health Payroll System Commission of Inquiry is looking into whether IBM had an unfair advantage in winning a bid to supply a state government computer system.
The contract included a disastrous payroll system for Queensland Health.
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Payroll inquiry: independent consultant a 'long-time IBMer'
Date March 18, 2013
Petrina Berry
An independent consultant involved in hiring IBM to overhaul the Queensland government's IT systems identified himself as a "long-time IBMer", an inquiry into the health department's payroll debacle has been told.
The Queensland Health Payroll System Commission of Inquiry is looking into whether IBM had an unfair advantage in winning a bid to supply a computer system for the state government, which included Queensland Health.
An email by IBM's public-sector expert Lochlan Bloomfield to fellow IBM workers was presented to the inquiry on Monday.
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Queensland Health payroll at 'point of critical vulnerability'
- by: Rosanne Barrett
- From: The Australian
- March 18, 2013
A PROJECT to roll out a new government IT system across Queensland's public service was costing $45 million every six months without a solution in place, an inquiry has heard.
IT contractor Gary Uhlmann told Queensland's Health Payroll System inquiry hearing this morning the government's own "Shared Services" model was on the verge of failure in 2007.
The Arena Consulting director - a former deputy director-general in the Queensland government - said his company's April 2007 four-week snapshot review of the system revealed it was at a "point of critical vulnerability".
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Sharp increase in online orders for counterfeit pills
- by: Sean Parnell
- From: The Australian
- March 18, 2013
AUSTRALIANS are fuelling the global trade in counterfeit pharmaceuticals, going online to order everything from diet pills to sex aids and putting their health at risk.
The popularity of internet shopping, combined with the high dollar, has led to a dramatic increase in the number of parcels seized by Customs. In 2009-10, only 262 parcels breached the Therapeutic Goods Act, but for the past two years the number has exceeded 700. The seizures -- separate to the rising number of illicit drug detections -- include erectile dysfunction, slimming and tanning drugs. Authorities warn that up to 50 per cent of pharmaceuticals purchased online are fake, and Australian consumers are already reporting the adverse effects of taking unregulated imported drugs.
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Australian FHIR Connectathon and Tutorial
Posted on March 20, 2013 by Grahame Grieve
We’ll be holding a FHIR connectathon here in Australia as part of the IHIC 2013 – International HL7 Interoperability Conference in Sydney in late October 2013 (around 28-30).
This is an opportunity for Australasian implementers and vendors to get practical experience in FHIR. Here’s why you should consider attending:
- Find out what all the excitement is about
- Get a head start building FHIR into your products
- Get a real sense of what FHIR is good for, and what it isn’t
- Help ensure that FHIR meets real-world Australasian requirements
- Be a recognised part of the FHIR community
- Connectathons are real fun
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Get a handle on your health
- by: TECH TIME: DAVID FRITH
- From: The Australian
- March 21, 2013
WHEN Samsung's new Galaxy S4 smartphone hits the Aussie marketplace next month, buyers will be offered a new line of accessories that turn the dog-and-bone into something else.
For instance, there's to be a Game Pad that clamps around the Galaxy handset, turning it into an Xbox controller with dual analog sticks.
Also promised are an S Band waterproof biometric bracelet that tracks how many paces you have walked or run, calories burned, distance travelled and your sleep patterns; S-Health blood pressure and heart rate monitors; and a body scale that relays your weight to the smartphone via Bluetooth wireless technology.
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Software developers pave the way to eHealth records system
12 March 2013. NEHTA is pleased to announce that all vendors from its three Vendor Panels have passed their Notice of Connection testing enabling access to the national Healthcare Identifier Service. In addition, the majority have passed all the Compliance, Conformance and Accreditation (CCA) tests necessary for their first PCEHR-enabled release, and are now finalising this release or working on their second release.
With this complete, there is now widespread availability of software for healthcare providers to connect to the national eHealth record system.
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Comparing Clinical Practice Cuts Hospital Waste
Posted Fri, 15/03/2013 - 14:04 by Fran Molloy
Melbourne Health CEO Dr Gareth Goodier brings extensive experience in heading one of the UK’s leading research hospitals to his new role – and says that understanding expenditure right down to patient level costing is the key to big savings in hospitals.
The Health Service Journal named Dr Goodier one of the UK’s most influential leaders in both 2010 and 2011 for his role of chief executive of Cambridge University Hospitals, which he left in June last year to join Melbourne Health.
Comprising one of the UK’s five academic health science centres as well as two major public hospitals (Addenbrooke and Rosie) and as a leading national centre for specialist treatment, Cambridge University Hospitals form an exceptionally complex institution, Dr Goodier says.
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MMR Global vs. Nehta, Round 2 (US/AU)
March 11, 2013 | |
Ding! The Australian reported last week that Nehta (National E-Health Transition Authority) is defending itself against charges by PHR company MMRGlobal that it has not responded to information earlier requested from and supplied by its operating company MyMedicalRecords and its licensee in Australia.
MMRG is claiming that Nehta’s planned national PHR system will infringe upon patents held in Australia. According to The Australian article, Nehta’s chief Peter Fleming said that they learned of the claims only on 7 February and that MMRG had “nothing solid” to back them up: ”MMRGlobal has never contacted us at all and indeed our understanding is that they’re investigating a potential claim but have nothing solid” and “we’ve obviously taken a look at their patents, both from an architectural and a legal perspective, and have obviously briefed our lawyers to investigate, but certainly this company has not contacted us at all …
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New Zealand streamlines e-health with robotics technology
In a first such project for e-health, New Zealand’s Gore Hospital is rolling out robotics technology to streamline healthcare for home-bound patients and the elderly across remote areas.
Gore Hospital’s chief executive Karl Metzler told FutureGov that one in five New Zealander lives in a rural or remote area. “We’re exploring robotics technology to manage healthcare, and reduce pressures on our medical system.”
Healthcare-oriented robots and software are being piloted for primary, community and aged care. “We want to understand where robots can best provide improved health outcomes, especially for long-term chronic care patients.”
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Iron Man meets HULC: exoskeleton suit coming to a body near you
Date March 20, 2013 - 1:30PM
Thomas Black
Wearable machines that enhance human muscle power are poised to leave the realm of science fiction and help factory workers hoist heavier tools, lighten soldiers' loads and enable spinal patients to walk.
Lockheed Martin and Parker Hannifin are joining a handful of start-ups in finding practical uses and, more importantly, paying customers for bionic suits inspired by novelist Robert Heinlein's 1959 Starship Troopers and Stan Lee's Iron Man comic-book character.
Sales of mechanical exoskeletons cap decades of scientific tinkering that included a 680-kilogram General Electric clunker in the 1960s. Strapped to users' bodies and powered by lithium-ion batteries, the emerging technology has led to some models that sell for about $US70,000, weigh less than 22 kilograms and are nimble enough to dance the Macarena.
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Plibersek accuses Opposition of plan to sack 3000 ML workers
20th Mar 2013
THE rift between Health Minister Tanya Plibersek and shadow health minister Peter Dutton has intensified with Ms Plibersek accusing her opposite number of promising to sack 3000 frontline health workers connected to Medicare Locals (MLs).
Mr Dutton has said a Coalition government would put an end to MLs and yesterday Ms Plibersek said Mr Dutton had repeated in parliament – in comments not recorded by Hansard – that he would sack the 3000 “bureaucrats” who worked for them.
“The truth is the vast majority of staff employed by Medicare Locals are frontline health workers including doctors, nurses, psychologists, podiatrists, pharmacists and speech pathologists,” Ms Plibersek said in a statement.
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Nothing healthy about department of stuff-ups
- by: JUDITH SLOAN
- From: The Australian
- March 16, 2013
HEALTH is an area the Labor Party thinks it owns. According to the polls, Labor has generally been judged the better manager of health (and education) than the Coalition.
One of the worrying recent trends for Labor is that this ascendancy has been significantly whittled away. Labor now holds only a slim lead - down to four points -- as the better manager of health. (The gap for education is five points.) One of the more interesting aspects of government involvement in, and funding of, health is that monumental stuff-ups often go under the radar. There are programs that cost hundreds of millions, even billions, but which never generate the anticipated benefits. In some cases, they never generate any benefits. And then there are the forecasting errors of the Department of Health and Ageing that have led to extreme shortages of doctors followed by extreme surpluses.
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http://www.computerworld.com.au/article/456545/australian_government_releases_big_data_issues_paper/
Australian government releases big data issues paper
AGIMO mulls how to combine government data with publicly available data
- Adam Bender (CIO)
- 18 March, 2013 11:14
The Australian government could tap data from Google, Twitter and Facebook as it seeks to embrace big data, according to an issues paper released Friday evening.
“Private sector organisations such as Google, Twitter and Facebook hold enormous data stores on Australian citizens and people across the world, and offer access to these on commercial terms,” the Australian Government Information Management Office (AGIMO) wrote in the report.
“While needing to carefully consider the veracity of this data, it may be that agencies could consider using this data as part of big data analytics projects.”
Australian Government CIO Glenn Archer announced the big data strategy last week. The release of the issues paper opens a three-week consultation period to collect feedback from industry and the public. A final big data strategy will arrive in June or July this year.
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NBN rollout delayed, again
Date March 21, 2013 - 4:38PM
Lia Timson
IT Pro Editor
Australians will need to wait a little longer for faster and universal broadband, after the company building the NBN again delayed delivery of the project.
NBN Co announced on Thursday afternoon it was revising down its forecast for the rollout of fibre optic cable from the June 2013 target of 341,000 premises to between 190,000 and 220,000 premises. It is the third time the target has been revised.
NBN Co chief executive Mike Quigley said: "We are accountable for the delay and are disappointed it has occurred.
However, he laid the blamed squarely with contractors who he said were responsible for meeting the targets.
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Disconnect on fibre reality
- by: MITCHELL BINGEMANN
- From: The Australian
- March 21, 2013
NEITHER Australia nor the world has seen anything quite like Labor's National Broadband Network. No other government in the world is committing the scale of funding - a cost of $37.4 billion - or attempting to build such a far-reaching fibre network as the one promised by the NBN.
As a vision, there's much to be admired in the mammoth infrastructure project that aims to connect 93 per cent of the nation to a fibre network capable of download speeds as fast as 1000Mbps by 2021.
Its champions, none louder than the project's overseer, Communications Minister Stephen Conroy, tout the NBN as a glistening technological marvel that will revolutionise industries, economies and the way Australians connect with each other and the world.
But in reality the building costs and delivery schedule of the large-scale infrastructure project have departed drastically from the script.
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http://www.smh.com.au/technology/sci-tech/baby-picture-reveals-an-older-universe-20130322-2glfr.html
Baby picture reveals an older universe
Date March 23, 2013
Dennis Overbye
The Planck telescope has excited cosmologists with a more detailed map of the Big Bang afterglow. Dennis Overbye reports.
Astronomers have released the latest and most exquisite baby picture yet of the universe, one that shows it to be 80 million to 100 million years older and a little fatter, with more light and dark matter than previously thought, and perhaps ever so slightly lopsided.
Recorded by the European Space Agency's Planck satellite, the image is a heat map of the cosmos as it appeared only 370,000 years after the Big Bang, showing space speckled with faint spots from which galaxies would grow over billions of years.
The map, the Planck team said, is in stunning agreement with the general view of the universe that has emerged during the past 20 years, of a cosmos dominated by dark energy that is pushing it apart and dark matter that is pulling galaxies together. It also shows a universe that seems to have endured an explosive burp known as inflation, which was the dynamite in the Big Bang.
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BlackBerry inventor to make Star Trek device a reality
Date March 21, 2013
Hugo Miller and Jon Erlichman
Mike Lazaridis, inventor of the BlackBerry smartphone, is starting a $C100 million ($A94 million) quantum technology fund aiming to turn devices like the medical tricorder from Star Trek into reality.
The fund, called Quantum Valley Investments, is being financed exclusively by Lazaridis and Doug Fregin, an old friend and co-founder of Research In Motion (RIM), the company behind BlackBerry. The goal is to commercialise technologies from a cluster of research labs that have been bankrolled by Lazaridis. At least one start-up has signed up with the fund and the first products may emerge in the next two to three years, he said.
"What we're excited about is these little gems coming out," said Lazaridis. "The medical tricorder would be astounding, the whole idea of blood tests, MRIs – imagine if you could do that with a single device. That may be possible and possible only because of the sensitivity, selectivity and resolution we can get from quantum sensors made with these quantum breakthroughs."
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Enjoy!
David.
Sunday, March 24, 2013
There Are Some Real Concerns Around How Citizens Are Being Corralled Into The NEHRS.
I found this a very interesting report a few days after some of the following comments (One alerted us all to it.):
PCEHR in for a 'big push' says DOHA Secretary
Posted Wed, 20/03/2013 - 13:57 by Fran Molloy
Launceston residents can register for the PCEHR via trained administrative staff using the new assisted registration tool from this week, with the tool to then be rolled out nationally, Department of Health and Ageing (DOHA) Secretary Ms Jane Halton said today.
The assisted registration tool is one of the final parts of the PCEHR puzzle, now that all major GP software developers have system upgrades to ensure compliance.
"From May this year we are ready for a publicity push on the PCEHR," Ms Halton said.
A slow rollout of the health record had been flagged from the outset, she said, but momentum is building and over 85,000 enrolments have been completed so far.
Of these, around 90 per cent have been done online rather than through a Medicare office or via the Medicare-staffed hotline.
Ms Halton told health professionals in the audience at the 2013 Health-e-Nation SUMMIT Conference in Melbourne that they needed to "all get out there" and encourage sign-ups.
"Word of mouth is one of the ways people find out about new technology; it takes a while," she said, citing the early adopters of 'brick' mobile phones as the vanguard of today's smartphone-enabled population.
Lots more here:
http://ehealthspace.org/news/pcehr-big-push-says-doha-secretary
As if to cue we then had the following discussion break out.
Terry Hannan said...
This topic has distinct relevance in my local hospital this week. Our corridors are populated by DOHA staff wearing DOHA e-health T-shirts who confront people passing by with the request that "would they like to have their own "secure" electronic record. This is followed by "all you need to do is give us your Medicare Card and your Licence and we will set the record up for you." The initial data is 'transcribed by hand onto an clipboard then entered later on a portable device off site-after a given individual has signed the clipboard form containing their personal information.
When I asked one of the data collection person what they are doing she informed me they were registering the people for their SECURE medical record and that she understands it is secure because "she has been told it is secure"!!! An individual who signs up is then given a small pamphlet to take and read about the e-record. Personally I have a lot of difficulty with this data collection process-not only from patient data security but the real risk of transcription errors in the data recording. On straw polls in this institution ~0% of doctors know what a PCEHR is and for the rest of the staff I am sure the figure is not much more. This whole process seems like a political stunt to enhance the PCEHR registration numbers for a project that has been very costly and doomed to failure-implementation wise and politically.
3/21/2013 08:59:00 AM
Anonymous said...
Think you've nailed it Terry - a pretty cynical bid to boost registration numbers! It's also happening in some GP clinics, where people persuade you to sign up in the waiting room.
Who are these DoHA people - casual staff employed for the "campaign"?
Exactly what information are they collecting and what details are they entering later into the system?
And how many patients thus railroaded will actually go home and look up their record to see what's there, or otherwise make use of the record as intended?
3/21/2013 10:23:00 AM
Anonymous said...
Terry Hannan has highlighted a very disturbing activity which he describes as - a political stunt to enhance the PCEHR registration numbers.
It reeks of a blatant invasion of privacy. To waylay people inside the protected environment of the walls of a public hospital is sickening. Many people are just holding themselves together wrestling with illnesses and deep personal traumas.
To use the credibility and reputation of a trusted public hospital environment in this way is inexcusable. They should join the American Express sales people at the airport terminals if they want to use such enrollment techniques.
Handing out a simple explanatory flyer to people as they pass without interrupting their thoughts is probably still unacceptable in the protected confines of the hospital environment.
Good governance suggests that the Hospital Board should immediately instruct the Hospital Executive to terminate that activity without delay.
3/21/2013 10:30:00 AM
Anonymous said...
I say a PCEHR sign up team in the mall at Bondi junction last week, little desk, big signs. Clearly a broad push all over the place to get numbers up. What is the cost per sign up I wonder? Smells desperate to me.
3/21/2013 11:06:00 AM
Anonymous said...
Yes, there is a big push on...
At CHIK in Melbourne, apparently
http://ehealthspace.org/news/pcehr-big-push-says-doha-secretary
3/21/2013 12:37:00 PM
Anonymous said...
How much (more) is being spent on this PCEHR activity and what funding bucket is this being sustained by?
+$1B and counting.
3/21/2013 06:55:00 PM
Paul Fitzgerald said...
How can accosting complete strangers in a hospital corridor/waiting area and taking their Medicare Number and Driver's Licence not be a breach of Privacy? This is enough to get a stolen ID up and running. Surely the Feds don't have an immunity to the Privacy Laws that we mere Plebs need to follow? And as someone else suggests, at what cost?
3/21/2013 10:10:00 PM
Anonymous said...
But they pretty much are immune...
the bill says: "While each jurisdiction will be legally bound by the arrangements set out, the Crown will not be liable for pecuniary penalties or subject to prosecution for offences. While the Crown cannot be liable to be prosecuted for an offence, or liable for a pecuniary penalty, this does not mean that all action against the Crown is precluded.
"If the Crown in any of its capacities does not comply with its obligations under this bill, other remedies are potentially available. For example, it may be subject to a declaration or injunction, investigated by the Information Commissioner under the Privacy Act, investigated by the Ombudsman, subject to Parliamentary scrutiny or subject to claims for breach of statutory duty.
"Further, while the Crown may have immunity in certain regards, the employees and contractors of the Crown will not necessarily have any such immunity. Finally, nothing in the Bill prevents an individual who suffers loss or damage from seeking to recover that loss or damage from the person who caused it."
From: http://www.theaustralian.com.au/australian-it/government/personally-controlled-electronic-health-record-system-coming/story-fn4htb9o-1226203867730
3/22/2013 09:16:00 AM
Anonymous said...
Unbelievable - what will they stoop to next?
So just how "secure" is the data of the poor, sick individual who has been bullied into giving it to some bureaucratic types with clipboards in a hospital corridor?
What happens to it between the time it is captured on the clipboard and entered on a PC or iPad or whatever? Can't wait for the first time a clipboard full of personally identifiable information is stolen, lost, left in a taxi etc. How is Ms Halton going to explain that away?
Don't seem to remember this registration method being in any of the previous "design" briefs......
3/22/2013 05:29:00 PM
Our commenters have provided a rich set of comments to all this - thanks team!
The one that really worries me is the power imbalance between the hospitalised patient and the ‘clip-board wielding’ bureaucrat. What should happen is that the hospital patient be given a brochure and once at home and feeling better they should then consider if the NEHRS is for them. Anything else is just unfairly coercive in my view.
There is also this obvious issue that we have paid bureaucrats - who clearly must be paid for their time, wandering about doing all this recruiting. Or worse we have caring staff who have better and more useful things to do being diverted from their primary task. All this is happening when no one has seen any business case or evidence that the system will make the least difference to real world clinical outcomes.
I will leave it to others to comment on the obvious privacy and security implications of all this. Someone really needs to ask the Privacy Commissioner to have a close look at how this is all being done.
All this is not to ignore the great work being done in Dungog where 2% of the population have signed up for the NEHRS. What you are not told is the population of Dungog is a massive 2102 souls - so 40-45 people have signed up.
http://en.wikipedia.org/wiki/Dungog
Here is the NEHTA headline:
http://www.nehta.gov.au/media-centre/nehta-news/1013-2-of-dungog-and-surrounding-area-have-registered-for-an-ehealth-record
And this is what the NEHTA Benefits and Evaluation Team spend their time doing.
Sorry but WTF!
David.
PCEHR in for a 'big push' says DOHA Secretary
Posted Wed, 20/03/2013 - 13:57 by Fran Molloy
Launceston residents can register for the PCEHR via trained administrative staff using the new assisted registration tool from this week, with the tool to then be rolled out nationally, Department of Health and Ageing (DOHA) Secretary Ms Jane Halton said today.
The assisted registration tool is one of the final parts of the PCEHR puzzle, now that all major GP software developers have system upgrades to ensure compliance.
"From May this year we are ready for a publicity push on the PCEHR," Ms Halton said.
A slow rollout of the health record had been flagged from the outset, she said, but momentum is building and over 85,000 enrolments have been completed so far.
Of these, around 90 per cent have been done online rather than through a Medicare office or via the Medicare-staffed hotline.
Ms Halton told health professionals in the audience at the 2013 Health-e-Nation SUMMIT Conference in Melbourne that they needed to "all get out there" and encourage sign-ups.
"Word of mouth is one of the ways people find out about new technology; it takes a while," she said, citing the early adopters of 'brick' mobile phones as the vanguard of today's smartphone-enabled population.
Lots more here:
http://ehealthspace.org/news/pcehr-big-push-says-doha-secretary
As if to cue we then had the following discussion break out.
Terry Hannan said...
This topic has distinct relevance in my local hospital this week. Our corridors are populated by DOHA staff wearing DOHA e-health T-shirts who confront people passing by with the request that "would they like to have their own "secure" electronic record. This is followed by "all you need to do is give us your Medicare Card and your Licence and we will set the record up for you." The initial data is 'transcribed by hand onto an clipboard then entered later on a portable device off site-after a given individual has signed the clipboard form containing their personal information.
When I asked one of the data collection person what they are doing she informed me they were registering the people for their SECURE medical record and that she understands it is secure because "she has been told it is secure"!!! An individual who signs up is then given a small pamphlet to take and read about the e-record. Personally I have a lot of difficulty with this data collection process-not only from patient data security but the real risk of transcription errors in the data recording. On straw polls in this institution ~0% of doctors know what a PCEHR is and for the rest of the staff I am sure the figure is not much more. This whole process seems like a political stunt to enhance the PCEHR registration numbers for a project that has been very costly and doomed to failure-implementation wise and politically.
3/21/2013 08:59:00 AM
Anonymous said...
Think you've nailed it Terry - a pretty cynical bid to boost registration numbers! It's also happening in some GP clinics, where people persuade you to sign up in the waiting room.
Who are these DoHA people - casual staff employed for the "campaign"?
Exactly what information are they collecting and what details are they entering later into the system?
And how many patients thus railroaded will actually go home and look up their record to see what's there, or otherwise make use of the record as intended?
3/21/2013 10:23:00 AM
Anonymous said...
Terry Hannan has highlighted a very disturbing activity which he describes as - a political stunt to enhance the PCEHR registration numbers.
It reeks of a blatant invasion of privacy. To waylay people inside the protected environment of the walls of a public hospital is sickening. Many people are just holding themselves together wrestling with illnesses and deep personal traumas.
To use the credibility and reputation of a trusted public hospital environment in this way is inexcusable. They should join the American Express sales people at the airport terminals if they want to use such enrollment techniques.
Handing out a simple explanatory flyer to people as they pass without interrupting their thoughts is probably still unacceptable in the protected confines of the hospital environment.
Good governance suggests that the Hospital Board should immediately instruct the Hospital Executive to terminate that activity without delay.
3/21/2013 10:30:00 AM
Anonymous said...
I say a PCEHR sign up team in the mall at Bondi junction last week, little desk, big signs. Clearly a broad push all over the place to get numbers up. What is the cost per sign up I wonder? Smells desperate to me.
3/21/2013 11:06:00 AM
Anonymous said...
Yes, there is a big push on...
At CHIK in Melbourne, apparently
http://ehealthspace.org/news/pcehr-big-push-says-doha-secretary
3/21/2013 12:37:00 PM
Anonymous said...
How much (more) is being spent on this PCEHR activity and what funding bucket is this being sustained by?
+$1B and counting.
3/21/2013 06:55:00 PM
Paul Fitzgerald said...
How can accosting complete strangers in a hospital corridor/waiting area and taking their Medicare Number and Driver's Licence not be a breach of Privacy? This is enough to get a stolen ID up and running. Surely the Feds don't have an immunity to the Privacy Laws that we mere Plebs need to follow? And as someone else suggests, at what cost?
3/21/2013 10:10:00 PM
Anonymous said...
But they pretty much are immune...
the bill says: "While each jurisdiction will be legally bound by the arrangements set out, the Crown will not be liable for pecuniary penalties or subject to prosecution for offences. While the Crown cannot be liable to be prosecuted for an offence, or liable for a pecuniary penalty, this does not mean that all action against the Crown is precluded.
"If the Crown in any of its capacities does not comply with its obligations under this bill, other remedies are potentially available. For example, it may be subject to a declaration or injunction, investigated by the Information Commissioner under the Privacy Act, investigated by the Ombudsman, subject to Parliamentary scrutiny or subject to claims for breach of statutory duty.
"Further, while the Crown may have immunity in certain regards, the employees and contractors of the Crown will not necessarily have any such immunity. Finally, nothing in the Bill prevents an individual who suffers loss or damage from seeking to recover that loss or damage from the person who caused it."
From: http://www.theaustralian.com.au/australian-it/government/personally-controlled-electronic-health-record-system-coming/story-fn4htb9o-1226203867730
3/22/2013 09:16:00 AM
Anonymous said...
Unbelievable - what will they stoop to next?
So just how "secure" is the data of the poor, sick individual who has been bullied into giving it to some bureaucratic types with clipboards in a hospital corridor?
What happens to it between the time it is captured on the clipboard and entered on a PC or iPad or whatever? Can't wait for the first time a clipboard full of personally identifiable information is stolen, lost, left in a taxi etc. How is Ms Halton going to explain that away?
Don't seem to remember this registration method being in any of the previous "design" briefs......
3/22/2013 05:29:00 PM
Our commenters have provided a rich set of comments to all this - thanks team!
The one that really worries me is the power imbalance between the hospitalised patient and the ‘clip-board wielding’ bureaucrat. What should happen is that the hospital patient be given a brochure and once at home and feeling better they should then consider if the NEHRS is for them. Anything else is just unfairly coercive in my view.
There is also this obvious issue that we have paid bureaucrats - who clearly must be paid for their time, wandering about doing all this recruiting. Or worse we have caring staff who have better and more useful things to do being diverted from their primary task. All this is happening when no one has seen any business case or evidence that the system will make the least difference to real world clinical outcomes.
I will leave it to others to comment on the obvious privacy and security implications of all this. Someone really needs to ask the Privacy Commissioner to have a close look at how this is all being done.
All this is not to ignore the great work being done in Dungog where 2% of the population have signed up for the NEHRS. What you are not told is the population of Dungog is a massive 2102 souls - so 40-45 people have signed up.
http://en.wikipedia.org/wiki/Dungog
Here is the NEHTA headline:
2% of Dungog and surrounding area have registered for an eHealth record
Here is the link:http://www.nehta.gov.au/media-centre/nehta-news/1013-2-of-dungog-and-surrounding-area-have-registered-for-an-ehealth-record
And this is what the NEHTA Benefits and Evaluation Team spend their time doing.
Sorry but WTF!
David.
Saturday, March 23, 2013
Weekly Overseas Health IT Links - 23rd March, 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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EHR incentive payments top $12 billion
By Mary Mosquera, Senior Editor
Created 03/15/2013
With some healthcare providers now into their second year of meaningful use reporting, Medicare and Medicaid electronic health record payments were estimated at $12.3 billion paid to a total of 219,000 physicians and hospitals through February since the program’s inception.
The Centers for Medicare & Medicaid Services will post final figures for February later this month as it captures more complete data, said Robert Anthony, a specialist in CMS’ Office of eHealth Standards and Services at Thursday’s Health IT Policy Committee meeting, which was broadcast live.
In February, 27,500 Medicare physicians received $425 million; 5,500 Medicaid clinicians and eligible professionals, $100 million; and 90 hospitals in either program, $200 million, for a total of $725 million to 33,090 providers.
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Report: 1.7B to download health apps by 2017
Mobile industry analysts Research2Guidance have come out with a new report on health apps, predicting that in 2017, worldwide mobile health market revenue will total $26 billion.
The report categorizes the mobile health market as growing in three phases: an initial trial phase, a commercialization phase, and an integration phase. We are currently in the second phase, the report said, which is “characterized by a massive increase of offered solutions, the creation of new business models and the concentration on private, health-interested people, patients and corporations as major target groups.”
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Software updates can be hazardous to a health IT system's health
March 15, 2013 | By Mike Bassett
A study published online in the Journal of the American Medical Informatics Association demonstrates how a simple software update can create unintended consequences that can have an adverse impact on patient care.
Doctors from Boston's Brigham and Women's Hospital in Boston, led by Adam Landman, M.D., were inspired to explore the problem when the hospital's information systems help desk was inundated with calls from physicians who could no longer access a web-based image viewer from the emergency department's tracking board.
The link from the ED tracking to the web-based image viewer was lost on workstations running Microsoft Explorer 6. It turned out the cause was a security update Microsoft had released days earlier.
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With e-prescribing, doctors choose cheaper drugs
March 15, 2013 | By Susan D. Hall
Physicians who have electronic access to their patients' formularies, including copays, are more likely to prescribe a less-expensive drug for Type 2 diabetes and hypertension, according to a survey from research and advisory firm Decision Resources.
Seventy primary care physicians, 70 endocrinologists, and 25 managed-care organization (MCO) pharmacy directors were polled for the report "E-Prescribing and Electronic Health Records: Impact of Technology on Prescribing for Hypertension and Diabetes."
"Physicians are now more acutely aware of MCOs' formularies and are therefore more likely to prescribe more favorably reimbursed drugs as well as better identify undiagnosed patients, sharply impacting their prescribing decisions for diabetes and hypertension therapies," the report states.
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EHR implementation in Malawi brings additional challenges
March 13, 2013 | By Susan D. Hall
Implementing an electronic medical records system in Malawi included the usual challenges, such as having tech staff available, selling clinicians on its value and training them to use it. But there were additional challenges, including power outages, low computer literacy in some areas and co-existing with a paper-based system, according to a new study published in PLOS Medicine.
According to researchers, an open source records system--Surveillance Programme of IN-patients and Epidemiology or SPINE--was installed at a major referral hospital, Queen Elizabeth Central Hospital, in the African nation. With the high rate of HIV infection, readmission is common. Fifteen percent of those admitted died in the hospital.
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EHR use puts physicians between a rock and a hard place
March 14, 2013 | By Marla Durben Hirsch
The electronic health record landscape is pretty gloomy for physicians these days. For every report that says that physicians are adopting EHRs in record numbers, there seems to be one that relates to a problem with EHR adoption. Only 12 percent of physicians have attained Meaningful Use. Physician practices continue to suffer from usability and financial woes in making the transition. They suffer increased muscle strain when using the tools. Physicians who use EHRs are even perceived by some patients as less capable.
And now a study published this month in Health Affairs says that EHRs are not worth the investment for physicians, with the average physician losing nearly $44,000 over five years and just a fourth of practices seeing a five year positive return on investment. This study blames physicians for the losses for not changing their operations to take advantage of the benefits that EHRs offer. For instance, almost half of the physicians examined didn't obtain savings in part because they were still using paper records; many weren't using their EHRs to increase revenue, according to the study.
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New disease registry puts patients in control of data
March 14, 2013 | By Susan D. Hall
A new disease registry aims to line up more people for clinical trials by giving patients ultimate control over the use of their information.The website--dubbed Reg4All--is the brainchild of Genetic Alliance, a nonprofit that advocates for people with rare genetic disorders. It will launch April 4, reports Technology Review.
"The usual way of recruiting people is astoundingly bad," Sharon Terry, president and CEO of Genetic Alliance, told Technology Review. The consent forms used by many current biobanks and DNA databases give participants little control over the data.
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Debunking the Top 10 I.T. Usability Myths
MAR 12, 2013 11:58am ET
The usability of health and other information technology systems has long been a challenge.
And there are a number of common misconceptions as to why the problem persists, according to Nancy Staggers, RN, a professor of Informatics at the University of Maryland’s School of Nursing, and Lorraine Chapman, Director of Use Experience Research at Macadamian Technologies, a user experience design and software development firm that does work in the health care field.
But if the IT community is going to solve its usability issues, it must first acknowledge, and then dispel, these wrongly held beliefs. As a first step in that process, Staggers and Chapman at HIMSS13 presented a list of the top 10 usability myths:
Myth No. 1: Clinicians are uncomfortable with technology
Vendors often say there is nothing wrong with their systems that more training can’t fix. But the reality, said Chapman, is that doctors and other health care providers like technology, they just don’t like processes that hinder their job performance.
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Thursday, March 14, 2013
Security Questions Loom as Health Care Takes on Analytics
by John Moore, iHealthBeat Contributing Reporter
"Big Data" analytics projects have arrived in the health care space and so too have security and privacy concerns.
Enterprises in a range of markets now build analytics platforms in hopes of finding useful and actionable information hidden in their vast data stores. Those systems generally consist of a central data repository, tools for moving data into that repository and a front-end component that lets users work with the data and generate reports.
In health care, the growing use of electronic health records means that many organizations have more data to work with than ever before. Hospital networks and academic medical centers may use analytics platforms to yield insight into how to improve patient care or make better decisions regarding disease outbreaks.
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Four Ways to Make Your Company More Secure
Rachael King
Reporter
Cybersecurity is now a national threat on a par with terrorism, according to top U.S. intelligence officials.
While the Obama administration is ramping up warnings regarding cybersecurity, such warnings only “admire the problem.” They don’t do much to actually mitigate future attacks on businesses, said Alan Paller, founder of cybersecurity research and education organization SANS Institute, speaking at the RSA Conference in February. For companies that want to dig into the real work of increasing security, Paller suggests starting with some critical tasks. Those include creating an inventory of hardware and software on the network, creating secure configurations for hardware and software and quickly repairing newly discovered software vulnerabilities.
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Docs Urged to Be Patient with EHRs
By Kathleen Struck, Senior Editor, MedPage Today
Published: March 13, 2013
Electronic health records (EHRs), although they may be frustrating now, will become more than just legible medical records and will provide more robust tools for improving patient care, predicts an information technology expert.
"Improvements in the documentation process hold promise for more than simply efficient data entry and legible notes," wrote James J. Cimino, MD, in a Viewpoint article published online in the Journal of American Medical Association. "If impressions and plans can be captured within EHRs as explicit data elements, using standard terminology rather than being buried in the narrative text of a note, clinicians could use this information to better support clinical workflow."
Furthermore, a "problem or diagnosis entered in this way could allow an EHR to provide a suggested list of appropriate tests and treatments, based on best available evidence," wrote Cimino, chief of Laboratory for Informatics Development at the National Institutes of Health Clinical Center in Bethesda, Md.
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Tiger Team aims to remove HIE barriers
By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT
Created 03/13/2013
The day before the ONC’s privacy and security subcommittee met to discuss policy recommendations for health information exchange query and response issues, Epic Systems CEO and subcommittee member Judy Faulkner got an email from a doctor in Madison, Wisconsin.
“I have a patient who moved to Chicago,” the doctor said, as Faulkner recounted at the subcommittee Tuesday. “She needs a bladder biopsy at Northwestern, which as you know is on Epic. She wanted me to look at the records, but I couldn’t unless she came to Madison and signed a release.”
That’s the protocol Northwestern Memorial Hospital has been using, not necessarily the norm. “Everybody can set it up in different ways,” Faulkner said.
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UCLA, IBM team to use big data to prevent brain swelling
March 13, 2013 | By Mike Bassett
Researchers at the University of California Los Angeles are using an experimental software system that uses big data analytics to test the effectiveness of a real-time alarm designed to predict the development of brain swelling in trauma cases.
The system--the result of a partnership between physicians in the UCLA Department of Neurosurgery and IBM and Excel Medical Electronics--analyzes in real time the vital signs obtained from a patient's bedside monitor in order to detect changes in the patient's pulse, blood and intracranial pressure, heart activity and respiration.
Current alarm systems are designed to alert caregivers when these vital signs pass a critical threshold, forcing physicians into action if the condition is considered to be life threatening or could cause brain damage.
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Lack of healthcare IT workers slows tech progress
Tech workers skilled in informatics are the most-sought
Lucas Mearian
The U.S. healthcare industry is facing an even more significant IT worker shortage than previously thought, and that shortage is slowing efforts to roll out electronic health systems.
A new analysis by PricewaterhouseCoopers (PwC) Health Research Institute showed that the shortage of health IT (HIT) workers has healthcare providers scrambling to fill the talent void by recruiting technology specialists from other industries.
The PwC report cited a recent survey by the College of Health Information Management Executives (CHIME) that showed 67% of healthcare CIOs are experiencing IT staff shortages, up from 59% in 2010.
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Health IT worker shortage looms
By Bernie Monegain, Editor
Created 03/12/2013
A significant and growing shortage of health information technology workers appears greater than previously estimated, according to a new analysis by PwC's Health Research Institute. The report, Solving the talent equation for health IT, finds that the healthcare industry is vying for a limited number of IT professionals - and many companies are scrambling to fill the talent void by recruiting technology specialists from other industries.
"The challenge for healthcare is not just a shortage of people with technical skills. It's also a shortage of people with the skills to marry technological savvy with business strategy as healthcare becomes more connected, coordinated and accountable," said Daniel Garrett, principal and PwC's Health Information Technology practice leader, in a news release. "Despite billions of dollars spent investing in HIT, the lack of qualified professionals could slow progress toward quality and efficiency. The benefits of HIT will not be realized until organizations can ensure information is unlocked and integrated in a way to best inform critical business and clinical decision-making."
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Cloud gets high marks on security
By Bernie Monegain, Editor
Created 03/12/2013
With an average satisfaction score of 4.5 out of 5 on security, cloud users feel safe. Non-cloud users though remain at bay-particularly with many questions still looming around the future of cloud computing in healthcare. The conclusions are from a recent report from research firm KLAS.
Cloud Computing Perception 2013: The Hybrid Cloud in Healthcare looks at the evolution of the cloud in healthcare, provider concerns, as well as vendor performance.
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Tele-ICU guidelines developed for critical care nurses
March 12, 2013 | By Dan Bowman
As more and more hospitals turn to remote intensive care units to boost care for critical patients, provider roles will need to be clearly defined to ensure quality and safety. With that in mind, the American Association of Critical-Care Nurses just unveiled a new document outlining practice guidelines specifically geared toward tele-ICU nurses.
The document, meant to serve as a "framework" for the practice of tele-ICU nursing, outlines three guidelines, including:
- Establishing an environment that promotes effective communication, collaboration, and collegiality
- Demonstrating proficiency in specific knowledge, skills, and competencies to contribute to patient outcomes
- Engaging in measuring and analyzing outcomes to ensure ongoing improvement in patient care and tele-ICU nurses' contribution to care.
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Survey: EHR Satisfaction Declines Steadily
March 11, 2013 by Gabriel Perna
According to a survey from the American College of Physicians (ACP), user satisfaction of electronic health records (EHRs) has decreased steadily since 2010. The study, from 4,279 responses to multiple surveys developed and analyzed by ACP and AmericanEHR Partners, found that user satisfaction has fallen 12 percent from 2010 to 2012, while the number of those who say they are “very dissatisfied” has increased 10 percent during the same time period.
“Dissatisfaction is increasing regardless of practice type or EHR system,” Michael S. Barr, M.D., head of ACP’s medical practice, professionalism & quality division, said in a statement. “These findings highlight the need for the Meaningful Use program and EHR manufacturers to focus on improving EHR features and usability to help reduce inefficient work flows, improve error rates and patient care, and for practices to recognize the importance of ongoing training at all stages of EHR adoption.”
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March 11, 2013
Royal Philips Electronics Unveils Graphical Dashboard to Expand its eICU Telehealth Services
Royal Philips Electronics, a diversified well-being and health company, has launched its advanced IntelliSpace eCareManager 3.9 health care platform that is powered by orb.
Philips unveiled its latest offering at the Healthcare Information and Management Systems Society (HIMSS) 2013 exhibition and conference. Philips included its latest offering, orb, in its eICU program, which is an advanced graphical dashboard that is certified by over 100 clinical rules to efficiently analyze, visualize, and process clinical data in real time. At the same time, it has the ability to tell precisely about what is happening with a particular patient and in a more vivid, “visually digestible form.”
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GPSoC to mandate online patient access
7 March 2013 Rebecca Todd
The IT necessary to provide patients with online access to their GP records needs to be mandated via the GP Systems of Choice contract, a new report states.
The government has made a commitment that by 2015 all patients will have secure online access to their GP record if they want it.
All practices must also make transactional services available online such as booking appointments and ordering repeat prescriptions.
The government asked the Royal College of GPs to lead on the development of guidance to make this goal a reality.
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Cerner and TPP show NHS Blue Button
11 March 2013 Jon Hoeksma
The NHS looks set to copy the hugely successful US Blue Button initiative, which enables patients to very easily download their electronic records by pressing an eponymous online blue button.
EHealth Insider can exclusively reveal that the NHS Commissioning Board will demonstrate a UK implementation of Blue Button this week.
The pilot, involving patient downloads of records from TPP for primary care and Cerner for secondary care, will be showcased at this week’s NHS Innovation Expo.
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Informatics Pioneer Says Healthcare Needs Better Systems
Dr. Lawrence Weed continues his longstanding advocacy for computer-aided healthcare and revamping medical education.
By Neil Versel, InformationWeek
March 11, 2013
URL: http://www.informationweek.com/healthcare/leadership/informatics-pioneer-says-healthcare-need/240150506
March 11, 2013
URL: http://www.informationweek.com/healthcare/leadership/informatics-pioneer-says-healthcare-need/240150506
Numerous reports have shown that the medical profession is responsible for hundreds of thousands of preventable deaths a year, according to medical informatics pioneer Dr. Lawrence L. Weed.
"Where's the outrage? You get one plane crashing and it's on the evening news for days. Well, there's no outrage. No one's investigating it," Weed said during a rare appearance at the Healthcare Information and Management Systems Society (HIMSS) last week in New Orleans. 
Weed, 89, has been advocating -- often to deaf ears -- for the computerization of healthcare because he strongly believes the human mind simply is not capable of remembering every nuance of medicine and disease without assistance from what we now know as clinical decision support systems.
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HIMSS Review: Technology Priorities and Realities
Scott Mace, for HealthLeaders Media , March 12, 2013
Another HIMSS conference is history. The technology cart, however, may be getting ahead of the horse. Everywhere I turned, vendors touted their technology solutions to transform existing healthcare providers into ACOs. Many of these solutions tackle the worthy challenge of correlating claims data coming from payers with clinical data coming from providers, in an effort to create longitudinal records of care for any patient who walks through the provider's doors. In this way, providers will catch comorbidities they are missing today, eliminate duplicative tests, reduce readmissions, and increase patient satisfaction, all in one fell swoop.
At least, that's the theory. But wait—if the brave new technology future is at hand, why are the Pioneer ACOs petitioning CMS to ease up on demanding early results?
I think I now understand why the pioneers are freaking out.
The ACO concept only works if health information exchange between providers is mature enough to handle what the ACOs require. And I'm here to report that health information exchange still has a long way to go.
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Intermountain takes on readmissions
By Bernie Monegain, Editor
Created 03/11/2013
Researchers at the Intermountain Heart Institute at Intermountain Medical Center have developed a tool designed to eliminate 30-day hospital readmissions for heart failure patients and improve the quality of medical care a patient receives in the hospital, Intermountain announced March 9.
The tool, known as the IMRS-HF, was adapted from the Intermountain Risk Score that has been used at Intermountain Medical Center to predict mortality rates in trauma patients.
Heart researchers discovered that by using the IMRS-HF, they could more accurately evaluate a patient’s condition prior to discharge, and ensure there is less risk of the patient being readmitted for the same condition within 30 days.
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Mostashari: 3 interoperability questions
By Bernie Monegain, Editor
Created 03/11/2013
Interoperability was one of the most talked about topics throughout HIMSS 2013 Annual Conference and Exhibition last week. The Interoperability Showcase proved to be as popular as ever with many use cases on display, recurring tours and speakers slated every half hour. There was also the recent announcement that interoperability testing would occur year-round at HIMSS Innovation Center in Cleveland. At the conference, six EHR vendors staged a news conference to spotlight their commitment to interoperability with the formation of the CommonWell Health Alliance.
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The HIT Approach to Big Data
MAR 1, 2013
Like "The Cloud" last year or "Mobile Apps" the year before, it's the I.T. catchphrase that's considered so big it's deemed worthy of double capitalization. Computers are capturing stray scraps of information on everyone's medical conditions, shopping habits, driving records, and weekend partying patterns; data architects in every business are struggling with how to put it all together to answer big questions.
No business has bigger questions than health care, which is being pressured as never before to provide better care to more people at lower cost.
But what the heck is Big Data? What makes it different from the small data that populates spreadsheets on so many departmental desktop PCs? "Volume, velocity, variety," says Elizabeth McGlynn, director of the Kaiser Permanente Center for Effectiveness and Safety Research. Kaiser, with 9 million members in eight regions, has the volume: 30 petabytes of patient data, which McGlynn says is more than three times the amount of digitized storage at the Library of Congress.
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EHR dissatisfaction on the rise
March 11, 2013 | By Susan D. Hall
We've known that many providers are unhappy with their electronic health record systems, but the level of dissatisfaction appears to be growing, according to a survey by the American College of Physicians and AmericanEHR Partners, web-based resource for EHR system selection and implementation.
Overall, user satisfaction dropped by 12 percentage points between 2010 and 2012 and the "very dissatisfied" group grew by 10 percentage points.
The findings represent 4,279 responses to multiple surveys developed by ACP and AmericanEHR Partners between March 2010 and December 2012. The surveys were conducted in conjunction with 10 different professional societies. Seventy-one percent of respondents were in practices with 10 physicians or fewer, according to an ACP announcement.
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82% of Physicians Want Patients to Update Their Own EHRs, But Few Want Them to Have Full Access
March 08, 2013
A new survey, by Accenture, shows that a majority of U.S. physicians want patients to participate in their own healthcare by updating their electronic health records, but only a few of them believe that a patient should have full access to his or her EHR.
Accenture surveyed 3,700 physicians in eight countries: Australia, Canada, England, France, Germany, Singapore, Spain and the United States.
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Monday, March 11, 2013
A Fork in the Road at HIMSS13: How Patients & Payment Are Forcing 'Open' Health IT
by Jane Sarasohn-Kahn
At the recently concluded annual Healthcare Information and Management Systems Society conference in New Orleans, 34,696 got to experience a yin and yang vibe that embodies the disruption that the health care IT industry is undergoing. That is, the full-on face-off between developers of health IT that have been long-closed to data liquidity and those vendors innovating on open standards and cloud-based platforms.
The culmination of this was the announcement of the not-for-profit organization called the CommonWell Alliance, an affiliation of six health IT vendors who are planning to adopt, promote and certify standards for interoperable health information. The first vendors committing to the CommonWell pledge were Allscripts, athenahealth, Cerner, Greenway, McKesson and RelayHealth.
The group's press release stated that "this historic effort is aimed at improving the quality of care delivery while working to lower costs for care providers, patients and the industry as a whole." While an announcement doesn't equal outcomes at this early stage, it was a signal that the times, they are a'changin, especially with the name "Cerner" attached to the project.
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Home care, tele-medicine cut health costs
Florida programs reduce unnecessary hospital stays
By William E. Gibson, Washington Bureau
6:54 a.m. EDT, March 11, 2013
WASHINGTON—
To understand how the health-care system sometimes fails patients and often wastes money, consider the case of a South Florida nursing-home patient who developed a cough and slight fever.
"The nurse notifies the doctor, who doesn't get much information and says, 'Send her to the emergency room,'" recounts Joseph Ouslander, associate dean for geriatric programs at Florida Atlantic University. "She has tests in the emergency room, some of which are falsely positive, and is admitted unnecessarily to the hospital, where she gets acute confusion and breaks her hip.
"It happens every day: An episode that could have cost Medicare a couple hundred bucks turns into one that costs closer to $20,000. So you are creating human misery, and you're spending money."
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Enjoy!
David.
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