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."

Sunday, October 11, 2009

Useful and Interesting Health IT News from the Last Week – 11/10/2009.

The Australian E-Health Press provided a good serve this week. It included these:

First we have:

Rushing to hospital? Don't forget medicines

DANNY ROSE

October 5, 2009

IF YOUR loved one is about to be rushed off in an ambulance, research shows there is something you can do to cut the risk of them facing a ''prescribing error'' in hospital.

An Australian study has shown that patients are better off carrying their prescription medications with them to the emergency department.

Having the drug packets on hand led to fewer errors in the recording of a patient's medication history and also reduced the chances of a patient receiving the wrong drug or dose errors during their hospital stay.

''Bringing a patient's own medication to the emergency department was associated with less than half as many prescribing errors on admission medication charts,'' said pharmacist and PhD candidate Esther Chan. Ms Chan and fellow researchers studied the cases of 100 patients admitted to Melbourne's Austin Hospital during a month in 2006.

They counted 428 different medications that arrived with the patients, and a 13 per cent error rate occurred when it came to their recording or ongoing delivery. The patients were also taking a total of 372 medications that they didn't carry with them - resulting in a prescription error rate of 25 per cent.

More here:

http://www.theage.com.au/national/rushing-to-hospital-dont-forget-medicines-20091004-ghwt.html

The level of error makes it clear just the level of impact accessible electronic records for the patients could provide.

The full paper can be found here:

http://www.mja.com.au/public/issues/191_07_051009/cha11452_fm.html

Second we have:

Beacon website shines light on e-health

October 7, 2009 - 12:04AM

The stresses of managing a budding acting career and her Year 12 studies is something Home and Away's Samara Weaving knows a little about.

The young star has helped launch a groundbreaking website which will help guide people, young and old, through the myriad of mental and physical e-health applications now available online.

The Beacon web portal, developed by a team at the Australian National University, is a world-first compilation of online mental and physical e-health programs.

Not only does it provide access to e-health programs for health professionals and members of the community, the site also provides a description and scientific rating of the effectiveness for each.

Weaving says she was happy to lend her support to the launch, adding that for her and others of her generation, the internet is where they get a lot of their information.

More here:

http://news.brisbanetimes.com.au/breaking-news-national/beacon-website-shines-light-on-ehealth-20091007-gljn.html

The portal is found here:

http://www.beacon.anu.edu.au/

This is a great idea – pity the press reports did not mention the link

This page explains the program well.

http://www.beacon.anu.edu.au/users/about

Third we have:

E-therapy moves in on the shrink's couch

ADELE HORIN

October 7, 2009

INTERNET therapy programs for depression and anxiety can be twice as effective as seeing a psychologist or psychiatrist in person, studies show.

A series of internet programs delivered to more than 1000 people appears to have produced better results than gained by seeing a specialist at one of the country's best mental health clinics, and much better results than reported in the scientific literature.

''We're doing something unnerving,'' said Gavin Andrews, professor of psychiatry at the University of NSW, and the director of the Clinical Research Unit for Anxiety and Depression at St Vincent's Hospital. He joked about ''the end of psychiatry as we know it''.

The apparent success of the programs poses fundamental questions for professionals for whom the patient-therapist relationship is considered integral to treatment.

More here:

http://www.smh.com.au/technology/etherapy-moves-in-on-the-shrinks-couch-20091006-glfb.html

More real world commentary on the mental health side of the portal cited above.

Fourth we have

Global Health extends Geelong reach

E-health solutions developer Global Health has been selected to provide its ReferralNet connectivity solution to the Geelong Medical Imaging practice. The system will be used as a secure messaging platform enabling the transmission of radiology results and reports to clients in the Geelong region.

More below:

E-prescription fix for Vic practice

The Coliban Medical Centre in Kyneton has completed a trial of an electronic prescription service provided by MediSecure. The installation was undertaken by Argus Connect (www.argusconnect.com.au)

More here:

http://tc106.metawerx.com.au/Rustreport/rust_newsletter_story.jsp?id=1864

A couple of interesting short reports from smaller companies. (links found at URL above)

Fifth we have:

Launch of world-first lymphoma awareness centre in Second Life®

October 6, 2009

Protected: Health 2.0 – launch of world-first dedicated lymphoma awareness centre in Second Life®

With the support of leading health consumer organisations Lymphoma Australia and the Leukaemia Foundation, Roche Products is pioneering the provision of health information through the launch of an innovative online, pilot cancer awareness program.

More here:

http://smr.cube.com.au/wp-content/plugins/st_newsletter/stnl_iframe.php?newsletter=4&code=l82UKLFsVZBHPaToJtpO

Interesting set of downloads from the link. Interesting e-health based campaign.

Sixth we have:

iSoft expects sales growth in 2009/10

October 6, 2009 - 1:39PM

Health information technology company iSOFT Group Ltd has reaffirmed that it expects sales growth of 10 per cent in 2009/10.

ISOFT, formerly IBA Health, publishes patient information software for hospitals and other healthcare providers, which also delivers health-related information via the internet and mobile phone messaging.

Executive chairman and chief executive Gary Cohen told shareholders at the company's annual general meeting on Tuesday that the company was well placed for growth.

"iSOFT forecast sales growth of 10 per cent in 2009/10 - almost five times the industry average," Mr Cohen said.

More here:

http://news.brisbanetimes.com.au/breaking-news-business/isoft-expects-sales-growth-in-200910-20091006-gkvl.html

This is encouraging for those of us who want at least some reasonably scaled Australian Health IT software providers (and have a few shares)

Seventh we have:

NBN Tasmania overhead cables 'foolish'

Matthew Denholm, Tasmania correspondent | October 09, 2009

TASMANIANS, guinea pigs for the national broadband network, could lose their high-speed internet for days on end because overhead cabling is vulnerable to the state's wild climate, a senate inquiry has heard.

Digital Tasmania, Tasmania's residential and small business IT consumer group, told the Senate's NBN select committee yesterday 96 per cent of the network's "backbone" in Tasmania would be via overhead cable.

Spokesman Andrew Connor told the committee, taking evidence in Hobart, that while overhead cables allowed a cheaper, quicker roll-out, his and other IT groups would prefer the fibre optic cable to be buried.

"It's a necessary roll-out method to get the roll-out happening in a timely period - if streets had to be dug up to lay new conduit or if existing conduit had to be accessed, it may be at a very high cost," Mr Connor said.

"(But) aerial cabling is a non-preferred option for many and that is because it is more susceptible to interference from mechanical interference - car crashes, floods and storms, as we've seen in Tasmania recently." Asked by committee chairwoman, Liberal senator Mary Jo Fisher, whether this meant using overhead cables as opposed to underground might prove to be "pennywise but pound foolish", Mr Connor said "certainly".

More here:

http://www.australianit.news.com.au/story/0,24897,26185993-15306,00.html

How silly can it be planning to create 50-100 year infrastructure like this? It seems there is also trouble brewing on the Government / Telstra front.

See here:

http://www.smh.com.au/business/conroy-says-winwin-possible-20091009-gqvd.html

Eighth we have:

$23m blowout in NSW IT project

Fran Foo | October 07, 2009

A MAJOR government IT project in NSW that commenced eight years ago will cost taxpayers an additional $23 million due to chronic communication breakdowns.

The project, originally due for completion in 2005, has not even passed the halfway mark and is set to deliver $50m less in savings. It is now forecast for full implementation by 2014.

NSW Auditor-General Peter Achterstraat's report on the project, released today, showed a lack of project governance and ownership - both detrimental to its successful completion.

In 2001, the government licensing project (GLP) kicked off with the aim of standardising and simplifying the licensing processes of all agencies, bar drivers’ licences by the Roads and Traffic Authority.

Due to be completed in four years, it was meant to replace 40 licensing systems in 20 agencies with a common platform.

Combined, these agencies issue 300 different types of licences to four million people and businesses in the state.

Originally, the GLP was slated to cost $63m and provide a net benefit of $69m. However, that price tag is expected to balloon to $86m over 12 years, delivering a net benefit of only $19m.

So far, 15 legacy systems have been replaced and 102 licence types consolidated to 55. The new system has been implemented in six agencies that are collectively responsible for 1.7 million licences.

More here:

http://www.australianit.news.com.au/story/0,24897,26177826-15306,00.html

This makes most e-Health projects look just wonderful. What a shambles!

Lastly for the week a more technical article:

Windows 8: Dying gasp or next big thing?

By Tim Ferguson, silicon.com
09 October 2009 02:50 PM

Just as the marketing hype around Windows 7 heads towards its peak, a few details are starting to surface about its likely successor.

You may groan but work on Windows 8, as Microsoft CEO Steve Ballmer has referred to it, is already underway.

The next generation of Windows is unlikely to appear for a few years — probably by 2012 — but Microsoft is working on what comes next, even before Windows 7 hits the shelves.

Ballmer for one has implied there is still more to come. "In a sense there's still a lot of work to do [with the operating system]," he said recently in London.

The company remains tight-lipped about the work being done but Ballmer has suggested that improved management and voice recognition are development priorities. There is also speculation that it may feature a 128-bit architecture.

Clive Longbottom, analyst with Quocirca, predicts virtualisation will feature more prominently with Windows 8. He said: "With Citrix, VMware and Microsoft all looking at how to give the ultimate experience to the user, expect to see virtualisation within the OS providing enhanced support for virtual desktops, for streaming applications, for access to applications when untethered and unconnected to the internet and so on."

He added that Windows 8 could be "a big step forwards towards being a unified client operating system" with Windows Mobile, Windows Embedded and Windows Client all becoming more aligned in terms of their release schedule.

Despite these potential additions, Longbottom suggests businesses won't necessarily be looking for a big shift with Windows 8 as they generally just want an OS that allows people to do their work while also helping to save money and time, extend the life of assets and provide better support for business processes.

More here:

http://www.zdnet.com.au/news/software/soa/Windows-8-Dying-gasp-or-next-big-thing-/0,130061733,339298984,00.htm

And Windows 7 isn’t even quite out yet!

More next week.

David.

Saturday, October 10, 2009

NEHTA postpones Conference on Civil Wars to Fall, 2010

Sorry, this was just too funny to pass up..

NEHTA postpones conference on civil wars to fall, 2010

Posted October 7th, 2009 by Janna Bremer

The Board of Directors of NEHTA has decided to put off the conference on “Civil Wars” until the fall of 2010. This decision was not made lightly, but was agreed upon by the Board and the Conference Committee as a way to ensure wide participation and a top-flight historical conference. Given the difficult economic times, we are hearing that a number of schools are struggling with budgets and requests for out-of-school conferences. We are convinced of the importance of offerings such as our fall conference, but also know that attendance would be impacted by budgets. Further, our delay of the conference from an early October date to November was designed to give more time for registrations. Unfortunately, we also lost our keynote speaker in the process. By putting off the “Civil Wars” conference until 2010, the Conference Committee will have time to redesign the conference. In the meantime, we hope the economy will begin to turn around.

More here:

http://www.masscouncil.org/node/220

I knew things were bad, but this is just ridiculous!

By the way, NEHTA stands for the New England History Teachers Association in this context!

They have been around for a while.

“Founded in 1897, the New England History Teachers Association (NEHTA) is the nation’s oldest association of teachers of history and social studies in the United States. Through our conferences, publications, and awards, the NEHTA provides teachers, students and academics opportunities to engage in meaningful conversations about the teaching and learning of history and its related disciplines.”

See here:

http://www.nehta.net/history.html

Sorry!

Just a hoot.

David

Friday, October 09, 2009

Report and Resource Watch – Week of 5, October, 2009

Just an occasional post when I come upon a few interesting reports and resources that are worth a download or browse. This week we have a few.

First we have:

Women With Diabetes at Increased Risk for Irregular Heart Rhythm

Kaiser Permanente study finds association between diabetes and atrial fibrillation

PORTLAND, Ore., Sept. 28 /PRNewswire/ -- Diabetes increases by 26 percent the likelihood that women will develop atrial fibrillation (AF), a potentially dangerous irregular heart rhythm that can lead to stroke, heart failure, and chronic fatigue. These are the findings of a new Kaiser Permanente study, published in the October issue of Diabetes Care, a journal of the American Diabetes Association.

While other studies have found that patients with diabetes are more likely to have AF, this is the first large study--involving nearly 35,000 Kaiser Permanente patients over the course of seven years--to isolate the effect of diabetes and determine that it is an independent risk factor for women.

"The most important finding from our study is that women with diabetes have an increased risk of developing this abnormal heart rhythm," said the study's lead author, Greg Nichols, PhD, investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. "Men with diabetes are also at higher risk, but the association between the two conditions is not as strong. For men, obesity and high blood pressure are bigger risk factors from diabetes."

Much more here:

http://www.prnewswire.com/news-releases/women-with-diabetes-at-increased-risk-for-irregular-heart-rhythm-62289407.html

The article abstract is found here:

http://care.diabetesjournals.org/content/32/10/1851.abstract

Again the Kaiser Computer Systems are making useful contributions to clinical knowledge.

Second we have:

Australia - Towards national indicators of safety and quality in health care

This report sets out recommendations for a set of 55 national indicators of safety and quality in health care. The report concludes the National Indicators Project, a major project funded by the Australian Commission on Safety and Quality in Health Care (the Commission) and undertaken by the Australian Institute of Health and Welfare (AIHW) in close consultation with the Commission and a wide range of clinical and other stakeholders.

Authored by AIHW.

Published 29 September 2009; ISBN-13 978 1 74024 961 4; AIHW cat. no. HSE 75; 286pp.; INTERNET ONLY

More here:

http://www.aihw.gov.au/publications/index.cfm/title/10792

There is much more detail and downloads available from the link above. These indicators, once finalised, will doubtless be used to shape a ‘pay for performance’ program in Australia.

Third we have:

Dutch health system retains ‘Best in Europe’ crown

Published: Tuesday 29 September 2009

The Netherlands has the best healthcare system in Europe, according to the annual Euro Consumer Index. Dutch healthcare was top of the list for the second year running, this time with an even bigger margin of victory.

Background:

The annual Euro Health Consumer Index compares health services in 33 European countries based on patient rights, e-health, waiting times, outcomes, range of services offered, and access to medicines.

Last year, the Netherlands edged out Denmark to take the title of Europe's best healthcare system (EurActiv 14/11/08), while Austria came out on top in 2007 (EurActiv 1/10/07).

Greater information sharing and patient choice have been highlighted by proponents of cross-border healthcare in Europe. The European Parliament passed a directive in April which paves the way for greater patient mobility (EurActiv 24/4/09)

In second place was Denmark, which performed strongest in providing patients with access to information and enforcing patient rights, but lost marks for having longer waiting times. While Sweden fared best in the analysis of health outcomes, its e-health investment was weaker. The Netherlands' performance was broadly strong in all categories.

Much more here:

http://www.euractiv.com/en/health/dutch-health-system-retains-best-europe-crown/article-185837

The link between e-Health and the better health systems is explicitly drawn.

The report can be found here:

http://www.healthpowerhouse.com/files/Report-EHCI-2009-090925-final-with-cover.pdf

Fourth we have:

Docs Miss Test Results -- Even With Alerts

Communication woes still plague medical system, researchers find

Posted September 28, 2009

MONDAY, Sept. 28 (HealthDay News) -- Even an advanced, computerized medical-record system with alerts cannot guarantee that patients will receive timely follow-up care when imaging tests turn up signs of trouble, new research suggests.

"Our findings suggest that an electronic medical record that facilitates transmission and availability of critical imaging results to the health care provider through either automated notification or direct access of primary report does not eliminate the problem of missed test results even when one or more health care providers read the results," write the authors of a study in the Sept. 28 issue of the Archives of Internal Medicine.

According to the authors, communication breakdowns are blamed in cases when doctors don't follow-up on abnormal test results. In some cases, all the doctors involved in a patient's care don't receive information about, say, a lung mass.

More here:

http://health.usnews.com/articles/health/healthday/2009/09/28/docs-miss-test-results----even-with-alerts.html

The article abstract is available here:

http://archinte.ama-assn.org/cgi/content/short/169/17/1578?home

Fifth we have:

EHR Implementation is a Journey, Not a Destination

Carrie Vaughan, for HealthLeaders Media, September 29, 2009

If you have seen one physician practice, you have seen one physician practice. I often hear that phrase when talking with healthcare executives about best practices and lessons learned from successful electronic health record implementations. Health systems, hospitals, and clinics all have their own unique personality that is shaped by their geographic and organizational culture. That means there is no set formula to guarantee a successful EHR implementation. Organizations must find the path that works best for them.

A recent report by healthcare market research firm IDC Health Insights analyzed how two Norwegian hospitals—St. Olavs Hospital in Trondheim and Ahus Hospital in Oslo—successfully adopted digital technologies. The study, "Best practices: Norway's hospital evolution—A tale of two cities," concluded that there wasn't a single template for successful health IT implementations. Both projects were full replacements of aging facilities, but they used different methods to realize the vision of a digital hospital.

For example, St Olavs chose a single-vendor and an outsourced solution, whereas, Ahus worked with multiple vendors, retained some of its legacy systems, and managed its IT transformation internally. Even though Ahus was able to adopt more mature technology, since it began its implementation two years later than St. Olavs' project, both systems are now fully operational and their digital transformations deemed a success by their staff members and communities.

More here:

http://www.healthleadersmedia.com/print/content/239750/topic/WS_HLM2_TEC/EHR-Implementation-is-a-Journey-Not-a-Destination.html

A useful report – the link is in the text.

Sixth we have:

Health IT prevents heart attacks?

Posted by Dana Blankenhorn @ 2:00 pm

Kaiser Permanente is pushing a study in today’s American Journal of Managed Care as proof that health IT saves lives.

It proves to me my pill regimen may be keeping me alive.

In the study 68,560 people with diabetes or heart disease were given a combination of generic statins and hypertension drugs, resulting in 1,271 fewer heart attacks and strokes.

But what’s the health IT angle?

  • KP HealthConnect, the insurer’s Electronic Health Record system, was used to identify the patients at risk.
  • The findings validate a computer-created model predicting that the bundled drugs would cut heart attack and stroke in the target population by 71%.
  • Kaiser researchers conducted the study.

Much more here:

http://healthcare.zdnet.com/?p=2777

Link in the text. Kaiser strikes again!

Lastly we have:

Electronic medical records give early warning of domestic abuse

Posted by Elizabeth Cooney September 29, 2009 07:09 PM

Boston researchers reported today a novel use for electronic medical records -- using data in patient records, they say they were able to identify likely victims of domestic abuse an average of two years before a diagnosis was actually made.

Ben Reis, Dr. Isaac Kohane, and Dr. Kenneth Mandl of Children's Hospital Boston and Harvard Medical School studied six years of hospital admissions and emergency visits for patients over 18 years old. Based on the patient's history, including injuries and assaults, they determined whether patients met a definition of domestic abuse. Then they looked at actual diagnoses of domestic abuse.

"Our model predicted abuse two years before it appeared on medical records," Reis said in an interview. The article appears online in the British Medical Journal.

The risk factors linked to a future domestic abuse diagnosis differed between men and women. For women, the red flags were trips to the hospital to treat injuries, poisoning, and alcoholism. For men, depression and psychosis were associated with the greatest risk.

The researchers developed a visual display that could become part of a patient's electronic health record. The work is not ready to be implemented, they said, but the model could form the basis for an early warning system that would help busy doctors decide which patients need further screening and perhaps intervention.

"This is not a diagnosis but a screening support system," Reis said.

Their hope is to bring the wealth of information about a patient to the forefront during a doctor-patient encounter encumbered by competing demands. They plan to study other health problems, from diabetes to depression, that might lead to what they call "predictive medicine."

More here:

http://www.boston.com/news/health/blog/2009/09/post_31.html

The full report is here:

http://www.bmj.com/cgi/content/abstract/339/sep29_1/b3677

Good stuff!

Enjoy!

David.

Thursday, October 08, 2009

International News Extras For the Week (05/10/2009).

Again there has been just a heap of stuff arrive this week.

First we have:

Thursday, September 24, 2009

HHS Holds Keys to Next Generation of Health Information Privacy

by Deven McGraw and Harley Geiger

While lawmakers continue to debate health reform, health IT already is poised to be a major factor in changing how health care is delivered. Recognizing health IT's potential to enhance efficiency and quality of care, Congress made a substantial taxpayer investment in health IT earlier this year through the American Recovery and Reinvestment Act of 2009.

Congress also recognized that digitized health records pose privacy issues that, if left unresolved, can profoundly undermine patient trust in the health care system. Consequently, ARRA devotes significant attention to strengthening the privacy and security of health information.

However, stronger laws are not enough. Effective implementation -- including education, outreach and oversight -- will be needed to embed better privacy and security practices throughout the health care system, particularly as we move into the age of digital health records.

To realize the promise of health IT, we need a new generation of health privacy that can be accomplished best with proactive and consistent privacy leadership from HHS. Specifically, HHS should:

  • Capitalize on opportunities provided in ARRA to strengthen and more effectively implement and enforce privacy and security protections for digital health information;
  • Ensure effective communication and coordination on privacy policy among its subagencies and offices, as well as with other federal agencies; and
  • Serve as an ongoing resource for stakeholders on the law and on effective privacy and security practices.

Much more here (including links):

http://www.ihealthbeat.org/Perspectives/2009/HHS-Holds-Keys-to-Next-Generation-of-Health-Privacy.aspx

This is an important review of the trends that need to be watched as the US moves forward. Worth a browse.

Second we have:

On the Watch for Flu and More
Health Agencies Create Post-Vaccine Monitoring Systems

Associated Press

Monday, September 28, 2009

More than 3,000 people a day have a heart attack. If you're one of them the day after your swine flu shot, will you worry that the vaccine was to blame and not the more likely culprit, all those burgers and fries?

The government's system to track possible side effects of mass flu vaccinations will begin next month, aimed at detecting any rare but real problems quickly, and explaining the inevitable coincidences that are sure to cause some false alarms.

"Every day, bad things happen to people. When you vaccinate a lot of people in a short period of time, some of those things are going to happen to some people by chance alone," said Daniel Salmon, a vaccine safety specialist at the Department of Health and Human Services.

Health authorities hope to vaccinate more than half of the population in just a few months against swine flu, which doctors call the 2009 H1N1 strain. Vaccination is voluntary, and how many get it depends partly on confidence in its safety.

"The recurring question is, 'How do we know it's safe?' " said Gregory Poland of the Mayo Clinic.

Enter the intense new monitoring. On top of routine vaccine tracking, there are these government-sponsored projects:

-- Harvard Medical School scientists are linking large insurance databases that cover as many as 50 million people with vaccination registries around the country for real-time checks of whether people see a doctor in the weeks after a flu shot and why. The huge numbers make it possible to quickly compare rates of complaints among the vaccinated and unvaccinated, said the project leader, Richard Platt, Harvard's population medicine chief.

-- Johns Hopkins University will direct e-mails to at least 100,000 vaccine recipients to track how they're feeling, including the smaller complaints that wouldn't prompt a doctor visit. If anything seems connected, researchers can call to follow up with detailed questions.

-- The Centers for Disease Control and Prevention is preparing take-home cards that tell vaccine recipients how to report any suspected side effects to the nation's Vaccine Adverse Event Reporting system.

More here:

http://www.washingtonpost.com/wp-dyn/content/article/2009/09/27/AR2009092702913.html?hpid%3Dmoreheadlines&sub=AR

I wonder what is in place in Australia? I have not heard of an approach like this to pro-actively see how we are going. Anyone know?

Third we have:

Zakaria and Meyerson: How to Fix Health IT

By Sammy Zakaria and David A. Meyerson
Thursday, September 17, 2009 7:22 PM

President Obama's address to Congress on health-care reform overlooked one of the most important issues: the poor state of health information technology.

Last week, a 62 year old woman, whom we will call Mrs. B, came into our office complaining of shortness of breath. She also mentioned a history of severe hypertension, coronary artery disease and dialysis-dependent kidney failure. We discovered that she had been admitted several times in the past year to five different area hospitals. Beyond these bare facts, we had no other information. We had no reliable details of her recent testing, treatment or medications. Also, she could not recall the names or dosages of her sixteen pills, and she knew that she was severely allergic to a certain heart medicine, but she couldn't remember its name, either. We were understandably reluctant to prescribe new medications or therapies without obtaining her recent records.

Mrs. B's situation is all too common. Information is fragmented and not readily accessible. Even the most prepared patient carrying copies of previous medical records is handicapped by the difficulty in deciphering handwriting and medical notations. It is common for duplicate tests to be ordered, increasing health-care costs by perhaps 15 percent or more.

The comments continue here:

http://www.washingtonpost.com/wp-dyn/content/article/2009/09/17/AR2009091703734.html

I would say the diagnosis is right – but the solution of going to a single standardised EMR to solve interoperation issues is a trifle naive I think. Where ever there has been a situation like what it proposed here it has met substantial resistance – everywhere from HealthSMART to the UK NHS. (I know I have commented on this before (last week) – but have given the article a second read and thought)

Fourth we have:

Achieving paperless health care

Shift to electronic medical records is transforming patient care by improving safety, efficiency and lowering costs

By GUY KOVNER

THE PRESS DEMOCRAT

Published: Saturday, September 26, 2009 at 3:00 a.m.

Last Modified: Saturday, September 26, 2009 at 11:45 p.m.

The bar code on a Kaiser Permanente patient’s wristband may seem the epitome of impersonal medicine, but it’s part of a digital revolution aimed at cutting costs, boosting efficiency — and promoting health.

WHAT IS EMR?

Electronic medical records, known as EMR, is a computerized system that provides instant and complete patient information to medical offices, emergency rooms, hospitals and other health facilities.

• A system typically includes patient history, diagnoses, X-rays and other images, test results and communications with health care providers.

• Patient files can be accessed 24/7, expediting diagnosis and treatment of acute illnesses, management of chronic conditions and reducing duplicate testing.

If the magnetic reading by a nurse doesn’t match the bar code on a drug about to be administered at Kaiser Medical Center in Santa Rosa, an alert will sound, intended to avoid the kind of medication mixup that nearly killed actor Dennis Quaid’s newborn twins in 2007.

About 7,000 Americans die every year from medication errors.

And when Dr. Steve Levenberg saw a woman with an ankle problem at his Rohnert Park office, a few computer keystrokes gave him the patient’s medical history, including lab tests and X-rays from her recent visit to an orthopedic surgeon in Sacramento.

“My laptop computer,” Levenberg said, “is a clinical tool, just like my stethoscope.”

The healing arts, as old as humankind, are rushing to pursue and refine the use of electronic medical records, known as EMR, across Sonoma County, from rural health clinics to megasystems like Kaiser.

Medicine is a relative latecomer to the digital revolution, which has transformed many endeavors — engineering, architecture, publishing, moviemaking, warfare and personal communication — over the past 30 years.

Medical record-keeping, until recently, relied on rooms full of paper files that were easily misplaced and filled with hurried, handwritten entries that could be hard to read. Electronic records hold orderly, keyboard-entered data that never leaves a hard drive and have the potential to move seamlessly from a primary care provider’s office to an emergency room or specialist’s suite.

Coinciding with the national debate over health care costs and efficiency, EMRs — which received $19 billion in economic stimulus funding — are a prescription for making health care more efficient and less costly.

Much more here :

http://www.pressdemocrat.com/article/20090926/ARTICLES/909269945/-1/WEATHER?Title=Achieving-paperless-health-care

This is a good long article that explains where things are up to with some EMR leaders.

Fifth we have:

Orion wins Northern Ireland ECR deal

28 Sep 2009

Northern Ireland has named Orion as the winner of a procurement for a proof of concept project for a province-wide electronic care record (ECR).

The one-year deal will be to develop a new portal-based electronic health record, predominantly for use in secondary care but linking hospitals and practices, with the potential to also link social care.

Brian McKeown, head of ICT planning, commissioning and performance management with the Health and Social Care Board for Northern Ireland, said the deal was worth just under €100,000.

He said: "We want to get something up and running to pull out data from the various systems. Essentially it will be used in secondary care-unscheduled care and particularly for those with chronic conditions.”

In the proof of concept project two hospitals and two GP surgeries will be connected to an ECR, intended to be used in A&E, and for out-of-hours services.

Lots more here:

http://www.e-health-insider.com/news/5240/orion_wins_northern_ireland_ecr_deal

http://computerworld.co.nz/news.nsf/news/3DE991D4F27CE0FCCC25763C0018BB49

Health sector tackles patient record access

HealthLink-Medtech stoush brings issues into the spotlight

By Rob O'Neill Auckland | Monday, 28 September, 2009

Health bodies have converged to address issues with access to patient medical records, highlighted by a dispute between to ICT vendors Medtech Global and HealthLink earlier this year.

The Ministry of Health hosted an interoperability and standards workshop this month to address the safe sharing of information, says the deputy director-general of health information, Alan Hesketh. He says the effort aims to put in place “common approaches” to the commercial arrangements for interoperability between IT systems used in the health sector.

Hesketh says the ministry’s position is two-fold: how to share information safely and privately and how to do this so the commercial terms between ICT providers do not add costs into the health system.

Members of the New Zealand Health IT Cluster, which represents health technology vendors, participated in the meeting and the cluster is taking action to put in place agreed approaches, Hesketh says. He adds that it isn’t just about Medtech and HealthLink, but also about iSoft and Orion and a host of other players.

The Health Information Strategy Advisory Committee (HISAC) is one of several groups interested in the records review. HISAC, which advises the Minister of Health on the direction of health IT, is driving to have electronic referrals between primary and secondary health providers implemented nationwide by the middle of next year, says chairman Graeme Osborne.

Osborne and Hesketh both say there is no dispute about the ownership of health records: they belong to the patient and are held in trust by health providers. Where issues get trickier is at the integration point between systems, Osborne says.

It seems clinical information sharing issues are causing a few ructions in NZ. Australia has a similar mixed base of client systems and more messaging providers so this will need to be watched.

Seventh we have:

E-health technology adopted in Radius rest homes

Monday, 28 September 2009, 1:02 pm
Press Release: Radius Residential Care

For immediate release

Monday 28th September 2009

Revolutionary new e-health technology adopted in Radius rest homes

Radius Residential Care rest homes are among the first in the country to employ a new e-health technology initiative that is revolutionizing the way doctors can access rest home patient clinical notes.

The leading edge computer technology system ‘NZHealthNet’ enables doctors to remotely link into their patients medical notes when attending rest home patient care appointments.

Doctors can easily refer to and update clinical patient notes, order laboratory tests, write referrals and print prescriptions with NZHealthNet - all without the need to carry confidential patient records during routine visits to rest homes.

“One of the main benefits of this new e-health technology is that patient safety is improved due to doctors having real time access to patient records and data. And for rest home patients the new technology will allow them all the benefits of a regular GP visit but without leaving the comfort of their own surrounds“, says Kirsten Stone, CEO Rotorua General Practice Group (RGPG) who have developed the new technology.

Radius Glenbrae Estate was the first rest home to adopt the new technology which was implemented by RGPG onsite last week. Other rest homes within the wider Rotorua region are also expected to become ‘online’ before the end of the month.

More here:

http://www.scoop.co.nz/stories/BU0909/S00727.htm

This looks like very interesting work indeed from the Shaky Isles!

Eighth we have:

September 28, 2009

E-Records Get a Big Endorsement

By STEVE LOHR

The nation’s drive toward computerized medical records is getting a push from big hospitals, which hope not only to improve patient care but to gain an edge on competitors.

And an effort to be announced on Monday by a big New York regional hospital group may be the most ambitious effort of this type yet — a sizable investment intended as a linchpin in the group’s $400 million commitment to digitize patient records throughout its system, including 13 hospitals.

North Shore-Long Island Jewish Health System plans to offer its 7,000 affiliated doctors subsidies of up to $40,000 each over five years to adopt digital patient records. That would be in addition to federal support for computerizing patient records, which can total $44,000 per doctor over five years.

The federal program includes $19 billion in incentive payments to computerize patient records, as a way to improve care and curb costs. And the government initiative has been getting reinforcement from hospitals. Many are reaching out to their affiliated physicians — doctors with admitting privileges, though not employed by the hospital — offering technical help and some financial assistance to move from paper to electronic health records.

Efforts by hospital groups to assist affiliated doctors include projects at Memorial Hermann Healthcare System in Houston and Tufts Medical Center in Boston. But the size of the North Shore program appears to be in a class by itself, according to industry analysts and executives.

Big hospitals operators like North Shore, analysts say, want to use electronic health records that share data among doctors’ offices, labs and hospitals to coordinate patient care, reduce unnecessary tests and cut down on medical mistakes.

But hospitals are seeking a competitive edge, too. Digital links, analysts say, can also tighten the bonds between doctors and the hospital groups that subsidize the computerized records. In most local markets, independent physicians typically have admitting privileges at more than one nearby hospital, and so hospitals compete for doctors as well as patients.

“The North Shore-L.I.J. program is larger than other programs,” said Wes Rishel, a health technology expert at Gartner. “And it punctuates a trend of hospital groups trying to solidify and tighten relationships with physicians in their communities.”

In other words, the government-backed campaign to hasten the adoption of electronic health records has the potential not only to change how health care is delivered. It could also influence which institutions emerge as leaders in delivering care, as some local markets consolidate further.

Full article here:

http://www.nytimes.com/2009/09/28/technology/28records.html?_r=1&ref=health

This is a pretty considerable investment to get rolling.

Ninth we have:

Former ONC chief Kolodner announces retirement

By Joseph Conn / HITS staff writer

Posted: September 28, 2009 - 11:00 am EDT

Robert Kolodner, the former head of the Office of the National Coordinator for Health Information Technology and more recently a senior advisor to ONC, has retired from federal government service after 31 years.

More than 28 of those years were spent at the Veterans Affairs Department and the Veterans administration, where Kolodner started in 1977 and worked as a psychiatrist and in increasingly higher levels of leadership in healthcare IT. The VA's Decentralized Hospital Computer Program, later renamed VistA, was developed during that period.

More here:

http://www.modernhealthcare.com/article/20090928/REG/309289951

A true friend of Health IT – who no doubt made a big difference!

Tenth we have:

Tennessee gave doctors wrong fax number in privacy breach

Patients' private medical records faxed out of state

By Chris Echegaray
THE TENNESSEAN

The Tennessee Department of Human Services said it accidentally sent the wrong fax number to 100 medical providers across the state, leading them to erroneously send sensitive patient information to an Indiana businessman.

"We're extremely embarrassed, and we're working to remedy the situation," said Michelle Mowery Johnson, spokeswoman for DHS. "We hope it doesn't happen again."

The state sent an e-mail blast to 29,000 medical providers with the correct toll-free fax information on Monday.

The problem was first reported by The Tennessean.

More here:

http://www.tennessean.com/article/20090929/NEWS01/909290346/Tennessee+gave+doctors+wrong+fax+number+in+privacy+breach

Old technology causing trouble!

Eleventh for the week we have:

Survey Highlights Power, Limits of EHR Data

HDM Breaking News, October 1, 2009

More than three-quarters of 732 surveyed executives at provider, payer and pharmaceutical organizations believe secondary use of data from electronic health records will be their organizations' greatest asset during the next five years.

But respondents also cite multiple barriers to best use of de-identified and aggregated health information. They also cite the necessity of guidelines for the usage of secondary data that is to be shared. New York consulting firm PricewaterhouseCoopers conducted the e-mail survey in June, getting replies from 482 providers, 136 insurers and 114 pharmaceutical/life sciences organizations.

Sixty-five percent of surveyed providers use secondary data to some degree, as do 54% of payers and 66% of pharmaceutical firms. Besides EHRs, this data can come from claims, clinical trials, laboratory and radiology reports, employers, and disease management companies. Those surveyed expect their use of such data to rapidly grow and already report such benefits as quality improvements, reduced costs, increased revenue and higher patient/member satisfaction.

More here:

http://www.healthdatamanagement.com/news/survey-39069-1.html?ET=healthdatamanagement:e1033:100325a:&st=email

More information is available at pwc.com/us/en/healthcare/publications/secondary-health-data.jhtml

Very interesting survey indeed.

Fourth last we have:

Practice Fusion to offer ARRA-based EHR guarantee

By Joseph Conn / HITS staff writer

Posted: September 30, 2009 - 11:00 am EDT

Another electronic health-record system developer has joined the growing ranks of those offering a guarantee that providers using their EHRs will meet the so-called “meaningful use” critieria under the American Recovery and Reinvestment Act of 2009.

San Francisco-based EHR developer Practice Fusion said its program provides “a guarantee that physicians using Practice Fusion's EHR will qualify for meaningful use before the economic stimulus payments begin in January 2011” and that amounts to “effectively guaranteeing payout of stimulus package money.”

Much more here:

That Federal Money is certainly having the desired effect of getting the software industry motivated etc.

It is a bit of a worry that this is a free, advertiser supported EHR. We know all about this in Australia!

Third last we have:

Tuesday, September 29, 2009

Technology Incentives Not So Stimulating for Dentists

by George Lauer, iHealthBeat Features Editor

Although the HITECH Act includes dentists among the "eligible professionals" in line for federal stimulus money, some dental advocates are worried oral health might get short shrift in the push toward electronic health records.

Efforts are well under way to get medical care providers in position to earn incentives under Medicare and Medicaid if they adopt and make "meaningful use" of certified EHRs, but similar efforts on behalf of dentists are less organized and not as nationally focused, according to some dental advocates.

"Dentistry is included in the stimulus language, but in practical terms, the stimulus money for electronic records isn't going to have much of an impact on most dentists," said Paul Glassman, director of Community Oral Health at the University of the Pacific School of Dentistry in Stockton, Calif.

"There's a process going on right now, largely spearheaded by California activists, to try to figure out what can be done to change that," Glassman said. "State government, statewide foundations, academics and at the national level the ADA (American Dental Association) are trying to figure out how dentistry can have more of an impact in the move toward EHRs. We're working on answering questions like what are the barriers and what can be done about them," Glassman said.

Much more here:

http://www.ihealthbeat.org/Features/2009/Technology-Incentives-Not-So-Stimulating-for-Dentists.aspx

It seems the dentists are not thrilled!

Second last we have:

Free PHR a Hit at Indiana University

HDM Breaking News, September 25, 2009

The Indiana University Health Center in Bloomington early this year began testing a free personal health record for students. The goal was to work out bugs, and offer the PHR to the incoming freshman class this fall (see healthdatamanagement.com/issues/2009_67/-28272-1.html).

Just weeks into the new semester, 3,100 of 7,200 incoming students--40% of the class--have activated a PHR and entered some data, says Pete Grogg, associate director at the health center. And half of those with a PHR are sharing data with the center as they start seeking treating. "We're very happy, we weren't quite sure what to expect," Grogg says.

.....

More information is available at Indiana.edu/~health/ and nomoreclipboard.com.

More here:

http://www.healthdatamanagement.com/news/PHR-39019-1.html?ET=healthdatamanagement:e1029:100325a:&st=email

This is interesting – and good news!

Last, and very usefully, we have:

Women With Diabetes at Increased Risk for Irregular Heart Rhythm

Kaiser Permanente study finds association between diabetes and atrial fibrillation

PORTLAND, Ore., Sept. 28 /PRNewswire/ -- Diabetes increases by 26 percent the likelihood that women will develop atrial fibrillation (AF), a potentially dangerous irregular heart rhythm that can lead to stroke, heart failure, and chronic fatigue. These are the findings of a new Kaiser Permanente study, published in the October issue of Diabetes Care, a journal of the American Diabetes Association.

While other studies have found that patients with diabetes are more likely to have AF, this is the first large study--involving nearly 35,000 Kaiser Permanente patients over the course of seven years--to isolate the effect of diabetes and determine that it is an independent risk factor for women.

"The most important finding from our study is that women with diabetes have an increased risk of developing this abnormal heart rhythm," said the study's lead author, Greg Nichols, PhD, investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. "Men with diabetes are also at higher risk, but the association between the two conditions is not as strong. For men, obesity and high blood pressure are bigger risk factors from diabetes."

Much more here:

http://www.prnewswire.com/news-releases/women-with-diabetes-at-increased-risk-for-irregular-heart-rhythm-62289407.html

There is an amazing amount happening. Enjoy!

David.

Wednesday, October 07, 2009

A Small Contribution to Openness in Australian E-Health – The Full National E-Health Strategy

With the release of the NEHTA Strategic Plan (or whatever it is) it seems time that the document which it is meant to support is also in the public domain.

You can download the full Deloittes National E-Health Strategy Document from here:

http://moreassoc.com.au/downloads/National%20E-Health%20Strategy%20REPORT%20-%20Final%20Release%20300908%20v1.pdf

The time has really come to let it fly – since everyone seems to have it other than the public - and I know the Deloittes Partner who developed it has authorised its release under FOI. Yes, I do have an e-mail from him confirming the FOI release and that he is happy people can access it!

Settle down for a good read.

David.

Tuesday, October 06, 2009

AusHealth IT Blogger Features on the Scoop from MIS Australia

The Scoop - e-Health's road to recovery

Posted: Tue 6 Oct 2009 9:39AM

e-Health is still an unhealthy industry, yet the federal government needs it to drive the NBN. So how will e-health deliver the dream? Joining The Scoop host Mark Jones is Dr Mukesh Haikerwal, clinical lead at NeHTA; Gary Cohen, chairman of iSoft; and Dr David G. More, executive director of More and Associates.

Go here to listen to or download the podcast:

http://tv.misaustralia.com/video/8454

Enjoy!

David.

A Reality Check For NEHTA.

A short piece on the NEHTA Strategic Plan was published a few days ago by Karen Dearne on the Australian IT web site.

NEHTA releases strategic plan

Karen Dearne | October 02, 2009

THE National E-Health Transition Authority has released a strategic plan repositioning itself as an implementation agency with a role well beyond its present funding to 2012.

"Since its establishment, there has been a misalignment between NEHTA's current direction and the expectations of the various stakeholder groups," the plan says. "As the organisation evolves it is important to ensure a foundation exists for 'what' it has been put in place to deliver."

NEHTA will "co-ordinate and manage the uptake of e-health systems which are of a high priority, interoperable and scalable" nationwide.

Chief executive Peter Fleming said the 2009-2012 plan outlined how NEHTA would fulfil its mission in relation to delivering the National E-Health Strategy adopted by the Council of Australian Governments last December.

The full article is here:

http://www.australianit.news.com.au/story/0,24897,26155170-15319,00.html

What is interesting is as of the time of typing 4 days later there are 16 comments about the article.

Pretty much all express a view of NEHTA which would make one believe I am being kind!

It will be interesting to see the NEHTA spin machine attempt strike back with some unalloyed praise!

Isn’t free speech wonderful!

Browse the comments for a belly laugh or two.

David.

Monday, October 05, 2009

The New NEHTA Strategic Plan Has More Spin Than a Tumble Drier!

What to make of this new, and presently incomplete, document?

First, we have a couple of press reactions.

First we have:

NEHTA releases strategic plan

Karen Dearne | October 02, 2009

THE National E-Health Transition Authority has released a strategic plan repositioning itself as an implementation agency with a role well beyond its present funding to 2012.

"Since its establishment, there has been a misalignment between NEHTA's current direction and the expectations of the various stakeholder groups," the plan says. "As the organisation evolves it is important to ensure a foundation exists for 'what' it has been put in place to deliver."

NEHTA will "co-ordinate and manage the uptake of e-health systems which are of a high priority, interoperable and scalable" nationwide.

Chief executive Peter Fleming said the 2009-2012 plan outlined how NEHTA would fulfil its mission in relation to delivering the National E-Health Strategy adopted by the Council of Australian Governments last December.

"We have considered our future work program based on the (Deloitte) strategy and other important work completed this year, including the National Health and Hospital Reform Commission recommendations," he said.

"As a result we have produced our plan to clearly show our stakeholders the directions we are taking to drive the adoption of e-health."

More analysis here:

http://www.australianit.news.com.au/story/0,24897,26155170-15306,00.html

Next we have:

NEHTA to test health ID this year

By Suzanne Tindal, ZDNet.com.au
02 October 2009 04:54 PM

The National E-Health and Transition Authority (NEHTA) has today released its strategy for 2009 to 2012, listing priorities and timelines to enable e-health, including developing an "office" model for health identifiers by December.

The strategy was formed considering the National E-Health Strategy written by Deloitte last year and the recent National Health and Hospital Reform Commission recommendations. NEHTA admitted that there had been a gap between what stakeholders expected of it and where the authority was heading. "As the organisation evolves it is important to ensure a foundation exists for 'what' the organisation has been put in place to deliver," it said.

There are four parts to the strategy: "urgently" developing the foundations to enable e-health, coordinating the progress of priority e-health solutions and progresses, accelerating adoption, and leading the progression of e-health in Australia.

The strategy will see an "office model" for the healthcare identifiers released by December this year. An early adopters release will follow in April 2010, followed by a later adopters release in July 2010.

NEHTA CEO said earlier this year that legislation to enable the use of individual health identifiers was unlikely to be passed until next year.

http://www.zdnet.com.au/news/software/soa/NEHTA-to-test-health-ID-this-year/0,130061733,339298878,00.htm

Third we have:

NeHTA strategic plan to unlock stalled eHealth

by James Riley

Friday, 02 October 2009

The government agency set up to assist the roll-out of electronic health services in Australia, the National eHealth Transition Authority, has released its much-anticipated strategic plan for progressing the nation's stalled eHealth initiatives.

The NeHTA plan positions the organisation as a long term implementation authority, extending the role it has so far played in standards setting. NeHTA was established by Federal, state and territory health departments and is chaired by businessman David Gonski.

While NeHTA enjoys committed funding until 2012, its strategic plan 2009-12 clearly sees a longer term role for the body during the long implementation phase – an evolution of its primary role in setting standards that created an environment conducive to eHealth adoption.

NeHTA chief executive officer Peter Fleming said the strategic plan responded to – and reflected – the goals of the Rudd Government’s national eHealth strategy released last December.

It also reviewed the recommendations of the National Health and Hospital Reform Commission – including plans to create an Individual Healthcare Identifier.

More here:

http://www.itwire.com/content/view/28172/53/

I think these can be summarised as hopeful with a touch of scepticism.

For me, all I can say is that there are certainly a few big issues raised by this plan.

Ignoring the detail the biggest issue to my mind is this Purpose Statement and then what follows:

Purpose Statement

“To lead the uptake of e-health systems of national significance;

and

To coordinate the progression and accelerate the adoption of e-health by delivering urgently needed integration infrastructure and standards for health information.” (Page 5)

But further on we find on Page 37.

“NEHTA does not currently have a role in setting governance arrangements. However, NEHTA does have a role in informing, promoting and communicating the best practices, outcomes and opportunities which are presented as a result of e‐health. Strategic initiatives relating to these areas are found in Strategic Priority 4 of NEHTA’s strategic plan.”

Translation we don’t set national e-Health Governance, we can’t work out who does and so we don’t know if we are aligned with the National E-Health Strategy or not! Our view is that this is not NEHTA’s problem it is problem of Health Ministers – and most especially the Federal Health Minister – to sort out and provide the leadership and direction to NEHTA.

The entire NEHTA document is circular in my view. What it essentially says is that Element 4 of the National E-Health Strategy has not been implemented and so we are hoping we can steal in under the radar and just get on with what we imagine is what is needed. Just who is watching, making sure the right things are being done and managing this is left totally undefined and indeed is!

Element 4 of the National E-Health Strategy reads that Australia should:

“Develop a governance regime which allows strong coordination, visibility and oversight of national e‐health work program activities.”

The details are as follows:

R 4.1

Establish a national e‐health governing board that reports to AHMC, has an independent chair and has a breadth of cross sectoral stakeholder representation.

R 4.2

Establish an independent national e‐health regulation function to implement and enforce national e‐health regulatory frameworks.

R 4.3

Establish a national e‐health entity incorporating strategy, investment management, work program execution, standards development and compliance functions.

R 4.4

Leverage NEHTA to establish the new entity and undertake a transition process to address changes to accountabilities, brand, culture, resources and operating model.

NEHTA has been unaccountable and secretive thus far, and to perpetuate this situation, ignoring advice both from the Boston Consulting Group and Deloittes about the need for much improved accountability and governance is just ridiculous. NEHTA should be planning to go no-where in the absence of appropriate national Governance as recommended by Deloittes.

The second main issue is that NEHTA seems to have actually decided it is its role to take on and undertake Element 4 on the National E-Health Strategy itself. In slightly different words, pages 25-28 make that clear.

Just who has decided this is NEHTA’s role is just not specified and I for one am unhappy about a situation where we have a clear attempt on the part of Health Ministers in an approved strategy to improve e-Health governance, and are apparently about to see that thrust utterly subverted

NEHTA does not have the Board make up or indeed the authority to do this without explicit sign-off and approval from Ministers. If they had this I am sure they would have told us so I am pretty sure they don’t.

That NEHTA is in the situation of picking and choosing what of the National Strategy it will do and ignoring the rest also does not wash with me. I don’t disagree that much of what is here needs doing – but it needs to be done on a more grounded, better led and more formal, governed and empowered basis.

It is interesting NEHTA has noted that ‘e-Health is breaking out all over’. I seriously doubt they can do much about it without a much better and totally revised governance and leadership. (Page 28)

Last we still have all this chatting on about the NEHTA IEHR with a continuing lack of any useful information on any aspect of this plan. This present document again adds zero. When are they actually going to come clean and tell us what they plan etc. It is just absurd and now it is again off until 2013 or so. They still are to get a Business Case approved – despite multiple attempts!

The good aspect of the document is that at least we know what NEHTA is supposed to be doing and can now follow their progress.

Overall this document should be seen for what it is. That is a grab for continuity and authority which is has not earned over the last 5 shambolic years of its existence. That this is the first strategic plan ever developed by NEHTA says it all. What on earth have they been doing all this time. Making it up as they go along I guess!

For the avoidance of doubt, this document is, I believe, an attempt on the part of NEHTA to legitimise it as the manager and implementer of the e-Health agenda in Australia, and to sideline the National E-Health Strategy. If I am right then they should be much more explicit about it and seek agreement from a much wider constituency than the present NEHTA Board.

If they were really wanting to implement the National E-Health Strategy the present document should have been entitled “NEHTA National E-Health Implementation Plan”! We could have done with one of those a few years ago too!

David.