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."

Tuesday, January 19, 2010

Weekly Australian Health IT Links - 19-01-2010

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

General Comment:

The is little doubt the biggest item this week has been the ‘sham’ consultation process conducted by DoHA / NEHTA on the proposed legislation for the Health Identifier Service.

Civil Liberties Australia made the point most forcefully!

“Timing of the consultations

Finally, we note that the request for comment on this draft legislation was issued on 10 December, with a closing date of 7 January 2010.

We note that the public servants within the Health Department will have been able to enjoy a break over Christmas and New Year while expecting civil society, in the form of unpaid volunteer organisations, to provide unrecompensed analysis and input into making the legislation as good as it can be.

CLA raised this timing issue at the face-to-face consultations, and warned the department against doing exactly what the department has done in terms of timing. In our opinion, there could be no more contemptuous action on the part of the department, representing the government, than to treat the consultation process, and civil society organisations and people who contribute to it, in this manner.

We trust that the public servants of the Department of Health enjoyed their Christmas and New Year break.

We request that the department never, ever do something like this again, and we ask that our request be communicated to the Secretary of the Department for her to issue an instruction to the appropriate effect. Whether she chooses to apologise for the abysmal behaviour of her staff is up to her.”

See here:

http://www.privacy.org.au/Papers/HId_Bill-CLA-100107.pdf

There also some other important issues raised in the submission – some very serious indeed!

Love the paragraph quoted!

Another public service favourite is to release major tenders late in December to close in early February – to ruin responders Christmas Breaks. SA Health stands condemned this year for that annoying act!

See here:

http://aushealthit.blogspot.com/2010/01/south-australian-health-treats-nehta-as.html

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http://www.abc.net.au/news/stories/2010/01/14/2792636.htm

Doctors call for patient privacy protection

Posted Thu Jan 14, 2010 6:02pm AEDT

A group representing general practitioners has called on the Federal Government to ensure patient confidentiality is maintained when privacy laws are reformed this year.

The Government has proposed streamlining the Privacy Act into a national set of principles across the public and private sectors.

The move coincides with a widespread increase in the use of electronic patient data by doctors, specialists and hospitals.

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http://www.australiandoctor.com.au/articles/8e/0c06678e.asp?

E-health patient privacy warning

14-Jan-2010

By Sarah Colyer

A FORMER employee of the nation’s top e-health body is warning of ‘Big Brother’-style privacy breaches if a plan to identify every patient with a unique number goes ahead.

Software developer Peter West, who quit the National E-Health Transition Authority last year, is now facing legal action from his former employer for setting up an alternative patient identification system.

Mr West told Australian Doctor he left NEHTA because he believed its project to identify all Australians in the health system using a single number was a privacy risk.

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http://www.smh.com.au/technology/technology-news/australia-responds-to-threats-of-internet-war-20100115-mcgv.html

Australia responds to threats of internet war

DAN HARRISON

January 16, 2010

HACKERS are launching 200 attacks a month on the Defence Department's computer networks, the Defence Minister, John Faulkner, revealed as he unveiled a new centre to co-ordinate the nation's response to online threats.

Journalists were allowed into the Defence Signals Directorate yesterday for the first time since its creation in 1947. The occasion was the opening of the Cyber Security Operations Centre.

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http://www.liebertonline.com/doi/abs/10.1089/tmj.2009.0079

Telehealth on Advanced Networks

Laurence S. Wilson, Ph.D.,1

Duncan R. Stevenson, M.Sc.,2 and

Patrick Cregan, M.D.3

1CSIRO ICT Centre, Sydney, NSW, Australia.

2Australian National University, Canberra, ACT, Australia.

3Sydney West Area Health Service, Penrith, NSW, Australia.

Address correspondence to:

Laurence S. Wilson, Ph.D.

CSIRO ICT Centre

P.O. Box 76

Epping NSW 1710

Australia

Abstract

We address advanced Internet for complex telehealth applications by reviewing four hospital-based broadband telehealth projects and identifying common threads. These projects were conducted in Australia under a 6-year research project on broadband Internet applications. Each project addressed specific clinical needs and its development was guided by the clinicians involved. Each project was trialed in the field and evaluated against the initial requirements. The four projects covered remote management of a resuscitation team in a district hospital, remote guidance and interpretation of echocardiography, virtual-reality-based instructor–student surgical training, and postoperative outpatient consultations following pediatric surgery. Each was characterized by a high level of interpersonal communication, a high level of clinical expertise, and multiple participants. Each made use of multiple high-quality video and audio links and shared real-time access to clinical data. Four common threads were observed. Each application provided a high level of usability and task focus because the design and use of broadband capability was aimed directly to meet the clinicians' needs. Each used the media quality available over broadband to convey words, gestures, body movements, and facial expressions to support communication and a sense of presence among the participants. Each required a complex information space shared among the participants, including real-time access to stored patient data and real-time interactive access to the patients themselves. Finally, each application supported the social and organizational aspects of their healthcare focus, creating and maintaining relationships between the various participants, and this was done by placing the telehealth application into a wider functioning clinical context. These findings provide evidence for a significantly enhanced role for appropriate telemedicine systems running on advanced networks, in a wider range of clinical applications, more deeply integrated into healthcare systems.

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http://www.pharmacynews.com.au/article/agreement-ushers-in-new-dispensing-charter/509268.aspx

Agreement ushers in new dispensing charter

14 January 2010 | by Mark Gertskis

A nationwide system of medication information and compliance will be implemented in every pharmacy under the Fifth Community Pharmacy Agreement negotiated by the Pharmacy Guild with the Federal Government.

According to new details of the agreement released yesterday, a new Prescription Commitment will compel pharmacies to issue every patient filling a prescription with a leaflet tailored to the patient and the drug dispensed.

The leaflet will include consumer medicine information (CMI) for that drug, information on premium free products and a patient's compliance score for chronic disease medications derived via dispensary systems.

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http://www.pharmacynews.com.au/article/pharmacists-gain-e-script-incentive/509272.aspx

Pharmacists gain e-script incentive

14 January 2010

Community pharmacies will receive a financial incentive for every prescription they fill using an electronic prescribing system, under a new measure proposed in the Fifth Community Pharmacy Agreement.

New details of the agreement reveal that pharmacies are set to be paid $0.15 per script to "offset some of the costs of providing electronic prescriptions".

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http://www.theaustralian.com.au/australian-it/icsglobal-us-expansion-plans-hits-legal-wall/story-e6frgakx-1225819943165

ICSGlobal US expansion hits legal wall

  • From: Australian IT
  • January 15, 2010 1:04PM

ICSGlobal's bid to enter the US health billing and banking market with the $2.16 million purchase of Georgia-based Medical Recovery Services has been marred by financial irregularities in MRS's accounts and alleged misconduct by the former owner, Donna Murphy, the company told the Australian Securities Exchange.

In a statement this week, ICSGlobal managing director Tim Murray said management had begun legal proceedings after "becoming aware of irregularities in the MRS accounts and actions by Ms Murphy and three (of her) relatives, which the company believes are in breach of employment and other agreements they entered into.”
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http://www.zdnet.com.au/news/software/soa/iSoft-lays-off-several-dozen/0,130061733,339300421,00.htm

iSoft lays off several dozen

By Suzanne Tindal, ZDNet.com.au
14 January 2010 12:15 PM

in brief Australian health software company iSoft has recently held a round of redundancies, despite outlining a vision late last year to increase its workforce.

ZDNet.com.au understands that the company laid off around 25 to 30 Australian workers in December, naming a restructure as the reason. There had also been rumours that a further round was planned. The company has declined to comment on the issue.

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http://www.zdnet.com.au/news/software/soa/NEHTA-sicks-lawyer-on-ex-staffers/0,130061733,339300415,00.htm?omnRef=1337

NEHTA sicks lawyer on ex-staffers

By Suzanne Tindal, ZDNet.com.au
13 January 2010 05:35 PM

Two former National E-Health Authority employees who are pushing a self-developed alternative to individual health identifiers have been threatened with legal action by the authority for what it claims is theft of its intellectual property.

NEHTA's charge has been to bring Australia into the e-health era where every Australian has an electronic medical record. It has been working with Medicare on a number for each citizen which can be used to collate medical information.

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http://www.theaustralian.com.au/australian-it/e-prescribing-tender-cancelled/story-e6frgakx-1225818883921

E-prescribing tender cancelled

  • Karen Dearne
  • From: Australian IT
  • January 13, 2010 3:22PM

NINE months after a tender aimed at resolving key management arrangements for new national electronic prescribing systems closed for consideration, the federal Health Department has quietly advised bidders by letter that the project has been canned.

Department officials say the call for a consultancy to develop an e-prescribing and dispensing "benefits realisation and implementation plan" has been overtaken by recent events.

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http://www.6minutes.com.au/articles/z1/view.asp?id=509249

Government scraps e-prescribing project

by Jared Reed

The Federal government has abandoned an electronic prescribing project started last year, claiming that its health reform agenda has changed the course of the project.

The open tender call was launched in May 2009, one month before the National Health and Hospitals Reform Commission released its 123 reform recommendations, and called for advice in the creation of an “e-prescribing and dispensing of medicines benefits realisation and implementation plan”.

http://www.smh.com.au/technology/technology-news/broadband-billions-left-hanging-as-wireless-bites-back-20100112-m4u7.html

Broadband billions left hanging as wireless bites back

ARI SHARP

January 13, 2010

AUSTRALIANS are flocking to 3G mobiles and wireless broadband devices, bringing into question some of the assumptions behind the Rudd Government's $43 billion national broadband network.

A report published yesterday by the Australian Communications and Media Authority shows that take up of wireless technology more than doubled last financial year as quicker speeds and more sophisticated handsets made it a viable alternative to fixed-line internet.

''Australians increasingly seek flexibility in where and how they access communications and content,'' the report found.

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http://www.theaustralian.com.au/australian-it/federal-government-boosts-e-health-funding/story-e6frgakx-1225818209976

Federal government boosts e-health funding

FOUR more e-health projects will be funded under the federal government's $60 million Digital Regions initiative.

Communications Minister Stephen Conroy yesterday allocated an additional $6.5m to clinical outreach and telehealth programs.

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http://www.smh.com.au/national/vinnies-misused-donor-data-20100111-m2rr.html

Vinnies 'misused' donor data

ERIK JENSEN

January 12, 2010

THE St Vincent de Paul Society has been accused of breaching public trust and aspects of the Privacy Act after entering into an agreement that allowed one of the world's largest data companies to gather information through a Christmas mail-out from the charity.

The society defended its relationship with Acxiom but admitted to allowing it to write half the questions in the survey - and to collecting only limited data from the four-page questionnaire.

It paid for the printing and mailing of the survey in exchange for a targeted mailing list from Acxiom.

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http://www.psnews.com.au/Page_psn1996.html

New DVA health cards are big deal

The Department of Veterans’ Affairs is to reissue its Repatriation Health Cards which are due to expire in 2010.

Minister for Veterans’ Affairs, Alan Griffin said some improvements would be made to the new cards which would be given to all eligible veterans, war widows/widowers and dependants.

Mr Griffin said the changes would increase the cards’ security, improve provider satisfaction and increase veteran access to services.

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http://news.cnet.com/8301-13860_3-10426627-56.html?tag=rtcol;pop

January 6, 2010 12:04 PM PST

Windows 7 has lots of 'GodModes' (exclusive)

by Ina Fried

Those intrigued by the "GodMode" in Windows 7 may be interested to know that there are many other similar shortcuts hidden within the operating system.

Intended for developers as a shortcut to various internal settings, such features have been around since Vista and even before, according to the head of Microsoft's Windows division, who tells CNET that the so-called GodMode settings folder uncovered by bloggers is just one of many undocumented developer features included in Windows.

In an e-mail interview, Steven Sinofsky, Windows division president, said several similar undocumented features provide direct access to all kinds of settings, from choosing a location to managing power settings to identifying biometric sensors.

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See article for all the possibilities! Just amazing!

Enjoy!

David.

This Commonwealth Health Minister Is Just Utterly Clueless on e-Health Introduction.

This appeared in 6minuites today.

Doctors to pay for e-health upgrades

by Jared Reed

Nicola Roxon says doctors rather than the government will foot the bill for upgrading IT systems during the move towards an integrated national e-health system.

The minister toured the offices of Medicare in Canberra yesterday to look at the various tools that will be encompassed in e-health legislation the government plans to introduce soon.

Ms Roxon says she expects health providers, not the government, to fund the majority of its e-health agenda.

“We believe there's good reasons that healthcare providers and businesses and professionals can pay to upgrade their systems,” she said yesterday.

The government will adopt a more hands-off approach in the execution of e-health, acting instead as an overseer and intermediary between providers, she added.

“This isn’t an entire government enterprise. It’s about government using its role to link the different providers at appropriate times for the benefit of the patient.”

More here:

http://www.6minutes.com.au/articles/z1/view.asp?id=509538

What on earth is she smoking? There is no reason for Doctors to do anything of the sort that I can see, other than those few who operate with a (very deep) sense of altruism or those who are technogeeks and love playing with the blinking lights.

Nowhere else in the world has it been seen to be reasonable to pay for technology upgrades which, after all, typically require time, effort and cost to install and once operational provide the majority of the benefits of the use of the technology to the patient and those who fund the health services.

Technology Introduction 101 is quite clear – those who benefit are those who should pay!

Unless the migration to e-Health is made cost neutral for the health-care providers you can have a rolled gold 100% guarantee progress will be glacial at best!

I wonder just what the good reasons are she has for her "provider to pay" plan. Funny there is no explanation provided. The reason is, of course, that no rational justification exists - as the rest of the world knows!

Just arrant nonsense. I have never seen such silliness from a Minister of the Crown in all my now rather too many adult years!

David.

Monday, January 18, 2010

Ms Roxon Plans to Over Invest in E-Health – One Million Dollars To Get It Started.

If this reporting is accurate one can only despair!

Govt says e-health will deliver a safer system

  • Correspondents in Canberra
  • From: AAP
  • January 18, 2010 6:39PM

THE federal government says its proposed e-health system will improve patient safety and free up GPs.

The system, currently under design, will see patient records stored in one national database that can be accessed by different health professionals.

The government hopes to see the opt-out system up and running in ten years, and says more than $1 million has been put on the table to get it started.

Federal Health Minister Nicola Roxon says it will cut the time GPs spend pulling up patients health records during visits.

She insists the system will be secure and won't affect strict patient privacy laws.

"This doesn't change the existing laws of when it's appropriate for an individual have their records...accessed," she told reporters in Canberra.

States, territories and health professionals will also have to invest in technologies to allow them to link in to the system.

More here:

http://www.theaustralian.com.au/australian-it/govt-says-e-health-will-deliver-a-safer-system/story-e6frgakx-1225820965086

Also we have this:

e-health legislation

Monday, 18 January 2010 06:16

Patient care will be improved and inefficiency in the health system will be cut by new e-health legislation soon to be introduced by the Rudd Government.

Today I visited Medicare Australia to see first hand how the secure e-health system currently being developed will work for patients and health care professionals.

The demonstration clearly showed how useful tools like electronic health records, medications-management systems and electronic clinical messaging (discharge, referrals, pathology, and prescriptions) will help improve delivery of health care – particularly when patients are being cared for by multiple providers.

The first step in creating an e-health system will come into effect in the middle of the year when unique healthcare identifiers are assigned to all health consumers as well as to health professionals and the organisations that provide health care in Australia.

The unique healthcare identifiers will be available on a secure system, operated by Medicare Australia.

These identifiers will be provided in addition to Medicare numbers, as a further step to ensure the security of the system. Legislation to underpin this work – the Healthcare Identifiers Bill 2010 - will be introduced to Parliament in the first half of this year. The draft legislation is available for comment at www.health.gov.au/ehealth/consultation.

More here:

http://australia.to/2010/index.php?option=com_content&view=article&id=559:e-health-legislation-&catid=100:just-in

A ministerial ‘puff piece’ if ever there was one!

What can one say?

Does anyone seriously believe she knows what she is talking about? (Or is she just being badly misquoted?). We are all glad she visited to see stuff that is still unfunded and unwanted as far as she seems to be concerned

Blowed if I know what she is on about. – this really is just unclear policy nonsense.

David.

Ms Roxon Speaks on E-Health Funding

As reported on ABC News Radio at about 6pm 18 Jan, 2009.

The Health Minister does not think we need e-Health which is funded by Government - as is happening in other countries including the US, the UK and Europe. She is confident care providers and vendors will come to the party to save the Government from spending any money.

In the interview clip I heard she provided no reason why she imagined that might be the case.

Seriously clueless is my assessment on the basis of this report. Policy nitwit might also fit.

More to follow once there is more available.

David.

It Looks Like The Pharmacists Have Just Gazumped the Docs.

You humble scribe is easy to confuse but recently the level of confusion has really accelerated.

First we have the announcement I reported last week:

Government scraps e-prescribing project

by Jared Reed

The Federal government has abandoned an electronic prescribing project started last year, claiming that its health reform agenda has changed the course of the project.

The open tender call was launched in May 2009, one month before the National Health and Hospitals Reform Commission released its 123 reform recommendations, and called for advice in the creation of an “e-prescribing and dispensing of medicines benefits realisation and implementation plan”.

But in a letter sent to bidders seven months after the NHHRC report’s release, the government says the recommendations had “materially affected the department’s anticipated workplan” for the e-prescribing project.

Bidders for the contract were required to submit recommendations as to whether the system should be government-owned and operated, government-owned and controlled but industry operated, or wholly industry-owned and operated.

On his blog, health IT commentator Dr David More says the cancellation would annoy groups who had put in a huge amount of development work.

More here:

http://www.6minutes.com.au/articles/z1/view.asp?id=509249

Then following appeared a few days ago in Pharmacy News.

Pharmacists gain e-script incentive

14 January 2010

Community pharmacies will receive a financial incentive for every prescription they fill using an electronic prescribing system, under a new measure proposed in the Fifth Community Pharmacy Agreement.

New details of the agreement reveal that pharmacies are set to be paid $0.15 per script to "offset some of the costs of providing electronic prescriptions".

Dispensing software vendors are also set to receive extra funding to help them implement e-script functions into their platforms.

The new payment, however, coincides with the abolition of the $0.40 PBS Online incentive payment.

More here:

http://www.pharmacynews.com.au/article/pharmacists-gain-e-script-incentive/509272.aspx

and here a similar report.

Govt agreement delivers new incentives to pharmacists

Elizabeth McIntosh - Thursday, 14 January 2010

PHARMACISTS will soon receive new incentives for patient medication management and harnessing new technology, as part of the Fifth Community Pharmacy Agreement.

The fifth agreement between the Pharmacy Guild and the Federal Government will set out community pharmacy funding until 2015, and though negotiations are not complete, the Government has announced ambitions to cut up to $1 billion from the agreement.

According to industry e-newsletter Pharmacy Daily, while details of specific programs have not been released, a new Pharmacy Practice Incentive has been created which will be linked to defined outcomes in patient medication management.

A new Prescription Commitment has been created, which will require provision of consumer medication information and checking patient compliance with chronic disease medications.

Last year pharmacists came under fire from Federal Health Minister Nicola Roxon for a lack of consistency in providing medication information and advice to consumers, despite receiving incentive payments for the service (MO, 27 November 2009).

More here:

http://www.medicalobserver.com.au/News/0,1734,5777,14201001.aspx

We also discover that there are some other changes.

Agreement ushers in new dispensing charter

14 January 2010 | by Mark Gertskis

A nationwide system of medication information and compliance will be implemented in every pharmacy under the Fifth Community Pharmacy Agreement negotiated by the Pharmacy Guild with the Federal Government.

According to new details of the agreement released yesterday, a new Prescription Commitment will compel pharmacies to issue every patient filling a prescription with a leaflet tailored to the patient and the drug dispensed.

The leaflet will include consumer medicine information (CMI) for that drug, information on premium free products and a patient's compliance score for chronic disease medications derived via dispensary systems.

"We will be the first country in the world to implement a nationwide charter for a dispensing services in a community pharmacy," Guild national president Kos Sclavos told Pharmacy News.

More here:

http://www.pharmacynews.com.au/article/agreement-ushers-in-new-dispensing-charter/509268.aspx

The only detail available from the DoHA is this:

Agreement to Deliver Certainty for Community Pharmacy and Government

24 December 2009

The Australian Government and the Pharmacy Guild of Australia have reached agreement on the major components of the Fifth Community Pharmacy Agreement, which will commence on 1 July 2010.

The current agreement ends 30 June 2010.

The agreement is being negotiated in a very tight fiscal environment, in which the Government has to carefully consider its expenditure in all areas. This is especially the case given the Government’s significant health reform agenda.

Consumers can be assured that the Australia-wide network of community pharmacies will remain viable and at the front line of health care, delivering access to vital medicines to the community and delivering professional services such as medicines counselling and health advice.

The Government will make $15.1 billion available to community pharmacy over the life of the agreement, ensuring a viable community pharmacy network.

At the same time, through working closely with the Guild, the Government will make a saving of $1 billion on the forecast spending for community pharmacy, helping to maintain a sustainable health system and making other health reforms more affordable to Government.

I would like to thank the Guild, and in particular its President, Mr Kos Sclavos, for working so constructively with Government in the interests of the Australian community.

Release is here:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr09-nr-nr243.htm?OpenDocument&yr=2009&mth=12

So what we have here is a payment for e-prescribing being introduced and the consultation required to determine how e-prescribing would be best done being canned in pretty much the same week.

Can I say I smell a rat!

What is more the doctors have lost the Easyclaim incentive and the pharmacists are being incentivised for providing a service which relies on Doctors doing electronic prescription transmission for which they are not being paid.

It also can’t be in a Standardised way as the standards have not yet been finalised so how is it being done and what is the measure on which payment will be made? More important, who counts?

Pity the actual agreement still seems to be secret, despite copious leaking from the Pharmacy Guild.

This is heading towards a huge mess in my view!

David.

Sunday, January 17, 2010

It Seems The Whistle Has Been Blown on the Commonwealth Department of Health and Ageing.

The following appeared in the Australian a few days ago.

Federal health `riddled with conflict'

  • David Uren, Economics correspondent
  • From: The Australian
  • January 15, 2010 12:00AM

THE commonwealth Health Department is an obstacle to reform and should be broken up, with its core staff numbers slashed by 95 per cent, a report presented to the Prime Minister's Department yesterday recommends.

The report, based on interviews with former commonwealth and state health ministers, treasurers and health administrators, says the department is riven with conflicts of interests and should be split, retaining its core function of specialist policy advice while a separate department would deliver services such as Medicare and aged care.

Ken Baxter, lead author of the report and formerly head of the premiers' departments of NSW and Victoria, said the Rudd government would not achieve its goal of improving health services delivery until the department's roles and responsibilities were sorted out.

"There appears to have been a long-standing culture of obfuscation and opposition to major reform from middle-level management," the report says, adding this was also true of state departments.

The department, with about 5000 staff, had become too broad for a single minister to handle effectively, Mr Baxter said. A pared-down policy advisory department would require no more than 250 specialist staff.

The report, funded by the private hospital and health fund body, the Australian Centre for Health Research, was based on interviews with 15 former ministers and health administrators.

Lots more here:

http://www.theaustralian.com.au/news/nation/federal-health-riddled-with-conflict/story-e6frg6nf-1225819422755

Coverage is also found here:

Report: Health Dept hindering reform

15-Jan-2010

The Federal Health Department is rife with conflict of interests and is a serious obstacle to reform, a report by the Australian Centre for Health Research claims.

The report, which was presented to the Prime Minister’s Department this week, recommends that the department should specialise in providing specialist advice, while another department should be created to oversee the delivery of other services such as Medicare, according to an article in the Australian.

"There appears to have been a long-standing culture of obfuscation and opposition to major reform from middle-level management," the Australian quoted the report as saying, adding this was also true of state departments.

More here (registration required):

http://www.australiandoctor.com.au/articles/e4/0c0668e4.asp

It is interesting that this research has been, in part sponsored by Government – and must have been close to one of the last ministerial acts of the now Opposition Leader.

Press Release

Australian Centre for Health Research

17 October 2007

ABB135/07

Subject to successful contractual negotiations, the Commonwealth Government will provide funding of $500,000 to the Australian Centre for Health Research (ACHR) for its work.

Australia has a very good record in medical research. The Government wants health policy research to match our scientific and medical research in reputation and quality.

The ACHR will consider measures that could be taken to improve the delivery of health services and boost the quality of the performance of the health system.

It is headed by a former national president of the ALP, Neil Batt. A former federal Coalition health minister, Michael Wooldridge, is on its research committee.

The grant to the ACHR should help to establish a critical mass of practical heath policy that can subsequently be supported by competitive NHMRC grants.

The ACHR was established in 2005 as a research body that is representative of the entire health sector. It aims to produce independent, quality research to advance the effectiveness of health services in Australia.

The release is here:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr07-ta-abb135.htm

One really has to wonder that if these findings are indeed accurate then what sort of impact such division and dissention might be having on policy formation in e-Health. It sure can’t be helping.

Ken Baxter is no amateur assessor of bureaucracies and so his comments deserve, prima facie, to be taken quite seriously. It is a pity the report is not yet available from the ACHR website:

http://www.achr.com.au/

Maybe then we could all form our own views on the reported findings.

Heavens knows what impact all this might be having on the broader, and seemingly stuck, health reform agenda.

I look forward to comments from those on the inside of DoHA telling us all how this is just nonsense!

David.

Saturday, January 16, 2010

Submissions Regarding The Sneak Exposure Draft of the HI Services Bill (2010).

Dr Juanita Fernando has kindly posted a listing of the current public submissions for the request for public comment conducted while DoHA employees holidayed over Christmas.

Publicly available submissions addressing the Draft HI Bill are listed here. These and others will eventually be available from the Department of Health website.

If you'd like to add your submission to those listed below, please email us and we'll post your link accordingly.

As new entries may be added – it might be worth checking back here every few days.

http://www.consumerehealth.org/hi_bill_subs_14.html

This is a very useful thing to have done and I am sure she would be happy if I publicised her work.

The submissions confirm the view that there are a lot of unaddressed issues and that without prior publication of the regulations associated with the legislation the consultation is a total farce.

David.

Thursday, January 14, 2010

Weekly Overseas Health IT Links 13-01-2010

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

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http://fcw.com/articles/2010/01/04/hhs-electronic-health-records-ehr-final-rule.aspx

Proposed rules set stage for e-health records incentives

Proposed rules address stimulus law payments, meaningful use and certification

Physicians will have to submit 80 percent of their clinical orders electronically, while hospitals will have to do so for 10 percent of their orders, under expansive new proposed regulations released by the Health and Human Services Department for meaningful use of electronic health records (EHRs).

The Centers for Medicare and Medicare Services (CMS) released a 556-page proposed rule on Dec. 30 about the definition of “meaningful use” and how eligible professionals and hospitals may qualify for incentive payments as meaningful users under the American Reinvestment and Recovery Act (ARRA) of 2009. The Recovery Act allocates at least $17 billion for such payments by doctors and hospitals that buy and meaningfully use certified EHR systems.

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http://www.healthleadersmedia.com/content/TEC-244313/Marathon-of-Meaningful-Use-EHR-Standards-Just-Beginning.html

Marathon of Meaningful Use, EHR Standards Just Beginning

Dom Nicastro and Janice Simmons, December 31, 2009

With the release yesterday of its "meaningful use" definition and standards, government agencies have laid the foundation for an "evolutionary process in achieving and maintaining the meaningful use of certified EHR technology," says Frank Ruelas, director of compliance and risk management at Maryvale Hospital and principal, HIPAA Boot Camp, in Casa Grande, AZ.

CMS and the Office of the National Coordinator for Health Improvement Technology (ONC) on Wednesday, December 30, released two anxiously-awaited regulations providing both the definition of "meaningful use" for electronic health records (EHRs) and the standards to improve the efficiency of health information technology used nationwide by hospitals and physicians.

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http://www.europolitics.info/social/organs-health-inequalities-consumer-head-spanish-priorities-art258933-26.html

Health and consumers

Organs, health inequalities & consumer head Spanish priorities

By Marianne Slegers | Monday 04 January 2010

The Spanish EU Presidency has set out three main priorities for public health. Health inequalities, human organs and chronic diseases are high on its agenda. On the first priority, Spain will organise an expert conference in April ahead of the informal Health Council on 22-23 April. According to sources, the “main challenge” is to agree on “better indicators” and improved health information systems across the European Union to make it easier to identify inequalities in the first place.

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Spain’s third priority in this area is to provide a policy framework to tackle the looming EU wide problem of chronic diseases. The Presidency will organise two expert conferences on this issue: one will focus on e-health and the other on patient safety related to infectious, cardiovascular and chronic mental health diseases, such as Alzheimer’s, which will become common as a result of the EU’s ageing population.

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http://www.ihealthbeat.org/perspectives/2010/innovation-inspired-by-economics-2010-health-it-forecast.aspx

Monday, January 04, 2010

Innovation Inspired by Economics: 2010 Health IT Forecast

by Jane Sarasohn-Kahn

Health IT is one of the fastest-growing business sectors, expected to grow by 11% annually through 2013, according to Scientia Advisors. That's a bullish expectation, especially in the context of continued financial challenges for U.S. health providers.

Health IT purchases will be made despite fiscal constraints such as reimbursement pressure, inflationary costs for labor, supplies and other operating expenses, as well as high patient bad debt expenses.

Necessity being the mother of invention, a constrained economic environment will lead to health IT innovations in two ways.

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http://www.ehealtheurope.net/news/5511/tech_vital_to_medication_adherence

Tech vital to medication adherence

04 Jan 2010

Information technology has a vital role to lay in cutting medication-related errors and improving medication adherence among older people, suggests a recent report.

The report says that of the 3 billion medication prescriptions issued each year in the US, 12% are never picked up by the patient and 40% are not taken correctly.

Published by the US Centre for Technology and Aging in Oakland, California, the report says "widespread use" of technology aimed at older people has the potential to save thousands of lives and billions of dollars.

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http://www.healthcareitnews.com/news/study-says-telemedicine-doesnt-improve-icu-outcomes

Study says telemedicine doesn't improve ICU outcomes

December 30, 2009 | Molly Merrill, Associate Editor

CHICAGO – The use of telemedicine in intensive care units does not improve patients' risk of death or length of stay, according to a recent study.

The study, published in the December issue of the Journal of the American Medical Association, assessed the effect of a tele-ICU intervention on mortality, complications and length of stay in six ICUs of five hospitals in a large U.S. healthcare system. It was led by Eric J. Thomas, MD, of the University of Texas Health Science Center at Houston and colleagues, who measured outcomes before and after implementation of the tele-ICU system.

"Remote monitoring may be a partial solution for the intensivist shortage, but it is expensive, its use is increasing and there are few data in the peer-reviewed literature evaluating its effect on morbidity and mortality," said the authors.

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http://www.bostonherald.com/business/healthcare/view.bg?articleid=1221632

At-home technology can monitor seniors for safety

By Associated Press | Monday, December 28, 2009 | http://www.bostonherald.com | Healthcare

At 88, Grif Crawford knows he’s at risk of a fall or other sudden health problem. So he wears a pendant around his neck that can summon help if something goes wrong.

"It’s kind of like life insurance," said Crawford, of Lee Summit, Mo. "I feel very comforted with this."

The device has come a long way since the days when it merely allowed the wearer to alert someone that he or she had fallen and couldn’t get up. Crawford’s equipment also can be programmed to answer his phone, remind him to take his medicine or alert him to a fire, among other things.

It’s one of several new products designed to help seniors stay in their homes rather than move to a nursing home or assisted living facility.

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http://www.informationweek.com/blog/main/archives/2010/01/so_what_is_micr.html;jsessionid=I01NAO3HS0DHLQE1GHOSKHWATMY32JVN

So What Are Microsoft's Tablets? Chopped Liver?

Posted by David Berlind, Jan 6, 2010 01:51 PM

Yesterday, on the way home from my interview of Free Software Foundation founder and president Richard Stallman, I listened closely as Slate's Farhad Manjoo told NPR's Neal Conan the facts about Apple's forthcoming tablet PC: that there are no facts. Well, there's one. Apple's brand has gotten so powerful that everyone including the stock market is putting faith in pure vapor as though the tablet mode of Microsoft's Windows 7 doesn't matter. Nary a mention. What gives?

The credit Apple is already getting for reinventing the tablet market is 100 percent lock stock and barrel based on the belief (faith for many) that Apple can do for tablets what it has done for music and smartphones. Although I love Apple (I made the switch to Mac OS X over 2 years ago and have never looked back and own several iPods), I'm unconvinced that a tablet from Apple can achieve the same sort of market success.

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http://www.itbusinessedge.com/cm/blogs/bentley/e-health-records-data-privacy-continue-to-be-hot-topics/?cs=38567

E-Health Records, Data Privacy Continue to Be Hot Topics

Posted by Lora Bentley 06-Jan-2010 12:58:12

Monday I noted that posts about online privacy were among my most read of 2009. Posts about the HITECH Act and electronic health records were also at the top of the list.

Interestingly, the seond-most-read governance post of the year touched on both the HITECH Act and privacy issues -- it addressed the data breach notification rule included in the HITECH Act.

To review, the Health Information Technology for Economic and Clinical Health Act was enacted as part of the American Recovery and Rehabilitation Act, which Congress passed shortly after President Obama took office. Along with setting aside nearly $22 billion for health information technology, the act extended the reach of the data privacy and security requirements of the Health Insurance Portability and Accountability Act (HIPAA) to include business associates of health care organizations.

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http://www.futuregov.net/articles/2010/jan/07/building-healthy-malaysia/

Building a healthy Malaysia

By Jianggan Li | 7 January 2010

Malaysia’s Ministry of Health has come a long way on its e-health journey, with many success stories as well as lessons learned. Some of the key planners share their stories with Jianggan Li.

Like many of its neighbours, Malaysia has been experiencing changing disease patterns. The era of acute infectious diseases and malnutrition has been succeeded by one of chronic diseases and lifestyle related illnesses. So the country’s healthcare strategy has had to shift from making traditional health and hygiene improvements to promoting healthier lifestyles and managing chronic diseases.

“This calls for change in the role of healthcare professionals and the delivery interface between the consumer and health system,” says Dato’ Dr Jai Mohan, Professor of Health Informatics at Kuala Lumpur-based International Medical University and the Vice President of the Malaysia Health Informatics Association.

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http://www.modernhealthcare.com/article/20100105/REG/301059985

Family docs unhappy with EHR support: AAFP

By Andis Robeznieks / HITS staff writer

Posted: January 5, 2010 - 5:59 am ET

Family physicians who use electronic health-record systems employ a wide range of products, have been using them for only a few years, and are generally not that happy with vendor training and support, according to a survey of American Academy of Family Physicians members published in the most recent issue of Family Practice Management, an AAFP journal.

The survey questionnaire was open to the AAFP's 94,600 members and was published in the journal and posted online with 2,556 members responding. Out of those, 544 were excluded for various reasons such as those who responded by saying they don't use an EHR (477), while others named a practice-management program instead of an EHR when asked which system they used.

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http://www.healthleadersmedia.com/content/TEC-244439/Nine-Healthcare-Executives-Respond-to-the-Meaningful-Use-Definition.html

Nine Healthcare Executives Respond to the Meaningful Use Definition

Carrie Vaughan, for HealthLeaders Media, January 5, 2010

The long-awaited definition of meaningful use is finally here. Just before the New Year, the Centers for Medicare & Medicaid Services and the Office of the National Coordinator released both the definition of "meaningful use" for electronic health records and the standards to improve the efficiency of health information technology.

Hospital and provider group organizations have already offered their criticism of the proposed regulations. Yesterday, my colleague Janice Simmons offered a good evaluation of the American Hospital Association, Medical Group Management Association, and the American Medical Association concerns.

I was curious what individual providers thought of the definition, so I asked physicians, chief information officers, and other industry leaders whether they thought the meaningful use bar was set too high or low, and what they thought was the most significant change to the HIT Policy Committee's recommendations, if any. Many executives are still delving into the 700+ page document, but here are their initial reactions.

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http://www.signonsandiego.com/news/2010/jan/06/a-medical-breakthrough-va-kaiser-to-share-records/

Medical breakthrough: VA, Kaiser to share records

National-level alliance has been elusive goal

By Keith Darcé, UNION-TRIBUNE STAFF WRITER

Wednesday, January 6, 2010 at 12:01 a.m.

Kaiser Permanente and the U.S. Department of Veterans Affairs today will launch an electronic medical-data exchange program in San Diego that could become the seed for the much touted but equally elusive national health records system.

The collaboration, which will be detailed at a news conference in La Jolla, marks the first time a computerized patient-records system operated by a federal agency has been linked to one operated by a private organization.

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http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=213238

Buying into BI

Technology helps hospital executives apply business strategies to health care.

By Marianne Slight

As in traditional corporations, health care providers are facing increased pressure to accomplish strategic business goals, such as increasing profitability, reducing costs, improving patient satisfaction and doing more with less. As a result, many hospitals function like business corporations: Management sets high-level objectives; objectives cascade down the organization in the form of targets and budgets; and those targets are turned into tactical operational plans, which evolve and change based on external pressures and internal constraints.

Because the health care industry is now expected to accomplish the same sorts of strategic goals as ordinary businesses, it should come as no surprise that business intelligence (BI) is becoming increasingly utilized by health care organizations to make course corrections, hit targets at all levels of the organization and accomplish strategic objectives.

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http://www.e-health-insider.com/news/5519/first_clinical_director_for_informatics

First clinical director for informatics

05 Jan 2010

The Department of Health has announced that it has appointed Charles Gutteridge as the first national clinical director for informatics.

Dr Gutteridge has been the medical director at Barts and the London NHS Trust since 2002, and the DH says he has been closely involved in confidentiality, patient safety and informatics issues.

He was the Caldicott Guardian for Barts, led the Health Foundation’s Safer Patients Initiative from 2006-8, and chaired the Clinical Informatics Design Authority.

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http://www.govhealthit.com/newsitem.aspx?nid=72905

Health IT panel gropes for NHIN authentication plan

By Mary Mosquera
Friday, January 08, 2010

To accelerate use of the nationwide health information network (NHIN), a panel of the Health IT Policy committee met yesterday to explore methods to verify the identity of healthcare providers who will use the network to exchange patient data.

Authentication verifies identity and assigns credentials for electronic transactions but there are a variety of approaches to accomplish this basic component of e-health exchange, experts told the NHIN work group Jan. 7.

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http://www.ihealthbeat.org/features/2010/california-health-it-sphere-in-flux-in-wake-of-calrhio-shake-up.aspx

Thursday, January 07, 2010

California Health IT Sphere in Flux in Wake of CalRHIO Shake-Up

by George Lauer, iHealthBeat Features Editor

CalRHIO, one of the country's first organizations designed to oversee the exchange of digital health information, has been thrown into a state of flux after failing to win designation as California's lead health IT agency. Leaders and employees have left. Some of CalRHIO's board members may still be active in negotiations with the state, but the future of the organization is unclear.

The upheaval at the California Regional Health Information Organization leaves the recently reorganized California eHealth Collaborative as the front-runner in the race to win the state's nod to oversee billions of federal stimulus dollars for health IT projects. The first wave of federal money -- about $40 million -- is expected to begin flowing into California early this year. The state-designated agency could end up disbursing billions of dollars through a variety of federal programs over the next several years.

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http://www.seattlepi.com/local/413941_infection07.html

Infection data helped Swedish clean up its act

State now lists infection rates of hospitals on Web site

By ERIC NALDER

HEARST NEWSPAPERS

The state aired the dirty laundry, or shall we say the infected laundry, of certain hospitals on Wednesday.

And there were some surprises when the Washington State Department of Health went live shortly before noon with its long-awaited Web site revealing the infection rates for hospitals statewide.

The biggest shock involved Swedish Medical Center, one of the state's biggest and most prominent hospitals. Swedish was listed as one of only two hospitals in the state with unusually high infection rates caused by tubes known as "central lines" that are inserted into patients.

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http://www.healthcareitnews.com/news/hhs-unveils-nations-first-health-security-strategy

HHS unveils nation's first health security strategy

January 07, 2010 | Bernie Monegain, Editor

WASHINGTON – Health and Human Services Secretary Kathleen Sebelius has unveiled The National Health Security Strategy, focused on protecting people's health during a large-scale emergency.

Sebelius said the "comprehensive" document, the first for the nation, sets priorities for government and non-government activities over the next four years.

"As we've learned in the response to the 2009 H1N1 pandemic, responsibility for improving our nation's ability to address existing and emerging health threats must be broadly shared by everyone – governments, communities, families and individuals," Sshe said. "The National Health Security Strategy is a call to action for each of us so that every community becomes fully prepared and ready to recover quickly after an emergency."

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http://www.computing.co.uk/computing/news/2255850/1bn-spent-far-national

£6.1bn spent so far on National Programme for IT

Figures is £2bn less than original forecasts due to slow progress on scheme

Written by Tom Young

Computing, 08 Jan 2010

The government will have spent £6.1bn on the NHS National Programme for IT (NPfIT) by April, some £2bn less than it had forecast.

The figure is for central spending by Connecting for Health only – it doesn't include any of the £3.6bn which was expected to be spent by NHS trusts on the NPfIT by now. However it does include recent contracts awarded to BT in the South.

The figures were released by NPfIT minister Mike O'Brien in response to a parliamentary question by shadow health minister Stephen O'Brien.

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http://www.ehiprimarycare.com/news/5513/tory_manifesto_has_records_for_all

Tory manifesto has records for all

04 Jan 2010

David Cameron has promised that online health records will underpin a new direction for the NHS if the Conservative Party is elected in this year’s general election.

In a speech at Westminster today, the Tory leader unveiled the first chapter of the Conservative Party’s draft manifesto, which focuses on the health service.

Cameron said: “It’s the patient who’ll have the power in our NHS. You’ll be able to check your health records online in the same way you do your bank account.

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http://www.ehiprimarycare.com/news/5509/cancer_detection_software_to_be_trialled

Cancer detection software to be trialled

30 Dec 2009

Software to help GPs to detect the early signs of cancer is to be trialled in England in 2010.

The new computer-assisted cancer risk assessment announced by cancer tsar, Professor Mike Richards, will help GPs to decide whether the symptoms a patient presents with indicate the presence of cancer and whether further tests or investigations are needed.

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http://www.healthleadersmedia.com/content/TEC-244376/How-to-Prevent-Top-Three-Health-Information-Breaches.html

How to Prevent Top Three Health Information Breaches

Dom Nicastro, for HealthLeaders Media, January 4, 2010

Major breaches of patient information in 2009 break down into three types: snoopers, hackers, and those involving large quantities of data.

So let's examine the top breaches from the past year and find out what facilities can do to prevent similar problems.

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http://www.govhealthit.com/newsitem.aspx?nid=72852

Provider groups raise a clamor over 'meaningful use'

By Mary Mosquera

Monday, January 04, 2010

Health providers and IT policymakers returned from the holiday weekend on Monday having had just enough time sort through the administration’s “meaningful use” proposal, its 700-page incentive plan designed to spur hospitals and physicians to pursue digital make-overs of their practices.

Their first impression: That the administration’s hugely ambitious, carefully crafted, $20 billion incentive plan may provide too much stick for the carrot.

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http://www.healthdatamanagement.com/news/meaningful_use_survey_hospitals_EHR_HITECH-39606-1.html?ET=healthdatamanagement:e1127:100325a:&st=email

Survey: Hospitals Not Ready for MU

HDM Breaking News, January 4, 2010

A small survey of 58 hospitals of all sizes shows they are not ready for meaningful use of electronic health records requirements.

Consulting and I.T. services firm Computer Sciences Corp. conducted the survey this past fall and released results on Jan. 4. The proposed rule for meaningful use requirements issued on Dec. 28 retains many expected provisions that were first recommended by federal advisory committees last summer.

.....

Full survey results are available at csc.com/musurvey.

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http://www.modernhealthcare.com/article/20100104/FREE/301049998#

NQF endorses 70 data-related measures

Posted: January 4, 2010 - 5:15 pm ET

The National Quality Forum is endorsing 70 performance measures that combine data from various electronic sources—such as administrative claims, pharmacy and laboratory systems, and registries—in order to advance the use of electronic data platforms to measure, report and improve quality.

The NQF reviewed more than 200 measures used by health plans to assess physician performance, but endorsed less than half of those.

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http://www.nytimes.com/2009/12/22/health/22cyst.html?_r=2

Tool in Cystic Fibrosis Fight: A Registry

By MILT FREUDENHEIM

HARTFORD — In the 1950s, children with cystic fibrosis usually died before they reached kindergarten age, their airways choked with mucus by a genetic disorder that disrupts their ability to clear infections from their lungs.

Today, many people with the disorder are living well into their 30s and beyond, and children like Caroline Castonguay, a preteen patient at the Central Connecticut Cystic Fibrosis Center here, can do all the things their classmates do — ski, ice-skate, play soccer, get top grades in school.

These patients owe their lives, at least in part, to a carefully updated nationwide collection of personal profiles called a patient registry.

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Enjoy!

David.