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."

Monday, May 24, 2010

Weekly Australian Health IT Links - 24-05-2010.

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. Note also that full access to some links may require site registration or payment.

General Comment:

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There really was only one issue that emerged this week in my mind. That was, with an election looming in the next six months, we are probably not going to get any policy sense from either side on the e-Health front.

It is a pity because both sides know they need a credible plan to take development of the use of Health IT in Australia but somehow neither seem prepared to invest the intellectual effort to get there.

In an ideal world we would have bi-partisan agreement that implementation of the already agreed National E-Health Strategy would be a very sensible way forward – but I won’t hold my breath.

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http://www.ovum.com/news/euronews.asp?id=8633

Steve Hodgkinson

Australian government commits to national e-health record system

The Australian government last week announced a significant budget commitment to the implementation of a national e-health records system. Details are sketchy, but the aim is to launch a person-controlled, opt-in, online system to enable patients and providers to better share health information. The government needs the project to be out of the blocks quickly, so vendors with ready-to-go solutions should be fine-tuning their proposals.

At last a positive commitment to a national e-health records system

In last week's budget the Australian government committed A$466.7 million over two years for a national e-health records initiative. Few details were forthcoming beyond statements that the funding is to create a person-controlled system that will enable Australians to check their medical history online. It is claimed the system will provide summaries of patients' health information such as medications, immunizations, and medical test results, and will provide patients and healthcare providers with secure any-time, any-place access to records.

The announcement was a welcome follow-up to recent decisions regarding reform of the country's health-sector funding regime with a shift to a national case-mix model and the creation of local hospital networks (clusters of hospitals) and primary healthcare organizations (community-level clusters of GPs and other primary healthcare providers). These decisions reinforce the fragmented nature of the sector, so an announcement to fund the creation of a national e-health records system is regarded as a vital boost to information-sharing between healthcare providers.

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http://www.adelaidenow.com.au/news/south-australia/gp-dentist-finance-records-released-by-mistake/story-e6frea83-1225868876488

GP, dentist finance records released by mistake

THE confidential financial records of many South Australian health professionals have been inadvertently revealed by the nation's largest medical financier.

Medfin Finance, a subsidiary of National Australia Bank, this week sent the details of up to 4000 SA doctors' and dentists' bank accounts and borrowings by email to its state members.

It is understood the document included details of SA health professionals only.

The finance company, which has about 20,000 clients, tried to recall the email message, which contained a spreadsheet detailing the accounts and personal information of its members, however, it has no way of stopping the recipients from viewing the material.

One affected health professional, who did not wish to be named, told The Advertiser the incident was "a complete breach of privacy".

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http://www.australiandoctor.com.au/articles/82/0c069a82.asp

Email of bank details puts 4000 at risk

21-May-2010

By Louise Wallace

THOUSANDS of doctors are at risk of identity theft and having their money swindled after their personal information was accidentally leaked by the nation's largest medical financier, AMA warns.

Medfin Finance inadvertently revealed financial records and confidential information of up to 4000 doctors and dentists based in SA after an email containing private information was accidentally sent to 500 doctors.

Bank amounts, transaction details and debt expenses were included in the email, as well as personal details, contact information and private business data.

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http://www.rustreport.com.au/ (May 21, 2010)

Aust tech helps Canadian health fixes

Researchers at Alberta Health Services in Canada are using Australian software to help them devise better methods for the delivery of primary healthcare services in the province. The NVivo 8 analytical software from Melbourne-based QSR International is being used by researchers undertaking a large multi-disciplinary mixed methods research project to investigate different models of healthcare and how they support collaboration among primary healthcare professionals, explained John Owen, CEO of QSR.

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http://www.computerweekly.com/blogs/tony_collins/2010/05/-should-hospitals-study-mortal.html

Doctors criticise Cerner system six months after it went live

The Daily Examiner, which is one of the oldest newspapers in Australia, reports on the controversial installation of a Cerner-based hospital system in New South Wales.

It's not clear whether the controversy is because the IT is making the lives of doctors more difficult - and therefore potentially dangerous for patients - or whether clinicians are critical of a system that, given time, could make their working lives more productive and improve outcomes for patients.

Or both?

Cerner is one of two software products that are at the heart of the NPfIT, the other being iSoft's Lorenzo.

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http://www.theaustralian.com.au/news/opinion/in-digital-age-politics-its-duelling-transcripts-at-ten-paces/story-e6frg6zo-1225869798459

In digital-age politics it's duelling transcripts at ten paces

What about those e-health commitments, Tony? Abbott as health minister on March 1, 2006:

ANOTHER issue I just want to touch on briefly is the importance of e-health. The technology is not really a problem; I think privacy issues can be dealt with. What has been missing is the will to make it happen. And I believe that with the creation of the National E-Health Transitional Authority we do have the opportunity to really make a difference over the next few years.

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http://www.smh.com.au/digital-life/games/tick-of-approval-wii-a-healthy-choice-20100518-v9vw.html

Tick of approval: Wii a healthy choice

May 18, 2010

Talk about strange bedfellows. The American Heart Association and Nintendo are teaming up to promote the popular Wii video game console, as the health advocacy group concedes that its campaign for traditional exercise isn't working

The surprising partnership comes amid growing concern about obesity among kids who spend much of their time watching television and playing video games.

Nintendo will be able to brand its Wii products with the AHA's iconic heart logo to let consumers know that the organisation considers the items a healthy choice. Nintendo will donate US$1.5 million ($1.7 million) to the AHA as part of the partnership.

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http://www.misaustralia.com/viewer.aspx?EDP://1274402002701&section=news&xmlSource=/news/feed.xml&title=CSIRO+program+to+aid+e-health

CSIRO program to aid e-health

Friday, 21 May 2010 | Rachael Bolton

A new program developed by the Commonwealth Scientific and Industrial Research Organisation (CSIRO) will be employed to aid the roll out of standardised electronic health records by patching existing systems to match internationally agreed standards.

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http://www.medicalnewstoday.com/articles/189201.php

E-health Will Talk For The Unconscious And Elderly, Australia

19 May 2010

The Australian Nursing Federation are disappointed that the shadow treasurer, Joe Hockey, at his Press Club address, failed to discuss Coalition health policy while also dismissing the benefits of e-Health.

Ged Kearney, ANF federal secretary, said the initiative could save many lives each year because hospital nurses would have instant access to the health details of new patients.

"Everyday you have people who have been in a car accident or are victim of attack or have fallen ill suddenly, they arrive by ambulance unconscious and unaccompanied by family and friends needing immediate treatment. Nurses are forced to decide instantly how to initiate care for that person without knowledge of their medical histories," she said.

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http://www.medicalnewstoday.com/articles/189229.php

e-health Has Huge Potential And Challenges For Rural Australia

19 May 2010

Australians living in rural and remote areas stand to benefit substantially from e-health. However, those areas also have the poorest infrastructure in Australia - particularly access to Broadband - presenting huge challenges for rural and remote GPs.

The Royal Australian College of General Practitioners (RACGP) says that e-health strategies need to take this into account and find out how rural and remote GPs can receive the resources and support they will need.

Dr Kathryn Kirkpatrick, Chair of the RACGP National Rural Faculty and rural GP in Dalby, Queensland, said that GPs often have to deal with incomplete and fragmented information and waste time collecting information and duplicating treatment activities.

"Rural and remote GPs may not have access to the required health information and have to manually coordinate care with other providers. This can often be exacerbated in rural and remote areas where health system access and equity issues have long been recognised.

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http://www.computerworld.com.au/article/347269/royal_flying_doctor_service_backs_e-health/?eid=-6787

Royal Flying Doctor Service backs e-health

RFDS says devil is in the details but supports Federal Government’s decision

The Royal Flying Doctors Service (RFDS) has come out in support of the Federal Government’s $466.7 million commitment to personally controlled electronic health records.

RFDS chief executive officer, Nigel Milank, said that, while the initial burst of publicity in the Budget was around the metropolitan issue of hospital beds, the famed healthcare provider was pleased that there is more money for primary healthcare.

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http://www.news.com.au/national/fines-for-refusing-to-take-part-in-abs-health-survey/story-e6frfkvr-1225868423359

Fines for refusing to take part in ABS health survey

  • Fines for refusing to answer
  • Up to 50,000 people face fines
  • ABS says participation is compulsory

UP TO 50,000 people face a fine of $110 a day if they refuse to divulge information on their health and lifestyle to Australian Bureau of Statistics researchers.

The Australian Health Survey announced in last week's Budget will be the most comprehensive research on the health of Australians ever undertaken and will be jointly funded by the National Heart Foundation.

But the 50,000 people chosen to take part will be compelled to do so.

Participants will be weighed and measured and will be asked to give a blood and urine sample.

Comment: Surely a ‘beat up’!

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http://www.theaustralian.com.au/news/nation/joe-hockey-takes-swing-at-e-health/story-e6frg6nf-1225868400495

Joe Hockey takes swing at e-Health scheme

  • Patricia Karvelas, Political correspondent
  • From: The Australian
  • May 19, 2010 12:00AM

JOE Hockey will today map out the Coalition's return to economic conservatism, promising to cut the Rudd government's controversial new e-Health scheme to save $467 million and announcing a review of the Trade Practices Act to help small business.

In a speech to the National Press Club, the opposition Treasury spokesman will announce that the review -- which he will describe as the most significant in decades -- will not be headed by Treasury secretary Ken Henry. That is an apparent swipe at the independence of the Treasury boss.

The "root and branch" review will be charged with easing burdens on small business and infrastructure projects through the laws defining business conduct.

And the Coalition will kill the e-Health scheme which was announced with the budget and which will cost $467m over the next two years.

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http://www.computerworld.com.au/article/347102/hockey_wants_blood_over_e-health/?eid=-255

Hockey wants blood over e-health

Shadow Treasurer says he always takes a “strong line” on IT projects, but deflects question on whether e-health will be cut by the Opposition

The shadow treasurer, Joe Hockey, wants blood over e-health.

After giving his detail-scarce budget response speech to the National Press Club this weel, Hockey was asked if dumping e-health, a rumoured part of Liberal's election policy, was “short-sighted and stupid”.

But Hockey predictably side-stepped giving a real answer, a familiar theme in all of his responses to questions.

“I’ve always taken a strong line on investment in IT,” he said. “When I was Human Services minister there were programs in IT in health and Medicare that I wanted closed down because they were not delivering what I promised. Sadly, my successor re-birthed them and put more money into them and I suspect not much has been done.

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http://www.misaustralia.com/viewer.aspx?EDP://1274311979168&section=news&xmlSource=/news/feed.xml&title=Govt+calls+Abbott+a+risk+to+health+system

Govt calls Abbott a risk to health system

AAP

The federal government has used the coalition's plan to cut $467 million worth of funding for electronic health records to renew attacks on Tony Abbott as a risk to the health system.

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http://www.pharmacynews.com.au/article/mixed-views-on-coalition-e-health-plan/517412.aspx

Mixed views on Coalition e-Health plan

20 May 2010 | by Nick O'Donoghue

Plans by the Coalition to abandon the Federal Government’s $467 million investment in e-health should they gain power have received mix reactions from pharmacy’s leading bodies.

Pharmaceutical Society of Australia president Warwick Plunkett said the decision would be detrimental to the health of consumers.

“There is no doubt that the development of the e-health policy has been overly expensive and its implementation delayed far too long, but at this stage it would be unwise to simply abolish this strategy.

“It will give pharmacists access to essential patient health information to allow better outcomes to be delivered by the pharmacy profession. Through e-health, the delivery of e-prescribing is now within our grasp with little additional investment required,” Mr Plunkett said.

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http://www.abc.net.au/news/stories/2010/05/20/2904819.htm?section=justin

Aboriginal health group slams Abbott over e-health

By Alex Johnson

Posted Thu May 20, 2010 1:00pm AEST

A Northern Territory Aboriginal health alliance has called on the Federal Opposition to reconsider its election policy to abolish an electronic patient information system.

The Coalition says abandoning the online medical filing system would save more than $460 million over four years.

But the chief executive of the Aboriginal Medical Services Alliance, John Paterson, says the system has been vital in the fight against chronic disease among Indigenous people.

"It enables those clinicians where Aboriginal people are visiting to quickly access electronically all their health records, their medication records."

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http://www.australiandoctor.com.au/articles/6f/0c06996f.asp

E-health funds, super clinics on the block

19-May-2010

By Sarah Colyer

The Federal Opposition has vowed to scrap half-a-billion dollars in promised e-health funding and discontinue the planned establishment of 23 GP super clinics if it wins government in this year’s federal election.

The measures were announced today as part of Shadow Treasurer Joe Hockey’s promise to “get the budget back to surplus as quickly as possible”.

In total, the Coalition would scrap more than 40 funding proposals announced by the Rudd government that it claims would save $46.7 billion.

AGPN chair, Dr Emil Djakic, said Mr Hockey would “send Australia back to the health care dark ages” if he pulled funding on e-health initiatives and infrastructure funding for general practices.

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http://www.medicalobserver.com.au/news/abbott-attracts-criticism-for-plan-to-axe-ehealth-program

Abbott attracts criticism for plan to axe e-health program

21st May 2010

Caroline Brettingham-Moore

THE Opposition’s controversial about-face on e-health has come under fire from all sectors, with doctors arguing the plan would be an enormous backward step.In his Budget response, Shadow Treasurer Joe Hockey said the Opposition would reap savings of $467.2 million by abolishing the e-health program – a project it has previously supported.

The Rudd Government was quick to pounce on the backflip, referring back to previous statements from Opposition leader Tony Abbott where he advocated a fully-functioning e-health system. In 2007, Mr Abbott, then Health Minister, said “failure to establish an electronic patient record system within five years... would be an indictment against everyone in the system”.

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http://www.medicalobserver.com.au/news/ehealth-budget-below-expectations

E-health budget below expectations

16th May 2010

Caroline Brettingham-Moore

The Federal Government’s commitment to e-health has been called into question, following the news its latest investment of $466.7 million will span just two years.

The funding is well below the $1.5 billion investment, over five years recommended in the National E-health Strategy developed for the Government by consultants Deloitte.

Health IT consultant Dr David More said the amount of funding and time-frame demonstrated a lack of confidence from the Government.

“Who is going to get involved in a program which has two years of funding and then it stops cold? What does that tell you about their level of confidence?” he asked.

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http://www.itwire.com/it-policy-news/government-tech-policy/39137-e-health-needs-more-funds-and-a-rethink

e-health needs more funds and a rethink

The Government’s fooling itself if it thinks that the $466.7 million allocated in last week’s Budget will buy it a national e-health record system, but nor should it pony up billions to pay for a big bang electronic health network as the UK’s £30 billion e-health initiative has proved a squib.

Health IT experts say it’s time for a rethink on both funding and strategy – and some long overdue clarity about who should drive Australia’s e-health initiatives.

Although consulting firm Booz & Co earlier this month found that a comprehensive e-health system could lead to healthcare savings of more than $7.6 billion a year by 2020, the report’s co-author and Booz principal, Klaus Boehncke told iTWire today that $466.7 million wasn’t enough to buy such a system. That would require an investment of $200-$400 per Australian – as much as $8.6 billion given the current population of almost 21.5 million.

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http://www.medicalobserver.com.au/news/eprescribing-guide-needed

E-prescribing guide needed

14th May 2010

Caroline Brettingham-Moore

STANDARDS to ensure the quality and safety of electronic prescribing systems could be based on key software features identified by a recent study.

The study, conducted by the National Prescribing Service (NPS), singled out 27 key features of prescribing software currently used by general practitioners.

These ranged from warnings on patient contraindications, clearer designs, and automatic medicines lists that can be printed out for each patient to take away with them.

“In the absence of national standards, we hope these provide vendors with guidance about key features to include,” said NPS CEO Dr Lynn Weekes (PhD).

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http://www.theaustralian.com.au/news/brain-tumour-link-to-mobiles/story-e6frg6n6-1225867464272

Industry study shows brain tumour link to heavy mobile phone usage

A LONG-awaited international study of the health risks of mobile phones has linked extended mobile phone use to an increased risk of developing brain tumours.

The 10-year Interphone study, the world's biggest study of the health effects of mobile phones, found while there was no increased risk of cancer overall, those in the top 10 per cent of phone use are up to 40 per cent more likely to develop glioma, a common type of brain cancer.

Just 30 minutes of mobile talk time daily was enough to put participants into the top 10 per cent category in the study, carried out in 13 countries, including Australia, and involving more than 5000 brain cancer patients worldwide.

The International Agency for Research on Cancer, which conducted the study and has repeatedly delayed its publication, summarised the findings by saying there were "suggestions of an increased risk of glioma, and much less so meningioma, in the highest decile (10 per cent) of cumulative call time, in subjects who reported phone use on the same side of the head as their tumour".

It added "biases and errors limit the strength of the conclusions that can be drawn . . . and prevent a causal interpretation".

Note: The study is basically inconclusive – despite all the headlines see here.

http://www.theaustralian.com.au/news/nation/cancer-risk-from-mobiles-a-riddle/story-e6frg6nf-1225867930553

Cancer risk from mobiles 'a riddle'

  • Adam Cresswell, Health editor
  • From: The Australian
  • May 18, 2010 12:00AM

RESEARCHERS will seek access to individuals' mobile phone records as part of further studies to pin down the cancer risks from mobile phones, after the world's biggest study found disturbing but inconclusive evidence of a danger to heavy users.

The long-awaited final analysis of the 13-nation Interphone study involving more than 5000 cancer cases, to be officially released today, found adults who talked on their mobiles for longer than 30 minutes a day had an average 40 per cent increased risk of developing glioma, the commonest type of brain cancer.

But the study's authors also said there was no overall increased cancer risk from mobile phone use. The finding has triggered controversy among other scientists over the reliability of the long-awaited research.

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http://inside.org.au/inside-conroys-implement/

Inside Conroy’s Implement

What does $25 million worth of consultancy conclude about the national broadband network, asks Jock Given

17 May 2010

FIBRE-TO-THE-HOME is supposed to let you do pretty much anything. Anything except look into it. Side-on is okay, but peering down a live optical fibre cable is like staring into a tiny, focused sun. A lot of light bores straight into your eyeball. Definitely not a good look.

Staring at fibre is what consultants McKinsey & Company and accountants KPMG have been doing for the last several months. The federal government paid them around $25 million; broadband minister Stephen Conroy got a 534-page Implementation Study. Value for money? That depends on what you were looking for.

Comment: Invaluable Independent Analysis

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http://www.theaustralian.com.au/australian-it/seagate-spins-out-a-storage-marvel-goflex/story-e6frgakx-1225867893688

Seagate spins out a storage marvel: GoFlex

EXTERNAL hard disk drives tend to all be much the same, no matter who the manufacturer. Inside the casing there's one or two disks, magnetically encoded, and spinning at 5400, 7200 or, in a few cases, 10,000rpm.

The two top makers, Seagate and Western Digital, are always looking to come up with a new twist that will set their brand apart. Seagate reckons it may just have done it, with its latest range of "GoFlex" models, due to hit the Australian market this month.

It claims they'll change the way people store, access and share digital content, though others are not so sure.

Missing from the rear end of each GoFlex drive is the usual array of USB, FireWire or eSATA sockets for connecting to a PC.

Instead there's a single interface into which you can plug any of a range of special GoFlex cables: USB 2, USB 3, FireWire 800, eSATA 6, even an automatic backup cable. The "bridge card" that normally sits inside a conventional hard drive enclosure, translating the output to suit each socket, is instead contained in each cable itself.

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Enjoy!

David.

A Press Release from eRx Clarifies the Pricing Approach From This Prescription Exchange.

I was sent the following release today. Given the discussion in the comments of the previous post I felt it was worthwhile posting.

MEDIA RELEASE

24 May 2010

eRx ensures all e-scripts at no cost to pharmacy

Dispensing of electronic scripts will be effectively free for all pharmacies as a result of a new pricing policy announced by eRx Script Exchange today. The new policy includes two major changes. eRx will lower its transaction fee to match the 15c incentive payment under the Fifth Community Pharmacy Agreement. eRx will also exchange all electronic scripts not currently funded by the incentive scheme at no cost. This includes private and pharmacy initiated originals and repeats therefore ensuring that pharmacies are not out-of-pocket for using e-scripts.

According to Graham Cunningham, Chairman, eRx Script Exchange, the policy is motivated by a commitment to maintaining a straightforward and cost-neutral approach for users. “We believe that this is a vital step in providing an e-script service that is both comprehensive and easy to understand, but also in removing any cost concerns about e-scripts.”

“Whilst the announcement of incentive payments is extremely positive for patient care and for the future of e-health in Australia, we would prefer an approach that includes all prescriptions. As it stands, the selective nature of this incentive could lead to confusion and lower the future benefits of e-scripts such as contributing complete patient medication history to the newly announced government Electronic Health Record. Our new pricing policy allows us to continue discussions on these outstanding issues while we implement eRx fully across Australia for all prescriptions.”

Mr Cunningham advised that eRx may not be able maintain its cost-neutral approach indefinitely but it will continue to work with partners, government and the industry in an attempt to do so. If the pricing policy needs to be changed, eRx users will be provided with a minimum of two months’ notification in advance.

More than 3,700 doctors and 2,000 pharmacies are already using eRx for electronic prescribing and dispensing, and more than 8.5 million scripts have been safely, securely, and accurately completed via eRx since launch in April 2009. eRx remains cost free to doctors and while the incentive payments to pharmacy are due to begin on 1 July, eRx is available to Guild and AFSPA members for no cost today.

To register for eRx, or to find out more about the incentive payments and eRx’s cost-neutral pricing policy, visit www.erx.com.au.

Media enquiries

David Freemantle

Project Director, eRx Script Exchange

0417 398 726

About eRx Script Exchange

eRx Script Exchange is an industry-driven initiative designed to improve health outcomes for all Australians. Led by pharmacy IT specialist Fred Health, it brings together expertise in the e-health needs of pharmacists, GPs and medical practitioners. eRx Script Exchange utilises the development expertise of health exchange specialist Simpl NZ, Microsoft Australia, and HP. eRx Script Exchange is fully endorsed by the Pharmacy Guild of Australia.

----- End Release

The release can be found here:

http://www.erx.com.au/pdf/eRx_media_release_pricing_policy.pdf

It will be interesting to see how things now progress, and what competitive responses emerge!

David.

Sunday, May 23, 2010

After The Hype Now the Reality. Shared Records are Years Away, if Ever! We Have Been Here Before in 2004!

NEHTA released its second Clinical e-Newsletter a day or so ago – dated 19 May, 2010.

The full document can be obtained from here.

http://www.nehta.gov.au/component/docman/doc_download/1005-nehta-clinical-enewsletter-may-2010

Main Headline is this.

Federal Budget - $467m for personally controlled electronic health records for all Australians

The Government’s investment of $467m into the development of electronic health records announced in the 2010/11 budget on 11 May represents a key building block of the National Health and Hospitals Network.

A secure system of personally controlled electronic health records will provide: summaries of patient health information including medications, immunisations and medical test results; secure access for patients and healthcare providers to their e-health records via the internet; rigorous governance and oversight to maintain privacy; and national standards, planning and core national infrastructure to enable healthcare providers to use the system.

In 2010-11, the Dept of Health and Ageing (DoHA) will consult with stakeholders on the planning, design and development of a personally controlled electronic health record system and will also develop related national governance and legislative requirements.

The second year will focus on building on existing foundation development to increase linkages to other health information elements, such as pathology and specialist reports, for incorporation into the electronic health summary.

The Budget paper also noted that in 2010-11 the Government will continue to provide incentives to general practices to promote the use of e-health tools and systems through the Practice Incentives Program (PIP). It also noted that DoHA will continue to support the development of secure messaging specifications to assist the use of electronic referrals, prescribing and discharge summaries ahead of the personally controlled electronic health record system rollout commencing in 2012-13

The secondary headline is here:

Federal Budget – Pharmacy e-prescription incentives

The Fifth Pharmacy Agreement with the Pharmacy Guild includes $82.6m in e-prescription incentives. From 1 July 2010 the Commonwealth will pay a fee of 15 cents per transaction to approved suppliers dispensing electronic prescriptions. Software vendors will have 24 months to comply with the requirements that include compliance with the Australian Standard specified relevant version of NEHTA’s specifications for ETP.

The Pharmacy Agreement defines an electronic prescription as one electronically generated by a prescriber, authenticated (electronically signed), securely transmitted (either directly or indirectly) for dispensing and supply, seamlessly integrated into dispensing software and, for PBS prescriptions, able to be electronically sent to Medicare Australia for claiming purposes.

----- End Extract.

For a silly bit of trivia it is worth noting that the document dated 19 May asks for consultation responses on e-Referrals and says this consultation closes on the May 21. What?

But to the substantive issues:

On the Personally Controlled Electronic Health Records (PCEHR) we note:

It is DoHA and not NEHTA who is going to consult on the planning, design and development of the PCEHR. This work is to happen 2010-11.

In 2011-12 we will work on messages to fill up the apparently central repository.

And implementation starts after all that.

I will leave it as an exercise for the reader to try and figure out where the skills for this project will come from, how whatever is planned will be procured (surely DoHA would not try to develop something like this?), what the governance will look like, and why clinicians would send information of this sort to a Government repository among a host of other questions about data quality, data priority, legal liability for contents transmitted and so the list goes on.

Remember we went down a similar path with such shared records ages ago. The program was called HealthConnect and was killed when Mr Abbott and Mr Hockey discovered just how much it was going to cost – and turned it into the legendary ‘change management strategy’.

All the details can be found here from December 2004!

This is a presentation of the concepts and how it would work

http://moreassoc.com.au/downloads/bap_dec2004.ppt (400k)

And here are all the details:

http://moreassoc.com.au/downloads/BA%20V1.9i%20final.zip (800k)

On the basis of this we have hardly moved forward in half a decade. Read and weep. Only the names have essentially changed!

If people are interested I have a large archive of this stuff – I can post the key ones. Let me know.

Remember as some wise soul said ‘those who forget the lessons of history are condemned to repeat them!’ (George Satayana or Arnold Toynbee - Google not clear!)

The e-Prescribing announcement is just amazing! Basically it seems to say for 2 years you can use any old un-standardised system to transmit prescriptions for 2 years – and get paid - and then you will have to conform to NEHTA’s specification! How about getting standardised first and then get paid. This is absolute policy rubbish in my view.

Sadly we seem to live in some very stupid and forgetful times!

David.

Saturday, May 22, 2010

Remember You Were Around When This Was Announced! It is a Biggie!

There is a little doubt this is the biggest announcement we will see in the life sciences for a good few years. As such I felt it was important to mark – especially as my first degree, way back when, was actually in microbiology.

Scientists Create Synthetic Organism

By ROBERT LEE HOTZ

Heralding a potential new era in biology, scientists for the first time have created a synthetic cell, completely controlled by man-made genetic instructions, researchers at the private J. Craig Venter Institute announced Thursday.

"We call it the first synthetic cell," said genomics pioneer Craig Venter, who oversaw the project. "These are very much real cells."

Created at a cost of $40 million, this experimental one-cell organism, which can reproduce, opens the way to the manipulation of life on a previously unattainable scale, several researchers and ethics experts said. Scientists have been altering DNA piecemeal for a generation, producing a menagerie of genetically engineered plants and animals. But the ability to craft an entire organism offers a new power over life, they said.

The development, documented in the peer-reviewed journal Science, may stir anew nagging questions of ethics, law and public safety about artificial life that biomedical experts have been debating for more than a decade.

"This is literally a turning point in the relationship between man and nature," said molecular biologist Richard Ebright at Rutgers University, who wasn't involved in the project. "For the first time, someone has generated an entire artificial cell with predetermined properties."

David Magnus, director of the Stanford University Center for Biomedical Ethics, said, "It has the potential to transform genetic engineering. The research is going to explode."

Leery of previous moral and ethical debates about whether it is right to manipulate life forms—which arose with the advent of cloning, stem-cell technology and genetic engineering—some researchers chose neutral terms to describe the experimental cell. Some played down the development.

"I don't think it represents the creation of an artificial life form," said biomedical engineer James Collins at Boston University. "I view this as an organism with a synthetic genome, not as a synthetic organism. It is tough to draw where the line is."

For the first time, scientists have created a synthetic cell, heralding a new era in biology. Shelly Banjo talks to Robert Lee Hotz about the huge implications of this development.

The new cell, a bacterium, was conceived solely as a demonstration project. But several biologists said they believed that the laboratory technique used to birth it would soon be applied to other strains of bacteria with commercial potential.

Much more here:

http://online.wsj.com/article/SB10001424052748703559004575256470152341984.html?mod=djemHL_t

I especially liked this comment from a Ken Carpenter.

“What makes a big part of this possible is the enormous increase in computing power over the last few years, and it's what will continue to make advances like this appear at a faster clip. The singularity approaches.”

Lots of stuff here if you want to follow up.

http://en.wikipedia.org/wiki/Synthetic_life

There is little doubt 20 years from now we won’t recognise much of biology, and possibly much of computing as well!

David.

Friday, May 21, 2010

The US Health Information Exchange Model. A Useful Set of Videos.

I have been doing a little background research on the US Health Information Exchanges(HIE).

In doing that I came upon some presentations and videos that explain how at least one vendor (apparently presently the most successful over there) is supporting the HIE vision.

They can be viewed here:

http://www.axolotl.com/products/product-demos.html

If we could get to this level we would transform Health Services in Australia I reckon.

I know these are advertising videos, but there is real value in seeing what they can now deliver.

I am also aware other providers can do similar things. This is just a well presented example that shows where things are over there.

Note the lack of need for a National HI Service to do all this!

David.

The Government Line on E-Health. Pity Its Over Simplistic and Being Oversold.

ABC Radio National Breakfast had a session on E-Health this morning.

E-health battleground explained

E-health is another political battleground opening up between the government and the opposition. More than $460 million was set aside in this month's budget to establish a national e-health system. Patient records would be available on-line, giving doctors ready access to their medical histories including medications, immunisations and test results. But the coalition has vowed to dump the measure, even though leader Tony Abbott voiced his strong support for electronic records when he was health minister.

Guests

Dr Nathan Pinskier
National Electronic Health Transition Authority

The web site is here

http://www.abc.net.au/rn/breakfast/stories/2010/2905500.htm

We are told the Health Identifier Service is all ready to go July 1, 2010 and that this will really make a difference – apparently overnight!

Oh dear, oh dear. Why not just be open and honest make it clear e-Health will be a long and difficult program that will take years to make a major difference?

Setting expectations too high is a very bad way to start!

David.

Thursday, May 20, 2010

Weekly Overseas Health IT Links 20-05-2010.

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. Note also that full access to some links may require site registration or payment.

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http://govhealthit.com/newsitem.aspx?nid=73730

White House cyber security plan to cite e-health

By Mary Mosquera

Wednesday, May 12, 2010

The White House has begun developing a strategy for securing online transactions and stemming identity fraud that pays particular heed to the importance of building a trusted arena for electronic healthcare transactions.

Howard Schmidt, the nation’s cyber security coordinator, said this week that the administration wants to make online commerce more secure so that government, industry and consumers will feel comfortable doing more of their business to the Internet.

The plan to develop a strategy will focus on ways to improve identity management, Schmidt said at a May 11 conference on privacy and security sponsored by the Health and Human Service Department’s Office of Civil Rights and National Institute for Standards and Technology.

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Guerra On Healthcare: Health IT Safety Needs Serious Attention

Growing questions about risks can't be brushed aside.

By Anthony Guerra, InformationWeek

May 13, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224701470

Psychologists say people don't research problems to find solutions, but rather to support the solution they've already decided upon.

To cite a recent political example, many said the Bush administration "cherry picked" intelligence to foster support for a war that it was already committed to. In addition to the selection side, this type of analysis entails ignoring or discounting information that casts doubt upon the intended course.

I fear that the Office of the National Coordinator--the newly minted federal agency overseeing the implementation of the HITECH legislation--is falling into this trap. In my opinion, ONC can't be relied on to objectively evaluate and respond to growing concerns that electronic health records, in their current state of sophistication, bring with them as many patient safety risks as improvements.

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http://www.healthleadersmedia.com/content/HR-250784/Experts-Train-Employees-Not-To-Snoop-Fire-Those-Who-Do

Experts: Train Employees Not To Snoop; Fire Those Who Do

Dom Nicastro, for HealthLeaders Media, May 10, 2010


Patient-record snooping is inevitable, but with the advent of electronic health records (EHRs), it took "a new twist," says Kate Borten, CISSP, CISM, president of The Marblehead Group.

"The fact that e-records can be accessed from anywhere is both a blessing and a privacy and security curse," Borten says.

Borten says facilities should consider not only blocking access to PHI for employees who don't need it, but also to have strict policies and penalties in place for those who snoop at patient records.

Says Borten: "Today the standard approach–after technically blocking access from those who don't need it, of course—is to have a policy prohibiting snooping and sanctions for violations, workforce training that makes this crystal clear, and then follow-through with technical and manual auditing and disciplinary action."

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http://www.modernhealthcare.com/article/20100514/NEWS/100519962

Where does VistA, Veterans Affairs go from here?

By Joseph Conn / HITS staff writer

Posted: May 14, 2010 - 11:45 am ET

Part four of a four-part series (Access part one, part two and part three):

If the Veterans Affairs Department chooses to pursue an open-source software development scheme to upgrade its VistA clinical information technology system, a key decision must be made. What database software will be used in the redeveloped VistA system?

To the VistA outsider, the question—if not the choice—seems simple enough. To members of the burgeoning community of VistA insiders, however, the battle for the answers is shaping up to be a holy war for the digital soul of the software. And, as sometimes happens in soulful battles, there is a lot of money at stake.

Brian Lord is a former VA programmer who is now CEO of Sequence Managers Software, a Durham, N.C., developer of open-source VistA systems.

In reading the report released last week by the Industry Advisory Council, or IAC, of the American Council for Technology advising the VA on a way forward for VistA, Lord said he was “thrilled to see that they even went so far as to say, if you're going to make it open-source, you have to create a community, you have to have a bill of rights to what this community is going to be. I've never seen open-source characterized so well in any political document. That's unheard of.”

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http://healthit.hhs.gov/portal/server.pt?CommunityID=1959&parentname=CommunityEditor&control=SetCommunity&parentid=52&in_hi_userid=11673&PageID=0&cached=false&space=CommunityPage

There Is No ‘One-Size-Fits-All’ in Building a Nationwide Health Information Network

A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology

May 14, 2010

Private and secure health information exchange enables information to follow the patient when and where it is needed for better care. The Federal government is working to enable a wide range of innovative and complementary approaches that will allow secure and meaningful exchange within and across states, but all of our efforts must be grounded in a common foundation of standards, technical specifications, and policies. Our efforts must also encourage trust among participants and provide assurance to consumers about the security and privacy of their information. This foundation is the essence of the Nationwide Health Information Network (NHIN).

The NHIN is not a network per se, but rather a set of standards, services, and policies that enable the Internet to be used for the secure exchange of health information to improve health and health care. Different providers and consumers may use the Internet in different ways and at different levels of sophistication. To make meaningful use possible, including the necessary exchange of information, we need to meet providers where they are, and offer approaches that are both feasible for them and support the meaningful use requirements of the Centers for Medicare & Medicaid Services (CMS) Electronic Health Record Incentives Programs. As with the Internet, it is likely that what is today considered “highly sophisticated” will become common usage. Moreover, users may engage in simpler exchange for some purposes and more complex exchange for others.

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http://www.european-hospital.com/en/article/7178-E-health_advances_in_Austria.html

E-health advances in Austria

Report: Michael Krassnitzer

Like many others, Austria is in the process of introducing electronic patients’ records (EPRs) for use in and by all healthcare facilities. After a drawn out preparation phase, a company was founded to implement the project and ELGA (Elektronische Gesundheitsakte) is underway. ‘E-health will come, step by step, but inexorably’, said Austrian Health Minister Alois Stöger.

With the launch of the public health portal www.gesundheit.gv.at, the first ELGA milestone has now been reached.

ELGA is a searchable database that contains all health data about a patient, no matter when and where they were collected – i.e. in healthcare institution. The data can be accessed anytime by everybody who has the necessary access privileges. ‘A reliable system of strict access privileges is a crucial issue,’ said Dr Susanne Herbek, managing director of ELGA-GmbH. ‘Privacy and patient autonomy have to be guarded under all circumstances.’

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http://www.ihealthbeat.org/features/2010/personal-health-records-may-not-be-so-personal.aspx

Friday, May 14, 2010

Personal Health Records May Not Be So Personal

by Kate Ackerman, iHealthBeat Senior Editor

Personal health records often are touted as a way to engage patients by giving them control over their own health care. However, it turns out that personal health records might not be so personal.

A recent study published in the Journal of the American Medical Informatics Association found that PHRs aren't as patient centered as perhaps they should be. Researchers at Beth Israel Deaconess Medical Center assessed the patient centeredness of PHR systems at seven large early adopter organizations in 2007.

The study, which was supported by the Commonwealth Fund, found that while most of the organizations offered some patient-centered functions, there is still plenty of room for improvement.

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http://www.fierceemr.com/story/wisconsin-governor-creates-statewide-hie/2010-05-13?utm_medium=nl&utm_source=internal

Wisconsin governor creates statewide HIE

May 13, 2010 — 12:39pm ET | By Neil Versel

Wisconsin Gov. Jim Doyle this week signed into law a bill establishing a statewide network for health information exchange. The bill puts into use $9.4 million in HIE money the state received from the federal government under the American Recovery and Reinvestment Act, and each state is required to create an entity to oversee the allocation of such funding.

"If someone from La Crosse gets sick in Milwaukee, they should be able to access all of their own personal medical information electronically," Doyle said in prepared remarks. "Without it, doctors have to run tests that have already been done, raising both the costs and possibility of errors. Creating an electronic exchange where medical records can be safely shared and patients' privacy rights can be protected is a critical part of reforming health care in America."

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http://www.boston.com/bostonglobe/editorial_opinion/editorials/articles/2010/05/07/digitize_medical_records_waiting_puts_lives_at_risk/

GLOBE EDITORIAL

Digitize medical records; waiting puts lives at risk

May 7, 2010

WHEN IT COMES to switching from paper to electronic records, medicine trails many other professions — even though study after study has shown that computerization will save not just money but lives. Even with the incentive of billions of federal dollars to cover much of the cost of the transition, doctors and hospitals have been slow to take even the first steps toward conversion. Apparently, they feel little or no responsibility for symptoms that get misdiagnosed because of inadequate information about a patient’s past medical care, let alone the tests that get repeated because no one has a record of the previous results.

In addition to offering the carrot of billions of dollars in stimulus-bill subsidies, the Obama administration is wielding the stick of reduced Medicare payments to doctors who do not make the change by 2015. Already, some medical professionals believe that date is too soon. But if anything, the deadline gives medical providers too much time to put off the inevitable. Under no circumstances should the administration backtrack on its threat.

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http://www.softwareadvice.com/articles/medical/ehr-software-market-share-analysis-1051410/

EHR Software Market Share Analysis

Posted on May 14, 2010 at 8:39 am

Calculating market share for the electronic health record (EHR) market is no easy task. There are over 300 software vendors, many market segments (consider: size of practice served, specialties services, inpatient/outpatient) and very “fuzzy” sources of data.

Nevertheless, the team at Software Advice set out to see what numbers we could pull together. We limited our analysis to the outpatient EHR software market. Moreover, we decided to measure market share based on the number of physicians users, rather than vendor revenue or other metrics. We tried to keep it simple. It’s not.

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http://www.fierceemr.com/story/ehr-implementations-open-cans-compliance-worms/2010-05-13

EHR implementations open 'cans of compliance worms'

May 13, 2010 — 1:07pm ET | By Neil Versel

In case hospitals didn't have enough to do while implementing EHRs in time to earn federal stimulus money, EHRs can open up "brand-new cans of compliance worms," reports AIS' Health Business Daily.

It's well known that the systems they buy have to be certified--according to standards that aren't yet final. And, of course, providers have to demonstrate "meaningful use" of EHRs. That term, likewise, hasn't been fully defined. But the HITECH Act portion of the American Recovery and Reinvestment Act also requires hospitals to define the patient's legal medical record.

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http://www.fierceemr.com/story/looking-value-phrs/2010-05-13?utm_medium=nl&utm_source=internal

Looking for value in PHRs

May 13, 2010 — 11:44am ET | By Neil Versel

Let's get one thing straight: It's not that I don't like the idea of personal health records. I simply don't like the breathless hype around products with virtually zero market traction, and thus don't think there's much news in stories like the Mayo Clinic making a deal with Dossia.

Where I do see news is in stories that attempt to show the value of PHRs as a component in a much more connected health system, where data flows from multiple sources into a patient-accessible record, without requiring data entry by patients themselves.

In that spirit, I offer kudos to Canadian Healthcare Technology for providing a realistic argument in favor of PHRs. "Ideally, the test results for patients should be forwarded to a secure Patient Health Record (PHR), where they can be collated for future reference. It's a way of creating a unified record for care-givers, too, who want to see the records of patients who have been treated at other clinics and hospitals," writes CHT editor Jerry Zeidenberg. The key word here is "ideally." We certainly don't live in an ideal world when it comes to heath information.

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http://www.healthcareitnews.com/news/survey-personal-health-information-less-secure-2010

Survey: Personal health information less secure in 2010

May 10, 2010 | Molly Merrill, Associate Editor

SAN FRANCISCO – Forty-seven percent of IT security professionals believe their personal healthcare information is less secure than it was a year ago, according to a recent survey.

The online survey, by San Francisco-based nCircle, a provider of automated IT security and compliance auditing solutions, polled 257 security professionals between Feb. 4 and March 12, 2010.

IT professionals ranked insider threats as the most serious security issue facing healthcare organizations. Alex Quilter, healthcare security strategist with nCircle, said he was surprised by this finding, but suggested that it could be the result of putting patient care before patient privacy.

"This prioritization is correct but should not come at the expense of patient privacy," Quilter said. "This is compounded by the large network of business partners that require access to patient data as part of the healthcare supply chain. As the push for electronic health records intensifies security professionals and many consumers feel that their personal health information is less secure than ever."

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http://www.healthcareitnews.com/news/work-begins-converting-new-york-docs-digital-records

Work begins on converting New York docs to digital records

May 07, 2010 | Bernie Monegain, Editor

NEW YORK – Two health IT extension centers in New York state have begun work helping primary care physicians convert from paper to digital records.

The centers, which received $48.2 million of federal stimulus money, are among 60 across the country that will offer providers step-by-step help implementing electronic health record systems in their practices. The implementation and use of digital records will position the practices to be eligible for federal incentives of up to $63,750.

"Our goal is to help approximately 10,000 primary care providers in the State of New York adopt EHRs within two years to enhance patient care and the efficiency of their practices," said David Whitlinger, executive director of the New York eHealth Collaborative, one of the state's two extension centers.

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Health IT Savings May Reach $261 Billion

Innovative health IT systems that go beyond electronic health records to provide better analytics and drive greater efficiency could save billions over a decade.

By Nicole Lewis, InformationWeek

May 10, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224701400

As the healthcare system braces for a new age, using technology to develop interoperable, patient-centered health IT systems could yield billion of dollars in savings, a report predicts.

The report, "A 21st Century Roadmap for Advancing America's Health: the Path from Peril to Progress," highlights the role HIT will play in re-engineering healthcare through the adoption of electronic health records, providing better analytics, and driving greater efficiency as the country builds a more comprehensive framework that strengthens the public health infrastructure. Additionally, new systems can create cost savings.

"If used in innovative ways, the estimated savings from HIT expansion could reach $261 billion over 10 years," the report said.

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http://www.ehealtheurope.net/news/5897/mckesson_wins_%E2%82%AC40m_irish_pacs_deal

McKesson wins €40m Irish PACS deal

12 May 2010

Ireland’s Health Service Executive has confirmed that it has signed a €40m deal with US healthcare IT company, McKesson, to implement a National Integrated Medical Imaging system to digitise Ireland’s radiological services.

The three year deal will see Ireland’s hospitals digitise and store its full range of diagnostic images including ultrasound, x-rays, CT and MRI scans.

According to the HSE, all of the patient’s previous information and current images will be held electronically in the radiology department, outpatient clinics and hospital wards and will be able to be sent to GPs.

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http://www.chcf.org/publications/2010/04/clinical-documentation-ehr-deployment-techniques

Clinical Documentation: EHR Deployment Techniques

SA Kushinka of Full Circle Projects

April 2010

This issue brief on clinical documentation techniques is the second in a series of tactically oriented publications based on lessons learned through the California Networks for Electronic Health Record Adoption (CNEA) initiative. With electronic health records (EHRs), chart information can be accurately shared among multiple users, including specialists, behavioral care providers, labs and pharmacies, insurers, public health entities, and research organizations.

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Document Downloads

Clinical Documentation: EHR Deployment Techniques (147k)

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http://www.healthleadersmedia.com/content/TEC-250624/DukeDurham-Partnership-Uses-Informatics-to-Redesign-Health-System.html

Duke-Durham Partnership Uses Informatics to Redesign Health System

Cynthia Johnson, May 5, 2010

When Durham-based Duke University and the Durham, NC, community launched Durham Health Innovations (DHI) in April 2009, they knew they were embarking on a groundbreaking project that would use medical informatics to identify chronic disease interventions and improve the health of patients. But at some point during the recently completed planning stages of the project, team members realized that they had stopped talking about patients—and started talking about communities.

"We realized that we were doing a whole lot of work on individuals," says Lloyd Michener, MD, chair of the Department of Community and Family Medicine at Duke. "Until this project, we hadn't clearly seen how individuals were part of the same networks, the same communities, and the same neighborhoods. In many cases, it makes sense to do things at the community and neighborhood level rather than one at a time at an expensive doctor's office."

The project uses data from Duke's electronic medical records (EMR) system. The university runs customized software that assigns geographic locations to the data, also known as geocoding. This HIPAA-compliant process lets team members look at areas of disease clustering.

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http://www.healthleadersmedia.com/content/TEC-250829/Five-Tips-to-Guide-Your-Hospitals-Social-Media-Policy.html

Five Tips to Guide Your Hospital's Social Media Policy

Gienna Shaw, for HealthLeaders Media, May 11, 2010

Hospitals are increasingly pulling their heads out of the sand when it comes to the social media activity of their employees, recognizing that they're active on sites such as Facebook, Twitter, and YouTube regardless of whether the IT department blocks access to them from work computers. Time to face facts: Employees post online comments from their computers at home and use their smart phones to update their Facebook status while at work. And yes, they're talking about your hospital online.

In last week's column, I offered up four steps to take when crafting a social media policy, including borrowing ideas from hospitals that have already begun the process. This week I'll show you some examples of policies with language worth borrowing.

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http://www.fiercehealthit.com/story/saving-healthcare-clinical-narrative/2010-05-09

Saving healthcare with the clinical narrative

May 9, 2010 — 4:18pm ET | By Dr. Nick van Terheyden

A recent exposé on the dangers of electronic health records and in particular "copy-and-paste" functionality accentuates the battle between innovative technology and the essential inclusion of the nuanced clinician narrative. As one specialist put it, limiting a patient's medical record to a point-and-click template decreases the ongoing value of that record and weakens its contribution to clinical decision making. In fact, the value of the narrative is even evident from medical records dating back to 1547; consider the medical history of Henry VIII that even today continues to provide new insights into his clinical conditions and cause of death.

While templates help drive standardization and can ease data analysis, without the narrative we risk losing important clinical data that is buried, as shown in an example found on the Medical Transcription Industry Association website. The same note captured using a typical EHR system balloons to five pages, burgeoned with excess and difficult-to-read content, but from the narrative shrinks to two concise, readily digestible pages. The challenge is how to integrate the narrative into the EHR so as to benefit from the numerous EHR advantages of digitization and rapid sharing of information.

Speech remains the preeminent means of knowledge capture in healthcare. According to the Centers for Disease Control and Prevention, approximately 1.2 billion clinical documents are produced in the U.S. each year, of which 60 percent come from dictation and transcription, the MTIA says. A solution that thousands of clinicians are already using to preserve their often preferred dictation method, while still being able to capture the narrative as part of the EHR, is to apply speech recognition technology to the EHR process.

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http://www.healthdatamanagement.com/news/va-vista-open-source-recommendation-40241-1.html

VA Advisors: Go Open Source on VistA

HDM Breaking News, May 6, 2010

The Veterans Administration should commit to move to an open source, open standards model for the next generation of its VistA information system, according to a report from an advisory group the VA asked to submit recommendations.

The Industry Advisory Council on May 6 released a 100-page report. The council, providing a forum for government agencies and industry to collaborate, works under the umbrella of the American Council for Technology, a Fairfax, Va.-based not-for-profit educational organization created by government executives.

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http://www.ncbi.nlm.nih.gov/pubmed/20386011?dopt=Abstract

Arch Intern Med. 2010 Apr 12;170(7):648-53.

Association of health information technology and teleintensivist coverage with decreased mortality and ventilator use in critically ill patients.

McCambridge M, Jones K, Paxton H, Baker K, Sussman EJ, Etchason J.

Division of Critical Care Medicine, Lehigh Valley Health Network, Allentown, PA 18105-7017, USA.

Abstract

BACKGROUND: Little evidence exists to support implementing various health information technologies, such as telemedicine, in intensive care units. METHODS: A coordinated health information technology bundle (HITB) was implemented along with remote intensivist coverage (RIC) at a 727-bed academic community hospital. Critical care specialists provided bedside coverage during the day and RIC at night to achieve intensivist coverage 24 hours per day, 7 days per week. We evaluated the effect of HITB-RIC on mortality, ventilator and vasopressor use, and the intervention length of stay. We compared our results with those achieved at baseline. RESULTS: A total of 954 control patients who received care for 16 months before the implementation of HITB-RIC and 959 study patients who received care for 10 months after the implementation were included in the analysis. Mortality for the control and intervention groups were 21.4% and 14.7%, respectively. In addition, the observed mortality for the intervention group was 75.8% (P < .001) of that predicted by the Acute Physiology and Chronic Health Evaluation IV hospital mortality equations, which was 29.5% lower relative to the control group. Regression results confirm that the hospital mortality of the intensive care unit patients was significantly lower after implementation of the intervention, controlling for predicted risk of mortality and do-not-resuscitate status. Overall, intervention patients also had significantly less (P = .001) use of mechanical ventilation, controlling for body-system diagnosis category and severity of illness. CONCLUSION: The use of HITB-RIC was associated with significantly lower mortality and less ventilator use in critically ill patients.

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http://www.kaiserhealthnews.org/Daily-Reports/2010/May/10/Health-IT.aspx

Companies Await Health IT Windfall

May 10, 2010

The Washington Post: A Virginia firm, Vangent, is positioning "itself for a surge of federal spending on health information technology" by setting up a health IT strategy group. "Vangent is likely to face stiff competition for those dollars, but company officials say they expect the firm's reputation as a health-related services provider to serve it well as it bids on contracts." The firm is also involved in civil, defense and national security work, but health services are its largest business. It runs Medicare's "information and assistance program" (Censer, 5/10).

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FairWarning Foils EMR Privacy Breaches

Data definition guides help hospitals and healthcare offices detect, notify, and prevent privacy violations in electronic medical records.

By Nicole Lewis, InformationWeek

May 7, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224701076

FairWarning has developed data definition guides that the company says will help detect and prevent breaches of patient information in healthcare settings, a growing concern as the adoption of electronic medical records accelerates.

The St. Petersburg, Fla. firm supplies cross-platform healthcare privacy auditing for EMRs, and said it has deployed privacy, auditing, and monitoring solutions in more than 300 hospitals and 1,200 clinics across the United States, Canada, and Europe.

The FairWarning Patient Privacy Framework is a series of three documents that help hospital CIOs, IT managers, and other employees implement wide-scale patient privacy auditing, breach detection, remediation, and breach prevention, the company said.

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http://www.modernhealthcare.com/article/20100510/NEWS/100519998

Design with IT in mind

By Andis Robeznieks / HITS staff writer

Posted: May 10, 2010 - 11:45 am ET

The influx of information technology in healthcare means today's hospital architects and designers have to accommodate more wire, more conduit, more plugs and more closets holding more racks of flashing lights than ever before. But they also have a little more room to do so because of smaller—or even nonexistent—central nurse stations, fewer IT-dedicated employees on-site and disappearing file rooms.

If they do it right, experts say, no one really notices. “It just feels substantially different,” said David Sides, vice president of Cerner Worldwide Consulting, a division of the Kansas City, Mo.-based electronic health-record system vendor. “But the good ones do it so it's unobtrusive.”

Von Lambert, a technology solutions manager at HDR, an Omaha, Neb.-based architectural and engineering firm, agrees.

“To the standard observer, you wouldn't notice this,” Lambert said of the flood of IT devices being used by doctors, nurses, patients and their families and the electronic infrastructure that's needed to keep them running. “It's behind a door, so people don't notice, but it does take up space, and it's getting larger and larger.”

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Enjoy!

David.