Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Sunday, September 19, 2010

Weekly Australian Health IT Links – 19 September, 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 subscription payment.

General Comment:

The main issue this week has been the failure of governance in the e-Health domain in Australia that has led to the sort of thing that is editorialised about here:

Where did the common-sense button go?

By Suzanne Tindal, ZDNet.com.au on September 16th, 2010

News that doctors have been paid an incentive for implementing e-health systems that are not available has floored me.

I can't blame the doctors for claiming offered money for taking part in a program. However, given that the government knew that the systems involved in parts of the program were not going to be available on time, why didn't anyone stop the flow of compensation?

Apparently the risk that systems might be delayed was identified early, but no one did anything to stop the incentive program. Instead everything trundled along as normal, ending in systems not being ready.

No one thought to say "In that case, we should probably delay payments for that part of the incentive". (I'm not sure of the legal ins and outs of being able to do so, but surely someone must have written a contingency into whatever doctors had to sign to be a part of the program, especially since $83 million was budgeted for the e-health portion of the incentive program per year.)

More here:

http://www.zdnet.com.au/where-did-the-common-sense-button-go-339306065.htm

Of course we also had the appalling revelation that after having messed about for almost three years in implementing NASH finally admitted it was all too hard!

Details here:

http://aushealthit.blogspot.com/2010/09/some-one-needs-to-be-held-accountable.html

Dramatic improvement is needed here - to say the least.

-----

http://www.theage.com.au/national/health-of-a-nation-to-go-by-the-numbers-20100917-15gdp.html

Health of a nation to go by the numbers

Karen Kissane

September 18, 2010

MORE than 22 million Australians now have new government-issued identity numbers as part of a $466 million plan to create individual electronic health records that can be shared online - but most of them don't know it yet.

Privacy advocates have criticised the automatic mass assignment of numbers and the fact that recipients have not been notified that they exist.

The 16-digit number has been created by Medicare and can be accessed via Medicare cards. Called an ''individual health identifier'', it is the first step in a national plan to move to ''e-health'', computerising health records, prescriptions and referrals, and creating an encrypted mail system for doctors and hospitals. It has been estimated e-health could save $8.7 billion over 10 years by improving medical practices.

From July 2012, patients will be able to ask their doctors to use the identifier to create a shared ''e-record'', containing a summary of an individual's health details and personal information.

-----

http://www.theaustralian.com.au/australian-it/consumer-support-is-the-key-to-getting-e-health-off-the-ground/story-e6frgakx-1225921410049

Consumer support is the key to getting e-health off the ground

HEALTH Minister Nicola Roxon will need to win over consumers as she moves on her e-health agenda.

She has $467 million on the table for personal records and a further $392m to get GPs and specialists consulting with patients over the internet.

The National E-Health Transition Authority's head of strategy and e-health architecture, Andrew Howard, last week conceded a failure to address community concerns over the past two years. "We've had a big focus to engage with medical professionals, and our clinical leads program has been outstanding," he told Chik Service's Health-e-Nation conference in Sydney..

"But we still lack engagement with consumers.

"We need to find out what people really want, and how we can involve them in the (development) process."

-----

http://news.theage.com.au/breaking-news-national/emergency-alert-to-be-improved-20100914-159zg.html

Emergency alert to be improved

September 14, 2010 - 10:39AM

AAP

The federal government will improve the national emergency warning system so it can alert people to disaster threats based on the location of their mobile phone.

The Emergency Alert system already sends warnings by recorded voice and text message to landlines and mobile phones based on an owner's billing address.

In response to last year's interim report of the Victorian Bushfire Royal Commission, Labor agreed a national warning system that delivered alerts according to where a person's mobile phone was actually located was also needed.

-----

http://www.6minutes.com.au/articles/z1/view.asp?id=523314

Roxon meets with GP leaders on second term

by Michael Woodhead

In one of her first actions as health minister in the new Gillard government, Nicola Roxon today met with peak general practice groups to discuss issues such as e-health.

According to the umbrella group United General Practice Australia, there was strong shared support for accelerated implementation of e-health initiatives such as the GP patient summary as the basis for the proposed electronic patient health record.

There was support also for electronic initiatives to improve access to pathology, diagnostic imaging, discharge summaries, and electronic prescriptions.
-----

http://www.news.com.au/breaking-news/medicare-rebate-call-for-sick-web-gamers/story-e6frfku0-1225920242991

Medicare rebate call for sick web gamers

EXPERTS want computer addicts to be allowed to claim their treatment on Medicare.

Psychiatrists and psychologists receiving calls for help from distressed families believe addiction to the internet and computer games will soon be listed as a mental disorder.

School children and young adults are becoming so dangerously hooked on computer games that they are being offered live-in treatment at psychiatric facilities.

Psychologist Andrew Campbell from the University of Sydney and psychiatrist Philip Tam of Concord's Rivendell Adolescent Unit have told The Daily Telegraph computer addiction should be classified as a disorder.

-----

http://www.smh.com.au/business/ipad-invasion-proves-bittersweet-20100918-15h7a.html

iPad invasion proves bitter-sweet

Stephen Cauchi

September 19, 2010

THEY call it a tablet, but four months after the Australian release of Apple's iPad revolutionary touch-screen computer, the device's popularity is proving a bitter pill for laptop sellers.

While it has been swiftly embraced by businesses as diverse as airlines and hospitals, the iPad is opening up new markets while cannibalising the cheaper end of the established computer market.

Qantas subsidiary Jetstar is the latest organisation to be considering a bulk order.

Students, lawyers, sales reps and sporting clubs have embraced the device and 500 doctors in Victorian hospitals will be testing it next year.

-----

http://www.e-health-insider.com/news/6244/morecambe_bay_creates_stabilisation_plan

Morecambe Bay creates stabilisation plan

16 Sep 2010

University Hospitals of Morecambe Bay NHS Trust has launched a stabilisation plan to bring major and persistent problems with its electronic patient record system, Lorenzo, under control.

Weekly updates sent to Morecambe Bay staff, and seen by E-Health Insider, show that one of the aims of the plan is to allow them to “transact a day’s work in one working day - reducing the need for spending extra hours putting-in information.”

The updates also note some of the problems that the trust is still experiencing with the system. These include some live patients being identified as deceased when contacts are being created.

The 'Lorenzo - thirteen weeks' in log says that 'when creating contacts for certain non-deceased patients, a message box appears asking the use if they want to continue as the patient is deceased.'

-----

http://www.cfoworld.com.au/news/533368/medtech-wins-nz-e-health-contract/

Medtech wins NZ e-health contract

17:03, 15th September 2010

By Dylan Bushell-Embling (CFO World)

Health IT company Medtech Global (ASX:MDG) has won a contract to deliver an e-therapy service to the Northern DHB Support Agency.

Medtech, through a consortium led by its New Zealand subsidiary Medtech Limited, will supply a program for the assessment and treatment of mild to moderate depression for use nationwide in New Zealand.

-----

http://www.zdnet.com.au/suspended-e-health-plans-now-on-track-339305955.htm

Suspended e-health plans now on track

By Josh Taylor, ZDNet.com.au on September 13th, 2010

Workshops and the trial sites for e-health roll-out in Australia had to be stopped in the course of the election, but they're now back on track, according to National e-Health Transition Authority (NEHTA) CEO Peter Fleming.

In the 2010 election campaign, it was unclear what the Coalition was intending to do instead of the $466.7 million investment in e-health outlined by Labor in the May budget; the spend was expected by many to be reduced significantly. According to Fleming, this meant any projects that didn't come under the Council of Australian Governments then budgets were put on hold while the outcome was determined.

"Anything that came under the $466.7 million the Commonwealth had announced we needed to be fairly quiet on. We were still working but not on that particular component," Fleming told ZDNet Australia.

"Prior to the election being called we had actually started a series of workshops around the concept of operations for an electronic health record and also the architecture [and] when we went into caretaker mode those workshops had to be stopped," Fleming said. "But they've been reconvened, almost immediately as you'd expect, and the intention there is to get a very diverse series of views from all of our key stakeholders, document that and publish it for very wide input."

-----

http://www.smh.com.au/nsw/hospitals-fall-well-short-of-target-for-treatment-20100913-159d9.html

Hospitals fall well short of target for treatment

Louise Hall

September 14, 2010

Sydney's biggest hospital is still struggling to see patients who have ''potentially life-threatening'' conditions on time.

Leaked documents reveal that Westmead Hospital treated just 33 per cent of triage category three patients within the recommended 30 minutes last month.

But the state government refuses to publicly release the weekly performance reports generated by the Department of Health, opting instead to publish quarterly reports eight weeks after the end of each period, when the data is up to six months out of date.

A budget estimates hearing yesterday was told West Australian hospitals report the activity in their emergency departments in real time, with a website showing the number of people waiting to be seen, the average waiting time and whether ambulances are being diverted.

-----

http://www.zdnet.com.au/nehta-issues-major-e-health-tender-339306025.htm

NEHTA issues major e-health tender

By Renai LeMay, ZDNet.com.au on September 15th, 2010

The Federal Government today delivered the health sector a much clearer picture of how its giant $466.7 million electronic health records project will be delivered, with the initiation of a major purchasing initiative for the project through the nation's peak e-health body, the National E-Health Transition Authority (NEHTA).

NEHTA and the Federal Department of Health today went to market for its "National Authentication Service for Health" (NASH).

"The NASH is a foundation component within NEHTA's overall program to foster the design and development of technology to deliver the best e-health system for Australia," the government-owned company wrote. "It will provide a strong authentication service for the Australian healthcare sector and contribute to providing a capability that ensures that transactions are private, traceable and only conducted by known entities."

-----

http://www.theage.com.au/business/vacuum-of-facts-on-nbn-20100915-15cp8.html

Vacuum of facts on NBN

September 16, 2010

TONY Abbott wants Malcolm Turnbull to attack the government's ''reckless'' national broadband network (NBN) project and win over the independents, but so far the entire NBN cost-benefit debate has been hapless.

It's not the financial return the government-owned NBN Co gets from an NBN rollout that matters, it's the economic dividend the nation as a whole gets, either from Labor's high-speed, ubiquitous network or cheaper alternatives including the Coalition's lower-speed, lower-cost private-public hybrid.

And nobody knows the answer. Consulting firm Accenture estimated in 2001 that the economic benefits could be between $12 billion and $30 billion a year for Australia, but some of that upside has already been captured. What's left and whether it is worth the extra cost of Labor's high-speed national network is unknown - and it will be until an authoritative national cost-benefit report is produced.

-----

http://www.smh.com.au/opinion/politics/wires-crossed-in-quest-for-a-new-broadband-network-20100912-156vh.html

Wires crossed in quest for a new broadband network

September 13, 2010

Narrow thinking is bogging down what is a crucial debate.

THE big winner out of the 2010 federal election was democracy. The longer we have a minority government that can't be sure it has the numbers to ram through legislation in Parliament, the more issues will have to be debated.

But the potential for open government should be put to the test to ensure it is the servant of good government.

The big campaign issue that still divides the major parties is the national broadband network. It is in the nation's interest that the decision on this be subject to proper process, including a cost/benefit study and an examination of the role of Lindsay Tanner. The former finance minister is a newly appointed director of financial advisers Lazard, which was granted a $3.4 million contract in July to advise the government on financing the project. Tanner joins former Labor prime minister Paul Keating on the board.

-----

http://www.computerworld.com.au/article/360336/conroy_keeps_communications_portfolio/?eid=-255

Conroy keeps communications portfolio

Kate Lundy appointed parliamentary secretary

  • AAP (AAP)
  • 11 September, 2010 14:25

Prime Minister Julia Gillard says her new ministry delivers on a promise to establish a portfolio dedicated to regional Australia.

It will be headed by Simon Crean, previously responsible for education and workplace relations.

The announcement on Saturday comes four days after Labor secured the support of two country independents to form minority government in the first hung federal parliament in 70 years.

-----

http://www.theaustralian.com.au/business/media/chief-executives-demand-change-from-conroy/story-e6frg996-1225919958966

Chief executives demand change from Conroy

  • James Chessell and Mitchell Bingemann
  • From: The Australian
  • September 13, 2010 12:00AM

THE federal government has been presented with a broad array of potential media and telecommunications reforms.

This has come about as part of its promise to consider overhauling the way the industry is regulated in a convergent media era.

A survey by The Australian of media and telco executives stresses the difficulties that Broadband and Communications Minister Stephen Conroy will face in balancing competing corporate interests after the $43 billion National Broadband Network is constructed.

Although most chief executives agree many media and communications laws are out of date, there is little industry-wide consensus on the best way to tackle the challenges and opportunities brought about by the digital economy. Copyright, anti-siphoning, spectrum allocation, ownership rules, mandatory digital radio in cars, local content quotas and the operational separation of Telstra are just some of the issues executives say should be examined by the Gillard government.

-----

http://www.theaustralian.com.au/australian-it/government/election-delayed-telstra-nbn-paperwork/story-fn4htb9o-1225920583769

Election delayed Telstra NBN paperwork

  • From: AAP
  • September 13, 2010 10:36AM

THE election held up the legal work for Telstra's multibillion dollar involvement in the national broadband network, the federal government says.

The delay reportedly has upset Future Fund chairman David Murray who says his organisation, which has a large holding in Telstra, is in the dark about the heads of agreement struck between NBN Co and the giant telco in June.

"We don't know what the terms of the agreement are," Mr Murray was quoted in Fairfax newspapers today.

Broadband Minister Stephen Conroy says details will be made available to Telstra shareholders in the coming months.

-----

http://www.theaustralian.com.au/national-affairs/abbott-reveals-turnbulls-role-in-baton-change-strategy/story-fn59niix-1225923460327

Abbott reveals Turnbull's role in 'baton change' strategy

TONY Abbott today revealed that Malcolm Turnbull is central to his strategy to convince the independents to shift their support from Labor to the Coalition.

One day after announcing his line-up, Mr Abbott hit the airwaves to attack the Government's $43 billion National Broadband Network.

The Opposition leader said there was “no reason whatsoever why there couldn't be a baton change at some point early in the government's term”.

“We've got to demonstrate to the Australian public that we would be a better and safer pair of hands than the Labor party, that we can be better trusted with public money than the Labor party,” he told ABC radio.

-----

http://www.theage.com.au/victoria/secret-tests-of-nurse-hotline-reveal-unsafe-advice-20100915-15cn9.html

Secret tests of nurse hotline reveal unsafe advice

Julia Medew

September 16, 2010

VICTORIA'S nurse-on-call hotline has given people unsafe advice and failed to answer tens of thousands of calls fast enough since it began four years ago, an Auditor-General's report says.

The report, written by Des Pearson, said although the service was generally safe, 4 per cent of 800 mystery callers designed to test it in recent years had received unsafe advice from the nurses who did not process their calls properly.

In some of the 31 cases, the nurses' failure to pick up on information about how long the callers had been in pain or whether they were dehydrated meant they did not tell the callers to seek help fast enough. The nurses who took these calls have since received coaching and the report said the results of mystery-caller testing had improved over the past year with only 2 per cent of calls deemed unsafe, compared to 5 per cent in 2008-09.

-----

http://www.theaustralian.com.au/business/industry-sectors/deal-with-the-bush-puts-national-broadband-network-further-off/story-e6frg9hx-1225925080013

Deal with the bush puts National Broadband Network further off

  • Tracy Lee and Nicola Berkovic
  • From: The Australian
  • September 17, 2010 12:00AM

JULIA Gillard's deal with the independents to prioritise connecting rural Australia to high-speed internet will delay the rollout of the NBN.

The Australian understands that NBN Co, the government enterprise overseeing the $43 billion fibre broadband project, was expected to choose the final list of construction contractors by the end of this year.

But that has now been deferred until early next year after the federal election pushed out schedules and while contractors grapple with a requirement to show in their tender process how they will prioritise building in rural and regional areas.

-----

http://www.theage.com.au/national/unproven-breast-tests-could-put-lives-at-risk-20100918-15ha5.html

Unproven breast tests could put lives at risk

Jill Stark

September 19, 2010

CANCER specialists warn that private clinics offering unproven breast screening methods as a ''safe'' alternative to mammograms could be putting women's lives at risk.

Clinics selling Botox, liposuction and spray tans are increasingly providing breast cancer screening that uses thermal imaging and ''electrical impedance'' technology.

The methods are being marketed to women as young as 20, with claims they can detect cancer years earlier than mammograms.

Experts say the technologies are not backed by sufficient scientific evidence and those offering tests often have little medical training.

-----

http://www.theage.com.au/victoria/nursing-hotline-in-fresh-row-20100916-15eo5.html

Nursing hotline in fresh row

Julia Medew

September 17, 2010

VICTORIA'S troubled nurse-on-call service has failed to reduce demand for emergency departments, doctors say. They have also questioned the quality of advice provided.

Since the service began in 2006, the Victorian government has said it was saving precious hospital resources.

But yesterday, the Victorian chairman of the Australasian College for Emergency Medicine, Dr Simon Judkins, said emergency departments were busier than ever.

He said ''we should not pretend'' that the service was a panacea for hospital overcrowding, saying that people who used the service were not those who spent long hours in emergency departments.

-----

http://www.theaustralian.com.au/news/world/making-skin-that-responds-to-touch-has-been-the-biggest-obstacle-in-robot-design/story-e6frg6so-1225920705987

Making skin that responds to touch has been the biggest obstacle in robot design

  • From: AFP
  • September 13, 2010 12:00PM

BIOTECH wizards have engineered electronic skin that can sense touch, in a major step towards next-generation robotics and prosthetic limbs.

The lab-tested material responds to almost the same pressures as human skin and with the same speed, they reported in the British journal Nature Materials.

Important hurdles remain but the exploit is an advance towards replacing today's clumsy robots and artificial arms with smarter, touch-sensitive upgrades, they believe.

“Humans generally know how to hold a fragile egg without breaking it,” said Ali Javey, an associate professor of computer sciences at the University of California at Berkeley, who led one of the research teams.

“If we ever wanted a robot that could unload the dishes, for instance, we'd want to make sure it doesn't break the wine glasses in the process. But we'd also want the robot to grip the stock pot without dropping it.”

The “e-skin” made by Javey's team comprises a matrix of nanowires made of germanium and silicon rolled onto a sticky polyimide film.

-----

http://www.computerworld.com.au/article/360386/uni_gives_ipads_science_students/?eid=-6787

Uni gives iPads to science students

University of Adelaide to provide free iPads to hundreds of students

The University of Adelaide is ditching paper-based textbooks in favour of iPads and will hand out free devices to students enrolling in a science degree in 2011, claiming the new Apple tablets will revolutionise the way science is taught at the institution.

"I believe this approach will revolutionise the way science is taught at the University of Adelaide. We will be the first university in Australia to teach in this innovative way," Faculty of Sciences Executive Dean, Professor Bob Hill, said in a statement.

"Our teaching material will be more accessible, more relevant and more frequently updated, providing the flexible learning environment that students are looking for."

-----

http://www.smh.com.au/world/science/dark-matter-discovery-hopes-raised-at-us-mine-20100915-15cs5.html

Dark matter discovery hopes raised at US mine

Deborah Smith SCIENCE EDITOR

September 16, 2010

TWO small signals detected in an experiment deep underground in an abandoned US iron ore mine could be the first glimpses of the mysterious dark matter that is thought to make up about 24 per cent of the universe.

Scientists are not claiming it has been discovered yet. More results are needed to be certain.

But of all the missing parts of the cosmos, dark matter is possibly the closest to being found, with three different kinds of searches under way.

Like wind in a fluttering flag, it is obviously there. We just cannot see it. ''There is very clear evidence for dark matter from the way spiral galaxies rotate,'' Ken Freeman, of the Australian National University, said. Without it, they could not spin as fast as they do.

-----

Enjoy!

David.

AusHealthIT Poll Number 36 – Results – 19 September, 2010.

The question was:

Do You Believe Labor and Ms Roxon Will Make Substantial Progress in E-Health over the Next 3 Years?

Definitely

- 6 (14%)

Possibly

- 7 (17%)

Do Not Know

- 0 (0%)

Probably Not

- 23 (56%)

No Way Known

- 5 (12%)

Votes: 41

Very clear cut view here with 31.5% hopeful and 68.5% not so sure. I think putting some clearer plans on the table might be a good first step.

Again, many thanks to all those who voted!

David.

Saturday, September 18, 2010

Weekly Overseas Health IT Links - 17 September, 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 subscription payment.

-----

http://www.rand.org/health/projects/clinical-decision-support/

Advancing Clinical Decision Support

Clinical Decision Support

Clinical decision support (CDS) provides clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care. CDS encompasses computerized alerts and reminders to care providers and patients, clinical guidelines, condition-focused order sets, patient data reports and summaries, documentation templates, diagnostic support, and other tools that enhance decision making in clinical workflow.

From the Office of the National Coordinator for Health Information Technology

"Advancing Clinical Decision Support" is an intensive, multi-part project funded by the U.S. Office of the National Coordinator for Health Information Technology (ONC) to address the major barriers to achieving widespread use of clinical decision support. The project is being led by the RAND Corporation and Partners Health Care / Harvard Medical School. A particular focus of the project is on making CDS more-ready to serve among the requirements for "meaningful use" of electronic health record (EHR) systems.

-----

http://www.e-health-insider.com/news/6227/end_of_npfit_to_be_announced_today

End of NPfIT to be announced today

09 Sep 2010

The National Programme for IT in the NHS is set to end in its current form, a ministerial statement will announce this morning.

A further £700m will also be cut from the cost of the programme, with £500m coming from ‘local savings’ and £200m from the local service provider contract with CSC.

E-Health Insider expects the ministerial statement to be made at around 10.30am.

-----

http://www.e-health-insider.com/news/6228/npfit_future_is_modular_and_locally-led

NPfIT future is modular and locally-led

09 Sep 2010

The National Programme for IT in the NHS’ centralised and national approach is “no longer required” and trusts will instead be able to operate “a more locally-led plural system of procurement”, health minister Simon Burns has announced.

In a ministerial statement this morning, Burns said that a Department of Health review of the national programme had concluded that a new, “modular” approach to implementation should also be adopted.

The statement said that the two changes together would allow “NHS organisations to introduce smaller, more manageable change in line with their business requirements and capacity.”

-----

See here also:

http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_119293

The future of the National Programme for IT

  • Published date:

9 September 2010

-----

http://www.ihealthbeat.org/features/2010/onc-names-temporary-certification-bodies-for-meaningful-use-program.aspx

Tuesday, September 07, 2010

ONC Names Temporary Certification Bodies for 'Meaningful Use' Program

by Kate Ackerman, iHealthBeat Senior Editor

Last week, the Office of the National Coordinator for Health IT unveiled one of the final missing puzzle pieces of the "meaningful use" incentive program by naming the Certification Commission for Health IT and the Drummond Group as the first ONC-Authorized Testing and Certification Bodies under the temporary electronic health record certification program.

The 2009 federal economic stimulus package included Medicare and Medicaid incentive payments for physicians and hospitals that demonstrate meaningful use of certified EHRs. Prior to the announcement, no certifying groups were in place to determine whether vendors' EHR products have the functions necessary for health care providers to meet the federal government's meaningful use Stage 1 criteria.

National Coordinator for Health IT David Blumenthal said the announcement "is a crucial step because it ensures that certified EHR products will be available to support the achievement of the required meaningful use objectives, that these products will be aligned with one another on key standards, and that doctors and hospitals can invest with confidence in these certified systems."

-----

http://www.fiercehealthit.com/story/peel-pushes-informed-consent-over-every-element-patient-data/2010-09-07

Peel pushes for 'informed consent' over every element of patient data

September 7, 2010 — 7:14am ET | By Neil Versel

Depending on your point of view, Dr. Deborah Peel and her Patient Privacy Rights Foundation either continue to rail against the national push for EHRs or take further steps to hold policymakers honest. (We're not going to go as far as ZDNet Healthcare's Dana Blankenhorn, who recently called Peel a "Luddite" whose organization's goal "appears to be keeping healthcare in the paper-based dark ages.")

The latest from Patient Privacy Rights is a white paper making "The Case for Informed Consent" to give patients more complete control over their personal health information. In the paper, Peel dismisses arguments that it's too technically difficult and too expensive to design health IT systems that offer patients granular control over what elements of their records healthcare organizations can share.

-----

http://www.fiercehealthit.com/story/health-it-systems-often-overlook-care-management/2010-09-07

Health IT systems often overlook care management

September 7, 2010 — 2:02pm ET | By Neil Versel

When it comes to designing health IT systems, more than a few organizations may be missing the big picture in terms of integrating care management workflows into their technology.

A new survey of how IT is changing case management largely corroborates findings from a 2008 survey that providers, payers, case managers and others that support care coordination are making only modest progress toward automating care management.

The study, conducted by TCS Healthcare Technologies on behalf of the Case Management Society of America and the awkwardly named American Board of Quality Assurance and Utilization Review Physicians (ABQAURP), found that just 23 percent of IT systems are fully interoperable with external applications and that a similar share of organizations had gone paperless in care management.

-----

http://www.govhealthit.com/newsitem.aspx?nid=74559

ONC seeks reusable approach to future NHIN services

By Mary Mosquera

Tuesday, August 31, 2010

The Office of the National Coordinator is developing an “interoperability framework” designed to eliminate the need for technical planners to start from scratch in identifying standards and services for future uses of the nationwide health information network (NHIN).

The upcoming start of health IT incentive program has put pressure on the ONC’s policymakers to come up with a streamlined approach to identifying specs and standards for new health information exchange features and services that might be created to help boost health IT adoption.

A reusable approach will reduce the time it takes ONC to identify the demand for the standards and then apply them to emerging services, according to Dr. Doug Fridsma, ONC’s acting director of ONC’s standards and interoperability office.

-----

http://www.ehiprimarycare.com/news/6204/chronic_medication_service_launches

Chronic Medication Service launches

02 Sep 2010

Scottish health secretary Nicola Sturgeon has launched the country’s Chronic Medication Service, which aims to set up shared care records between GPs and pharmacists by the end of the year.

The service is one of four elements in Scotland’s e-pharmacy programme, which the Scottish Government has said will cost £5.2m a year to deliver.

The CMS aims to enable shared care of patients with long term conditions between GP practices and pharmacists, backed by IT links between the two.

When a patient signs up for the CMS, the pharmacy’s patient medication record will send an electronic notification to the GP’s IT system. This will allow the GP to choose whether to enter into a shared care agreement, with an option to generate serial prescriptions for up to 48 weeks.

-----

http://www.healthleadersmedia.com/content/TEC-256089/Advances-in-Science-Technology-Informed-Consent.html

Advances in Science, Technology, Informed Consent

Gienna Shaw, for HealthLeaders Media, September 7, 2010

Science and technology are at a fortuitous crossroads: As we’re learning more about how variations in human genetics affect health and disease, we’re expanding our use of the electronic medical records systems that make it easier to gather, store, sort, and analyze genetic data. And growing right alongside clinical and technological medical advances: The importance of informed consent and its kissing cousin, re-consent.

So, how many times do you have to get permission from patients before you use their medical data for research? From the patients’ point of view, the answer is “every time,” a new study suggests. It doesn’t matter if the data is de-identified or if they’ve already approved its use for one purpose. If you want to use it again, they want you to ask them again, say investigators at Group Health Research Institute and the University of Washington (UW) in a report called “Glad You Asked,” which was published in the September 2010 Journal of Empirical Research on Human Research Ethics.

-----

http://www.fiercepracticemanagement.com/story/scribes-help-doctors-eliminate-emr-downsides/2010-09-08

Scribes help doctors eliminate EMR downsides

September 8, 2010 — 5:30am ET | By Debra Beaulieu

Do your physicians fret over how their productivity might slow down upon implementing an electronic medical record? Are they worried that the effort to learn the new technology will distract them from patient care? If so, you may want to consider hiring a scribe--an emerging type of medical professional who shadows clinicians and inputs all necessary data into the EMR.

Most do the job part-time as college students and plan to go on to full-time careers in medicine or nursing. Because of the valuable head start offered by the experience, scribes often are willing to work for $8 to $10 an hour with no benefits, the Los Angeles Times reports.

-----

http://www.fierceemr.com/story/emrs-help-improve-people-planet-profits/2010-09-09

EMRs help to improve 'people, planet, profits'

September 9, 2010 — 11:33am ET | By Neil Versel

You want an EMR, but you also want a return on your investment. At least one non-healthcare pundit believes you should look past just the financial bottom line and see that EMRs can provide benefits for the "3 Ps" of sustainability--people, planet, profits.

A post on the Triple Pundit blog says that EMRs deliver on all three areas, with better patient care, a smaller environmental footprint and fewer write-offs of accounts receivable.

-----

http://www.modernhealthcare.com/article/20100909/NEWS/100909933/

Guest commentary: Privacy issues overlooked

By Latanya Sweeney

Posted: September 9, 2010 - 11:00 am ET

From my son's pediatrician to my father's specialist, physicians are talking about electronic health records. Widespread EHR adoption is a goal of the American Recovery and Reinvestment Act of 2009, which provides financial compensation to healthcare providers and hospitals for meaningful uses of EHRs in years 2011 to 2015.

If successful, the ARRA will ignite a mass exodus from a prehistoric paper age into a tech-savvy networked cosmos called the Nationwide Health Information Network in which patient information flows seamlessly across computers, devices, organizations and locations as needed. For lasting success, special care must be taken to allow widespread sharing of patient information while protecting patient privacy, and that brings into question the recently released list of requirements from the CMS that include no privacy incentives and the current NHIN approaches from the Office of the National Coordinator that lack privacy and utility.

Read the full story here.

----

http://www.healthleadersmedia.com/content/TEC-256203/Physicians-Mobile-Devices-Expedite-Decision-Making

Physicians: Mobile Devices Expedite Decision Making

John Commins, for HealthLeaders Media, September 9, 2010

Two thirds of physicians say they are using personal devices for mobile health solutions that aren't connected to their practice or hospital IT systems, but nearly a third said their hospital or practice leaders will not support the use of mobile health devices.

As for patients, 40% would be willing to pay for a remote monitoring device that sends health information to their doctors, according to a new online survey and report by PricewaterhouseCoopers' Health Research Institute.

The findings of the survey, published in a report titled Healthcare Unwired were presented this week by PricewaterhouseCoopers at the mHealth Initiative 2nd International mHealth Conference in San Diego. Physicians' interest in mobile technologies reflects the growing market for remote and mobile health applications and business opportunities for organizations using consumer technologies to support preventative, acute, and chronic care, PWC said.

-----

http://www.ihealthbeat.org/perspectives/2010/electronic-health-records-hold-great-promise-for-longterm-care-facilities.aspx

Friday, September 10, 2010

Electronic Health Records Hold Great Promise for Long-Term Care Facilities

by Eric Ford

Health IT holds great promise for improving health care quality and safety and reducing the costs of providing care in long-term care facilities. Numerous empirical studies conducted in other health settings support the view that health IT can help health care providers to reduce errors, improve safety and quality, and decrease costs. While acute care settings and physician practices are adopting electronic health record systems at a brisk pace, LTC settings, specifically licensed nursing facilities, have been slower to embrace such technologies

-----

http://www.eweek.com/c/a/Health-Care-IT/Medical-Smartphone-Apps-May-Need-New-Federal-Regulation-607844/

Medical Smartphone Apps May Need New Federal Regulation

The FDA is evaluating if medical smartphone apps require additional federal regulation, according to reports.

The Food and Drug Administration is looking into whether smartphone apps that allow patients to monitor their vital signs wirelessly should earn FDA approval before implementation.

Bradley Merrill Thompson, an attorney with law firm Epstein, Becker & Green, who studies health care issues, told GigaOM that the FDA is keeping an eye on app stores to see which medical applications for smartphones might require regulation. "The FDA is actively engaged in surveillance of various app stores to see if apps should trigger their involvement," Thompson told GigaOM for an Aug. 31 report. "Applications where a smartphone is connected in any way to imaging are under scrutiny, in particular. Any app that is used to transmit images to a medical facility requires FDA approval."

-----

http://www.healthdatamanagement.com/news/health-care-technology-news-accreditation-medical-homes-40977-1.html

Joint Commission to Accredit Medical Homes

HDM Breaking News, September 8, 2010

The Joint Commission in 2011 will offer a "Primary Care Home" option to ambulatory organizations for accreditation of their medical home programs.

Under the medical home model, primary care practices are designated patients' "medical home" to coordinate the continuum of care. The practices are redesigned to be more functional and workflow-friendly, and new processes are developed to focus on quality, safety and alternative reimbursement methods. The care model also calls for extensive use of health information technologies, including electronic health records, e-prescribing, clinical decision support, secure messaging and Web portal software.

-----

http://blogs.wsj.com/health/2010/09/08/how-much-would-you-pay-for-a-remote-health-monitoring-device/

  • September 8, 2010, 2:34 PM ET

How Much Would You Pay for a Remote Health Monitoring Device?

Patients are willing to use remote or mobile monitoring devices to transmit health info right to their physicians — they just don’t want to pay much for them.

We’ve written about telemonitoring before, in the context of managing high blood pressure and in looking at all the tech-industry companies dipping a toe into the market.

But the question of who pays for all of this looms over the entire subject. A new PricewaterhouseCoopers study finds that 40% of 2,000 consumers surveyed said they’d be willing to pay for a remote or mobile monitoring device, such as a scale, blood pressure cuff, glucose meter or heart-rate monitor — but when we asked to dig into that data, we learned that of those willing purchasers, 64% said they’d ante up only if a device cost less than $50. About 41% said they’d be willing to pay for a monthly subscription to send data automatically via a remote or mobile device to a health-care provider — but 47% of them said their limit was $5 per month.

-----

http://govhealthit.com/newsitem.aspx?nid=74602

Health IT group sets sights on NHIN road rules

By Mary Mosquera
Wednesday, September 08, 2010

A new federal health IT advisory panel has set to work on setting up a means of governing the nationwide health information network (NHIN) in a way that will earn the trust of healthcare providers and consumers and expand its use by the health care community.

There are no official rules-of-the-road for the NHIN, a basket of standards and services for enabling providers to exchange patient information securely over the Internet.

-----

http://www.ehealtheurope.net/comment_and_analysis/625/expert_view:_loukianos_gatzoulis

Expert view: Loukianos Gatzoulis

01 Sep 2010

The next shift in healthcare will be towards a more personalised and patient-centric care process. Information and Communication Technologies can contribute by offering personal health systems - both for chronically ill patients and for people at risk. This is a trend the European Commission is supporting through a number of research projects.

When we are ill, we suffer at home or at work. Symptoms can occur suddenly in the situations in which we need them the least. More often than not, there is no doctor or therapist available to offer immediate help or to check what is wrong.

Illness, in other words, can turn our lives upside down. But most of us tend to visit the doctor only on rare occasions, and often we wait until things go very wrong. Then we can end up being hospitalised.

-----

http://www.ehealtheurope.net/comment_and_analysis/622/expert_view:_robyn_tolley

Expert view: Robyn Tolley

24 Aug 2010

The managing director of NoemaLife argues the Italian experience shows that English trusts will benefit from the likely demise of NPfIT.

Three months on from the general election, we not only have a new coalition government, but a white paper that promises a radical shake-up of the NHS.

Healthcare IT managers will be hoping that ministers will also free them from the straight-jacket of the National Programme for IT in the NHS.

For the past six years, English trusts have either been grappling with the practicalities of NPfIT or weighing up the options while waiting to see what a change of government might bring.

Meanwhile, their European counterparts have been ploughing ahead, assessing and implementing technologies which are bringing new efficiencies and cost savings to their operations.

The Italian Job

Take Italy. As with the UK, there’s a strong reliance on the public sector, particularly when it comes to the nation’s health, and hospitals are managed at a regional level.

Yet Italian hospitals have had much greater flexibility and freedom when it comes to selecting what technology to invest in and, more importantly, which companies to purchase it from.

Not having a ‘one designated supplier for all’ approach has helped to keep offerings and prices competitive. Hospitals have been able to select the solution which best meets their requirements, however niche they may be.

-----

http://www.ehealtheurope.net/news/6213/compugroup_targets_us_market_in_buyout

CompuGroup targets US market in buyout

07 Sep 2010

German software company, CompuGroup Medical, has signed an agreement to purchase US company, Visionary Healthware Group.

The group, which includes American Healthcare Holdings, Visionary Medical System and Visionary RCM, is a provider of practice management software and electronic health records to more than 10,000 GPs in the US.

The company also provides laboratory information systems and revenue cycle management services across Europe.

-----

http://govhealthit.com/newsitem.aspx?nid=74599

HHS launches site for disaster medical volunteers

By Mary Mosquera

Tuesday, September 07, 2010

The Health & Human Services Department launched a Web site that provides a single point of entry for health professionals across the nation to sign up to volunteer in advance of an emergency or disaster in their state.

The Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) is a national network of state-based programs that verifies the identity, licenses and credentials of health professionals before an emergency happens.

The Web site would makes it easier and faster to register potential volunteers by connecting them with each state’s ESAR-VHP program. Health professionals include doctors, nurses, dentists, veterinarians, medical technologists, clinical social workers, medical records technicians and mental health counselors.

-----

http://www.who.int/goe/ehir/2010/7_sep_2010/en/index.html

eHealth Intelligence Report.

7 September 2010

Scientific Articles

:: Deployment of e-health services – a business model engineering strategy (J Telemed Telecare 2010;16:344-353

Abstract: We designed a business model for deploying a myofeedback-based teletreatment service. An iterative and combined qualitative and quantitative action design approach was used for developing the business model and the related value network. Insights from surveys, desk research, expert interviews, workshops and quantitative modelling were combined to produce the first business model and then to refine it in three design cycles. The business model engineering strategy provided important insights which led to an improved, more viable and feasible business model and related value network design. Based on this experience, we conclude that the process of early stage business model engineering reduces risk and produces substantial savings in costs and resources related to service deployment.

-----

http://www.healthleadersmedia.com/content/TEC-256055/Healthcare-Breach-List-Hits-150-Mark

Healthcare Breach List Hits 150 Mark

Dom Nicastro, for HealthLeaders Media, September 7, 2010

The number of healthcare entities reporting breaches of unsecured PHI affecting 500 or more individuals has crossed the 150 mark, nearly one year after the first such breach was reported.

The Office for Civil Rights (OCR) breach notification website lists 153 entities as of Thursday, Sept. 2. The HIPAA privacy and security rule enforcer began publishing the breaches in February of this year, per the HITECH, but breaches date back to September 22, 2009.

The list is required in the breach notification interim final rule, which is in effect but under review by OCR before a final rule is submitted to the Office of Management Budget (OMB).

-----

http://www.modernhealthcare.com/article/20100907/NEWS/100909975/

Diagnostic errors merit more attention: Pa. agency

By Maureen McKinney / HITS staff writer

Posted: September 7, 2010 - 12:01 am ET

Despite their potential to cause serious medical harm, instances of missed, incorrect or delayed diagnoses rarely receive the attention garnered by other patient-safety problems such as medication errors. That's according to a recently released report from the Pennsylvania Patient Safety Authority, a Harrisburg-based independent state agency charged with collecting and analyzing safety data.

For the report, the agency reviewed 100 patient-safety events related to diagnostic errors that took place between June 2004 and November 2009.

"Misdiagnoses represent a substantial unmeasured source of preventable mortality, morbidity and costs," the authors wrote in the report. "However, it is not possible to focus on misdiagnosis-related harm without first understanding the broader issue of diagnostic error."

-----

http://www.healthleadersmedia.com/content/COM-256179/5-Tips-for-Avoiding-Diagnostic-Errors.html

5 Tips for Avoiding Diagnostic Errors

Cheryl Clark, for HealthLeaders Media, September 8, 2010

Now that the quality movement seems to be chugging along on a well-conceived, evidence-based track, some thoughtful person has come along tooting a horn to warn us to "wait here just a darn minute. Aren't you all forgetting something that's really, really important?"

Or words to that effect.

The man who made such a stir this week, and got my attention, is hospitalist and patient safety expert Robert Wachter MD, an author and associate chair of the University of California San Francisco Department of Medicine.

Measurements of quality—checklists, process measures, and pay for performance score cards—are all fine as ways to reduce medical errors, Wachter says. But they neglect to force us to repair an enormous defect that now exists in the way we care for patients.

Far too often we're getting the diagnosis wrong.

Turns out, the healthcare system performs rather terribly in this earliest stage of the healthcare delivery system. And hospitals, physician groups and quality experts together need to start paying attention, he says.

Wachter gave some examples in his article published this week in the journal Health Affairs "Why Diagnostic Errors Don't Get Any Respect—And What Can Be Done About Them."

-----

http://www.fiercehealthit.com/story/are-compliance-regulations-failing-healthcare/2010-09-06

Are compliance regulations failing healthcare?

September 6, 2010 — 10:58pm ET | By Neil Versel

Financial institutions suffer more data breaches than healthcare organizations, right? Wrong. It's healthcare--by a factor of three to one.

A recent report from the Identity Theft Resource Center showed that compromised data stores from healthcare organizations outstrip those in other industries. According to the ITRC, healthcare organizations disclosed 119 breaches this year through early August, compared to 39 reported breaches in the financial services industry. Why is this happening?

To start, let's acknowledge history: the financial services industry has always been safeguarding valuable assets, like money, gold, jewelry and documents. But the traditional focus of healthcare is the patient. Securing patient data is a relatively new imperative, one that has been mandated through extensive regulations.

-----

Enjoy!

David.

Friday, September 17, 2010

There Seems to Be A Consensus That A Cost - Benefit Study on the NBN is Needed.

It seems to me that now we have a new Government it really is time to address just what the full build of the National Broadband Network will cost, what it will actually deliver and to get some assurances that this is really the optimal way to be doing this.

To restate my basic position on all this, it is that I think fast broadband is a really ‘good thing’ and I happily pay for a pretty fast link from Optus Cable. (see bottom of blog to see how fast that is!). I also think that for all fixed high volume use it is clear ‘fibre’ is future proof and sensible way to go.

My questions mostly sit in the area of what is actually needed today, what might make sense in the life of this project (say the next decade) and how much should we sensibly pay to get the most out of the Internet while not overdoing it, or indeed underdoing it - recognising some of the investment will be very long lived (the fibre etc.) while other parts will be progressively evolved to gigabit or even faster speeds.

My other question is just what the right mix of fibre, satellite, wireless and whatever gets invented next should be.

When someone like Paul Budde says we need a study I tend to take notice.

See here:

What's the NBN really worth?

Paul Budde, Election 2010

Published 6:44 AM, 30 Aug 2010 Last update 10:01 AM, 30 Aug 2010

When the NBN announcement was first made and the issue of the cost-benefit analysis came up, BuddeComm’s comment was that it would be necessary to be aware of all the ingredients of such a plan before one could carry out such an analysis.

This is not just an issue for Australia. Other governments are also grappling with it. If the analysis were to be based simply on the use of traditional telecommunications services, it wouldn’t even be worthwhile starting on it, as it would not hold together.

One could argue that this is national infrastructure – as distinct from simply telecommunications infrastructure – and that no national cost-benefit analyses were provided for previous large-scale infrastructure projects.

But the reality is that we live in different times.

Nevertheless, governments still have the option of launching such a project, but perhaps they should not link it to a commercial return – as soon as that link is forged the market can, quite rightly, request a proper cost benefits analysis.

Full commentary here:

http://www.businessspectator.com.au/bs.nsf/Article/The-true-price-of-the-NBNThe-cost-of-the-NBNWhatS--pd20100827-8Q3QF?OpenDocument&src=srch

We also had this a few days ago.

Broadband plan is smoke and mirrors

THE objective to build a high-speed National Broadband Network is visionary but the strategy for the NBN - building fibre direct to 93 per cent of Australian homes to deliver up to 100 megabits per second, let alone the suggested gigabit - is based on some false assumptions.

The case to spend $43 billion has been pursued largely by the beneficiaries; the consultants, technologists and Telstra competitors selling a series of myths to influence politicians, the media and the public.

No other country is remotely proposing such expensive government expenditure.

Nevertheless, these myths have grown up around the government's NBN venture.

1. It's an enabling technology: Broadband internet has been compared with the great enabling technologies of history such as the wheel, the steam engine, the printing press, electricity, the telephone, computers and the internet. But broadband is not a new invention, it is only a means of delivering existing and well proven technologies in a faster way.

2. We need speed: In the US the Federal Communications Commission national broadband plan is for download speeds of at least 4Mbps and upload speeds of at least 1Mbps to deliver "universal access". Though some countries offer far higher speeds, the US maintains this plan offers one of the highest universalisation goals in the world.

In Britain, the Digital Economy Act, known as Digital Britain, allows for 90 per cent coverage in Britain by 2012 with a minimum speed of 2Mbps.

The ability to provide at least 12Mbps nationally through wireless and satellite will enable all people, including those living in outer metropolitan, country and remote areas, to be able to receive the same email, social networking, internet, music, movies, videos, health, education, teleconferencing and public services as those with fibre in the cities.

3. Speed is expensive: The US congress and Barack Obama, under the Recovery Act, committed the US to spending $US7.2bn ($7.8bn) to improve the country's broadband infrastructure. More than $US2.5bn of this is exclusively for infrastructure projects to take broadband to rural and remote communities.

Of the remainder, $US4.4bn goes to support anchor institutions such as hospitals, schools, public safety broadband networks and public computing centres, and to teach Americans the skills and to provide centres for easier access to high-speed internet.

The US also intends to move $US15.5bn during the next decade from the existing Universal Service Fund, which would have been spent on telephone services, to support broadband in unserviced areas.

The proposed expenditure in Britain is even more meagre, with the government's pound stg. 300 million ($501m) home access scheme for low-income families. It further plans to provide pound stg. 200m for the delivery of its universal service commitment on a mix of technologies.

The US and Britain believe in the need for universal broadband but intend to spend only a fraction of the $43bn Australia is spending on the NBN alone, which does not even include the costs of educating and training the public in its use or the provision of services.

……

This is an edited extract from a full version on www.coxmedia.com.au.

Peter J. Cox is a media economist and analyst with Cox Media.

The link is here (with a great Bill Leak Cartoon!):

http://www.theaustralian.com.au/news/opinion/broadband-plan-is-smoke-and-mirrors/story-e6frg6zo-1225917689577

And then we have material like this.

US regulator set to back ‘WiFi on steroids’

By Joseph Menn in San Francisco

Published: September 12 2010 22:30 | Last updated: September 12 2010 22:30

The prospect of new wireless devices resembling “WiFi on steroids” will open up next week when US regulators will vote to liberalise an important part of the airwaves.

The new spectrum is set to end the frustration of users who lose connectivity when they move rooms. It will also bring affordable broadband access to tens of millions of rural users.

Full article here:

http://www.ft.com/cms/s/2/8b165ee6-beab-11df-a755-00144feab49a.html

The bottom line to me is that some form of well-considered NBN is vital for effective use of e-Health. The question is just how well considered the present proposal is - McKinsey Study or no. Before this all happens I would really like to see a proper debate, while being aware that there seems to be almost religious conviction that this is a ‘good thing’ at any cost vs. those who reckon we can have what we need for 20% of the cost. I would just like to have a few more facts and plans to consider. I note today The Age is reporting that the business case is to be released in a few weeks - see here:

http://www.theage.com.au/national/broadband-network-will-save-jobs-swan-20100916-15eo4.html

That would be a really good first step!

David.