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."

Saturday, October 30, 2010

Weekly Overseas Health IT Links - 29 October, 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.

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http://www.nejm.org/doi/full/10.1056/NEJMp1000401

Perspective

Why Health Care Is Going Home

Steven H. Landers, M.D., M.P.H.

October 20, 2010 (10.1056/NEJMp1000401)

In Albuquerque, New Mexico, and Buffalo, New York,1 acutely ill patients have been sent out of the emergency department for hospital-like care at home. In Baton Rouge, Louisiana, and Little Rock, Arkansas, home health agencies provide chronic care management services, emphasizing care coordination and support for patients' management of their own conditions. In San Diego, California, physicians arrive at patients' homes with a new version of the black bag that includes a mobile x-ray machine and a device that can perform more than 20 laboratory tests at the point of care. Several engineering and electronics companies have developed products for monitoring health at home. Massachusetts General Hospital in Boston is experimenting with Internet videoconferencing to permit virtual visits from patients' homes.

In my Cleveland Clinic practice, I work in my patients' homes, using a cellular broadband connection to the same electronic record system used by my colleagues in offices and hospitals. I learn practical information about my patients' medications, management of chronic illnesses, and nutrition and check in on how their caregivers are coping. Patients often see the home visit as a gesture of caring, and many of my older patients express nostalgia for an era when house calls were common. Hundreds of other U.S. physicians are also emphasizing home-based care, many of them now as members of the American Academy of Home Care Physicians.

In the past century, health care became highly concentrated in hospitals, clinics, and other facilities. But I believe that the venue of care for the future is the patient's home, where clinicians can combine old-fashioned sensibilities and caring with the application of new technologies to respond to major demographic, epidemiologic, and health care trends. Five major forces are driving health care into the home: the aging of the U.S. population, epidemics of chronic diseases, technological advances, health care consumerism, and rapidly escalating health care costs.

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http://healthcareitnews.com/news/healthcare-ripe-videoconferencing

Healthcare ripe for videoconferencing

October 19, 2010 | Bernie Monegain, Editor

LONDON – Reduced prices and improved quality are boosting the adoption of telemedicine videoconferencing systems, according to new analysis from research and consulting firm Frost & Sullivan.

The practice of telemedicine has been undergoing significant evolution paralleled by technological advancements in the world of videoconferencing, according to the report "Visual Collaboration Applications in Healthcare." These changes open new opportunities for videoconferencing service providers as they continue to address a market that remains highly under-penetrated. Hence, healthcare practitioners are increasingly adopting interactive video or videoconferencing applications for providing enhanced access to healthcare as well as improving the quality of such services at lower prices across the globe.

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A Network For Everyone

On top of all the regional and local health information exchanges, the federal government has a national exchange in the works.

By Marianne Kolbasuk McGee, InformationWeek
Oct. 16, 2010
URL:
http://www.informationweek.com/story/showArticle.jhtml?articleID=227900054

On top of all the regional and local health information exchanges, the federal government has a national exchange in the works. The Nationwide Health Information Network is a set of standards, services, and polices to enable secure sharing of health data over the Internet.

NHIN, being developed by the Department of Health and Human Services with input from the healthcare industry and others, aims to let health information follow patients as they move among caregivers and institutions locally and around the country. The ability to electronically exchange data is expected to be one of the requirements healthcare providers have to meet to demonstrate "meaningful use" of e-health records and qualify for federal incentive money.

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http://today.msnbc.msn.com/id/39727967/ns/today-today_health#

Digital medical records: What you need to know

Online access to your medical info helps you get better and safer care

By Carol Diamond, MD, MPH

TODAY TODAY

updated 10/18/2010 5:29:45 PM ET 2010-10-18T21:29:45

Opinion

Imagine no more telephone tag with the doctor’s office just to get your medical records sent to a specialist. Imagine no more digging through stacks of paper to find an old immunization record.

Medicare beneficiaries and veterans now have something we all should have — the option to click a blue button to download key aspects of their personal health information. This simple step marks a significant milestone in an effort to put the power of information — your personal health information — at your fingertips.

When you go to the doctor’s office, do you get a summary of the visit afterward? Can you log in to a secure website and look up your recent laboratory results? If you are like most Americans, the answers to both questions are no.

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http://www.miller-mccune.com/health/when-facebook-is-your-medical-record-23607/

October 14, 2010

When Facebook Is Your Medical Record

Emerging research suggests kids’ social network postings reflect their real-life behavior. Should that information be used in their medical care?

Jordan Lite

Not long before some teenagers who’d been bullied on MySpace and Facebook started committing suicide in 2006, a doctor of adolescent medicine named Megan Moreno began hearing from her patients that social networking sites were making them sick. One girl started getting stomachaches after peers posted photos of her on MySpace. Another worried that the sexual references on her boyfriend’s profile meant she’d have to do things she didn’t feel ready for.

Moreno was troubled but intrigued: If MySpace, and more recently, Facebook, could so powerfully influence a teen’s health for the worse, might the same information on the sites that was making teens ill — the prolific reports on their moods, drinking, drug use and sex lives — be harnessed to promote well-being?

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http://www.healthdatamanagement.com/news/breach-flash-drive-medicaid-notification-hitech-41212-1.html

Lost Flash Drive Affects 280,000

HDM Breaking News, October 21, 2010

Two affiliated Medicaid managed care plans in Pennsylvania have acknowledged that an unencrypted flash drive containing protected health information on 280,000 members went missing on Sept. 20.

AmeriHealth Mercy Health Plan and Keystone Mercy Health Plan did not disclose the lost drive until a Philadelphia Inquirer reporter learned of the incident and called in recent days, according to the newspaper. The plans will be notifying affected members, according to a statement.

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http://www.healthdatamanagement.com/news/privacy-security-authentication-tiger-team-hitech-comment-41208-1.html

Fed Advisors Seek Comment on Authentication

HDM Breaking News, October 21, 2010

The Privacy and Security Tiger Team of the HIT Policy Committee is seeking public comment on authentication "trust" rules for provider organizations.

"For purposes of this discussion, authentication is the verification that a provider entity (such as a hospital or physician practice) seeking access to electronic protected health information is the one claimed, and the level of assurance is the degree of confidence in the results of an authentication attempt," the Tiger Team explains in an entry on the Federal Advisory Committee Blog.

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http://www.healthdatamanagement.com/news/health-level-seven-standards-ehr-phr-functional-model-41209-1.html

HL7 to Explain EHR, PHR Functional Models

HDM Breaking News, October 21, 2010

Standards development organization Health Level Seven International will host a free Web seminar on Oct. 26 to explain the Electronic Health Record System Functional Model and the Personal Health Record System Functional Model.

The models define the functions that should be in EHRs and PHRs. The EHR model, for instance, contains about 1,000 conformance criteria across more than 100 functions, according to Ann Arbor, Mich.-based HL7.

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http://www.fierceemr.com/story/hie-mobility-open-platforms-start-knock-down-walled-gardens-proprietary-emrs/2010-10-21

HIE, mobility, open platforms start to knock down 'walled gardens' of proprietary EMRs

October 21, 2010 — 3:04pm ET | By Neil Versel

On the cover of its September issue, Wired magazine declared the web "dead" but also proclaimed, "Long live the Internet." Instead of searching through a browser, people are increasingly turning to specific online applications to find the information they need or the online experience they seek.

As usual, healthcare is a bit further behind the rest of the world, according to consultant Vince Kuraitis, and is only beginning to move away from the "walled garden" approach that early Internet leaders Prodigy, CompuServe and AOL found success with, only to be overtaken by the open web once broadband took hold.

Kuraitis, author of the e-Care Management blog noted this Wednesday at the Mobile Health Expo in Las Vegas while attempting to assess whether the HITECH section of the American Recovery and Reinvestment Act was working. "Health IT has been a series of walled gardens, locking docs into a particular [EMR] company, but is moving toward open platforms," Boise, Idaho-based Kuraitis said.

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http://www.modernhealthcare.com/article/20101021/NEWS/310219994/

Blumenthal seeks better planning for Stage 2

By Joseph Conn / HITS staff writer

Posted: October 21, 2010 - 11:30 am ET

David Blumenthal, the National Coordinator for Health Information Technology at HHS, said planners developing Stage 2 meaningful-use criteria under the federal electronic health-record incentive program will have slightly more strategic-thinking time than they had in creating Stage 1 criteria.

"We're mindful of the fact that the first go-round was very rushed,” Blumenthal told members of the federally chartered Health IT Policy Committee.

Working under such tight deadlines "didn't allow for careful forward planning," Blumenthal said. "I want to do better this time."

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http://www.ihealthbeat.org/features/2010/health-care-futurist-questions-us-health-it-strategy.aspx

Thursday, October 21, 2010

Health Care Futurist Questions U.S. Health IT Strategy

Health care futurist Jeff Goldsmith says health IT adoption has lagged in the U.S. because there's no definable return on investment. Goldsmith -- president of Health Futures and an associate professor of public health sciences at the University of Virginia -- warns that health IT adoption, combined with the current U.S. payment system and quality measurement requirements, is actually hurting productivity.

Goldsmith spoke with iHealthBeat about whether the federal government's "meaningful use" incentive program will be successful in driving health IT adoption, what he would have done differently in designing such a program and which country the U.S. could learn from when it comes to health IT.

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http://www.euractiv.com/en/health/eu-health-chief-ehealth-no-science-fiction-interview-498817

EU health chief: 'eHealth is no science fiction'

Published: 21 October 2010

New EU laws allowing patients to travel across borders for health care will be crucial to putting in place the legal framework for the development of e-health services in Europe, according to EU Health Commissioner John Dalli.

What benefits can you see in adopting eHealth technologies?

We want to put patients' rights, patient safety and access to health services at the heart of policymaking. eHealth is a tool for delivering all of this, which is why I've made innovation in health care a priority. eHealth can help make health systems more efficient and give patients access to expertise from anywhere.

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http://www.medscape.com/viewarticle/730772

Electronic Medical Record of Wounds May Help Prevent Amputations in Diabetics

Daniel M. Keller, PhD

October 19, 2010 (Washington, DC) — An online wound (OW) electronic medical record (EMR) can contribute significantly to a decrease in amputation rates in patients with diabetes and lower extremity wounds, according to a study presented here at the American College of Surgeons 96th Annual Clinical Congress.

Senior author Jason Maggi, MD, from the Department of Surgery at the New York University Langone Medical Center in New York City, said that because of the number of people involved in the care of patients with diabetic foot ulcers (DFUs), a centralized EMR is needed to coordinate patient care.

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http://www.ehealtheurope.net/news/6328/belgium_consults_on_opt-in_vs_opt-out

Belgium consults on opt-in vs opt-out

19 Oct 2010

The Belgian national eHealth platform is calling for views on whether patient privacy and exchange of data should be governed by an ‘opt-in or opt-out’ approach on data be held on the system.

A consultation is now underway on whether the platform should be set-up on an opt-in system, in which the informed consent of the patient is required prior to communicating the data; or an opt-out system, where the data exchange takes place unless the patients oppose it.

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Health IT Czar Pushes EHR For Minority Communities

Warning against a "new digital divide," Health and Human Services officials have urged healthcare IT vendors to adopt electronic health records in underserved areas.

By Marianne Kolbasuk McGee, InformationWeek
Oct. 20, 2010
URL:
http://www.informationweek.com/story/showArticle.jhtml?articleID=227900405

In an open letter, national health IT czar Dr. David Blumenthal is urging the health IT vendor community to help bolster e-health record adoption rates among healthcare providers in underserved, minority communities.

The letter, co-signed by Blumenthal and Dr. Garth Graham, director of the office of minority health, cited a Centers for Disease Control and Prevention National Ambulatory Medical Care survey indicating that EHR adoption rates “remain lower among providers serving Hispanic or Latino patients who are uninsured or relied upon Medicaid.”

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http://www.ehiprimarycare.com/news/6334/four_suppliers_sign_up_for_ihr_in_wales

Four suppliers sign up for IHR in Wales

20 Oct 2010

NHS Wales has announced an agreement with four healthcare IT suppliers to deliver the Individual Health Record across the country.

Out-of-hours IT system supplier Adastra and GP system suppliers EMIS, iSoft and INPS have all signed an agreement to provide the technical solution that will make the IHR widely available.

The IHR is the Welsh equivalent of England’s Summary Care Record and Scotland’s Emergency Care Summary, but access is limited to individual health boards.

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http://www.hospitaliteurope.com/default.asp?title=EMISWebhelpstodeliverIndividualHealthRecordinWales&page=article.display&article.id=23454

EMIS Web helps to deliver Individual Health Record in Wales

Tuesday 19th October 2010

Real-time data streaming via EMIS Web – the new system from leading GP software supplier EMIS – is one of the components that will deliver the Individual Health Record (IHR) service being introduced by NHS Wales.

EMIS is one of the four main suppliers of GP computer systems in Wales who have signed an agreement with NHS Wales to provide the technical solution that will make the IHR available across the country.

The IHR is a Welsh Assembly Government initiative that allows important patient information to be securely shared between GPs, emergency care and out of hours services – with the patient’s consent. It gives an electronic view of key information held on the GP’s practice computer system.
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http://www.who.int/goe/ehir/2010/19_october_2010/en/index.html

e-Health Intelligence Report

19 October 2010

Publications

:: ICTs, Enterprises and Poverty Alleviation

UNCTAD - Published October 14, 2010

The Information Economy Report 2010, will centre on the theme of "Information and communication technologies (ICTs), enterprises and poverty alleviation", examining the possible implications for poverty reduction of production and enhanced use of ICTs by domestic businesses
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http://www.modernhealthcare.com/article/20101018/NEWS/310189938/

Blumenthal asks vendors to help prevent 'digital divide'

By Joseph Conn

Posted: October 18, 2010 - 3:45 pm ET

The much-feared digital divide now is being recognized as having racial and ethnic components that the government and health information technology vendors should address, according to the federal health IT czar.

In an open letter posted online to the health IT vendor community, David Blumenthal, the National Coordinator for Health Information Technology at HHS, asked health information technology vendors for their help "in making sure that we are not creating a new form of 'digital divide.' " Blumenthal also asked vendors of electronic health-record systems to ensure that they "include providers who serve minority communities in their sales and marketing efforts."

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http://www.modernhealthcare.com/blogs/it-everything/20101019/310199999

Unsafe data in Texas

Last month, a Texas online news site, the Austin Bulldog, published a lengthy investigative report on the sale and gifting of patient-level hospital data by the Texas Department of State Health Services.

Reporter Suzanne Batchelor's remarkable story found that if you're a Texan, your healthcare data can be given away or sold without your consent. And the Health Insurance Portability and Accountability Act, the main federal health information privacy law, won't—or can't—protect you.

In Texas, the health services department gathers claims data from hospitals by law—providers can be fined as much as $10,000 if they don't hand it over. But the department isn't a so-called “covered entity” as defined by HIPAA. So, the state isn't covered under the HIPAA privacy rule if it does anything that would be a violation if performed by a data-providing hospital.

Texas requires researchers to sign data-use agreements, analogous to business associate agreements under HIPAA, which bar re-identification of individual records and ban allowing "others to release any information that identifies persons, directly or indirectly."

Enforcement is tasked to the Texas Health Care Information Council and to the Texas attorney general's office. Abusers who "knowingly or negligently" release patient records face civil penalties of not more than $10,000. There have been no enforcement actions requested or taken against Texas data buyers, according to Texas agency spokesman Chris Van Deusen.

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http://www.ehiprimarycare.com/news/6327/dh_issues_%27info_revolution%27_strategy

DH issues 'info revolution' strategy

18 Oct 2010

The Department of Health has launched a three month consultation on proposals to deliver an “information revolution” to users of the NHS.

The consultation paper launched this morning on the DH website says that with modern technology playing “an ever increasing part in our everyday lives” too much of the health and care system still relies on “face to face contact and paper based transactions, even when it is neither necessary nor appropriate.”

It also says change is needed to deliver the “no decision about me without me” promise at the heart of the government’s recent white paper, ‘’Equity and Excellence, Liberating the NHS.’

To deliver on this, the paper says the public, carers and patients not only need good information but “a culture that enables people to make use of it.”

It says this culture must be based on “accurate and up to date health and care records” since these “form the basis of information systems for patients and service users.”

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http://www.e-health-insider.com/comment_and_analysis/645/reboot_nhs_information

Reboot NHS Information

18 Oct 2010

E-Health Insider’s managing editor, Lyn Whitfield, takes a first look at the three month consultation paper on a new information strategy for health and social care: ‘Liberating the NHS: an information revolution.’

The latest consultation on an information strategy for the NHS opens with a bold claim. “Much of the frustration within today’s care system has, at its root, information,” it says.

Not lack of money. Not poor structures. But having to repeat information, to hang around for test results, and “being unable to compare one service with another.”

Having identified this problem, ‘Liberating the NHS: an information revolution’ goes on to say that what is needed is information that puts people in control.

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http://www.healthleadersmedia.com/content/TEC-257899/5-Reasons-to-Consider-the-Cloud-for-Health-Data.html

5 Reasons to Consider the Cloud for Health Data

Gienna Shaw, for HealthLeaders Media , October 19, 2010

There are plenty of benefits to using cloud computing to share health data. Of course, the cloud isn't perfect. When it comes to diagnostic imaging, for instance, massive file sizes make even online access tricky.

But when you pair benefits such as ease of use with improvements such as greater efficiency and lower costs, it's easy to see why more organizations are turning to cloud computing solutions to gather and share digital records.

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http://www.govhealthit.com/newsitem.aspx?nid=74872

Army to deploy WorldVistA EHR for Iraqi health net

By Mary Mosquera
Friday, October 15, 2010

The U.S. Army is looking for a vendor to deploy WorldVistA EHR, an open source version of the Veterans Affairs Department’s VistA medical record system, for the Iraq Ministry of Defense. It will connect with the government’s healthcare system, enhance patient record-keeping and improve the level of healthcare in Iraq.

The WorldVistA EHR is used elsewhere in the Middle East, such as at the National Cancer Institute of Cairo University in Egypt, and in Jordan’s national health system.

The primary location for training and EHR use in Iraq is the Al Muthana Military Hospital in Baghdad, according to an Oct. 14 announcement on the Federal Business Opportunities Web site. The hospital, which opened in 2009, offers care for medical conditions requiring hospitalization, emergency care, initial wound surgery, and post-operative treatment.

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http://www.govhealthit.com/newsitem.aspx?nid=74873

HHS: Patients should receive easily understood HIE privacy notices

By Mary Mosquera
Monday, October 18, 2010

Healthcare providers should supply patients with layered and easy to understand notices of how their information will be used and protected when it is exchanged, an advisory panel of the Health & Human Services Department recommended.

Physicians should include this description in a short summary in the privacy practices notice that is required by HIPAA, and that patients receive and sign at office visits, it said at an Oct. 15 meeting. But more detailed information exchange explanations should be readily available to patients.

When written, the Health Insurance Portability and Accountability Act (HIPAA) did not foresee the broad exchange of personal health data.

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http://www.informationweek.com/blog/main/archives/2010/10/how_to_keep_hea.html

How To Keep Health Data Exchanges Going

Posted by Marianne Kolbasuk McGee on October 19, 2010 03:55 PM

Financial sustainability has been the hardest nut to crack for many health information exchanges. And even with the feds providing $564 million in stimulus funding for states to build and expand HIEs, the sustainability issue will likely remain one of the toughest challenges.

Under the American Recovery and Reinvestment Act, the Department of Health and Human Services awarded grants to states ranging from $4.6 million to $38.8 million. However, that money is designated for establishing or advancing the HIEs, including infrastructure, software, hardware costs. The grant money can’t be used for operations.

So once the HIE is running, there’d better be a well thought-out, solid plan to keep it going. The recent past is littered with promising health data exchange efforts that didn’t last after public or private grant money ran out.

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http://www.kaiserhealthnews.org/Daily-Reports/2010/October/19/Health-IT.aspx

Health IT Sector May Face Workforce Shortage

FierceHealthIT: A top federal health IT official said there is a workforce shortage in the sector that could hinder the widespread adoption of electronic medical records, but federal aide is on the way, for that, too. David Blumenthal, the national health IT coordinator, said federal training programs would meet 85 percent of the demand, which he estimated as a shortage of about 50,000 workers. "He notes that the University of Texas at Austin, a beneficiary of some of the government funding, recently graduated its first class of health information management and exchange specialists, and that the school will add three more health IT certificate programs next year" (10/18).

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http://www.healthdatamanagement.com/news/health-care-technology-news-blog-halamka-meaningful-use-41182-1.html

CIO Posts I.T. Operating Plan

HDM Breaking News, October 18, 2010

Whether he is discussing systems implementations, standards, federal policies, favorite vegetarian dishes or the beauty of New England, John Halamka's blog, "Life as a Healthcare CIO," is worth reading. Two recent posts bear particular notice for health information technology professionals.

Halamka, a practicing physician, serves as CIO of Beth Israel Deaconess Medical Center and Harvard Medical School. On Oct. 18, he posted the hospital's information systems operating plan for fiscal year 2011. Top projects include achieving meaningful use for 1,700 clinicians and go-live of a suite of new laboratory information systems that replace 13 major applications.

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http://www.fiercehealthit.com/story/verizon-opens-hie-services-imaging-test-results-small-providers/2010-10-18

Verizon opens HIE services to imaging, test results, small providers

October 18, 2010 — 12:04pm ET | By Neil Versel

Verizon Communications is making a broader push into health IT by expanding its cloud-based Verizon Medical Data Exchange to support interoperability of digital images and test results, in addition to dictated and transcribed notes. Additionally, the exchange is now open to a wider range of providers, including rural hospitals and small physician practices, the telecommunications giant says.

"The expanded capabilities of our data exchange will help accelerate the shift from paper-based to electronic-based medical records, and in the process help speed patient diagnoses and drive productivity and cost efficiency throughout the U.S. healthcare system," Peter Tippett, vice president of technology and innovation at Verizon Business, says in a press release.

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http://www.fiercehealthit.com/story/patientslikeme-incident-may-just-be-scraping-surface/2010-10-18

PatientsLikeMe incident may just be 'scraping' the surface

October 18, 2010 — 1:33pm ET | By Neil Versel

Ready for another threat to individual privacy? Less insidious, perhaps, than phishing, but potentially as damaging is a relatively new technique called "scraping."

Scraping is the practice of trolling social networking sites, message boards and chat rooms looking for personal information that can help firms target the right people with their marketing efforts. And instead of being cloaked in the guise of a Nigerian prince or other shady character, scraping is being sponsored by some big-name, legitimate companies, and it's starting to find its way into healthcare.

The Wall Street Journal reported last week that media research firm Nielsen Co.--you know, of TV viewership ratings fame--was caught copying messages off the message boards of consumer healthcare support site PatientsLikeMe. PatientsLikeMe identified and blocked Nielsen from its site and sent notices to registered users, but the damage had been done.

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http://www.ihealthbeat.org/perspectives/2010/retooling-and-the-emeasure-the-next-frontier.aspx

Monday, October 18, 2010

Retooling and the 'eMeasure': The Next Frontier?

You can't improve what you don't measure; you can't measure what you don't understand; and you can't understand what you don't collect. And, it's at this intersection of understanding where the National Quality Forum (NQF), measure stewards, "meaningful use," "retooling" and "eMeasures" meet.

NQF has played a key role in setting national priorities and goals for performance improvement and for endorsing national consensus standards for measuring and publicly reporting on performance. To date, most performance measures have been developed and are available in a paper-based format. This means data collection to understand performance, compare outcomes, and define key data inputs and outputs requires manual review and abstraction.

In 2009, HHS, motivated by the HITECH Act and the meaningful use regulations, requested that NQF manage the "retooling," or conversion, of a set of 111 measures from the traditional paper-based format to the electronic measure, or "eMeasure," format that is readable by electronic health records. Working in close collaboration with its measure steward partners, NQF is 61 measures down the path toward completion and expects to complete all measures by the end of 2010. This conversion should ensure that performance measure data are consistently defined, implemented, and usable in the context of an EHR and support the meaningful use requirements.

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http://gcn.com/articles/2010/10/18/gcn-award-hhs-connect.aspx

HHS Connect sets standards for sharing medical information

Open-source system lets health care organizations exchange records securely and efficiently

  • By Edmund X. DeJesus
  • Oct 15, 2010

Until recently, there wasn’t an easy way for federal agencies to securely and efficiently exchange health care information with one another or other organizations.

But a standards-based, open-source approach orchestrated by the Health and Human Services Department's Office of the National Coordinator for Health IT promises to do just that via the Connect program.

The Connect program supplies free software that government agencies and private-sector health care providers can use to exchange patient information.

Federal agencies that provide health-related services often face conflicting requirements. They must provide the best possible medical care for people, and they must make sure that patients' medical records remain private and secure. Moreover, they need to share health information using Nationwide Health Information Network (NHIN) standards. In addition, each federal agency has its own regulations about medical information.

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http://www.nytimes.com/2010/10/07/business/media/07adco.html?_r=1&ref=health

October 6, 2010

Web Site to Offer Health Advice, Some of It From Marketers

By STUART ELLIOTT

THE expression “sharing is caring” was coined long before the Internet and social media like Facebook and Twitter made it easier for information, opinions and advertising to be shared among multitudes.

Starting on Thursday, the Web site Sharecare.com is to arrive, offering what its proprietors call an interactive social Q.& A. platform to provide consumers with what they want to know on health and wellness subjects — with the A’s being contributed by, among others, marketers.

Those behind Sharecare, a company formed last year to operate Sharecare.com, hope its features will enable the new Web site to thrive in a crowded field. Others in the online health care category include About.com, AOL, CNN, eHow, Everyday Health, Health.com, MSN, WebMD and Yahoo.

Sharecare.com will begin with content contributed by organizations like AARP, the American Cancer Society, the American Heart Association, the American Red Cross, the Cleveland Clinic, Johns Hopkins and the National Academy of Sports Medicine, along with medical professionals like Dr. Mehmet Oz.

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http://7thspace.com/headlines/360611/development_and_formative_evaluation_of_the_e_health_implementation_toolkit_e_hit.html

Development and formative evaluation of the e-Health Implementation Toolkit (e-HIT).

The use of Information and Communication Technology (ICT) or e-Health is seen as essential for a modern, cost-effective health service. However, there are well documented problems with implementation of e-Health initiatives, despite the existence of a great deal of research into how best to implement e-Health (an example of the gap between research and practice).

This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT) which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format.
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Enjoy!

David.

A Small Toot Of The Blog’s Horn! - 200,000 Site Visits To Date!

Australian Health Information Technology

VISITS

Total - 200,000

Average Per Day - 238

Average Visit Length -2:19

Last Hour - 4

Today -36

This Week -1,663

PAGE VIEWS

Total - 338,629

Average Per Day - 370

Average Per Visit- 1.6

Last Hour - 9

Today - 51

This Week- 2,589

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Many thanks to all who have dropped in - and especially to those who have commented and added to the conversation!

David.

Friday, October 29, 2010

mHealth - Some Perspectives and Opportunities.

I was sent this link today.

http://www.cochrane.org/multimedia/multimedia-cochrane-colloquia-and-meetings/colloquium-colorado-2010/opening-session-ida-s

The session is from a Cochrane Foundation Colloquium that happened a week or so ago in Colorado.

The session title was as follows:

Beyond bounds: care and research in a mobile world

The presenter is:

Ida Sim, University of California, San Francisco

It lasts about 20 mins and is well worth a watch. If the area of Evidence Based Medicine is of interest you can watch a lot of other presentations here:

http://www.cochrane.org/multimedia/multimedia-cochrane-colloquia-and-meetings/colloquium-colorado-2010

Enjoy!

David.


What Is The Chance Of This Summit Being More Than An Ill Informed Talkfest? Zero I Fear!

We have had this special event announced yesterday.

E-Health Conference - Revolutionising Australia’s Health Care

28 October 2010

The nation’s leading health experts, consumer groups and information technology specialists will come together to discuss the technological revolution in the delivery of health care at the E-Health Conference.

Minister for Health and Ageing Nicola Roxon said the e-health conference to be held in Melbourne at the end of November is an important opportunity for stakeholders to discuss how Electronic health and telehealth will drive the delivery of health care into the future.

“The Gillard Government is investing almost $470 million to introduce e-health across the health system – including the introduction of personally controlled electronic health records to be rolled out from July 2012,” said Ms Roxon.

“This investment will build upon the $392 million committed to modernise the health system by providing Medicare rebates for online consultations across a range of specialties for the first time.

“This investment will help people who live in rural and regional Australia to get the health care they need. It will save patients the time and expense of travelling long distances to see medical specialists, and will help them to see the right specialist sooner.

“These reforms will derive clear benefits from the rollout of the National Broadband Network and will enable better and safer care for patients that is more responsive to their needs.

“That’s why I want to get the stakeholders together so that we can get maximum value out of the Government’s investment and ensure that there is detailed discussion about the implementation plans leading into broader community consultation.

“We have already selected three lead implementation sites – in Brisbane, East Melbourne and the Hunter Valley.

The conference – a landmark forum – will provide an important opportunity for cross-sector collaboration and discussion around the design, implementation and vision for future capabilities of the system.

Representatives from governments, industry, private and public sector health care organisations, clinicians and consumer groups will discuss how this innovative system will work into the future.

“The Gillard Government is getting on with the business of delivering improved health services to the community. E-health will help prevent medication errors that cause an estimated 190,000 hospital admissions each year, costing $660 million, and the 8% of medical errors caused by inadequate patient information.

Minister Roxon and Senator Stephen Conroy, Minister for Broadband, Communications and the Digital Economy, will be speaking at the event.

The E-Health Summit will take place on the 30 November and 1 December at the Melbourne Convention Exhibition Centre.

For more information regarding the E-Health Conference, please contact Ms Sharon McCarter at the Department of Health and Ageing on 02 6289 3558

Press release is found here:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr161.htm?OpenDocument&yr=2010&mth=10

What is missing from all this is the link to a series of strategic and technical discussion papers to be discussed at the Summit.

The whole process is utterly back to front as well as DoHA is having this gabfest after the release of tenders for components of the PCEHR. So how exactly is the Summit going to affect what we wind up with.

The phrase ‘window dressing’ pops into mind.

Last comment - remember we have all been here before with Summits and National E-Health Strategies developed by the Boston Consulting Group in 2004 and Deloittes in 2008. Where has all that actually got us?

If some detailed informative plans, budgets and resourcing is not provided well ahead of the Summit you can be assured it will be a joke! Any serious effort at consultation and discussion would have all this mapped out and delivered with the announcement I believe.

I look forward to the discussion documents!

David.

Thursday, October 28, 2010

Just How Come Is It That NEHTA can Thumb its Nose at Government? Is It Wise for It to Do So?

The following appeared late last week.

E-health group snubs local participation guidelines

THE National E-Health Transition Authority has snubbed government guidelines designed to boost local participation in its first major tender.

NEHTA cited its controversial status as a private corporation owned jointly by the federal and state governments.

The Health Department refused last week to reveal how much NEHTA spent on travel in the past financial year, saying the taxpayer-funded body was not required to report such information under its funding agreement.

Over the past year, Liberal senators Sue Boyce and Concetta Fierravanti-Wells have been pursuing details of NEHTA's spending and accountability to parliament, and Senator Boyce has expressed frustration that its representatives cannot be compelled to appear before Senate estimate hearings and inquiries.

Now NEHTA has told bidders on the large National Authentication Service for Health contract that it does not need to comply with normal agency purchasing rules.

"NEHTA is a company limited by guarantee and as such falls outside of the scope of the Australian government procurement guidelines," it said.

Under Innovation Minister Kim Carr's $19 million Australian Industry Participation program launched last year, firms bidding for federal government work must lodge a plan showing they have considered options to include local firms in their tenders.

Small to medium-size businesses now have a backer in their corner, with Mr Carr appointing Don Easter as his office's IT supplier advocate in June.

Mr Easter said he queried NEHTA's stance when the NASH tender was released.

"I wrote to them in my role as advocate, saying you have to include provisions for an industry participation plan, and they came back to me saying 'no we don't'," he said.

"That is the case. I checked with the Health Department and the AIP requirements only apply to government agencies. However, they did say they were committed to the principles of open tenders, fairness and equity."

Mr Easter said industry plans were a "light touch" approach intended to ensure opportunities for local firms were routinely considered in tender responses.

" I know a bit about authentication and there are many people in the marketplace who do this type of thing now," he said. "What's interesting is why it took NEHTA so long to put it to tender. . .

More here:

http://www.theaustralian.com.au/australian-it/e-health-group-snubs-local-participation-guidelines/story-e6frgakx-1225940393641

I wonder how long it is going to take the Government and Opposition to recognise they have an out of control train here that is happily spending public funds with no real oversight.

It would seem to me there is very considerable political risk for Government especially in all this. Consider the scenario that we are a year further down the track from the present. The HI Service Implementation has gone less than perfectly - with all sorts of predicable barriers to smooth implementation arising as workflow implications, costs to software providers and so on begin to bite. Combine this with a NEHTA sponsored public education program that is raising awareness but where the public is failing to see all that much actual outcome.

It is now 18 months or so since the inception of the service, with NASH and the PCEHR still to actually happen, and with the exception of the pilots not much is being delivered.

In that circumstance, which has to have at least a 50% chance of being reality, the Opposition will be able to have a picnic at Senate Estimates Committees and in the political lead up to the next election.

NEHTA would be much smarter to proactively and honestly work with Medicare to get real plans, budgets, resource requirements and so on out there as cover and risk mitigation. And they also should turn up at estimates to provide a clear account - unfiltered by DoHA - as to what is really going on, and what issues they face - so they are not torn apart in a political backlash when the issues are recognised long after the event and blame has to be apportioned.

Openness works well to protect from the damage of surprise revelations - especially in the political scene.

A little proper prophylactic disclosure could do great things for NEHTA’s reputation to say nothing of the e-Health Project in total.

I suspect the inevitable backlash, when it comes if this risk is not managed well, will just sweep both the good and the bad of NEHTA away.

David.

Wednesday, October 27, 2010

I Think NEHTA Needs To Do Some Serious Fence Mending and Industry Consultation!

The following popped up late yesterday.

NEHTA lead attacks e-health contracts

By Josh Taylor, ZDNet.com.au on October 26th, 2010

No vendor with half a brain would sign a developer contract with Medicare to work on software as part of the government's e-health agenda, National E-Health Transition Authority (NEHTA) national clinical lead Dr Mukesh Haikerwal said this morning.

When asked at an Australian Information Industry Association e-health forum in Sydney this morning why just 14 out of the 80 software developers who had a developer's kit had signed a developer's agreement with Medicare, Haikerwal said he wouldn't hide from the problem.

"I think the contracts — and this is on the public record and I've said this to the people responsible — the contracts the vendors have been asked to sign are not the sort ... that anyone with half a brain would want to sign," he said.

"If you're going to be fair dinkum about getting the vendor involved in this space you've got to make a contract that they can adhere to. [A contract] that is reasonable and is deliverable and you can't put belts and braces on them and hold them back and tie both hands behind their back and then say, now you've got to play in this space," he added.

"So I wholeheartedly agree there are problems with the contracts. And we've got to make it better. My job is to make it better. If they don't like me saying it, they can sack me that's fine. I'm very happy to go somewhere else."

Despite teething problems with getting developers onboard, the benefits e-health offered would be immediate for clinicians, Haikerwal said. In his own clinic he identified that secure messaging offered by e-health could potentially save up to $30,000 a year in the cost of scanning and sending patient documents manually.

Haikerwal admitted that delivering personally controlled e-health records in just two years was a big ask, and said that NEHTA needed help from the IT industry to meet its goals.

More worrying material here from a thorough coverage.

http://www.zdnet.com.au/nehta-lead-attacks-e-health-contracts-339306849.htm

I really don’t think there is much to add here. We have the NEHTA sponsored blogger spinning away saying how good all this is - but, as quoted, I find it very hard to see there is much good news for NEHTA and Medicare here.

My view, if their Clinical Lead finds it necessary to speak out like this there is ‘trouble at mill’!

David.