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, March 26, 2011

Weekly Overseas Health IT Links - 26 March, 2011.

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.modernhealthcare.com/article/20110316/NEWS/303169951/

HHS seeks to let states data-mine for fraud

By Maureen McKinney

Posted: March 16, 2011 - 4:15 pm ET

HHS' inspector general's office has issued a draft rule that would allow states to use federal funds to help identify instances of Medicaid fraud.

The proposed rule would amend a current HHS provision that prohibits state Medicaid fraud control units from using federal dollars to fund efforts to electronically sort claims looking for evidence of fraudulent practices.

In the rule, published in today's Federal Register, the inspector general's office notes that current restrictions force states to rely on referrals to investigate potential fraud. Also, the inspector general's office said, data-mining has proved to be an effective anti-fraud tool for the federal government.

-----

http://www.fierceemr.com/story/practice-outlines-real-time-costs-installing-ehrs/2011-03-17

Practice outlines real-time costs of installing EHRs

March 17, 2011 — 11:59am ET | By Janice Simmons

While there is no doubt that it will take much time and money to install electronic health records (EHRs) in physicians' offices, the question remains: How much will it all ultimately cost? A new analysis from the March Health Affairs from a primary-care practice in North Texas provides ideas about average costs.

The HealthTexas practice, affiliated with Baylor Health Care system, estimated that the total cost for implementation through the first 60 days after launch was $162,047 for a five-physician practice--with an average per physician total cost of $32,409. When adding in maintenance, the costs go up: Baylor researchers--looking for the whole first year after launch--estimated the total costs through the first year to be $233,297, with an average per physician cost of $46,659.

-----

http://www.fierceemr.com/story/senate-bill-looks-expand-ehr-use-mental-health-providers/2011-03-17

Senate bill looks to expand EHR use for mental health providers

March 17, 2011 — 11:56am ET | By Janice Simmons

A Senate bill calling for expanded health IT incentives for adoption of electronic health records (EHRs) by mental healthcare, behavioral healthcare, and substance abuse treatment providers and facilities was introduced this week by Sen. Sheldon Whitehouse (D-R.I.).

"Mental healthcare is a critical component of our healthcare safety net, and allowing these providers access to cost-saving, quality-enhancing advances in health information technology will improve the care that millions of American receive," Whitehouse said in a statement.

-----

http://www.fierceemr.com/story/how-do-you-persuade-docs-make-switch-ehrs/2011-03-17

How do you persuade docs to make the switch to EHRs?

March 17, 2011 — 11:20am ET | By Janice Simmons

If you build it, will they (the physicians) come? It's a whole new field of dreams for hospitals--and the stakes are high. As hospitals spend millions on obtaining and installing electronic health records (EHRs) systems--with an eye toward getting a piece of the government's $27 billion in incentives for meeting Meaningful Use provisions--many are faced with the same quandary: how do they get physicians and other healthcare providers on board to adopt and effectively use the EHRs?

In a recently released survey from Dell of 150 hospital execs taken last fall, this issue seemed to be on their minds: when asked what technology challenges their hospitals faced, 79 percent said, "training clinicians and hospital staff in order to achieve process improvements and time savings." This response was second only to being able to afford and maintain the technology (cited by 85 percent).

-----

http://www.ihealthbeat.org/features/2011/could-fourth-time-be-the-charm-for-telehealth-bill.aspx

Thursday, March 17, 2011

Could Fourth Time Be the Charm for Telehealth Bill?

by Kate Ackerman, iHealthBeat Senior Editor

On March 8, Sen. John Thune (R-S.D.) introduced a bill (S 501) that would create pilot programs to provide incentive payments to home health agencies that use telehealth technology to improve health outcomes for Medicare beneficiaries and reduce spending.

Sen. Amy Klobuchar (D-Minn.) is a lead co-sponsor of the Fostering Independence Through Technology Act of 2011.

If you are getting a sense of déjà vu, that's for good reason. Thune introduced the same bill in 2005, 2007 and 2009, according to AshLee Strong, Thune's press secretary. None of the bills made it past the Senate Finance Committee. In addition, there was an amendment to include the FITT Act in the Patient Protection and Affordable Care Act, "but it didn't get voted on because Democrats limited consideration of amendments," Strong said.

-----

http://www.itworldcanada.com/news/manitoba-off-and-running-with-e-health/142735

Manitoba off and running with e-health

The province has officially announced the first phase of its new e-health record system, which gives doctor’s access to patient demographic, immunization and drug data. Plus, analysis from e-health blogger Michael Martineau

By: Rafael Ruffolo

(17 Mar 2011)

The Government of Manitoba has officially launched the first phase of its new e-health record system at seven health centres and hospitals across the province.

The initial rollout of the eChart Manitoba system gives doctors the ability to view demographic, immunization and drug information. It also gives physicians access to select lab results.

Over the next 18 months, up to 30 sites will be phased into the project with a second phase of eChart expected to go live before the end of 2011. With that update, doctors will be able to get access to diagnostic imaging reports, allergy information and more lab data sources will be added.

-----

http://www.washingtonpost.com/national/despite-incentives-doctors-are-wary-about-switching-to-electronic-health-records-/2011/02/24/ABvRCuV_print.html

Despite incentives, doctors are wary about switching to electronic health records

By Lena H. Sun, Monday, March 14, 8:03 PM

With funding and technical support from his employer, Washington internist Brad Moore made a swift transition to electronic records seven years ago. He now pulls up a patient’s chart with a few clicks of his mouse.

Lab tests show the man, a diabetic, has his blood sugar under control. A surgeon’s note describes progress after a shoulder operation. Before heading to the exam room, Moore, 47, clicks on a yellow “FYI” button, the electronic equivalent of a sticky note. It reminds him to ask how his patient is doing after his wife’s recent death.

About 20 miles away in suburban Maryland, internist Jonathan Plotsky hunts for the same kind of information in charts, some of them six inches thick, others taking up three volumes. He is well aware of the benefits of electronic records, but like most U.S. doctors, Plotsky, 56, is hesitant to switch. At up to $50,000 per clinician, the systems cost too much for him and the part-time doctor with whom he practices, he says. He doesn’t know what to buy, how to install it or how he would transition to paperless.

-----

Costs, Training Top Hospital EHR Concerns

While electronic health record adoption is high, only 47% of executives think IT will improve their work environment and 85% are worried about how to pay for it, finds Dell study.

By Nicole Lewis, InformationWeek

March 14, 2011

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=229300903

Three out of four hospital executives say their organizations have partly or fully implemented electronic health records (EHRs) of some sort, and 83% have either selected or implemented an EHR that can fulfill federal meaningful use requirements, according to a survey conducted by Dell.

The Dell Executive & Patient Survey interviewed hospital executives as well as recent hospital patients in fall 2010 to gauge their attitudes toward various issues facing the healthcare industry.

The survey, which polled 150 hospital executives, also found that a third of respondents are participating in some form of local, regional, or state health information exchange (HIE), which allows multiple providers to have access to the same patient data. Another 54% are planning to participate in an HIE and almost 70% have partly or fully implemented an online physician portal.

-----

http://www.theatlantic.com/technology/archive/2011/03/small-study-shows-virtual-doctor-visits-can-prove-effective/72508/

Small Study Shows Virtual Doctor Visits Can Prove Effective

It's up for debate whether Internet helps or hurts doctors' ability to treat patients. While sites like WebMD bring out the hypochondriac in us all, researchers out of a hospital clinic in Barcelona may have found a way that the Web and medicine can mesh. This week, they presented results of their telemedicine program "Hospital VIHrtual," which successfully treated HIV patients using an Internet-based home care system.

The team cared for 200 HIV patients over five years, providing consultations via the Internet. The results of the study show that the medical, psychological and pharmaceutical needs for the participants were met as satisfactorily as those required by in-person visitors.

The virtual hospital reduces the amount of face-time patients have with doctors, moving many routine doctor-patient interactions online. The program facilitates consultations via Webcam and e-mail; offers online medication management; provides access to accurate information about the disease, medications, side effects, news and innovations; and plugs patients into a virtual community, which connects them to health professionals and others who share their illness.

-----

http://www.modernhealthcare.com/article/20110316/NEWS/303169950/

White House calls for online privacy law

By Jessica Zigmond

Posted: March 16, 2011 - 5:00 pm ET

The Obama Administration is urging Congress to pass Internet consumer privacy legislation, and the issue was the subject of Senate Commerce Committee hearing Wednesday on Capitol Hill.

"Based on our review, we have concluded that baseline consumer privacy legislation will strengthen the U.S. Internet privacy framework for consumers and businesses alike," Cameron Kerry, general counsel for the Commerce Department, wrote in a department blog post Wednesday. “The Obama administration is committed to working with Congress to pass a bill that provides a stronger statutory framework to protect consumers' privacy interests in data that are collected and used or disclosed in commercial contexts in the Internet economy, while supporting innovation.”

-----

http://www.modernhealthcare.com/article/20110316/BLOGS02/303169999/

Not so fast

Joseph Conn’s Blog

The HHS policy apparatus is beginning to signal—just a wee bit—that it may walk back its impossible and foolishly rushed timeline for enacting Stage 2 criteria for the meaningful use of electronic health-record systems. Here's what makes me think so:

Judy Murphy is a pioneer in nursing informatics and the vice president of information services at Milwaukee's Aurora Health Care. She also is a board member for the Healthcare Information and Management Systems Society. Of more importance, she's a member of the federally chartered Health IT Policy Committee's work group on meaningful use.

Murphy's work group generated 422 submissions to its request for public comments on its draft of proposed Stage 2 meaningful-use criteria it released in January. And in a meeting last week, the workgroup heard a preliminary report about the deluge of comments.

-----

http://www.govhealthit.com/newsitem.aspx?nid=76560

HRSA plans to revamp immunization systems, birth records

By Mary Mosquera

Monday, March 14, 2011

The Health Resources and Services Administration is looking to award grants for development of information systems that will support the exchange of maternal and child health information, such as immunizations.

HRSA’s Maternal and Child Health Bureau will focus on projects to expand the technical infrastructure to enable information exchange about immunizations across organizations that serve the maternal and child populations, and to develop electronic birth records.

-----

http://www.govhealthit.com/newsitem.aspx?nid=76541

NIH improves drug naming standard for EHRs

By Mary Mosquera

Friday, March 11, 2011

The National Library of Medicine has updated the RxNorm standard clinical drug vocabulary with more accurate and complete connections between national drug codes and standard non-proprietary names of medications recommended for use in electronic health records (EHR).

The vocabulary standard also includes for the first time the set of national drug codes from First DataBank, which provides drug databases that are widely used in the health care industry.

The additional content makes RxNorm more useful for healthcare providers, according to a March 8 announcement from the National Library of Medicine, part of the National Institutes of Health.

-----

http://www.govhealthit.com/newsitem.aspx?nid=76485

New survey shows EHRs benefit even small providers

By Mary Mosquera

Tuesday, March 08, 2011

A survey of studies from recent years shows that health information technology has benefited healthcare providers, even small practices, refuting other recent findings that suggest electronic health records and other health IT do not produce positive effects for patient care.

Previous studies focused on the early years of electronic health records (EHR) when functions were not as mature, according to one of the authors of the survey article, Dr. David Blumenthal, the national coordinator for health IT.

Furthermore, the survey found evidence of emerging measurable benefits for small practices in addition to the larger health IT leaders, such as Kaiser Permanente and the Veterans Affairs Department, which have been the source of much experience data in the past, he said at a March 8 briefing sponsored by Health Affairs journal to announce its latest published studies.

-----

http://www.healthleadersmedia.com/content/TEC-263693/When-Qualitys-a-Priority-so-is-HIT.html

When Quality's a Priority, so is HIT

Gienna Shaw, for HealthLeaders Media , March 15, 2011

Hospitals might be cutting back on spending, but they're still shelling out for electronic health records, according to a recent HealthLeaders Media Intelligence Report on capital spending. Among survey respondents, 39% said EMR systems will receive the majority of capital funds in the coming year. Another 27% say most of their capital funds will go to clinical technology this year.

An investment in health information technology is an investment in growth, Greg Pagliuzza, the vice president and CFO of Trinity Regional Health System tells senior finance editor Karen Minich-Pourshadi in the report.

-----

http://www.ehi.co.uk/news/acute-care/6720/bristol_shortlists_cerner_and_system_c

Bristol shortlists Cerner and System C

16 March 2011 Sarah Bruce

University Hospitals of Bristol NHS Foundation Trust has shortlisted System C and Cerner as part of its plans to implement a patient administration and electronic patient record system, eHealth Insider has learned.

The trust went out to tender last October and asked multiple suppliers to bid for a series of lots, inducing accident and emergency, operating theatres, maternity and a clinical portal.

In addition, the tender notice stated that the core PAS solution would be required to cover, among other functions, “patient registration, inpatient care, waiting lists, out-patients, coding, casenote tracking, bed management clinical data collection, referral to treatment pathways, Choose and Book compliance, audit reports.”

-----

http://www.ehi.co.uk/news/primary-care/6719/emis_gets_eps_r2_approval_for_emis_web

EMIS gets EPS R2 approval for EMIS Web

15 March 2011 Fiona Barr

EMIS has announced that it has become the first system supplier to receive full roll-out approval for Release 2 of the Electronic Prescription Service, for its EMIS Web system.

The accreditation has come more than 20 months after the first site for EPS R2 went live, and follows a decision earlier this month to stop any more primary care trusts from taking part because of problems with system availability.

Three system suppliers - TPP, INPS and EMIS - have been involved in first of type deployments in the eight practices and 30 pharmacies which are using EPS R2.

-----

http://www.healthcareitnews.com/news/medical-identity-theft-rise

Medical identity theft on the rise

March 15, 2011 | Mike Miliard, Managing Editor

IRVINE, CA – A new study from the Ponemon Institute, sponsored by Experian, finds that almost 1.5 million Americans are victims of medical identity theft – an increase from last year. While consumers grasp the importance of protecting their medical and personal information, it reports, few take the precautions to avoid medical ID theft.

The study also found that the average cost to resolve a case of medical identity theft stands at $20,663 – up from $20,160 in 2010.

-----

http://computerworld.co.nz/news.nsf/security/health-net-discloses-loss-of-data-to-19-million-customers

Health Net discloses loss of data to 1.9 million customers

HealthNet is notifying some 1.9 million customers that personal and health data may have been contained on drives that were found missing from a data center in California.

By Jaikumar Vijayan | Framingham | Wednesday, 16 March, 2011

Health Net, a provider of managed health care services, yesterday said that it's alerting some 1.9 million customers that nine server drives containing personal and health data were recently discovered missing from a data center in Rancho Cordova, Calif.

The data center is managed for HealthNet by IBM, which notified the insurer about the missing drives, HealthNet said in a statement.

An initial probe has found that the missing drives contained names, addresses, Social Security numbers, financial information and health data of current and former Health Net members, employees and health care providers, the statement said.

-----

http://www.fiercehealthit.com/story/joint-venture-including-ama-subsidiary-offers-web-based-services-doctors/2011-03-09

Joint venture including AMA subsidiary offers web-based services to doctors

March 9, 2011 — 6:35pm ET | By Ken Terry

A subsidiary of the American Medical Association is teaming up with Covisint--a technology vendor that has been helping the association develop a physician portal--and my1HIE, a health information exchange operated by several Michigan IPAs, to give Michigan physicians access to a range of cloud-based health IT applications.

The AMA subsidiary, Amagine, and its partners will offer doctors interoperable IT products and tools such as electronic health records, e-prescribing and online continuing medical education materials. The idea is to help physicians select an EHR, show meaningful use for federal health IT incentives, and collaborate with colleagues online, regardless of what system they're using.

-----

http://www.fiercehealthit.com/story/new-medical-home-accreditation-guidelines-emphasize-health-it/2011-03-10

New medical home accreditation guidelines emphasize health IT

March 10, 2011 — 2:15pm ET | By Ken Terry

Four medical societies have released a new set of guidelines for organizations accrediting patient-centered medical homes (PCMH) that are more specific about health IT considerations than their original joint statement on the medical home concept, which came out in 2007. The societies that issued the guidelines are the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association.

Whereas the 2007 statement simply called for information technology to be "utilized appropriately" in support of PCMH goals, the new guidelines recommend: "Recognition and accreditation programs related to the patient-centered medical home should actively work to align their standards, elements, characteristics, and/or measures with the meaningful use criteria [for government health IT incentives]."

-----

http://www.fiercehealthit.com/story/when-will-doctors-and-patients-connect-online/2011-03-12

When will doctors and patients connect online?

March 12, 2011 — 5:48pm ET | By Ken Terry

Patient portals have become more important to healthcare providers because of their desire to show meaningful use of electronic health records. But there's a disconnect with patient care: While clinical summaries are being made available to satisfy a meaningful use requirement, and some providers supply lab results to patients via portals, there's little emphasis so far on information exchange between doctors and patients. The predominant use of patient portals is still for appointment and refill requests and online bill payments.

A similar disconnect exists in the realm of personal health records (PHRs), which are growing rapidly but are still used by only 10 percent of the population.

Last year, the California Healthcare Foundation conducted a survey of PHR users. About half of respondents said they preferred to have a PHR provided by their physician. Aside from trust in their doctors, this seems to indicate they'd like to have some real clinical data in their PHRs. But, according to a new report from consulting firm CSC, the electronic health record--the most likely source of such data--is also the least prevalent source of information in today's PHRs. Moreover, none of the current PHRs met CSC's definition of a true PHR, which includes accurate and complete data from all care settings.

-----

http://www.deseretnews.com/article/700118229/University-of-Utah-Health-Care-gives-patients-on-the-go-access-to-medical-records.html

University of Utah Health Care gives patients on-the-go access to medical records

Published: Sunday, March 13, 2011 9:04 p.m. MDT

SALT LAKE CITY — No more anxiously waiting on hold for a doctor's office to make an appointment, refill a prescription, check test results or ask a question. All of that can now be done on-the-go.

MyChart — an iPhone, iPad, iTouch application that provides easy access to medical records — made its local debut Thursday, to anyone who is a patient within the University of Utah Health Care system of hospitals and clinics.

"We just view this as another opportunity to put the patients first in terms of care and to be able to provide additional services for patients that make receiving and monitoring their care more and more convenient," said Rob Lloyd, executive director for the U.'s ambulatory services and community clinics.

-----

http://www.healthdatamanagement.com/news/health-information-exchange-framework-42135-1.html

Framework Evaluates HIEs

HDM Breaking News, March 11, 2011

The Center for Health Information and Decision Systems at the University of Maryland has created a framework to assist in developing sustainable health information exchanges.

The CHIDS HIE Evaluation Framework includes a methodology for assessing any HIE on five performance measures: value creation and sustainability of a business model; organizational structure and decision making processes; technology; community engagement; and trust in the system.

-----

http://www.modernhealthcare.com/article/20110309/NEWS/303099988/

Boston researchers develop app platform

By Joseph Conn

Posted: March 9, 2011 - 11:45 am ET

Federally funded researchers at Children's Hospital Boston and Harvard Medical School have released a healthcare interoperability platform and interface "to support a flexible health information technology environment and promote innovation," according to a news release.

Development work on the platform was funded through a $15 million grant from the Office of the National Coordinator for Health Information Technology for its Strategic Health IT Advanced Research Projects, known as the SHARP initiative.

Announced last year, the SHARP program provided a total of $60 million in grants to fund research in four areas—security and health IT at the University of Illinois at Urbana-Champaign; patient-centered cognitive support at the University of Texas at Houston; secondary use of EHR data at the Mayo Clinic; and healthcare application and network design, the research area of the latest effort by Children's Hospital and Harvard.

-----

http://www.healthcareitnews.com/news/cios-enchanted-cloud-lack-metrics-justify-investment

CIOs 'enchanted' by cloud, but lack metrics to justify investment

March 10, 2011 | Molly Merrill, Associate Editor

SEATTLE – Although most CIOs are anticipating making significant investment in private and public cloud technologies over the next 12 months, they currently report they are not tracking the "fundamental metrics" required to make the case for ROI.

The survey, titled IT Survey on Cloud Computing, Virtualization, and IT Financial Services, was conducted by Apptio, a provider of on-demand Technology Business Management (TBM) solutions, in partnership with the Worldwide Executive Council (WEC), a research firm that facilitates dialogue between executives and Wall Street investors. WEC interviewed 100 U.S. CIOs from firms representing a broad range of vertical industries, including healthcare and technology.

The survey reveals that the majority of IT decision makers don't have the necessary metrics to build an intelligent business case for moving applications and infrastructure components to the cloud. Moreover, the vast majority of those surveyed indicated that they neither possess the ability to track utilization nor are they able to recover these costs via "chargeback" or "showback" methods, further complicating their ability to calculate ROI for the business.

-----

http://www.healthdatamanagement.com/news/physician-network-secure-messaging-doximity-42128-1.html

New Network for Docs Launched

HDM Breaking News, March 10, 2011

Doximity Inc., a start-up company has launched a free secure information network for physicians.

The official launch starts with a community of 7,000 physicians on the network as it has been in beta since October 2010. The network now is available to all physicians and supports iPhones, iPads and Android devices in addition to being accessed via a personal computer. Jeff Tangney, co-founder of drug reference content software vendor Epocrates Inc., is CEO of San Mateo, Calif.-based Doximity.

-----

Enjoy!

David.

The US Announces A New Health IT Strategic Plan for 2011 to 2015. A Must Read!

The following was announced overnight.

The Federal Health IT Strategic Plan 2011-2015

The Federal Health IT Strategic Plan: 2011-2015 ("the Plan") reflects ONC's strategy for coordinating with the public and private sector to realize Congress and the Administration's health IT agenda: improving the quality, efficiency, safety and patient-centeredness of health care.

The Plan, which was last published in 2008, has been updated to take into account the rapidly changing landscape of health IT and health IT policy that has been drastically altered over the past two years by two major pieces of legislation that have established an agenda and committed significant resources to health IT -- the Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as part of the American Recovery and Reinvestment Act, and the Patient Protection and Affordable Care Act.

Over the past year, ONC has collborated with its federal partners, the private sector (through the Health IT Policy Committee) and the public to update the Plan. The Plan serves as an important tool for guiding federal efforts and investments in health IT over the next five years.

For More Information:

Here is the link to the page:

http://healthit.hhs.gov/portal/server.pt?open=512&objID=1211&parentname=CommunityPage&parentid=2&mode=2

Happy weekend browsing. A quick look suggests a pretty clear forward looking approach to using Health IT to actually make a positive difference!

David.

Friday, March 25, 2011

This Might Be Another Reason To Get on With A Sensible EHR Program - National / Natural Disasters.

The following appeared yesterday.

Digital medical records provide critical backup

By Tyler Thia, ZDNet Asia on March 24, 2011

The wide-scale destruction caused by the recent north Japan earthquake and tsunami has highlighted the importance of electronic health records (EHR), with industry watchers urging for countries to digitize healthcare data.

According to IDC's Health Insights research manager Janet Chiew, the earthquake revealed compelling benefits that EHR can bring to citizens in situations when large scale medical and rescue operations are required.

"Imagine the enhanced effectiveness and savings in resources if rescue parties and medical teams are aware of the profile of people in danger, put on standby the necessary equipment and drugs for those chronically-ill, and quickly identify those with special medical conditions upon rescue. This can be possible if the information is made available via a national EHR (NEHR) [system]," Chiew explained in an e-mail.

With hospitals and clinics destroyed, records of the sick and elderly may be ruined, and this can lead to greater medical and logistical complications for those affected by the disaster. According to an EHR online forum, author Katherine Rourke shared that while Japan has a health information exchange (HIE) strategy, it is still immature.

"EMR (electronic medical record) coverage is patchy, though like here in the United States, is on the upswing. Research interest is high, in fact, medical informatics specialists there have developed their own clinical data exchange format, the Medical Markup Language. However, health data digitization and sharing is still in its early stages, or so it seems from the reading I've done," Rourke said. She also suggested that a robust HIE system would serve as a good backup in case of widespread infrastructure damage.

A review of the status in the regions of EHRs follows and is well worth a look for interest.

See here:

http://www.zdnetasia.com/digital-medical-records-provide-critical-backup-62208013.htm

Just as with Hurricane Katrina we see there is a place for electronic records - assuming they are properly protected from disaster.

Does anyone have any stories from Queensland, Victoria or WA where things worked (or didn’t)?

David.

Thursday, March 24, 2011

Here is A Model of a PCEHR That Makes A Lot More Sense Than the NEHTA / DoHA Plan.

The following appeared a few days ago:

Quarter of practices link to Welsh SCR

21 March 2011 Fiona Barr

More than 25% of GP practices in Wales are now feeding information into the country’s summary record via INPS’s Vision 360 data sharing solution.

INPS said it is streaming information from GP practices’ Vision 3 systems into its central Vision 360 repository to provide clinicians working out-of-hours with access to the Individual Health Record, Wales’ version of a summary record.

The company said communities now using Vision 360 include Pembrokeshire and Ceredigon, Aneurin Bevan and Cardiff and Cwm Taf, which between them have made 750,000 records available in the Vision 360 Patient Summary IHR.

There have been about 6,000 accesses to the IHR in the last 12 months using Vision 360, and INPS said accesses are currently running at about 700 views per month as more practices come on board.

.....

The NHS Wales Informatics Service announced last October that it had signed contracts with four suppliers – EMIS, INPS, iSoft and Adastra – to deliver the IHR across the country.

The IHR contains information on medications, allergies, adverse reactions, current problems and diagnoses and test results and is designed to be viewed in out-of-hours services with patient consent.

More here:

http://www.ehi.co.uk/news/primary-care/6731/quarter_of_practices_link_to_welsh_scr

Now what is interesting about this shared record is revealed in the following earlier report.

Welsh GPs put conditions on IHR

20 December 2010 Fiona Barr

GP representatives in Wales have listed a series of safeguards that they want to see implemented before Individual Health Records are uploaded.

The BMA’s Welsh General Practitioner Committee said it was “supportive” of the emergency summary record system in Wales but wanted to see explicit confidentiality safeguards.

The committee’s six-point list of requirements is: a public information campaign before roll-out in any area; an absolute right for patients to opt-out at any time; explicit consent to view that applies only for the duration of a consultation and is obtained directly by the clinician carrying it out; and access restricted to clinicians involved in the direct care of the patient.

Dr David Bailey, chairman of the Welsh GPC, said: “Because it is a précis of the GP record, we feel that access must be restricted to clinicians only - by which we mean doctors and nurses involved in the direct care of the patient.

“Explicit consent to view should be restricted to the time and for the purposes of the consultation only and not extended to allow access subsequently, even for audit purposes. Explicit consent to view should be obtained from the patient by the consulting clinician.”

The IHR has been running in Gwent since 2007. This year it was introduced in Pembrokeshire and parts of North Wales. And it is currently being piloted in Cwm Taf and Cardiff.

The BMA said Welsh government policy was to roll-out the IHR across the whole country over the next 12 months, but it pointed out that GPs practices needed to consent to the uploads.

The IHR contains patients’ demographic data, medications, significant medical history, Read codes of the most recent consultations, allergies and recent test results.

It is designed to be available to clinicians in hospitals and out-of-hours services.

More details here:

http://www.ehi.co.uk/news/ehi/6512/welsh_gps_put_conditions_on_ihr

So the features are:

1. A shared summary record designed to be used by clinicians involved in direct patient care - not patients.

2. Patient Control at point of record being sent to central store and patient required to consent for non-regular carer to view record. Obviously the usual care team has the full record.

3. Clarity that there is one primary record - the one held by the practitioner in their system and the IHR is a copy and a copy only. Ownership (and blame) is clear!

4. No concept of the record being a longitudinal record - it is purely an acute care summary to assist with emergent care.

5. No patient contribution to the record - i.e. responsibility for record contents is clear and unambiguous. (If they want a PHR they can set up their own.)

6. Defined and limited data set with each feeding system using a common data model for the basic items and coding.

7. Automated upload of consented records each evening so essentially zero effort and workflow impacts of a basic summary system being in place.

You can read more here:

http://www.wales.nhs.uk/IHC/page.cfm?pid=34153&orgid=770

While there are still to be any evaluations of this type of system that provide proper evidence that such systems make a difference it seems possible that a simple, clearly thought out model such as this gets as close as possible to be likely to be useful.

My view is that if the Government wants to press on with the PCEHR a model of this sort might be worth a very close look as I reckon what they are currently on about is a real dud!

David.

An Opportunity To Hear All About the PCEHR from The Horse’s Mouth.

I was alerted to this a day or so ago.

AIIA Healthcare Briefing

Tuesday 29 March 2011

Sydney

“More eHealth developments – Personally controlled electronic health records”

At this Briefing, you will have the opportunity to be briefed on the roll-out of personally controlled electronic health records (PCEHR) by the two people driving the policy and implementation.

Our keynote speakers are Ms Fionna Granger, First Assistant Secretary, eHealth Division, Commonwealth Department of Health and Ageing, and Andrew Howard, Head of Personally Controlled Electronic Health Record, NEHTA.

PCEHR records will become available to individual Australians from July 2012 and will be a major achievement of the Australian governments’ ehealth initiatives.

PCEHR records will build on the foundation laid by the introduction of individual and provider health care identities, SNOMED clinical terminologies, and secure messaging services through the national authentication service for health.

For patients and health providers, PCEHRs will bring key health information such as patient demographics, allergies and adverse reactions, medicines, medical history and immunisations from a number of different systems together and present it in a single view.

The PCEHR has already been rolled out into first wave sites, including Hunter Urban GP Access, GP Partners Brisbane, and Melbourne East GP Network. Soon to be announced, a second wave of early adopters will include the consortium lead, representatives from clinicians, consumers, hospitals and pharmacies.

Our briefing moderator, Andrew James will lead our discussions on what companies need to be doing to be business ready to take advantage of the e-health developments.

Please come along to listen, ask questions, and make suggestions.

AIIA is supporting NEHTA in the introduction of better ways of electronically collecting and securely exchanging health information in Australian healthcare.

Details

When: Tuesday 29 March 2011

When: 0800 - 0930

Where: Telstra Experience Centre, Level 4, 400 George St, Sydney

Cost: complimentary

Online registration: Click to register http://www.aiia.com.au/events/event_details.asp?id=149766

About AIIA Healthcare Network

Australia’s healthcare sector provides key commercial opportunities to Asia’s member companies, and AIIA seeks to assist our member companies to grow in this marketplace. Our AIIA Healthcare Briefings typically cover sector developments: business issues, drivers and constraints, buyer identification, and sector research.

Designed for senior ICT executives, healthcare account managers, commercial and government account and sales leaders and managers, healthcare business development managers, healthcare business analysts, and consultants. Our Briefings are a great opportunity to catch up with colleagues and to meet new colleagues in the industry.

Sponsored by NEHTA and Telstra

NEHTA is the lead organisation supporting the national vision for eHealth in Australia. NEHTA’s role as managing agent on behalf of the Department of Health and Ageing (DoHA) is to deliver the Personally Controlled Electronic Health Record (PCEHR) work program for the Australian health community.

Telstra is a strong supporter of the AIIA Healthcare Briefings and has kindly provided its Telstra Experience Centre venue. Telstra has Health and Aged Care Industry solutions for patient, medical professional and health administration services.

Further information

AIIA Healthcare Policy: Michel Hedley, AIIA Policy Manager 0417695 616 or m.hedley@aiia.com.au

AIIA Healthcare Network: Luli Adeyemo, AIIA Event Manager, luli@bestcasescenario.com.au

----- End Announcement.

I have to say I am a little startled to hear that “The PCEHR has already been rolled out into first wave sites, including Hunter Urban GP Access, GP Partners Brisbane, and Melbourne East GP Network.”

I had thought they we still working on it - well what do you know?

Sounds like a fun session for those who can make it!

David.