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."

Wednesday, February 15, 2012

It Seems The NEHTA War-Room Has Gone Into Overdrive. Maybe They Have Realised The Jig Might Be Up!

That there has been not much news out of the Senate Legislative Committee’s PCEHR Enquiry should not leave anyone with the impression that nothing is happening.
Indeed the absolute reverse is true and there is a lot of not very edifying activity going on behind the scenes.
In the Australian yesterday we had this article appear in the Predictions 2012 section:

Creating record system a huge task

  • INFLUENCER: PAUL MADDEN, CHIEF INFORMATION AND KNOWLEDGE OFFICER, DEPARTMENT OF HEALTH AND AGEING
A HUGE overhaul of federal IT systems in support of national health reform has begun, putting Health chief information officer Paul Madden in the hot seat with several big-ticket programs.
Under the Gillard government's shift to activity-based funding for public hospitals, new agencies, including the Independent Hospital Pricing Authority, National Health Performance Authority and National Health Funding Body, will between them set prices, monitor performance and ensure accountability.
The agencies need a common IT platform that ultimately ties the commonwealth, state and territory health departments into a unified system.
"We've recently awarded Accenture a contract (worth $111 million) for an enterprise data warehouse to support the information management and performance reporting that is part and parcel of activity-based funding," Madden says. "The same EDW will also support information management for the department."
Because all of the information will eventually be held in the one system, Madden will establish an enterprise data governance framework and enterprise information management plan "to ensure everyone is reporting on the basis of the same approach".
Madden is also looking for an enterprise documents and records management system, and an enterprise capability for grants management. "Part of my approach is to look at more expedient ways of doing things," he says.
"We can't afford multiple investments in what is essentially the same capability but supported by a different system.
"You're paying for the same thing more than once but, even worse, we've got people in different divisions using different work practices because they're on a different system. Staff should be using the same systems to do the same basic functions."
Madden is still developing a long-term strategy for the department's information systems but expects to have some conversations with the jurisdictions on aspects of data management along the way.
Lots more here:
And guess what not a single comment on the PCEHR and NEHTA. I wonder why?
Also of note is that we are seeing increasingly excited attacks from the NEHTA paid blogger ‘journalist’ on just what an awful collection of souls make up the MSIA and how the executive must be ‘unrepresentative swill’!
As an extra we have the last of many so far side swipes at me as well - saying I am not equipped in any way to be commenting - and presumably wondering why anyone reads the blog. (About 300 people per day do bye-the-way).
Incidentally I am also told that there is a chance there might be a short delay in the report of the PCEHR Committee Report and that the Committee would probably be able to consider additional submissions for the next week or two.
I note a new submission appeared as late as yesterday so input is still arriving and being considered!
Here are the contact details:
“For further information, contact:
Committee Secretary
Senate Standing Committees on Community Affairs
PO Box 6100
Parliament House
Canberra ACT 2600
Australia
Phone:  +61 2 6277 3515
Fax:        +61 2 6277 5829
If you have any views from any perspective get writing and submitting! Comments to the Committee addressing issues of patient safety, program governance and other issues I bang on about would be especially welcome!
What does all that is going on mean? From what I describe here and from a range of other sources what is actually happening is an attempt on the part of NEHTA to ensure any independent review of their activity and any independent scrutiny of the outcomes they create is simply suppressed or at best ineffective in causing any change to their plans - and especially their budget. If this is not true why all the public abuse rather than private e-mail and calls. I, and indeed the MSIA, are very easy to find!
NEHTA knows it is hanging on by a thread in terms of reputation and funding and is lashing out trying to protect its position. - it is as simple as that I reckon!
I can also tell you it is all getting pretty nasty and I don’t expect things to get better until we see the PCEHR report from the Senate!
David.

Senate Estimates Hearing Alert! This Afternoon!

Senate Estimates covering the Health and Ageing Portfolio is on this afternoon.

Here is a link to the program:

http://www.aph.gov.au/Senate/committee/clac_ctte/estimates/add_1112/commaff_addest_090212.pdf

Here is the link to the web-streaming of the session.

http://webcast.aph.gov.au/livebroadcasting/eventdetails.aspx?eventid=2356737


The session of interest runs from 3:45pm until about 5.15pm

Enjoy!

David.



Tuesday, February 14, 2012

It Seems We Are Not The Only Ones Bumping Up Against EHR Data Quality Issues. PCEHR Implications Are Worth Considering.

This very interesting report appeared a little while ago.
Thursday, February 09, 2012

EHR Data Not Ready for Prime Time, Studies Show

by Ken Terry, iHealthBeat Contributing Reporter
Two new studies cast doubt on whether the data in electronic health records are reliable enough to be used as the basis for publicly reported quality measurements and performance-based payments. A third study shows that EHR data on cervical cancer screening may be dependable, but only under certain circumstances.
Taken together, the studies -- all published in the Journal of the American Medical Informatics Association -- provide a snapshot of how well U.S. physicians are documenting preventive services and other clinical data in EHRs. This is important because public and private payers are beginning to require EHR-derived data to support programs aimed at lowering costs and improving the quality of care.
For example, Stage 1 of the meaningful use incentive program requires physicians to provide specific quality data through attestation. As early as 2013, they will have to submit the data electronically to CMS. Physicians already have the option of sending EHR data to Medicare's Physician Quality Reporting System.
Starting in 2015, CMS will use PQRS data to calculate a portion of physicians' Medicare payments under its value-based purchasing program. The ability of health care providers who join accountable care organizations to share in Medicare savings also will depend partly on electronically submitted quality data. And it's likely that private insurers will follow suit in their own ACO programs.
A lot is riding on the reliability of EHR data. But, in regard to the CMS programs, "we're not ready" to use this data, said Eric Schneider, distinguished chair in health care quality at the RAND Corporation. Moreover, he noted, "Until we get the EHR fully operational, we're pretty limited in the types of quality measures we can produce."
Structured Data Are Incomplete
In a study of New York City primary care practices that used the same publicly subsidized EHR, researchers assessed the accuracy of the structured data used for quality measurement. Structured data are computable information entered in discrete fields of the EHR. Researchers manually reviewed electronic charts to identify diagnoses related to preventive care measures anywhere within the record, including free text. According to the researchers, "the average practice missed half of the eligible patients for three of the 11 quality measures."
Because many preventive services were not documented as discrete data, the study also found that practices underreported the services their doctors provided on six of the 11 measures.
Another study -- conducted in a primary care network affiliated with Brigham & Women's Hospital in Boston -- focused on a clinical decision support tool designed to improve the completeness of EHR diagnosis lists, also known as "problem" lists. The program combed through lab, medication and billing data to find hints of missing diagnoses. Physicians who received prompts about these diagnoses through the EHR system added nearly three times as many old and new diagnoses to problem lists as doctors in the control group did.
The authors pointed out that in their prior research, a large portion of diagnoses had been missing from problem lists. For instance, only 51% of hypertension and 62% of diabetes diagnoses had been included. "Other institutions have found similar results," they added.
The third JAMIA study looked at whether EHR data could be used to detect overutilization of cervical cancer screening tests, known as Pap tests. Comparing manual e-chart reviews to the results of EHR queries, the researchers ascertained that EHR data could be used to measure accurately the overuse of Pap tests among low-risk women.
Jason Matthias -- the lead author and a research fellow in the Feinberg School of Medicine at Northwestern University -- said he was confident that every Pap test ordered during the study period had been documented as structured data. The EHR system had a lab interface, and "any results that returned from the pathologists were captured automatically," he said, adding, "If you didn't have results and you didn't have an order, the test hadn't been done."
Consequently, he said that data would be adequate for a quality measure. However, he added that similar information probably would be less accurate in a practice that had recently adopted an EHR system than in the university-affiliated clinic he studied. In a practice that was new to the technology, he said, it's likely that physicians would be less aware of the importance of problem lists and other discrete data.
.....

MORE ON THE WEB

Lots more with some comments here:
If ever there was an example of “garbage in, garbage out” in operation this has to be it. There has to be a great deal of care taken as we move from the most simplest data sharing to more complex efforts.
This very interesting study which is reported from the UK makes a similar point showing that after many years simple is actually starting to work!

Summary Care Record improving GP out-of-hours prescribing and helping patients die where they choose, DH data shows

By Nigel Praities | 03 Feb 2012
Exclusive: Out-of-hours GPs are changing their prescribing decisions after accessing a patient's Summary Care Record in around a third of cases, Pulse has learned, as the Department of Health prepares to publish data outlining the achievements of the programme so far.
Some 1,600 records are now viewed each week by out-of-hours providers and in other urgent care and hospital settings, with the programme's clinical director Dr Gillian Braunold claiming the rollout has now reached a ‘critical mass' in some areas.
One in five patients across England has now had a care record created – some 11 million in total – while more than 35 million patients have been contacted and told they will have a record created for them if they do not opt out.
Dr Braunold told Pulse the Summary Care Record was now proving of real benefit to clinicians, with the Department of Health due to publish official data imminently.
She said: ‘Primary care out-of-hours clinicians are finding that access to the information is making their consultations safer.'
‘On average, we are finding one in five of patients that turn up in out-of-hours, that is when we are finding it is making a difference. About 30% of cases, they are finding it is changing their therapeutic decisions because they have access to the Summary Care Record.'
Dr Braunold said there was also evidence from areas where end-of-life care plans had been uploaded to care records that more patients were dying in their preferred place.
She added that the future was to increase the scope of the Summary Care Record to help the 111 pilots run by NHS Direct and implement the Government's much-trumpeted ‘Information Revolution'.
Lots more here:
In the UK, as in Scotland, what is shared is the current information from the GP system on just demographics, current medications, reactions and allergies. Because this information is coded and is from the GP’s current record it has a high chance of being very reliable as the GP has a major interest in the information being correct so they can  provide repeats and the like.
All this supports my long held intention that the PCEHR is just way too much too soon. What we need is to scope the PCEHR back to just these basics, get it working as desired and then slowly and carefully grow from there.
You can read the scope of the UK Shared Care Record here:
Because the UK system is Opt-Out (and very few have) where available we are starting to see some real use and some clinical adoption. This, once confirmed with relevant studies, will be very good news indeed. I am very keen to see confirmation that a really simple basic approach can make a difference! I look forward to the official studies coming out.
There is a lesson for the PCEHR here. The UK has taken near to a decade to get a very simple system going and we are hoping to have a much more complex monster going nationally in 18 elapsed months. They are dreaming!
David.

Monday, February 13, 2012

A Quiet Insider Spills The Beans On What Goes On Within Government. Very Interesting And Very Sad Indeed!

I had a contact from an insider in Government today - no names and no packdrill!
Here is what I was told.
“Many in the public sector are quite aware of the mess DoHA/NEHTA are in but are powerless to do anything meaningful about it. Public Sector accountability rules do not let Finance/AGIMO do much else than insist on agencies following the government's procurement rules. AGIMO is not empowered to ask if what an agency is doing will work. The Gateway review process is not much help - it's too much self-assessment.
ANAO tend to follow along after the event and do post implementation reviews. They don't often get involved in "in-flight" projects. They also don't have the technical ability to make value judgements.
The Senate hearings are mostly about politics and the reports will be on party lines. It's always been like this and probably always will be.
I'm afraid neither AGIMO nor ANAO can do much to stop the train wreck from happening. Health and NEHTA will probably redefine success so that the train wreck will appear to the average voter as a minor derailment, causing a slight delay typical of all major IT projects.
BTW, I came across this advert today.
It looks suspiciously like a NEHTA advert. If it is, it makes you wonder what they are up to so late in the project.
----- Quote:
As part of the Architecture team, you will work closely with the assigned Technology Partner who will be building this national E-Commerce platform to ensure the build is validated to the design specifications.
With your SOA background, you will create the Standards and Specifications for the artefacts.
Working with other 3rd party portal technology to ensure transactional and document management is within the Health standards.
----- End Quote.
And to follow up, I (David) asked!
 > What if Tanya (Plibersek) asked Penny (Wong) to help save her bacon?
I doubt that anyone external to Health could save Tanya's bacon. Penny certainly doesn't have much power in this area. The government has approved the expenditure, so it's up to Health to manage it. That's Tanya's and Jane Halton's job.
If we compare this project with some other notable failures - the Australian Customs Service's Cargo Management Re-engineering (CMR) and the Access Card there are some interesting parallels. This is an informative article:
Minister Ellison got burned at Customs because the system was hurried and the legislation that it was based upon was not passed by the parliament early enough. When Ellison took over the Access Card he refused to authorise serious development expenditure until the enabling legislation was passed. - The Access Card project did not actually cost a lot of money. Of the $1.1billion estimated cost only about $100million (only?) was wasted. Eventually a change of government killed the thing, but Ellison greatly reduced the risk.
What Tanya could do, politically, is change the project timetable - delay as much as possible until the legislation was passed. That's effectively what Ellison did - he didn't want to get burned again. Tanya is going to get burned unless she does. As I said, this is all about politics, common sense does not come into it. She really needs someone external to blame (the Libs, AMA, anyone...) - or a change of government, but that's not in her best interest.
End Messages.
This is a very sad communication suggesting the money will just get spent - and probably wasted - and none of us can do zilch about it!
What a humongous mess we find ourselves in! All I can say is read, learn and weep!
David.

Weekly Australian Health IT Links – 13th February, 2012.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. 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 big news of the week was clearly the public hearing at the PCEHR Senate Enquiry. I covered this in detail last week and there are a few more articles here in this blog.
Last week’s post is here.
There is really little else going on as we wait for the Senate to report and wait for clarity as to what NEHTA and DoHA are really going to deliver. The next few weeks are likely to be very interesting indeed!
------

NEHTA a secret, 'toxic workplace'

7th Feb 2012
A PARLIAMENTARY inquiry has heard the government body responsible for the planned e-health record system has become a “toxic workplace” operating under a “cloak of secrecy”, which has shut privacy advocates and consumers out of consultations.
Giving evidence before the inquiry into the legislation enabling the personally controlled e-health record (PCEHR), Medical Software Industry Association treasurer Dr Vincent McCauley complained about a lack of transparency from the National E-Health Transition Authority (NEHTA) – which is not subject to the same Freedom of Information laws as other government organisations – and of difficulty obtaining reports of safety assessments conducted as part of the implementation of the PCEHR.
“Without removing the cloak of secrecy… that currently covers NEHTA’s activities I believe that is impossible [to improve accountability],” Dr McCauley said.
Dr McCauley’s evidence echoed that of Australian Privacy Foundation chair Dr Roger Clarke, who had earlier told senators his organisation had been “held off to one side” throughout the consultation process surrounding the PCEHR.
-----

Next round of e-health funding finalised, three months over schedule

The funding was scheduled for allocation in November
At least three months after it was scheduled to allocate the next round of funding for the Personally Controlled Electronic Health Record (PCEHR) project, the Department of Health and Ageing (DoHA) has confirmed a figure has been finalised.
A spokesperson for DoHA told Computerworld Australia it had finalised the funding with the National E-Health Transition Authority (NEHTA), originally scheduled to be allocated last November, for the “final scope” of activities to 30 June 2012.
“The final details of the work package have been completed,” the spokesperson said. “The funding figure will be published shortly."
The spokesperson said the change in federal health ministers, from Nicola Roxon to Tanya Plibersek in December, had not caused any delay in the $466.7 million initiative, with the exact figure to be published “shortly”.
-----

E-health stricken with privacy and software lurgies

Analysis: Senate hearings begin.

With less than five months before launch, differences between interest groups in the planning of the Federal Government’s $466.7 million personally controlled electronic health record (PCEHR) will be aired today before a Senate Committee.
Submissions from medical associations, privacy groups, rural and remote services, and the medical software industry collectively raise questions over privacy, standards and the ability to service remote regions.
A common view is that the July 1 launch date is too ambitious.
-----

Misleading Healthcare Register Puts Patients at Risk

Disciplinary records for dozens of doctors, nurses, and other health practitioners don’t show up on the national register – a new tool meant to improve transparency and public safety.
PATIENT SAFETY INVESTIGATION   |   February 6, 2012
Clare Blumer, Paul Farrell and Adam Glyde contributed to this report.
Misleading Healthcare Register Puts Patients at Risk
Disciplinary records for dozens of doctors, nurses, and other health practitioners don’t show up on the national register – a new tool meant to improve transparency and public safety.
The sound of a thud from a nearby room alerted a nurse at Caloundra Nursing Home in Queensland, that something was wrong. When she went to investigate, she found her supervisor standing above an elderly resident, who was lying on the floor.
The supervisor, a registered nurse named Christopher James Jones, yelled at the resident, and kicked him, according to a decision of Queensland's Nursing Tribunal, which was at that time responsible for oversight of nurses in that state. The nurse said she also heard Jones call the resident an "old fool."
The violence so shocked the nurse that she couldn't eat or sleep for days. Yet
Jones was not stripped of his duties at the home. In fact, less than a week later, on March 12, 2004, he kicked another frail, elderly resident in his left hip, after pushing the man to the ground with a stool. This time, three staff members witnessed the incident, according to the judgment.
-----

Hospital computer system found lacking

Julie Robotham
February 11, 2012
THE computer system that runs emergency departments across NSW is chronically underfunded and produces inadequate patient records, according to an independent report commissioned after some hospitals last year lost so much confidence in the software they returned to manual record-keeping.
But despite continuing problems and excessive time spent on data entry, the system - known as FirstNet - is too entrenched to be scrapped and the government should instead invest in bringing it up to scratch, according to the report by consultants Deloitte, obtained by the Herald under freedom-of-information laws.
Doctors and nurses were not adequately consulted on how the software should be used, the report found, and the system could not provide an acceptable record of the care received.
''With some exception, FirstNet reporting is inadequate for effective governance of [emergency department] operations,'' the authors concluded.
-----

Response to Critical Safety Issue for the PCEHR

Posted on February 7, 2012 by Grahame Grieve
While I was on leave at Tamboon Inlet (and completely off the grid), Eric Browne made a post strongly critical of CDA on his blog:
“I contend that it is nigh on impossible with the current HL7 CDA design, to build sufficient checks into the e-health system to ensure these sorts of errors won’t occur with real data, or to detect mismatch errors between the two parts of the documents once they have been sent to other providers or lodged in PCEHR repositories.”
Eric’s key issue is that
“One major problem with HL7 CDA, as currently specified for the PCEHR, is that data can be supplied simultaneously in two distinct, yet disconnected forms – one which is “human-readable”, narrative text displayable to a patient or clinician in a browser  panel;  the other comprising highly structured  and coded clinical “entries” destined for later computer processing.”
It’s odd to hear the central design tenant of CDA described as a “major problem with CDA”. I think this betrays a fundamental misunderstanding of what CDA is, and why it exists. These misunderstandings were echoed in a number of the comments. CDA is built around the notion of a the twin forms – a human presentation, and a computer processible version. Given this, it’s an obvious issue about how the two relate to each other, and I spend at least an hour discussing this every time I do a CDA tutorial.
Note: This link is for those who want to see the other side of a complex discussion where it is. Close reading of the whole thread will make it clear just how hard and contested some of the details are!  I leave it to others much smarter than myself to sort it out!
-----

Web-based counseling -- Telepsychiatry -- is taking off

More bandwidth, better security and emerging video technology are making telemedicine more acceptable to doctors, patients
Dr. Avrim Fishkind, a psychiatrist in Houston, rarely sees any of his patients in person, and that's the way they like it.
Fishkind is part of a fast growing movement in the mental healthcare field where therapists counsel patients via inexpensive, Web-based video conferencing technology.
"We've had just over 60,000 patient encounters. To my knowledge, only six have refused to be seen via teleconferencing," he said. "When it comes to mental health issues and the difficult things you need to talk about in a crisis, a lot of patients feel it's less threatening and easier to be open and communicate via telemedicine."
Fishkind said telepsychiatry is limited only by insurance reimbursements. As more insurance companies start to reimburse for telepsychiatry treatments at the same rate as they do for in-person visits, the emerging medical field will grow exponentially.
-----

Electronic organ donor records finally on the way

AS the Gillard government's plans for electronic health records were raked across the coals this week at a Senate inquiry, one arm of the Health Department is going it alone.
While organ donor information is to be included in the proposed $500 million Personally Controlled E-Health Records program, the Australian Organ and Tissue Donation and Transplantation Authority is poised to put out to tender specifications for its own national electronic donor record.
The goal: streamlining the sensitive and complex process of moving organs from donation to transplant. The present system is based on a paper form almost 20 pages long.
"We called for an expression of interest late last year and various companies responded," says AOTA general manager Elizabeth Flynn, adding that the firms built "dummy systems" that were trialled in confidence.
-----

RACGP calls for clear PCEHR governance

The Royal Australian College of General Practitioners (RACGP) has weighed into the debate surround the PCEHR, stating GPs must have confidence in the system if it is to succeed.
The statements were made in the RACGP’s recently-released comments on the legislation surrounding the PCEHR.
According to Dr John Bennett, chair of the RACGP National Standing Committee, the RACGP takes issue with several aspects of the PCEHR Bill.
These issues include the need for clear governance, clarity regarding the administrative burden on GPs, and issues associated with the professional and financial risks associated with breaching provisions of the legislation.
-----

Govt claims e-health records on track

7 February, 2012 AAP
The National e-Health Technology Authority (NEHTA) has told a Senate inquiry hearing that while building the new e-health records system was very complex it was still on track.
The authority was responding to a savage attack by the software industry and privacy advocates, who claimed the Federal health department had failed to provide the support needed to maintain the e-health records in the longer-term.
The Medical Software Industry Association and the Australian Privacy Foundation called for a pared-back scheme to be introduced on  July 1 this year, with a second-stage release to follow in mid-2013 when more functions have been finalised.
But chief executive of NEHTA, Peter Flemming, told the Senate committee in Canberra: "NEHTA began this journey back in 2005 and on July 1 the personally-controlled electronic health record (PCEHR) will be available for consumers to register."
-----

E-health sites ready consumer pile-on

Six-week delay to live implementation.

The Federal Government's decision to halt work at preliminary sites testing components of the personally controlled electronic health record have cost the project a further six weeks delay, according to one of the sites involved.
Metro North Brisbane Medicare Local chief executive Abbe Anderson told a Senate inquiry inspecting legislation for the e-health project that her implementation site now planned to sign up the first consumers to test live shared health summaries in mid-March, rather than January 30 as previously planned.
The delay comes after ten of 12 implementation sites were told by the National E-Health Transition Authority (NEHTA) on January 19 to halt work on "primary care desktop software development" due to "technical incompatibilities across versions" of the specifications provided to the sites in November last year.
-----

PCEHR not what the doctor ordered?

02.07.12
Doubts about Australia’s $A467 million Personally Controlled Electronic Health Record (PCEHR) project have emerged during submissions to a Senate inquiry underway this week in Canberra.
Under the proposed scheme, due to begin operation on July 1 2012, all Australians will have the option of registering for a PCEHR, designed to ensure medical professionals have access to comprehensive patient data.
The Australian Medical Association (AMA) does not believe that requiring patients to “opt-in” to the PHECR will deliver a sufficient uptake to make the system successful.
“Experiences of opt-in systems from Australia and from overseas indicate that adoption amongst consumers will progress slowly,” submitted Dr Steve Hambleton, AMA President.
-----

AMA tells Senate PCEHR deadline is problematic

The head of the Australian Medical Association (AMA), Dr Steve Hambleton, has told the senate hearing into the PCEHR legislation that the deadline for the electronic record’s introduction is problematic.
The PCEHR is set to become available to every Australian wanting one on July 1, 2012.
Dr Hambleton said the AMA supports the development of ehealth records, but he also stated a working system is years from completion.
He told the hearing there are problems with expectation levels associated with the introduction of the record, and with the ability of doctors to deliver meaningful connectivity using the record by the July 1 deadline.
-----

Qld releases NBN strategic plan

By Luke Hopewell, ZDNet.com.au on February 8th, 2012
The Queensland Government has released a laundry list of National Broadband Network (NBN) opportunities it will seize if it is returned to power in the upcoming state election, which includes partnering with the CSIRO, Energex, local governments and NBN Co to make sure that those in the state get the most from the incoming fibre network.
The 12-page plan said that the state government will look to align infrastructure deployment with local disaster rebuilding efforts, among other initiatives.
The January 2010 floods that tore through Grantham in the Lockyer Valley saw countless properties destroyed, and left a repair bill of several billion dollars. As the rebuilding effort continues, the Queensland Government is looking to speed up the NBN roll-out in construction areas.
"The Queensland Government is working with NBN Co to identify opportunities to align NBN infrastructure plans as part of the disaster reconstruction effort.
-----

QLD govt demands answers after pay glitch

Queensland Premier Anna Bligh wants answers after yet another Commonwealth Bank payroll glitch, affecting 15,000 police and civilian staff.
  • AAP (AAP)
  • 08 February, 2012 12:58
The Queensland government is demanding answers from the Commonwealth Bank after another glitch left thousands of police and civilian staff unpaid.
About 15,000 officers and staff were left without their fortnightly pay after money which was supposed to be paid into their bank accounts on Tuesday night did not arrive.
Premier Anna Bligh said she had received a guarantee from the Commonwealth Bank that the money would be paid on Wednesday but said she was furious about the bungle.
"I am very unhappy with the way the Commonwealth Bank is managing the government payroll," she told reporters in Townsville.
-----

Turing's Enduring Importance

The path computing has taken wasn't inevitable. Even today's machines rely on a seminal insight from the scientist who cracked Nazi Germany's codes.
By Simson L. Garfinkel
When Alan Turing was born 100 years ago, on June 23, 1912, a computer was not a thing—it was a person. Computers, most of whom were women, were hired to perform repetitive calculations for hours on end. The practice dated back to the 1750s, when Alexis-Claude ­Clairaut recruited two fellow astronomers to help him plot the orbit of Halley's comet. ­Clairaut's approach was to slice time into segments and, using Newton's laws, calculate the changes to the comet's position as it passed Jupiter and Saturn. The team worked for five months, repeating the process again and again as they slowly plotted the course of the celestial bodies.
Today we call this process dynamic simulation; Clairaut's contemporaries called it an abomination. They desired a science of fundamental laws and beautiful equations, not tables and tables of numbers. Still, his team made a close prediction of the perihelion of Halley's comet. Over the following century and a half, computational methods came to dominate astronomy and engineering.
-----
Enjoy!
David.

AusHealthIT Poll Number 108 – Results – 13th February, 2012.

The question was:
After Hearing and Reading About the Senate PCEHR Hearing Do You Expect Significant Changes To Come From The Enquiry?
Major Changes
-  7 (18%)
Minor Changes
-  17 (44%)
No Changes
-  10 (26%)
I Have No Idea
-  4 (10%)
Votes: 38
Interesting result. It seems many now think there will be some change with the majority seeing at least some small change and a significant minority seeing major change.
Again, many thanks to those that voted!
David.

Sunday, February 12, 2012

I Have An Answer For What the Senate PCEHR Committee and Minister Plibersek Could Do To Sort Out the DoHA / NEHTA / E-Health Imbroglio!

While chatting with a colleague it hit me!
What the Government needs to do is mobilise its internal resources - already mostly paid for - to take a look at NEHTA and the PCHER. Program.
There are 2 key resources they might use.
First we have:

The Australian Government Information Management Office

The Australian Government Information Management Office (AGIMO), Department of Finance and Deregulation is working to make Australia a leader in the productive application of information and communication technologies (ICT) to government administration information and services.

e-Government Strategy

The strategy charts how the Government is building on progress in e-government to date, and how the Government is progressing towards the vision of connected and responsive government by 2010. Activities are in four main areas:
  • meeting users' needs
  • establishing connected service delivery
  • achieving value for money
  • enhancing public sector capability.

ICT Reform Program

AGIMO programs

Further information on AGIMO programs is available on the following topics pages:

Recent Publications

More here:
Looking at those AGIMO programs - who better to advise Senator Collins and the Committee on the quality and so on of what has been done by DoHA and NEHTA in the PCEHR Program.
Better still this organisation reports to the Finance Department led by Penny Wong!
The other entity is, of course the Auditor General.
Read what these people are intended to do!

About Us

The Auditor-General is responsible, under the Auditor-General Act 1997 (the Act), for providing auditing services to the Parliament and public sector entities. The Australian National Audit Office (ANAO) supports the Auditor-General, who is an independent officer of the Parliament.
The ANAO's primary client is the Australian Parliament. Our purpose is to provide the Parliament with an independent assessment of selected areas of public administration, and assurance about public sector financial reporting, administration, and accountability. We do this primarily by conducting performance audits, financial statement audits, and assurance reviews. The ANAO does not exercise management functions or have an executive role. These are the responsibility of entity management.
We also view the Executive Government and public sector entities as important clients. We perform the financial statement audits of all Australian Government controlled entities and seek to provide an objective assessment of areas where improvements can be made in public administration and service delivery. We aim to do this in a constructive and consultative manner. This includes working co-operatively with those with key governance responsibilities in entities, including Audit Committees.
As part of its role, the ANAO seeks to identify and promulgate, for the benefit of the public sector generally, broad messages and lessons identified through our audit activities. The ANAO's Better Practice Guides disseminate lessons on specific aspects of administration. In addition, our newsletter, AUDITFocus, captures succinctly some of our experiences that are likely to be of general interest to public sector managers.
The ANAO has extensive powers of access to Commonwealth documents and information, and its work is governed by its auditing standards, which adopt the standards applied by the auditing profession in Australia. In accordance with these standards, our performance audit, financial statement audit and assurance review reports are designed to provide a reasonable level of assurance. The actual level of assurance provided is influenced by factors such as: the subject matter of the audit, the inherent limitations of internal controls, the use of testing and cost considerations.
The ANAO adopts a consultative approach to its forward audit program, which takes account of the priorities of the Parliament, as advised by the Joint Committee of Public Accounts and Audit, the views of entities and other stakeholders. The program aims to provide a broad coverage of areas of public administration and is underpinned by a risk-based methodology. The final audit program is determined by the Auditor-General.
The ANAO plays an important professional role by contributing, both nationally and internationally, to the development of auditing standards, professional practices and the exchange of experiences through participation in various peer and professional organisations.
Here is the link!
Assessment and review by these two agencies of what has gone on, who has done what with whom and why, how well it has been done, is it reasonable and safe to proceed, where we now are and so on is what the Committee needs. With this expert advice the Senate Committee can then decide what comes next.
Even if the reporting of the Committee was delayed for a month or two, in the grand scheme of things it would not be any real problem and we could also all know that there were sensible hands on the tiller going forward!
How annoying I did not think of this when writing this late last week.
Silly me!
I apologise in advance if such referrals have already happened for offering gratuitous advice!
David.

Saturday, February 11, 2012

Weekly Overseas Health IT Links - 11th February, 2012.

Note: Each link is followed by a title and few paragraphs. 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.
-----

HIMSS12 Preview: Kaiser to Share its EHR Journey Experiences

While many providers are working on their first full-blown electronic health record system, Kaiser Permanente has been through the process several times, starting back in the 1990s. Some of its facilities had EHRs long before others; its eight different regions tried out different systems at various times. Every time the organizational information technology strategy changed directions, it required full technological and operational overhauls.
Now, there's one EHR across the entire organization, encompassing 36 hospitals, 430 medical offices, more than 14,000 physicians, and 8.6 million members. Kaiser accounts for more than half the hospitals that have achieved HIMSS Analytics' Stage 7 EMR adoption--a complete paperless system with advanced use of integrated data. Kaiser recently introduced a mobile phone app to allow its members to access their medical records, make appointments, e-mail their physicians, and refill prescriptions.
 It took seven years, but Senior VP and CIO Philip Fasano says the it was well worth the effort. Kaiser is starting to reap benefits that the entire U.S. health care system should get eventually, as long as providers embrace the advantages of integrated patient data.
-----
Thursday, February 02, 2012

UC-Merced Students Use Telehealth To Treat Diabetes

by Alice Daniel, iHealthBeat Contributing Correspondent
MERCED -- Business students at the University of California--Merced are launching an ambitious telehealth project to help underserved women in the Central Valley manage their gestational diabetes without having to make multiple doctor visits.
Through the project, patients will be able to send results of their blood sugar tests electronically to their health care providers.
By allowing data to be digitally transferred from blood sugar monitor to doctor, physicians can obtain necessary information without having to see patients directly, and patients can avoid multiple office visits.
-----

5 healthcare data governance best practices

By Sunil Soares, Director of information governance at IBM
Created 2012-01-31 09:49
Information governance is the formulation of policy to optimize, secure, and leverage information as an enterprise asset by aligning the objectives of multiple functions. In our experience, information governance practitioners face critical challenges in explaining the value to the business.
This article details the five best practices imperative to selling the value of information governance within healthcare:
1. Improve the reliability of data to support a 360-degree view of providers, members and patients. Healthcare organizations need to understand where providers practice, whom they refer to, and what patients they see. As a result, identity information such as name, provider identifier, state license number, Medicare number, Medicaid number is important to link multiple profiles of the same provider. It is also not uncommon for health plans to find that more than half of the contact information in their provider network directories is out-of-date. The network directory might include dead providers, as well as providers who might not have renewed their contracts for several years.
-----

Study: E-prescribing improves medication adherence

By mdhirsch
Created Feb 1 2012 - 10:23pm
Patients are more likely to pick up their prescription drugs when their physicians use e-prescribing to order them. Assuming they then take the drugs they've purchased, this trend should improve medication adherance, patient outcomes and reduce long-term healthcare costs.
That's the skinny from the latest study, conducted by Surescripts in collaboration with pharmacies and pharmacy benefit managers. Researchers analyzed data sets representing more than 40 million prescriptions. Patient first-fill medication adherence was 10 percent higher when physicians used e-prescribing.
-----

Cloud-based EHRs raise data rights questions

By mdhirsch
Created Feb 2 2012 - 8:49am
With cloud-based electronic health record systems becoming more popular, providers should carefully read their vendor contracts regarding their rights and use of their patients' data, according to American Medical News
Gerard Nussbaum, director of technology services for the global management consulting firm Kurt Salmon Associates, tells amednews that since the data in the EHR is stored in the cloud, not at the host site, the vendor and others have access to the data, even if the provider owns it. That leads to issues regarding rights to the data, which the parties need to address.
-----

EHR Deployment Costs Approach $30,000 Per Doctor

Electronic health records move into the mainstream, thanks to Meaningful Use incentives. Most successful practices invest more in training, advanced functions, research shows.
By Ken Terry,  InformationWeek
February 01, 2012
Physicians are starting to embrace electronic health records en masse, according to a new survey by the Medical Group Management Association (MGMA). Two caveats to bear in mind: Many of the EHRs in use still have minimal functionality, and the MGMA survey excluded solo and two-doctor practices.
According to the report, Performance and Practices of Successful Medical Groups, 51% of groups of three or more physicians are using some kind of EHR. Similarly, a recent government survey found that in 2011, 57% of office-based physicians had an EHR. But 34% of the respondents had what the government researchers defined as a "basic EHR." A basic EHR includes only a patient's medical history, demographics, diagnoses, medications, and allergies, as well as the ability to prescribe and view lab and imaging results electronically AdTech Ad
-----

Health IT sales growth predicted to rise only slightly in 2012

By kterry
Created Feb 3 2012 - 3:53pm
Despite rising investments by venture capital firms, the health IT field as a whole i [1]s poised for no more than 5 to 10 percent growth this year, financial analysts who attended a panel discussion hosted by the Nashville Health Care Council this week predicted.
Factors conducive to continued growth include the impending conversion to ICD-10, the analysts said in remarks reported [1] by Healthcare IT News. "I foresee a slightly better 2012, with the emphasis on slightly," said Darren Lehrich, managing director of Deutsche Bank Securities.
-----

Health data breaches up 97 percent in 2011

By Diana Manos, Senior Editor
Created 02/01/2012
CARPINTERIA, CA – Health data breaches in the U.S. increased 97 percent in 2011 over the year before, according to a new report by Redspin, a leading provider of IT security assessments.
The annual survey, "Breach Report 2011, Protected Health Information,” found breaches in all 50 states, and examined a total of 385 incidents affecting over 19 million individuals since the HITECH Act's breach notification rule went into effect in August 2009.
"Information security data breach in healthcare has reached epidemic proportions – the problem is widespread and accelerating," said Daniel W. Berger, Redspin's president and CEO.
-----

66% of healthcare IT executives concerned about monitoring tablets

The concerns of healthcare IT executives trying to meet the demands of supporting consumer-grade computing devices are growing. A study — conducted by BizTechReports and published as a white paper by Panasonic (download here)– found major operational issues for media tablets in healthcare, with 66% of respondents stating consumer tablets create governance challenges for their organizations.
Other concerns include security, durability and electronic medical records(EHR) compliance. The risk management policies are meant to ensure that patients, practitioners and institutions are able to share information and collaborate, while limiting the chances of losing control of critical data. The survey also highlighted the control and remediation mechanisms that allow institutions to rapidly react and recover from unexpected situations that may expose the community of interest to risk. It also noted the productive end-to-end technology frameworks that optimize business processes from the end-point to back-office operation.
-----

Ireland gets upgrade for patient admin system

By Jamie Thompson, Web Editor
Created 02/02/2012
IMS MAXIMS has implemented the latest version of its Irish patient administration system across more than 50 healthcare organizations in the country. The upgrades will allow Ireland’s hospitals to meet national requirements and support advances announced by the Health Service Executive (HSE) to improve patient care.
The IMS MAXIMS software has been upgraded to support the interface to the National Integrated Medical Imaging System, which aims to make Ireland’s radiological services filmless, and the exchange of patient image data throughout the health service fast and secure.
-----
By Joseph Conn

Will the IT future be a dystopia?

Technology blogger Shelly Palmer has a futuristic warning in his recent post, "Google = Skynet … Yikes!"
Palmer began with a profession of love for technology and then fretted about the latest Google announcement on privacy, contemplating a frightening future of giant databases filled with personally identifying information (prescription records among them).
Also this week, electronic prescription company SureScripts issued a report on the inverse relationship between the amount of a patient's drug plan co-payment and willingness of a patient to show up and pay for the prescription—a good use of information in pursuit of better public policy. SureScripts said its review was based on more than 40 million prescription drug records, which were drawn from diverse sources. SureScripts garnered this information, for the most part, without patient consent, but it said the data had been de-identified so that no patient records were compromised.
-----

Mostashari expects big year ahead for data exchange

By Mary Mosquera, Contributing Editor
Created 02/03/2012
WASHINGTON – Health information exchange will ramp up significantly in 2012 because the necessary elements of interoperability will be in place, ONC chief Farzad Mostashari, told the Health IT Policy Committee at a meeting Feb. 1.
The health information exchange strategy means finally bringing together the standards, identity authentication certificates, governance for rules of the road, and the availability of directories or digital provider phone books.
These will enable providers to exchange information whether through a simple transaction for a referral or sharing a test with another provider or a more complex query for patient data.
-----

3 Essential Breach Prevention Steps

Attorney Also Offers Notification Insights
Jeffrey Roman
January 30, 2012
Encryption, staff training and audits of patient records access are three essential healthcare information breach-prevention steps, says attorney Robert Belfort.
Belfort urges healthcare organizations to encrypt data on mobile devices and media, educate staff about the sanctions they'll face if they're guilty of a breach and conduct internal audits of records access. "The belief that ... there's a high risk that if you access a record improperly you will be caught through some sort of audit trail review can have an important impact on behavior," he stresses.
In an interview with HealthcareInfoSecurity's Howard Anderson (transcript below) Belfort also notes organizations face a "difficult balancing act" in notifying patients of a breach and ensuring the risks aren't exaggerated.
The most difficult aspect of breach notification, Belfort says, is "figuring out how to frame the discussion in a way that balances the obligation to alert individuals to what's happened without causing unnecessary worry or exaggerating the risks that individuals really face."
-----

Improved Patient Problem List Enhances Diagnoses

New clinical decision support tool gives doctors a better patient problem list, reminding doctors of those medical issues and leading to improved care, say researchers at Brigham & Women's Hospital in Boston.
By Ken Terry,  InformationWeek
January 30, 2012
A new clinical decision support tool developed by researchers at Harvard-affiliated Brigham & Women's Hospital in Boston can increase the completeness of patient problem lists in electronic health records (EHRs). Having all of a patient's diagnoses on a single list helps physicians provide better care, because they're more likely to treat a condition such as diabetes or hypertension if they're reminded of that problem when a patient visits.
Unfortunately, as a recent paper in the Journal of the American Medical Informatics Association noted, medical problem lists are often incomplete. In a previous study of a primary care network affiliated with Brigham & Women's, the authors found that "completeness ... ranged from 4.7% for renal insufficiency or failure to 50.7% for hypertension, 61.9% for diabetes, to a maximum of 78.5% for breast cancer, and other institutions have found similar results." AdTech Ad
-----

Report: Data breaches from unencrypted devices up 525% in 2011

By danb
Created Feb 1 2012 - 1:45pm
Healthcare organizations need to "serve as their own watchdog" to increase security and decrease data breaches, a new report from IT security audit firm Redspin concludes. The increase in "bring your own device" policies at various hospitals, in addition to the continued implementation of electronic health record systems, are too much for government alone to regulate, the report's authors say.
The report digs into the latest major data breach figures--those breaches impacting 500 or more individuals--released by the U.S. Department of Health & Human Services' Office for Civil Rights [1]. With the addition last week of the 2011 Sutter Health [2] breach, which impacted 4.2 million patients, the number of major healthcare information breaches now sits at 385 since 2009.
-----

Halamka determined to upgrade DICOM standard for image sharing

By kterry
Created Jan 31 2012 - 3:39pm
John Halamka, CIO of Beth Israel Deaconess Medical Center (BIDMC) in Boston, had a personal experience recently that showed why the Digital Imaging and Communications in Medicine (DICOM) standard for transmission of medical images is not sufficient when it comes to cross-organization information exchange.
In a recent blog post [1], Halamka explains that his wife Kathy needed a follow-up visit following a breast cancer exam, and wanted to send her mammogram from her local hospital to BIDMC. It turned out that the only way to do it was to pick up a CD that contained the mammogram and the correct viewer and physically take it to BIDMC herself.
Halamka says that DICOM was created to move images across radiology systems within an organization. However, he said, "It is not sufficient for a healthcare information exchange world that uses the Direct implementation guide ... for content exchange among organizations. The fact that vendors such as LifeImage, Accelarad, and Merge Healthcare have created their own image sharing networks suggests that more standards work is needed to create an open ecosystem of image sharing among organizations."
-----

5 keys to discovering hidden data security risks

January 30, 2012 | Michelle McNickle, Web Content Producer
The threat posed to patient privacy by misused IT isn't anything new, and neither is all the "how to" coverage emphasizing the importance of protecting your organization from breaches. But, sometimes that’s easier said than done – something Earl Reber, executive director at eProtex, also agrees with. 
“If your organization has some improvement to do in the area of data security, knowing where to start can seem overwhelming,” he said, adding that one needs to "begin to explore these issues deeply and work toward a long-term solution, as opposed to applying a Band-Aid. If you feel you can’t afford the time or resources to address these issues, truly, you can’t afford not to.”
Reber outlines five basic keys to discovering hidden data security risks. 
-----

To Contain Hospital Costs, Leaders Must Look to IT

Edward Prewitt, for HealthLeaders Media , January 31, 2012

The federal government is offering bonus money to hospitals for meaningful use of healthcare IT, even as it terms 2012 the year of meaningful use.  To spur developers to come up with better tools to track patients after discharge, the Office of the National Coordinator for Health IT has launched a challenge  to create a Web-based application that could empower patients and caregivers to better navigate and manage a transition from a hospital.
Incentives like this are easy money, but they really shouldn't be necessary. Technology is the only means by which healthcare systems can make it out of their current impasse.
Last week, at one of our Roundtable events—HealthLeaders Media's gatherings of small groups of hospital executives to discuss topics of top concern—Dave Brooks, CEO of Providence Health and Services' Northwest Washington Region in Everett WA, said his system will need to cut costs by 10–15% over the next few years, beyond its already efficient operations.
-----

CNIO position on the rise

January 30, 2012 | Diana Manos, Senior Editor
OAK BROOK, IL – Chief Nursing Information Officer (CNIO) is a fairly new title, but it is growing in popularity and more and more organizations are recruiting for the position, according to Linda Hodges, vice president and leader of information technology search practice at executive search firm Witt/Kieffer.
An increasing number of nurses are setting their sites specifically on attaining a CNIO position, Hodges told Healthcare IT News in an exclusive interview.
“This is something that has become a passion for many people who went into nursing but also love IT,” she said. “They can see how this role can impact care, especially with the evolving new role of accountable care organizations.”
-----

Health organizations increasingly hiring chief nursing information officers

By kterry
Created Jan 30 2012 - 6:26pm
While the rise of chief medical information officers has gotten the spotlight recently, chief nursing information officers also are becoming more common. A growing number of healthcare organizations are recruiting candidates for this position, Linda Hodges, vice president and leader of information technology search practice at executive search firm Witt/Kieffer, told Healthcare IT News.
Today, most institutions hiring CNIOs are academic medical centers or large integrated healthcare systems, Hodges said. But that could change as more healthcare systems recognize that they need IT experts with nursing experience to help lead their health IT implementation, which is largely carried out by nurses.
-----

Consultant Describes Rocky Road Through the Health System

Paul Keckley, executive director at the Deloitte Center for Health Solutions, recently underwent knee surgery and things have not gone so well on the treatment and payment sides.
He’s been reminded that there’s nothing like using the health care system to see its strengths and weaknesses. In Deloitte’s latest weekly “Health Care Reform Memo,” Keckley lays his experiences over the first month following surgery and promises follow-ups, which Health Data Management also will publish:
It’s been 34 days since my knee surgery and subsequent clotting complication. I’ve used two hospitals in two states, three labs to draw blood to monitor my coagulation, and countless hours online trying to figure out my propensity for further complications that might lie ahead.
-----

Federal CTO Aneesh Chopra Resigns

Chopra, the first person to hold the federal CTO post and a strong voice behind Obama administration efforts on open government, will depart in February.
By J. Nicholas Hoover,  InformationWeek
January 27, 2012
The nation's first federal chief technology officer, Aneesh Chopra, will step down from his White House position in early February, according to the White House.
Chopra, who joined the Obama administration in May 2009, has been a vocal force and leader for the Obama administration's technology and innovation policy. Chopra serves as an adviser to the president on innovation and a government liaison with academia and industry. In that role within the White House's Office of Science and Technology Policy, he has been an outspoken advocate of open government and has focused many of his efforts on innovations in healthcare, the smart grid, and education.
-----

5 dos and don'ts of EHR interface design

January 27, 2012 | Michelle McNickle, Web Content Producer
Sometimes, small tweaks can make a big difference, and according to Bob Hunchberger, a clinical informaticist for a 500-bed hospital, that couldn’t be truer when it comes to your EHR. 
Hunchberger suggests five dos and don’ts of EHR interface design. 
-----

Mostashari: 2012 Will be a Big Year for HIT

At least 100,000 providers will receive electronic health records meaningful use incentive payments, during 2012, Farzad Mostashari, M.D., National Coordinator for HIT, predicts in a new blog posting.
And that’s just the start, he says, laying what he sees as a turning point year. “In summary, I see 2012 as the year in which health I.T. truly comes of age.”
Mostashari tackles five major I.T. trends during the coming year, starting with the taking off of meaningful use after 20,000 eligible professionals and 1,200 hospitals received incentive payments in 2011.
-----

Personal health data better protected by ISO standard

2012-01-30

ISO has published a new technical specification which will increase protection of personal health information processed, stored and transferred by computer systems for subsequent use by clinicians and others in healthcare organizations. ISO/TS 14265:2011, Health informatics – Classification of purposes for processing personal health information, defines a set of high-level categories of purposes for which such personal health information can be processed .
Electronic health records (EHRs) are used more and more. They involve the systematic electronic collection of health information about individual patients or populations, such as information about the physical or and mental health of an individual or provision of health services.
Health information is usually documented by healthcare professionals as part of the process of delivering care, and subsequently used to support the continuing care of each patient. However, EHR information might also be needed and used to enable the healthcare organization (such as a hospital) to manage its services better and more safely, and for a wider range of purposes such as public health, education and research.
-----

Bipartisan Policy Center calls for more, better health IT

By Bernie Monegain, Editor
Created 01/27/2012
WASHINGTON – A think tank with a healthcare task force chaired by former Senators Tom Daschle, a Democrat, and Bill Frist, MD, a Republican, is advocating for improved and better-used health information technology. Among the group's recommendations is "robust" data exchange.
The Bipartisan Policy Center's Task Force on Delivery System Reform and Health IT released its report on Jan. 27.
Besides data exchange, the recommendations range from realigning incentives and payments to support higher quality, more cost-effective care to increasing the use of electronic health records.
-----
January 27, 2012 10:10 AM

Report: Electronic health records still need work

WASHINGTON — America may be a technology-driven nation, but the health care system's conversion from paper to computerized records needs lots of work to get the bugs out, according to experts who spent months studying the issue.
Hospitals and doctors' offices increasingly are going digital, the Bipartisan Policy Center says in a report released Friday. But there's been little progress getting the computer systems to talk to one another, exchanging data the way financial companies do.
"The level of health information exchange in the U.S. is extremely low," the report says.
-----

Halamka outlines BIDMC's ICD-10 processes, shares resources

By danb
Created Jan 30 2012 - 12:25pm
While Beth Israel Deaconess Medical Center CIO John Halamka, M.D., doesn't necessarily believe that ICD-10 is a worthwhile project--particularly because it is used for reimbursement [1] instead of for research as it in other nations--he realizes the importance of making sure his facility is right on top of the implementation.
In his latest blog post [2], Halamka provides updates on BIDMC's progress with ICD-10. His outline, while brief, also provides a how-to guide for other hospitals in similar situations.
-----

10 steps to a successful telemedicine program

By gshaw
Created Jan 30 2012 - 1:05pm
From market assessments to self-assessments, Becker's Orthopedic, Spine & Pain Management Review offers 10 best practices for implementing telemedicine in hospitals that want to improve access, reduce costs and boost quality of care.
"The first step is to do an honest assessment of your capabilities and the needs [of] communities," Tim Smith, M.D., vice president of research for the Center for Innovative Care at St. Louis-based Mercy Hospital, told Becker's. Mercy started its telemedicine process with a community needs analysis. The organization's leaders met with members of the community at different events to determine what healthcare services they most needed, according to the article [1].
-----

Chaos as hospital trust's £4m new IT system fails

Last updated at 2:04 AM on 29th January 2012
Hundreds of patients have had operations cancelled or been given appointments at non-existent clinics after the failure of a £3.9 million new computer system.
Major glitches in the system have forced doctors to send patients home without treatment because their notes could not be accessed. In other cases, patients were given the wrong appointments.
The system, Cerner Millennium, was introduced at North Bristol NHS Trust in December and was designed to replace all paper documents – including medical records – and cope with about 30,000 outpatient appointments a month.
-----

Enjoy!
David.