Quote Of The Year

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

or

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

Monday, March 26, 2012

Weekly Australian Health IT Links – 26th March, 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

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Well last week was a ripper. Firstly we had a report on the PCEHR from the Senate, which despite the spin from NEHTA and DoHA, was pretty critical of how the PCEHR Program had been managed.
Secondly we have now had the Opposition has declared its position. This has to mean there is now considerable uncertainty with respect to the future of the PCEHR Program.
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Disarray surrounds database

  • by: Sue Dunleavy and Karen Dearne
  • From: The Australian
  • March 24, 2012 12:00AM
THREE months before the latest holy grail of the health system is launched, Labor's Personally Controlled e-Health Record is beginning to look like a pub with no beer, or an electronic health record with no clinical details.
The program is $300 million over budget and the list of significant technical, security and organisational flaws is growing, as is the likelihood it will go the way of Britain's $18.4 billion version of the PCEHR. It was dismantled last September after just 8.25 million people out of 60 million opted in and only 1203 GP practices loaded records on to the program.
This week government members on a Senate inquiry into the PCEHR reported concerns the system may not be ready on July 1. Coalition members called for it to be delayed for 12 months.
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E-Health start faces delay says Opposition Senator Sue Boyce

OPPOSITION Senator Sue Boyce says the Gillard government’s personally controlled e-health system will not start on July 1, as its enabling legislation has just vanished off the face of the earth”.
“The government has not put up its PCEHR Bills for debate in the Senate in this last sitting session before the Budget,” she said in a statement.
“The very earliest the Bill can be passed now is the week of May 8 to 10, just seven weeks before the PCEHR program is due to start.
“Coalition members have been warning the government for more than 12 months that their start-up date was too ambitious.
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Rules for personally controlled e-health record system released

  • by: Karen Dearne
  • From: Australian IT
  • March 21, 2012 11:35AM
THE proposed rules and regulations for the operation of the personally controlled e-health record system by the federal Health department have been released two days after a Senate inquiry into the PCEHR legislation reported its findings.
The head of Health's e-health division, Fionna Granger, invited public comment on the PCEHR System: Proposals for Regulations and Rules paper, by April 11.
"The Personally Controlled E-Health Records Bill 2011, currently before Parliament, provides the legislative framework for the operation of the PCEHR system but not the particular operational detail," she said.
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Concerns raised over e-health plan

  • by: Karen Dearne
  • From: Australian IT
  • March 20, 2012 10:28AM
THE results of a Senate inquiry into the Gillard government's Personally Controlled E-Health Record Bills have split along party lines, with the Labor majority recommending the bills be passed and Coalition senators calling for a delay until July 1 next year so that unresolved issues can be addressed.
In "additional comments" on the main report, the Greens have recommended five amendments to enhance the legislation, including greater privacy protections.
The PCEHR Bills will now be debated in the senate, following their passage in the lower house last month.
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Senate Committee qualifies e-health approval

Coalition Senators seek pushback.

A Senate committee examining proposed legislation for the Government's e-health records scheme has recommended the bills be passed as long as their operation is reviewed in 2014.
Senators on the committee approved the bills' passage without amendment, although they accepted a range of shortcomings raised in the evidence given to the committee.
The Greens sought four amendments, including around data protections. 
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Conflicting recommendations spur hot debate over PCEHR

21st Mar 2012
LEGISLATION enabling the personally controlled electronic health record (PCEHR) system is set to be hotly debated in the Senate after a parliamentary inquiry splintered into conflicting recommendations from government, Greens and Coalition senators.
Government senators on the Community Affairs Committee recommended the bills enabling the system be passed and reviews of the governance structure and a possible transition to an ‘opt-out’ model be conducted after two years.
An opt-out model would provide every Australian with an e-health record by default, rather than requiring them to sign up of their own accord.
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GPs key to e-health success: Plibersek

  • by: Karen Dearne
  • From: Australian IT
  • March 22, 2012 5:30AM
HEALTH Minister Tanya Plibersek wants GPs to take a lead role in reforming healthcare through the adoption of e-health systems.
"E-health is an important area with great potential to improve the convenience and quality of care for patients," she told a conference for GPs in Canberra.
"It's also an area where the government is keen for GPs to take a lead role."
Ms Plibersek said the government would start to roll out the personally controlled e-health system from July this year.
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Patients will have to pay for eHealth

 PATIENTS will have to pay up to $280 out of their own pockets if they want a personally controlled eHealth record from July because there is no Medicare rebate available to cover the cost of a doctor setting it up.
A Senate committee last night also raised concerns the government's $470 million eHealth scheme may not be ready to go on its proposed starting date of July 1.
The Senate community affairs legislation committee said the government should rethink the key design principle of the system and consider switching from a model where patients have to opt in to one where they must opt out.
The committee received evidence from consumers and doctors that the system might not fly if not enough patients decided to opt in. It says when the scheme is reviewed in 2014, the government should consider switching it to an opt-out model.
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DoHA secretary signals future for NEHTA

Department of Health and Ageing secretary Jane Halton has moved to ease concerns about NEHTA’s future, stating the organisation will continue to function into the second half of this year.
The current round of funding for the National Ehealth Transition Authority expires after June 30. However, Ms Halton has revealed the government’s lead ehealth organisation will continue to function beyond that deadline as it continues to work on the government’s Personally Controlled Electronic Health Record (PCEHR) project.
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DoHA expects ‘measured’ PCEHR adoption rate

The federal government’s incoming ehealth System Operator has revealed she is expecting consumers will not rush to sign up for personally controlled electronic health records, and has not set target rates for adoption.
Jane Halton, secretary at the Department of Health and Ageing and PCEHR System Operator from July 1, pending legislation, also said more than 1.4 million consumer identities were registered in the PCEHR system via the wave sites where the ehealth system is being trialled.
Speaking exclusively to eHealthspace.org ahead of her appearance at Health-e-Nation 2012, Ms Halton said: “I do not expect that the entire nation will opt in on 1 July, and actually we don’t want that.”
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Concerns raised over e-health records for elderly

NEHTA conceded that the system may not be "senior friendly"
The suitability and accessibility of the Federal Government’s Personally Controlled Electronic Health Record (PCEHR) system for the elderly has been brought into question by a Senate committee investigating cyber safety for senior Australians.
The committee voiced concerns to the National E-Health Transition Authority (NEHTA) — the body charged with the rollout of the PCEHR — around just how “senior-friendly” and easy to use the system would be for the demographic.
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NEHTA to front Senate cyber safety hearing

NEHTA is taking steps to reassure government and health industry stakeholders that it is comprehensively addressing a range of ehealth privacy and security concerns.
Industry groups including AusCERT have questioned the efficacy of the ehealth agency’s standards and technologies for protecting the Personally Controlled Electronic Health Record (PCEHR).
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NEHTA rejects claims of mismanagement

By Josh Taylor, ZDNet.com.au on March 19th, 2012
The Nation E-Health Transition Authority (NEHTA) has issued a 21-page rebuke to claims from the Medical Software Industry Association (MSIA) that the $466.7 million e-health program is being mismanaged by the government authority.
At a Senate inquiry into e-health legislation last month, MSIA made a number of claims that the specifications for the individual health identifier (IHI) — which links a person to their personally controlled e-health record — risk patient safety, because when a person changed gender or birth date information, they would be issued with a duplicate health identifier.
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Delay launch of PCEHR for a year - Senators

20 March, 2012 Michael Woodhead
With only three months to go before the launch of the PCEHR, opposition Senators say the rushed program faces too many problems and unanswered questions and should be delayed for a year.
A Senate inquiry into the PCEHR program has divided along party lines, with the Opposition saying the short timeframe for implementation is unrealistic and that there are still unresolved issues around patients being unable to control who has access to their records,  governance and the complex infrastructure of the system.
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Coalition calls for e-health launch delay

By Josh Taylor, ZDNet.com.au on March 20th, 2012
The Coalition has called for the Federal Government to delay the launch of personally controlled e-health records (PCEHRs) for all Australians by one year until 1 July 2013.
The Senate committee investigating the legislation required for the implementation of the $466.7 million PCEHR system yesterday called for the passage of the Bills in its report handed to the Senate yesterday. However, a dissenting report from coalition senators Sue Boyce and Bridget McKenzie noted that the majority of participants in the inquiry are extremely concerned about the launch date being just four months away.
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E-health records sign onto australia.gov.au

Whole-of-government sign-on system gains second member.

The Department of Health and Ageing has settled on the Federal Government’s single sign-on portal as the primary method of accessing consumer e-health records when they are made available later this year.
Consumers who opt for a personally controlled electronic health record from July 1 will be required to link their record to their login credentials on the australia.gov.au online portal in order to access the record online.
The e-health records portal itself will be hosted by the department, the designated systems operator for the project.
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Call to consider 'opt-out' e-records

20 March, 2012 Paul Smith
An inquiry into patient controlled e-health records is calling on the Federal Government to rethink its plan for patients to opt into the $467 million system and consider an opt-out scheme instead.
There have been long-running concerns that the success of the initiative will be undermined by low patient take up when it goes live in July.
On Monday night the Senate's community affairs legislation committee released its report recommending the current bill to create the personally controlled e-health records (PCEHR) system be passed.
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NBN key for Royal Children's Hospital

By Josh Taylor, ZDNet.com.au on March 22nd, 2012
Although the new Royal Children's Hospital in Melbourne is already equipped with a fibre backbone, director of ICT architecture Brendan Kelly says "thank god" for the National Broadband Network (NBN).
The new 357-bed Royal Children's Hospital in Melbourne was opened by Her Majesty The Queen on 26 October 2011.
The hospital has a 10-gigabit fibre backbone; 108 fibre joins the hospital with two other hospitals in the area. Kelly told journalists at CiscoLive! in Melbourne today that it was a "sparkly new facility".
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Aussie to webcast rare surgery

By Luke Hopewell, ZDNet.com.au on March 20th, 2012
Medical pioneer and self-professed evangelist professor Andrew Renaut will once again broadcast live, unedited footage of a rare surgical procedure over the internet to medical students and professionals. Renaut, however, is being cautious not to turn his educational webcast into a reality show.
Renaut has been broadcasting his surgeries for the past five years, with the last procedure aired in 2010. The professor is now gearing up for another webcast on Thursday that will see an unedited laparotomy, colectomy, ileorectal anastomosis and repair of ventral hernia broadcasted online with the support of the Australian Institute of Medical Education.
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eHealth display rolls out

By Karen Keast | Date of Posting: 20-03-2012
Allied health professionals, nurses and other healthcare providers across Australia will receive a first-hand look at how the new eHealth system will operate.
An innovative, interactive mobile display is touring Australia to showcase the Federal Government’s $465.7 million national Personally Controlled Electronic Health Record (PCEHR) system, which will be available from July 1.
Now touring Australia, the National E-Health Transition Authority’s (NEHTA) Model Healthcare Community truck has been designed to outline the eHealth story and its initiatives, ranging from reception to consultation, specialists, pharmacy, diagnostics and hospital.
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ACMA calls for improved senior citizen cyber safety education

Face-to-face programs preferred over online sessions, according to ACMA research
Improving cyber safety education of senior citizens through more targeted programs would greatly improve their confidence and get more elderly Australians online, according to an Australian Communications and Media Authority (ACMA) submission to a Senate committee investigating cyber safety for senior Australians.
Speaking at the Senate hearing in Sydney, ACMA digital economy division general manager, Andrea Wright, said that most cyber safety programs are aimed at young people and the Authority is trying to change this.
During Safer Internet Day in 2012, for example, ACMA targeted grandparents with face-to-face presentations across Australia.
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Safety of older net users in spotlight

THE Health Department will give evidence on the security of the personally controlled e-health record system at a Cyber-Safety for Seniors hearing on Wednesday.
Joint select cyber-safety committee chairwoman Catryna Bilyk said the hearing would examine the benefits of moving vulnerable people, including "the fragile elderly", to the system when it launches on July 1.
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PCEHR operational blueprint in final draft: DoHA

Written by Kate McDonald on 19 March 2012.
An operational blueprint that will set out how the PCEHR will be managed after the system is launched on July 1 is in its final draft, according to the Department of Health and Ageing (DoHA).
In a response to questions put on notice during a Senate committee hearing into the PCEHR last month, DoHA said the operational blueprint was being developed by administrative design company ThinkPlace.
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HealthLink launches electronic pathology ordering

Written by Kate McDonald on 21 March 2012.
HealthLink has launched its eLab electronic pathology ordering system on the Australian market.
eLab was originally developed as part of an international collaboration between HealthLink and Danish company Danish Medical Data Distribution (DMDD).
Called WebReq in Denmark, it has been up and running there for six years and is now used by all community-based practices and some hospitals to order more than 600,000 orders per month.
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Electronic medical records: why we should seek a second opinion

December 19, 2011
Opinion
There are fears that the US's overreach in Iraq and Afghanistan, in combination with its tenuous financial state, may spell the end of its global hegemony. But the superpower's downfall is just as likely to be caused by the cost of MRI scans as it is by defence spending.
Health remains the greatest non-security challenge Western governments face. The task of managing an ageing population, whizbang technologies and a demanding public is awesome.
Australia is not quite in the budget quagmire on health, but there is every chance its proportion of gross domestic product costs will continue to rise above the current 10 per cent. One of the great potential contributors to efficiency in what is notoriously the most inefficient of sectors is the electronic patient record. By allowing for more efficient sharing of information, health records stored as a transferable entity in digital form could transform the entire sector.
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Government kicks off NBN video conferencing pilot

The trial aims to increase access for rural Australians to services such as Centrelink and Medicare
The Federal Government has kicked off a video conferencing pilot over the National Broadband Network (NBN) which aims to give regional Australians increased access to services such as Medicare and Centrelink.
The trial will offer customers access to services under the Department of Human Services (DHS) portfolio which is part way through consolidating Centrelink, Medicare and the Child Support Agency.
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NBN trial sites to roll out e-health, education projects

Home monitoring of type two diabetes patients in Townsville, local government video services planned by Department of Broadband, Communications and the Digital Economy
National Broadband Network (NBN) trial sites inTownsville, Queensland and Armidale, New South Wales are in the process of rolling out separate trials over the NBN designed to help Townsville type two diabetes sufferers and, in Armidale, offer remote access to TAFE courses.
Speaking at the Cisco Live conference in Melbourne, Department of Broadband, Communications and the Digital Economy First Assistant Secretary, Keith Besgrove, said the Townsville trial, which is scheduled to run for 18 months, would involve in home monitoring via video of the type two diabetes patients in collaboration with the Queensland Department of Health. The trial is due to commence within the next two months.
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Out with passwords, in with cognitive fingerprints

Randall Stross
March 19, 2012 - 12:14AM
We are moving to a world where you sit down at a console, you identify yourself, and you just start working, and the authentication happens in the background.
Imagine sitting down at your work keyboard, typing in your user name and starting work right away - no password needed.
That's a vision the Defence Advanced Research Projects Agency, part of the Defence Department, wants to turn into a reality. It will distribute research funds to develop software that determines, just by the way you type, that you are indeed the person you say you are.
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Enjoy!
David.

AusHealthIT Poll Number 114 – Results – 26th March, 2012.

The question was:
What Impact Will The Senate Report On The PCEHR Have On The Future Of E-Health In Australia?
None
-  11 (52%)
Minor
-  7 (33%)
Major
-  1 (4%)
Transformative
-  2 (9%)
Votes: 21
A crystal clear outcome - readers think there will be no difference made. This is the first poll in a long time where I think the majority has it wrong. I really think the impact will be pretty large - especially on NEHTA.
The bad blood and relationships between NEHTA and DoHA is well understood by the political insiders (the Senators) and they clearly have sided with DoHA in their report. What this will mean for NEHTA is unlikely to be good.
Again, many thanks to those that voted!
David.

Sunday, March 25, 2012

The Future Of the PCEHR Program Is Now Really Up In The Air. Politics Will Now Play A Major Role In What Happens.

The following report appeared a couple of days ago.

E-Health start faces delay says Opposition Senator Sue Boyce

OPPOSITION Senator Sue Boyce says the Gillard government’s personally controlled e-health system will not start on July 1, as its enabling legislation has just vanished off the face of the earth”.
“The government has not put up its PCEHR Bills for debate in the Senate in this last sitting session before the Budget,” she said in a statement.
“The very earliest the Bill can be passed now is the week of May 8 to 10, just seven weeks before the PCEHR program is due to start.
“Coalition members have been warning the government for more than 12 months that their start-up date was too ambitious.
“Now it looks as though Health Minister Tanya Plibersek secretly agrees.”
On Monday, the Senate Community Affairs committee reported its inquiry into the PCEHR had uncovered a wide range of concerns and unresolved issues, but the Labor majority recommended passing the bills.
However, the Coalition members called for a one-year delay of the program’s commencement, in a dissenting minority report.
Senator Boyce said the PCEHR project was “just another example of Labor’s shambolic and systemic mismanagement”.
“The government makes a big deal of announcing a date and then scrambles ineptly to meet the deadline, irrespective of the quality of their programs,” she said.
“The Coalition has argued the July 1 deadline is foolish, and even dangerous.
“Expert evidence from clinicians, privacy organisations and the medical software industry is that neither the processes nor the systems have been adequately tested before being unleashed on the public.”
Senator Boyce said the inquiry had showed there were “a huge range of problems” still to be ironed out.
Lots more here:
In the same article there is also evidence the Health Minister is working to lower expectations.
“Earlier this week, Ms Plibersek confirmed that the government would commence its PCEHR rollout from July this year.
Over time, the system will join the dots electronically between GPs, pharmacists, specialists, allied health professionals, hospitals and patients,” she told a conference for GPs in Canberra.”
You can read the full press release from Senator Boyce here:
So where are we?
As I read it the Opposition is by no means convinced regarding the PCEHR Program and the Government is realising that the program will take years and years.
In this situation it has to be virtually certain that a change of Government - which on present polling seems likely in the next 18 months - would result in some very detailed and thorough review of what has been delivered and just what value for money has been realised. The outcome of that review is unlikely to be very positive in terms of either adoption or clinical benefits obtained I would suggest.
We also know the Paul Madden the DoHA CIO sees the PCEHR as an 8-10 year program. See here:
In that situation, and with the Opposition view being that things need, at the very least a 12 month pause, I would suggest scrutiny will be coming pretty soon and I also predict that with that scrutiny will come a recognition that there were some much better options that might have been pursued.
I note with interest even NEHTA, in its flashy brochure for consumers, is making it clear thing like e-diagnostics will not be done for a couple of years (at least).
See here:
This document is really 2 pages of content and 14 pages of NEHTA Paid Models smiling a lot! What a waste of paper and ink.
I really wonder just how long this charade can go on for before it becomes clear that we are heading for a really awful e-Health train-wreck and that sanity can only be regained by a major pause and review.
To just steam on towards the iceberg is plain idiotic.
Especially when the Senate Inquiry has provided a long list of  the issues to be addressed as well as the political cover for the Government to go ahead and actually pause and sort things out.
David.

Saturday, March 24, 2012

Weekly Overseas Health IT Links - 24th March, 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.
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Smartphones improve Kenyan disease surveillance

By Mary Mosquera
Created 2012-03-13 09:44
Smartphones show promise in disease surveillance in the developing world because it is faster, cheaper and more accurate than traditional paper survey methods to gather disease information after the initial set–up cost.
Smartphone data was more reliable than paper, according to the findings of the Kenya Ministry of Health and researchers in Kenya for the U.S. Centers for Disease Control and Prevention (CDC).
Survey data collected with smartphones in the study had fewer errors and were more quickly available for analyses than data collected on paper. For example, smartphone data were uploaded into the database within eight hours of collection compared with an average of 24 days for paper-based data to be uploaded, in a study released March 12 by CDC.
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6 keys to developing a BYOD program

By Michelle McNickle, Web Content Producer
Created 03/15/2012
With mobile technology evolving every few months, keeping up with the devices' changing role in the workplace can be tough. Even though their effectiveness is being debated, bring your own device (BYOD) programs are popping up left and right, offering employees the comfort and ease of having their personal mobile devices in the office. 
"Right now in the Xigo universe, we're seeing folks carrying somewhere between three to four devices, on average," said Randy DeLorenzo, chief mobility officer at Dimension Data company Xigo. "They're mobile devices that can be in the form of a smartphone, a wireless modem, an iPad [or] a second smartphone for international travel. And we're definitely seeing the entrance of BYOD on the second, third and fourth screens. ... Particularly in healthcare, security is a huge concern around HIPAA, but they are the most stringent of all our customers – they're very interested in security, digital finger printing, and those types of things."  
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Survey: Most hospitals with EHRs and HIEs plan cloud initiatives

By kterry
Created Mar 16 2012 - 9:55am
Hospitals and healthcare systems are increasingly eyeing the use of cloud-based systems, according to a new survey [1] by Harris Interactive for the Optum Institute. Nearly 60 percent of responding CIOs from organizations that have both an electronic health record (EHR) and a health information exchange (HIE) said they plan to invest in "cloud-based open systems."
Thirty-six percent of these respondents said they planned to use cloud computing for both EHRs and HIEs; 12 percent said they'd use it only to exchange health information; and 11 percent plan to use it only for.
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EHRs Aren't Specialist-Friendly Enough

KLAS survey shows that most electronic health records systems are not tailored to medical or surgical specialties.
By Ken Terry,  InformationWeek
March 15, 2012
Specialists are less satisfied with their electronic health records than primary care doctors are, according to a recent survey by KLAS Research. The survey results underline the difficulties that healthcare organizations encounter in searching for EHRs that meet the needs of all their physicians and that also work well with hospital systems.
KLAS assessed physician satisfaction with the ambulatory-care products of 18 vendors. In a section entitled "Inpatient and large group analysis", it compared the results for Allscripts, Cerner, eClinicalWorks, Epic, GE Healthcare, and NextGen EHRs. These EHRs have a broad coverage of specialties and have either limited or full ability to share data with inpatient systems. AdTech Ad
Across all products, internal medicine and family medicine scored 7.6 and 7.5, respectively, on a scale of 10 in physician satisfaction with EHRs. Pediatrics scored 7.2, ob/gyn 6.8, urology 6.4, and nephrology 6.2. Oncology (5.8) and ophthalmology (5.8) were among the lowest-rated programs.
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Thursday, March 15, 2012

Meaningful Use Stage 2: Raising the Bar With Exchange, Standards, Engagement

On Feb. 23, CMS released the long-awaited notice of proposed rule-making that details Stage 2 of the Electronic Health Record Incentive Program, advancing the next set of criteria that hospitals and health care providers must meet to continue successfully demonstrating meaningful use of EHR systems.
While proposals for the next phase of core and menu set requirements largely mirror the direction set by the Health IT Policy Committee's summer 2011 recommendations, they are, on the whole, more aggressive. This is unsurprising given that everything that is included in the final rule -- due out summer 2012 -- must be initially addressed in the NPRM and vetted in a public comment period.
Stage 1 focused on the adoption and implementation of certified EHR technology and the capture of critical, structured data elements. With Stage 2, CMS aims to advance clinical processes for continuous quality improvement. CMS has retained its basic framework for a core and menu set of measures. While the number of overall objectives does not increase, providers should note that CMS has subsumed a number of Stage 1 measures -- such as the problem list, medication list and medication allergy list -- into other Stage 2 objectives to make room for new requirements.
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Warwick to use iPads for patient records

14 March 2012   Chris Thorne
South Warwickshire NHS Foundation Trust has signed a five-year contract with Kainos to digitise all of its patient records and make them available to staff on iPads.
The trust hopes to give staff mobile access to its systems by the end of the year, using Apple iPad devices. The iPads will give staff the ability to access and update a patient’s record at the point of care during a clinic, or a visit to a patient’s home.
The trust published an ICT strategy for 2011-14 in June last year, which said it wants to create a paper-light environment and improve mobile working, especially among its community staff.
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March 13, 2012

Stepping Up to the Cloud

There has been a lot of publicity lately about the benefits of cloud computing in healthcare, although hospital systems have been taking a cautious approach when it comes to moving certain applications to a cloud platform.
I recently had a conversation about the cloud with Scott MacLean, deputy CIO of Partners HealthCare in Boston. He says Partners has uses the cloud in a limited way: it hosts its revenue cycle management application with a major software vendor, in what he describes as a private, corporate hosting arrangement; and also has certain software as a service (SaaS), with appropriate business associate agreements in place, at the departmental level, he says.
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Kalorama: EMR market hits $17.9B

Written by Jeff Byers
March 14, 2012
Propelled by government incentives, a desire to improve patient outcomes and the bottom line, sales of EMRs grew 14.2 percent in 2011, according to medical market research company Kalorama Information.
The New York City-based research company found increasing physician and hospital acceptance, robust competition and growth in EMR budgets; factors culminating in a $17.9 billion market in 2011.
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IBM platform to personalize cancer treatments

By danb
Created Mar 15 2012 - 1:35pm
A new decision support tool from IBM has the potential to personalize treatments for patients suffering from cancer, hypertension and AIDS, the company announced [1] this week.
The tool essentially takes patient data and runs it against de-identified data compiled from similar cases to create a treatment plan. It also would provide hospital administrators with a report on aggregated patient care, according to a ZDNet article [2]. Researchers are optimistic that increased efficiency will improve care and lower costs.
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ONC lays out strategy for health information exchange

By kterry
Created Mar 14 2012 - 5:56pm
The Office of the National Coordinator of Health IT (ONC) lays out its 2012 strategy for health information exchange in a new Health Affairs paper [1].
ONC plans to continue to develop the building blocks required for three types of information exchange: directed exchange, which enables providers to send clinical data to each other electronically; query-based exchange, which permits providers to search for data that could help them diagnose and treat a patient; and consumer-mediated exchange, which gives patients access to their own health information.
"Based on the work of Office of the National Coordinator and its many collaborators over the last year," the ONC paper says, "the building blocks required to initiate all three forms of exchange are complete, tested and available today. These standards are already in use by private networks and electronic health records vendors to exchange documents within their own networks."
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The Robots Are Coming to Hospitals

A New Breed of Blue-Collar Robots is Handling the Dirty Work, Transporting Linens and Laundry

By TIMOTHY HAY

In the next few years, thousands of "service robots" are expected to enter the health-care sector, Timothy Hay reports on digits.
Robots have already staked out a place in the health-care world—from surgical droids that can suture a wound better than the human hand to "nanobots" that can swim in the bloodstream.
But the stage is now set for a different kind of robots, one with a sophisticated brain and an unlimited tolerance for menial tasks.
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Beware virtual keyboards in mobile clinical apps

By: Neil Versel | Mar 14, 2012
Don’t look now, but there’s another report raising safety issues about electronic medical records – and this one is focused squarely on mobile devices.
Remember the problems Seattle Children’s Hospital had with trying to run its Cerner EMR, built for full-size PC monitors, on iPads? The hospital tried to use the iPad as a Citrix terminal emulator, so the handful of physicians and nurses involved in the small trial had to do far too much scrolling to make the tablet practical for regular use in this manner.
Well, there may be a greater risk than just inconvenience when tablets and smartphones stand in for desktop computers. According to a report from the Advisory Board Co., “[A] significant threat to patient safety is introduced when desktop virtualization is implemented to support interaction with an EMR using a device with materially less display space and significantly different support for user input than the EMR’s user interface was designed to accommodate.”
The report actually is a couple months old, but it hasn’t gotten the publicity it probably deserves. We are talking about more than user inconvenience here. There are serious ramifications for patient safety, and that should command people’s attention.
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After Blues HIPAA settlement, more work to do: privacy experts

Posted: March 14, 2012 - 1:00 pm ET
The first-ever penalties stemming from enforcement of the HITECH Act's breach-notification rule are drawing mixed reviews from data-privacy advocates, who say federal regulators' $1.5 million settlement with Blue Cross and Blue Shield of Tennessee seems unlikely to halt healthcare companies' lax treatment of patient data.
"This is not about breach notification, it's about security," said Twila Brase, a registered nurse and president of the Citizens' Council for Health Freedom in St. Paul, Minn. "The settlement brings this up into the news so people understand that we have a problem with security of private health data. But I just don't think that the fines are necessarily going to solve the problem."
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Healthcare groups team to promote PHRs

Posted: March 14, 2012 - 12:00 pm ET
Hoping to encourage adoption and use of personal health records "by showing consumers how they can use PHRs to store vital health information such as medical conditions, allergies, medications, and doctor or hospital visits in one convenient and secure place," several healthcare organizations have collaborated on brochures that explain the reasons for using a PHR.
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CCIO on NHS CB “jolly good idea”

9 March 2012   Lyn Whitfield
Health secretary Andrew Lansley has said a chief clinical information officer on the new NHS Commissioning Board would be a “jolly good idea.”
Responding to a question at the launch of the EHI CCIO Leaders Network in London yesterday, Lansley stressed that he was reluctant to “recommend” that the board in Leeds should appoint a CCIO.
The whole point of his Health and Social Care Bill, he insisted, was to give NHS organisations – including the powerful board headed by Sir David Nicholson – the freedom to run their own affairs.
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Global telemedicine market to reach $27B by 2016

By sjackson
Created Mar 14 2012 - 2:10pm
The healthcare industry is banking on telehealth to reduce healthcare costs and provide significant savings on health services worldwide. So much so, in fact, that the market is expected to grow more than 130 percent over the next four years--to a whopping $27.3 billion. That's an annual growth just shy of 20 percent per year. 
The report [1] from Wellesley, Mass.-based BCC Research breaks the telehealth industry down in an interesting way--comparing "telehospital/clinic" providers (hospitals that sponsor and run telehealth sessions from their facilities) "telehome" providers (which use telehealth to monitor and track patients in their homes).
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Health IT spending more efficient in Canada than in the U.S.

By danb
Created Mar 14 2012 - 2:18pm
Providers at Canadian hospitals could be using health technology resources more efficiently than their U.S. counterparts, according to a study published this week [1] in the Journal of the American Medical Association. The study examined rates of mortality, readmissions and cardiac events at hospitals throughout Ontario from 1998 to 2008 and found that hospitals that spent more money reported better outcomes.
While the study's true aim was to determine whether patients received better care at hospitals that spent more money--particularly in a universal healthcare system--the researchers also compared some of their statistics to data for hospitals in the U.S.
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Scientific proof of health IT benefits lacking: So what?

By gshaw
Created Mar 14 2012 - 1:15pm
As evidenced by the not-very-pretty online tit-for-tat between researchers who say there's evidence that electronic health records systems will increase costs [1] and the National Coordinator for Health IT who says the study was flawed [2], there's still plenty of room for debate over the benefits of electronic health records and other types of clinical IT.
But there is plenty of evidence. The only problem? None of it is conclusive.
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Chicago hospital doctors say iPads raise their efficiency

Mon, Mar 12 2012
By Genevra Pittman
NEW YORK, March 12 (Reuters Health) - When doctors-in-training at the University of Chicago were given iPad tablet computers to use on their rounds, they found that using the device helped them be more efficient at ordering tests and procedures for their patients.
The study from the university program, published Monday in the Archives of Internal Medicine, tracked 115 residents who received devices purchased by the hospital. There was no funding reported from Apple Inc, which makes the iPad.
Most residents who used the devices to access patient records and coordinate their care said they cut about an hour per day off their workload. Researchers also found that the internal medicine trainees tended to put in orders for patient procedures earlier than before they got an iPad.
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Posted: Tue, Mar. 13, 2012, 6:47 AM

Health-record privacy impeding medical research

Kathryn Segesser says she believes the current thinking about eating disorders may be wrong.
Segesser suspects that for centuries, anorexia and bulimia have afflicted both men and women. She would like to challenge the popular theory that blames modern cultural pressures and unrealistic images of beauty projected by lollipop-thin models.
"I'm trying to see if, in the 18th century, people understood that there was some psychological reason that people decided not to eat," Segesser said.
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Electronic Submission of Medical Docs Trial Goes Live

James Carroll, for HealthLeaders Media , March 13, 2012

This is part one in a series covering various topics in the world of recovery auditors. Part one focuses on CMS's esMD (Electronic Submission of Medical Documentation) program.
A year ago this month, CMS announced its esMD tool, which is an option for providers to electronically send medical documentation that is requested of them by recovery auditors and other government entities contractors. 
Phase 1 of esMD kicked off on September 15, 2011. During this period, providers will still receive medical documentation requests via paper mail, but will have the option to electronically send their documentation to the requesting review contractor.
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HIMSS on HIE formation: Why are you doing this?

By Laura Kolkman and Bob Brown
Created 2012-03-12 09:28
After all the time and effort you’ve expended so far in forming your HIE, two reasonable questions to ask are, “What’s your objective?” and, “What’s in it for you?” But don’t answer yet. We’ll come back to those questions—and give you our opinion—at the end of this month’s column.
First, let’s look at what others might say about the journey you’re on.
Some would say it’s simply about standing up an organization that can serve the needs of your community. When it’s operational, your HIE will have the requisite business plan, policies, governance model, leadership, technical architecture, procedures and staff to get the job done. You’ll have built the organizational engine that will enable the exchange of patients’ health information in a safe and secure manner. But is that all?
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Q&A: CEO Charles Jaffe on broadening HL7's horizons

By Tom Sullivan, Editor
Created 2012-03-08 10:19
HL7 – not just for IT anymore. That thinking is the catalyst behind a triptych of recent moves designed to open the standards process to more health professionals, notably caregivers.
Ideally, pulling in a new group of professionals will open the feedback loop, particularly to those concerned with usability and workflow, but by no means limited to that. According to Charles Jaffe, HL7 CEO, tapping into their minds and, indeed, day-to-day work experiences will also yield specialist knowledge that bolsters decision support.
Government Health IT Editor Tom Sullivan spoke with Jaffe about those initiatives, very positive initial reactions, and what the future holds for HL7. Hint: Genomics, and mobile health.
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5 best practices for HIPAA security

By Michelle McNickle, Web Content Producer
Created 03/12/2012
The risk of protected health information being breached has grown dramatically within the past few years, and to combat the threat, the HIPAA Security Rule was created to provide organizations with administrative, physical, and technical guidelines to safeguard their electronic PHI.  
"The guidelines underscore a higher goal of the HIPAA Security Rule: helping organizations maintain their data’s confidentiality, integrity, and accessibility," said Mahmood Sher-Jan vice president of product management at ID Experts. "Understanding the guidelines and their greater goal can help organizations implement best practices to better protect their ePHI."
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By Joseph Conn

Post-acute sector could use some government IT help

When is it appropriate for government to get involved in a task?
I'll give you one example. It's appropriate when something needs to be done collectively, as opposed to individually, and can be done most efficiently and expeditiously through a public, rather than a private, initiative.
A story I wrote this week for Modern Healthcare was, ostensibly, about how health information exchange can be extended to nursing homes, home health, acute long-term care and behavioral-health providers, all of which lag behind other enterprises in health information technology adoption.
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Doctors, Patients Can Spur HIE Progress, Feds Say

National HIT coordinator Mostashari calls on clinicians and patients to demand more data at point of care. This will help drive development of health information exchanges, he says.
By Neil Versel,  InformationWeek
March 12, 2012
National health IT coordinator Dr. Farzad Mostashari is challenging clinicians and patients alike to create demand for health information exchange by asking that pertinent information be available whenever and wherever healthcare decisions need to be made.
"No investment in standards or infrastructure for information exchange will rapidly mobilize information sharing if the underlying demand for the shared information is low. Demand for information is the business driver for health information exchange," Mostashari and colleagues in the Office of the National Coordinator for Health Information Technology (ONC) wrote in an article published in Health Affairs that outlined a new national HIE strategy. AdTech Ad
"Sharing information to coordinate care--where information is sent and received between providers, such as a referral from a physician to a specialist--can build demand for, and trust required to support, other exchange models that involve aggregating and finding patient data," ONC officials added. "The goal of health information exchange is for information to follow patients, wherever and whenever they seek care, in a private and secure manner so that teams of doctors, nurses, and care managers can provide coordinated, effective, and efficient care."
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Meaningful Use is indispensable to healthcare reform

By kterry
Created Mar 12 2012 - 11:24am
The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the 2009 stimulus legislation, authorizes the Department of Health and Human Services (HHS) "to establish [1] programs to improve health care quality, safety, and efficiency through the promotion of health information technology (HIT), including electronic health records and private and secure electronic health information exchange."
Judging by that description, the Meaningful Use EHR incentive program was always about more than just ensuring that the federal government spent its money wisely on HIT. Congress' real objective was to reshape the healthcare delivery system. To be sure, provisions of the Patient Protection and Affordable Care Act (PPACA) are also directed to the same end. These include sections that authorize HHS [2] to promote accountable care organizations (ACOs), bundled payments, medical homes and value-based purchasing. Nevertheless, none of these PPACA provisions has yet affected as many providers as the Meaningful Use program has. Moreover, the success of these care delivery innovations will depend in large part on how well the EHR incentive program works.
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Start-ups want to help hospitals harness big data

By gshaw
Created Mar 13 2012 - 12:12pm
As the healthcare industry wakes up and smells the potential of big data, hospitals are experimenting with ways to harness it--and two new start-ups want to help them do so.
Charité University of Medicine Berlin, Europe's largest university hospital, is using increasingly large stores of complex information not only to improve quality and aid clinicians and researchers but also helps improve senior management processes, according to a case study [1] in Forbes magazine.
Deputy CIO Martin Peuker told Forbes that more than 700 hospital employees have access to a central data warehouse that holds both financial and operational information. Every senior manager has ready access to data about operations, scheduling, patient care, and patient records. The entire repository of information stored by the hospital exceeds 1.6 petabytes.
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At SXSW, Hipsters Look for Healthcare Tech Tipping Point

Scott Mace, for HealthLeaders Media , March 13, 2012

South by Southwest, the conference that made Twitter a household word, now has its sights set squarely on the business of healthcare.

In other words, get ready for more technology-fueled disruption than ever before. At the expanded three-day health track at the annual three-ring film/music/tech circus in Austin, TX, healthcare payers were front and center this week, clamoring for change—or at least trying to get in front of the parade of patients.
"We have good doctors, and we have insurance companies that want to fund the right thing, but it's not working, and all the trends are going in the wrong direction," says Michael Golinkoff, executive vice president of specialty programs at Aetna.
In the current atmosphere of fear and loathing existing between payers, providers, and patients, Golinkoff and a small army of other speakers urge big and little actions to create an atmosphere of trust.
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Walgreens taps Surecripts to send patient data to docs

By Bernie Monegain, Editor
Created 03/12/2012
DEERFIELD, IL – Walgreens will use e-prescribing network Surescripts' Clinical Interoperability services to electronically deliver patient data directly to primary care providers. The intent, say Walgreens officials, is to improve the coordination of care.
In the coming months, all 7,800 Walgreens and Duane Reade pharmacies and 350 Take Care Clinics nationwide will use the Surescripts network to deliver immunization records to the patients' primary care providers. Later this year, Walgreens will also use the Surescripts network to provide immunization reporting to state and local public health agencies, and Take Care Clinic patient summaries to the patients' primary care providers.
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AHRQ hopes to help hospitals with health IT project workflow

By gshaw
Created Mar 12 2012 - 12:13pm
The Agency for Healthcare Research and Quality [1] hopes to address one of the most challenging aspects of big health information technology projects: workflow design. The federal agency announced [2] it is seeking feedback on a proposed Workflow Assessment for Health IT Toolkit.
"Understanding clinical work practices and how they will be affected by practice innovations such as implementing health IT has become a central focus of health IT research," the agency wrote in the March 9 Federal Register.
"While much of the attention of health IT research and development had been directed at the technical issues of building and deploying health IT systems, there is growing consensus that deployment of health IT has often had disappointing results, and while technical challenges remain, there is a need for greater attention to sociotechnical issues and the problems of modeling workflow."
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President Obama appoints Todd Park nation's CTO

By Bernie Monegain, Editor
Created 03/09/2012
WASHINGTON – Todd Park will take over as assistant to the President and U.S. Chief Technology Officer (CTO), filling a vacancy created by last month's departure of Aneesh Chopra, the nation's first CTO.
Park has served as CTO of the Department of Health and Human Services since August 2009, where he gained a reputation as an energetic agent for change. Hired as the department’s “entrepreneur-in-residence,” Park has been helping HHS harness the power of data, technology and innovation to improve the health of all Americans, the announcement from the White House said.
The President has asked him to bring that same approach to a broader mission – helping to replicate those and other best practices across government and bring them to scale.
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Monday, March 12, 2012

Security Risk Assessments Gaining Traction in Health Care

Security risk assessments are gaining a higher profile in the health care field as providers look to prevent data breaches, prepare for government audits and qualify for meaningful use incentive dollars.
A security risk assessment takes stock of an organization's data protection policies and procedures, with an eye toward identifying weakness and establishing an improvement regimen. This aspect of IT security, although not entirely unknown in health care, has been more prevalent in other regulated industries such as financial services. However, a number of factors are driving interest in risk assessments among hospitals, medical practices and other covered entities under HIPAA. 
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Enjoy!
David.