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."

Friday, April 19, 2013

Big Data In Health Care - A Useful Review Of The State of Play.

This appeared a little while ago:

The HIT Approach to Big Data

MAR 1, 2013
Like "The Cloud" last year or "Mobile Apps" the year before, it's the I.T. catchphrase that's considered so big it's deemed worthy of double capitalization. Computers are capturing stray scraps of information on everyone's medical conditions, shopping habits, driving records, and weekend partying patterns; data architects in every business are struggling with how to put it all together to answer big questions.
No business has bigger questions than health care, which is being pressured as never before to provide better care to more people at lower cost.
But what the heck is Big Data? What makes it different from the small data that populates spreadsheets on so many departmental desktop PCs? "Volume, velocity, variety," says Elizabeth McGlynn, director of the Kaiser Permanente Center for Effectiveness and Safety Research. Kaiser, with 9 million members in eight regions, has the volume: 30 petabytes of patient data, which McGlynn says is more than three times the amount of digitized storage at the Library of Congress.
Velocity is the speed at which the data accumulates-very quickly in the case of a hospital, which adds reams of test results, images, vital signs, and clinician notes every day.
But McGlynn says the third defining quality of Big Data-variety-is the one most people overlook.
"There's not only the data we create, but what's on social media sites, or data about people's shopping or driving habits, what's happening demographically in a given neighborhood," McGlynn says. For example, hospitals trying to reduce their readmission rates might want to know what social support networks are available in the patient's community. Maybe the neighborhood block association has a Facebook page where neighbors can check in on each other or volunteer to bring dinner to a patient who's been discharged. Combining all the available information can create a picture of which patients are at greatest risk for readmission and what interventions are most effective at keeping them healthy and out of the hospital.
As usual, health care is playing catch-up in the Big Data game. Brad Putnam, executive director of HealthShare Montana, a growing health information exchange, came from the financial industry and says banks were in the dark about their customers up until about 10 years ago. "They had all their information on slave dummy terminals, and they'd send out a survey occasionally and think that they were giving great service," he says. Once banks started tracking how customers actually behaved, they saw a gap between the services offered and the services needed. That's why today you can deposit checks via your smartphone and get pinged when a stock hits your desired price point. "It was a painful shift, but now people can actively manage their financial life instead of reacting when the monthly statement comes," Putnam says. "When we're able to look at patient populations and measure how well we're doing, we can create benchmarks and help patients change their behavior. That's when it gets fun and fascinating."
The average hospital I.T. department may feel it's drowning in data already and is not inclined to deal with more. But here are three Big Data areas to watch.
Read, at length, about the three areas to watch here:
I think some of these will take a while to get into productive delivery but clearly they will be important. Important reading.
David.

Thursday, April 18, 2013

This Is A Much Too Democratic Approach To E-Health For Australia I Suspect. Great Fun To Review.

This short article appeared a few days ago.

NYers can vote on design of patient portal

  • April 13, 2013, 2:17 p.m. ET
Associated Press
BUFFALO, N.Y. — New Yorkers are being invited to weigh in on the design of a website that will let them access their medical records online.
The New York eHealth Cooperative is working with the state Health Department in the shift toward electronic health records. From Saturday through April 23rd, the cooperative is asking people to vote on one of several "Patient Portal" designs at www.patientportalfornewyorkers.org.
The full article is here:
Amazingly there are 14 different designs for people to consider and vote on - each with a short video explaining the features and look and feel.
Do you reckon we would have got the pathetic, ill-conceived consumer portal with the PCEHR had a process like this been conducted. I think not.
A visit to see what is on offer is highly recommended.
David.

Wednesday, April 17, 2013

Is There A Real Trend Here With DoHA Slowly Stepping Away From The NEHRS /PCEHR? Not Really Given The Somewhat Covert Purpose.

A kind and diligent observer of all things PCEHR sent me this a day or so ago as a summary of Departmental comments.
2 Dec. 2010: NEHTA is now "Managing Agent" for DoHA's program
The change in NEHTA's governance became very obvious after Dec. 2010.
7 April 2011: PCEHR is for Chronic Disease and Aged Care
The scope of the PCEHR is wound back to small segments of the population!
 23 June 2011: Actual PCEHR deliverables for 1 July 2012
(Deputy Secretary Rosemary Huxtable)
The PCEHR deliverables are severely wound back to "citizens can register for the PCEHR" ...
On 1 July 2012, DoHA delivers exactly what RH outlines (on slide 15) one year before!
26 March 2012: No "Big Bang" with the PCEHR
The go-live scope of the PCEHR is further wound back to a "soft opening"... which is exactly what happened in July 2012.
20 March 2013: So what about the Future of the PCEHR?
Halton's speech says exactly nothing about the future of the PCEHR, apart from obvious operational growth...
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On a review of this collection of public utterances from DoHA  it is hard to disagree that the specific future plans have become pretty vague and diffuse - with a very interesting twist that what became obvious about 6 months ago and is now being made apparent. This is a ‘big data’ system for the Government to mine for their own purposes - not a clinically focussed system.
This is confirmed in the latest speech where there is a clear sense in the first 15 minutes that all the PCEHR is planned to be is a great big feed for the analytics efforts of the Department to manage the health system rather than actually trying to provide clinical benefit.
There is also a sense that we are going to see a multiple set of repositories separate to the NEHRS / PCEHR. The first would seem to be the National Prescribing and Dispensing Repository.
The implications of this are really quite interesting. Is it covered by the PCEHR Legislation and protections? What consent is required for these pharmacy records to be uploaded and so on?
The last 10-12 minutes were on Telehealth and were said to be an integral part of the National E-Health Strategy. While it is mentioned I think this is just a distraction from the failing part of what is going on which was not in the National Strategy at all!
All the speeches are useful but this last one lays bare the why DoHA is doing this. It is to create data for them to mine. Had it been designed to clinical care we would have seen something quite different.
David.

AusHealthIT Poll Number 163 – Results – 17th April, 2013.

The question was:

Should A New Revised National E-Health Strategy Recommend An Integrated and Simplified E-Health Governance Framework With All National E-Health Activities Under One Roof?

For Sure 49% (18)
Probably 16% (6)
Possibly 0% (0)
No Way 30% (11)
I Have No Idea 5% (2)
Total votes: 37
Looks like about 65% feel we need an improved Governance Framework for Australian E-Health.
Again, many thanks to those that voted!
David.

Tuesday, April 16, 2013

The Evidence Free Nature Of the NEHRS / PCEHR Confirmed By Independent Research.

The following appeared last week.

Analysing past mistakes to manage health records’ futures

Dr Karin Garrety is a researcher at the University of Wollongong’s Centre for e-Health and is on a mission to uncover the worst eHealth decisions ever made – so that the next generation of eHealth implementations can be more effective.
"This is a really interesting time in the development of the internet and the development of information technology for use in health," she says.
“The people implementing these systems are coming up against problems that we haven’t encountered on this scale before. It involves very complex issues, and involves many different professional groups who have different information needs.”
Dr Garrety is part of a five-person team working on an Australian Research Council (ARC) funded Discovery project under the Human Society field of research.
Other researchers include Professor Ian P McLoughlin, a management expert from Monash University and Dr Rob Wilson from Newcastle University in the UK.
The project will document the policies and processes used by government employees who tried to bring in eHealth systems in both the UK and Australia and analyse the impact of these.
The result will be a retrospective, comparative study of five attempts to set up regional and national systems for sharing electronic health records in Australia and Britain.
“We’re looking at this from a socio-technical perspective,” she says.
Big System Failures
“The majority of people in England now have a summary care record,” says Dr Rob Wilson.
“But the program initially called National Program for IT and later rebadged Connecting for Health failed to deliver on the promise of modernising hospital IT in the UK, with just three installations in ten years.”
…..
Australian approach
Dr Garrety says that Australia hasn’t made the same top-down approach that began with a big, outsourced system.
“We are going a bit more bottom-up here, which has been much better,” she says.
“There are still issues where for example, clinicians feel that NEHTA has not consulted enough with them and so they feel they are out of the loop.”
Dr Garrety says that the focus on the PCEHR came “out of the blue.”
“The idea to have personal control over your own health record didn’t come out of research into what are the current information practices in the health system,” she says.
“A better approach would have been to ask, what is it that would help people do their work better - and then to build something up from what people would find useful to help them to deliver health care.”
Lots more analysis was here:

Now here:

http://ehealthspace.org/news/lessons-past-will-drive-health-records-futures

Not sure why it moved!

The italics are mine.
It is impossible to disagree with Dr Garrety’s conclusion and indeed, as is well known, NEHTA was planning for a much different Shared EHR before the NEHRS / PCEHR was suddenly, out of a clear blue sky, dropped upon them with a large budget but very little in the way of evidence support or indeed time to execute!
The last two paragraphs really say it all!
It does need to be pointed out that I made similar points a little while ago.
Exactly two years ago indeed - but it is nice to see some academic support!
David.

Monday, April 15, 2013

Weekly Australian Health IT Links – 15th April, 2013.

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

Quite an interesting week with the Coalition actually admitting near to universal broadband was actually a good idea and being prepared to but quite a large sum of money up to have it happen. No major party now thinks universal broadband is a bid idea - Yeehaa!
Other than that we have recruiters wandering around at vast expense and glacial progress being made in sign-up and certainly usage rates of the PCEHR - which of course are secret.
Again the Queensland Health Payroll Enquiry provides some amusement and we see increasing confirmation that Windows 8 is not the success it was hoped to be.
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eHealth records: there are alternatives to the PCEHR

When Dr Mukesh Haikerwal tried to connect his Melbourne practice to the PCEHR system, the eHealth records database was offline. He contacted the Department of Health and Ageing and said: “Hey guys, the PCEHR is offline!” The answer from the help desk: “No it isn’t.”
Image: other eHealth record solutions in Australia offer advantages over the PCEHR. E.g. the confidential patient data only goes to health providers selected by the patient, and not to the government.
Dr Haikerwal commented in the Sydney Morning Herald: “If the Qantas website was like this, you would say, ‘I will go to the travel agent instead.’” I’d like to mention here that Dr Haikerwal is a clinical lead, meaning that he should get the Rolls Royce treatment from the help desk (clinical leads are also supposed to promote the PCEHR amongst colleagues). If this is the Rolls Royce treatment, then I have no hope whatsoever…
We’re all wondering what the government is doing with the eHealth budget. It appears The Australian knows the answer as it reported last year: “NEHTA has spent part of its $218 million budget on more than 731 functions for stakeholders, including lavish seafood dinners, after-dinner speakers, flights and accommodation in five-star hotels. The authority spent $871,000 on taxi fares in the past two financial years, $118,000 on business-class international airfares and $2.1m in total on travel.”
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Privacy issues barriers to PCEHR use

10 April, 2013 Nick O'Donoghue  
Pharmacists have highlighted their inability to legitimately access patient data outside consultation and the need to invest in staff training without compensation, as barriers to their use of the Personally Controlled Electronic Health Record (PCEHR).
An Australian study found many pharmacy owners and managers were concerned about medico-legal issues surrounding the PCEHR, which was introduced to consumers in July 2012, stating that they would only be able to access the data during consultations with the patient’s consent.
Results from the research, published in the International Journal of Pharmacy Practice, showed that pharmacists were concerned about the policing of their access to patients’ PCEHRs and potentially unwarranted disciplinary action for accessing and viewing a patient’s PCEHR outside of consultation time.
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Analysing past mistakes to manage health records’ futures

Dr Karin Garrety is a researcher at the University of Wollongong’s Centre for e-Health and is on a mission to uncover the worst eHealth decisions ever made – so that the next generation of eHealth implementations can be more effective.
"This is a really interesting time in the development of the internet and the development of information technology for use in health," she says.
“The people implementing these systems are coming up against problems that we haven’t encountered on this scale before. It involves very complex issues, and involves many different professional groups who have different information needs.”
Dr Garrety is part of a five-person team working on an Australian Research Council (ARC) funded Discovery project under the Human Society field of research.
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Outrage as eHealth record sign-up squads hit Australian hospital patients in bid to boost numbers

  • Sue Dunlevy
  • News Limited Network
  • April 14, 2013 12:00AM
BUREAUCRATS armed with clipboards have been sent into hospitals and nursing homes to cajole patients to sign up for an eHealth record their doctors still won't be able to use.
Nine months after it was launched, the Government's $1 billion eHealth system holds just 414 patient records and is only a fifth of the way towards its target of signing up 500,000 patient users by June 30.
There are currently only two hospitals using the personally controlled electronic health record (PCEHR) system and they have uploaded just 155 discharge summaries.
And the system remains barely operational because fewer than one per cent of doctors have signed up for the Healthcare Identifier service number they need to be able to access patient records.
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FREE peer-to-peer eHealth education seminars: registrations now open!

8 April 2013. FREE peer-to-peer eHealth education seminars: registrations now open! Are you ready for tomorrow’s clinical consultation when a patient asks you about their personally controlled electronic health (eHealth) record?
From April to June 2013, the Royal Australian College of General Practitioners (RACGP) will run free peer-to-peer education seminars across Australia. These seminars will highlight a number of key aspects on how to effectively use the national eHealth record system to get the most benefits for your patients and practice.
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See-through brains to clear up mental mysteries

Date April 11, 2013 - 10:10AM

Sharon Begley

If Dr Karl Deisseroth were an architect, he might be replacing stone or brick walls with floor-to-ceiling glass to build transparent houses. But since he is a neuroscientist at Stanford University, he has done the biological equivalent: invented a technique to make brains transparent, a breakthrough that should give researchers a truer picture of the pathways underlying both normal mental function and neurological illnesses from autism to Alzheimer's. In fact, the first human brain the scientists clarified came from someone with autism.
Deisseroth and his colleagues reported in the online edition of the journal Nature on Wednesday that they had developed a way to replace the opaque tissue in brains (harvested from lab mice or donated by people for research) with "hydrogel", a substance similar to that used for contact lenses.
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Researchers unlock mystery of how brain registers levels of pain

Date April 12, 2013
Scientists have discovered how to recognise pain in brain scans, paving the way for tests that accurately gauge its severity.
Magnetic resonance imaging brain scans were performed on 114 volunteers as heat ranging from warm to hot was applied to their left forearm.
Researchers from the University of Colorado, New York University, Johns Hopkins University and the University of Michigan believed they would find a unique pain signature in each individual, because pain is measured differently among people and some are more sensitive than others.
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Online medical records a boon for Blacktown patients

By Nick Soon

April 12, 2013, 11:30 a.m.
KILDARE Road Medical Centre has become the first in Blacktown to register more than 1000 patients for their electronic health records.
It achieved this last week with the help of WentWest and Western Sydney Medicare Local’s eHealth assisted registration team.
Patients who register don’t have to keep repeating your health summary each time they go to their your doctor.
The centre’s chief executive officer, Peter Rushton, said their eHealth records would be there with key information such as current medications, allergies, adverse reactions to medications, chronic health issues or your children’s immunisations.
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Question: Does HL7 free IP mean open?

Posted on April 12, 2013 by Grahame Grieve
Question
Now that the HL7 IP is free, can I just send someone I am working with a copy of the specification?
Answer
No. While the IP is now licensed as free for use, it’s not actually open. In particular, only HL7 is allowed to distribute the specifications themselves. So you’ll have to direct your trading partners to the HL7 website to get a copy for themselves.
This is really to drive membership. HL7 has a real legitimate case for driving membership – developing the standard isn’t cheap, and has to be paid for somehow. In the absence of selling the standard, rent has to be extracted from somewhere.
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Rapid IT development to transform healthcare in APAC

by CXOtoday News Desk Apr 08, 2013
The healthcare industry in the Asia Pacific region is undergoing a massive transformation and is increasingly looking to improve service delivery under the impact of an evolving consumer profile, disease patterns and increasing healthcare costs. According to research firm Frost & Sullivan, a large number of healthcare facilities in this region are leveraging Information and communication technology (ICT), to boost service delivery and improve ROI.
According to Natasha Gulati, Connected Health Industry Analyst, Frost & Sullivan Asia Pacific, and author of the report states that efficient, affordable and timely delivery of quality healthcare services is becoming a priority for healthcare companies. According to her, emerging technologies such as cloud computing, big data analytics, advanced visualization tools, mobile and social technologies can revolutionize healthcare delivery in Asia-Pacific.
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IBM used rival's information to win QLD Health contract

Date April 9, 2013 - 3:03PM

Nathan Paull

IT giant IBM has admitted using leaked rival information to help secure a multi-million dollar Queensland Health payroll contract.
An inquiry into the bungled system is investigating whether IBM, which eventually won the contract, was given an unfair advantage during the tender process.
The probe was triggered after thousands of public servants were underpaid, overpaid or not paid at all following the system's implementation in March 2010.
The blunder is expected to cost taxpayers $1.2 billion.
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IBM given 'dry run' in payroll system bid

Date April 12, 2013 - 10:09AM

Nathan Paull

A former IBM boss has denied urging bureaucrats to favour the global IT giant in competition for a lucrative Queensland Health payroll system contract.
The Queensland Health Payroll System Commission of Inquiry heard on Thursday that Mr Burns favoured his former employer by giving it a "dry run" presentation to iron out faults before tender proposals were put to the government's IT arm, CorpTech.
The inquiry is investigating whether IBM, which won the contract, was given an unfair advantage over its rivals during the tender process.
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IBM says it won Queensland Health contract fairly

Date April 8, 2013 - 7:44PM

Nathan Paull

Global IT giant IBM has denied it was given preferential treatment by a former staffer to win the multi-million dollar Queensland Health payroll contract.
An inquiry into Queensland Health’s bungled payroll system is investigating whether IBM, which eventually won the contract, was given an unfair advantage during the tender process.
The probe was sparked after thousands of public servants were underpaid, overpaid or not paid at all following the system’s implementation in March 2010.
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Queensland Health payroll inquiry to grill former IBM top man

Terry Burns, once IBM's "top man" in South Africa, is expected to front the Queensland Health payroll inquiry on Wednesday
  • AAP (Computerworld)
  • 10 April, 2013 09:13
A man who played a key role in the Queensland government adopting his former employer's flawed health payroll system has denied any wrongdoing.
Terry Burns, once IBM's "top man" in South Africa, is expected to front the Queensland health payroll inquiry on Wednesday.
Mr Burns led a tender process that resulted in IBM winning a Queensland government IT contract in December 2007.
In March 2010, IBM rolled out a health payroll system that subsequently incorrectly paid thousands of nurses and staff, and which continues to be costly to operate. It will ultimately cost taxpayers $1.2 billion.
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NBN and IPTV trial for dental students launches

The trial has been funded as part of an $18 million Broadband Enabled Innovation program
A trial has been launched at the University of Melbourne’s Shepparton campus which aims to deliver dental education to regional Victoria using high-speed broadband and IPTV.
The Uni TV trail will include live broadcasts, educational videos on-demand and other resources which will be accessible on the Uni TV multi-channel Internet protocol TV system.
The 18-month project will include a six-month trial by the Institute for a Broadband Enabled Society in collaboration with the Melbourne Dental School at the University of Melbourne. It will also be delivered in partnership with Ericsson Australia, AARNet and Panasonic Australia.
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Medical Students To Be Trained With Telehealth

Medical students will be trained in important areas of practice where it has been difficult to get enough clinical experience, thanks to a new telehealth network, Unicare e-health, established at the University of Adelaide. The project makes it efficient and easy to communicate via video from the university to hospitals, rural general practices, specialist practices and other health services.
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Dr Mukesh Haikerwal (AO) re-elected to WMA

10 April 2013. NEHTA's Head of Clinical Leadership and Stakeholder Management Dr Mukesh Haikerwal (AO) has been re-elected Chair of Council of the World Medical Association.
Dr Haikerwal, a Melbourne GP and former AMA president, was handed another two-year term at the association's council meeting last week.
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Melbourne virtual nurse service nominated for Asia Pacific Eldercare Innovation award

Telehealth leaders Royal District Nursing Service (RDNS) is planning a real-time video consultation between a volunteer in Singapore and a senior Australian nurse next Tuesday to demonstrate its ‘Happy Healthy Home’ project.
RDNS is a finalist in the ‘Outstanding ICT Innovation’ award category at the 1st Asia Pacific Eldercare Innovation Awards 2013for its broadband telehealth project.
Organisers hope that a senior Singaporean official will agree to a live video link with a senior nurse in Melbourne who will check the volunteer’s blood pressure and perform a medication management simulation.
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Researchers replace passwords with mind-reading 'passthoughts'

Date April 10, 2013 - 10:14AM

Camille Bautista

Remembering the passwords for all your sites can get frustrating. There are only so many punctuation, number substitutes and upper case variations you can recall, and writing them down for all to find is hardly an option.
Thanks to researchers at the University of California, Berkeley School of Information, you may not need to type those pesky passwords in the future. Instead, you'll only need to think them.
By measuring brainwaves with biosensor technology, researchers are able to replace passwords with "passthoughts" for computer authentication. A $US100 headset wirelessly connects to a computer via Bluetooth, and the device's sensor rests against the user’s forehead, providing an electroencephalogram (EEG) signal from the brain.
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Turnbull bets utility over bling in the NBN bout

Ultimately the difference between Stephen Conroy’s national broadband network and Malcolm Turnbull’s boils down to the 'vision thing' – and the best part of $15 billion, or perhaps far more.
Conroy’s gold-plated 100 Mbps fibre-to-the premises broadband network is predicated on the 'if you build it they (consumers and applications) will come' approach; Turnbull’s fibre-to-the-node network on providing fast-enough and affordable broadband sooner and far more cheaply.
Conroy’s plan makes existing infrastructure that is still perfectly useable redundant and creates a new national wholesale monopoly funded by taxpayers; Turnbull’s leverages off the existing infrastructure, envisages competition and has user-pays and private co-funding options.
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Coalition pledges cheaper, slower NBN

Date April 9, 2013

Jonathan Swan

The Coalition says its national broadband network will be about $17 billion cheaper than Labor's and will be built two years sooner, but will use slower technologies than in Labor's version.
By the time the Coalition's network is finished in 2019, Australians will pay about $24 a month less for broadband than under Labor's plan, opposition communications spokesman Malcolm Turnbull said on Tuesday.
Under the Coalition's plan every Australian will have access to ''fast'' broadband by 2016,  Mr Turnbull pledged at the policy announcement in Sydney.
Mr Turnbull defined ''fast'' broadband as 25 megabits per second download speeds, about six times faster than today's average speeds, and similar to the fastest speeds available in today's market.
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PC sales plunge as Windows 8 flops

Date April 11, 2013

Bill Rigby

Microsoft's Windows 8 appears to be driving buyers away from PCs and toward smartphones and tablets, according to research firm IDC.
That's leading to the fastest drop in PC sales the firm has ever seen.
Global shipments of PCs fell 14 per cent in the first three months this year, IDC said. That's the sharpest plunge since the firm started tracking the industry in 1994.
The report comes after a year of bad news for the PC. Consumers, especially in wealthy countries such as the US, are steering their dollars toward tablets and smartphones rather than upgrading their home PCs. It's the biggest challenge to the personal computer since the IBM PC was released in 1981.
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Enjoy!
David.

Sunday, April 14, 2013

Government Desperation With Uptake Of The NEHRS Is Reaching Fever Pitch. I Think It Is A Doomed Effort and Waste of Money.

The following appeared earlier today.

Outrage as eHealth record sign-up squads hit Australian hospital patients in bid to boost numbers

  • Sue Dunlevy
  • News Limited Network
  • April 14, 2013 12:00AM
BUREAUCRATS armed with clipboards have been sent into hospitals and nursing homes to cajole patients to sign up for an eHealth record their doctors still won't be able to use.
Nine months after it was launched, the Government's $1 billion eHealth system holds just 414 patient records and is only a fifth of the way towards its target of signing up 500,000 patient users by June 30.
There are currently only two hospitals using the personally controlled electronic health record (PCEHR) system and they have uploaded just 155 discharge summaries.
And the system remains barely operational because fewer than one per cent of doctors have signed up for the Healthcare Identifier service number they need to be able to access patient records.
Despite this, Canberra has sent out a sign-up squad in a bid to boost numbers.
A Department of Health spokeswoman said around 12 specially trained staff had been deployed in hospitals, community clinics and aged care homes in Tasmania and the ACT to sign patients up to the scheme.
The move has caused outrage on health IT blogs with experts worried about the security of signing a patient up on paper and then re-entering the data online.
Launceston Hospital's Professor Terry Hannan, who set up an eHealth record for HIV patients in Africa that was nominated for the Nobel Prize, said patients in his hospital were being asked to hand over their Medicare cards and drivers licence to get an e-health record.
"Personally I have a lot of difficulty with this data collection process - not only from patient data security but the real risk of transcription errors in the data recording," he said on the Australian Health Information Technology blog.
"This whole process seems like seems like a political stunt to enhance the PCEHR registration numbers for a project that has been costly and doomed to failure - implementation wise and politically."
More here:
I can understand e-Health awareness campaigns and providing support for the enrolment when people ask for it. But approaching people who are almost certainly not interested when they are ill in hospital - or even worse corralling unsuspecting and unfortunate public servants - is really over the top as well as being privacy invasive etc.
I have expanded on this a little here:
If you want to see how patient portals should be deployed - and not how the NEHRS / PCEHR is actually doing it - see here:

Patient Portals Resource Center

Online portals allow patients to interact with their health information and communicate with providers outside the traditional office visit. Such systems offer powerful benefits: encouraging patients to become more engaged in their own care and helping providers to improve efficiency, quality, and access.
However integrating a portal into a clinical practice is not easy. The California HealthCare Foundation (CHCF) has worked with early adopters to capture key lessons learned, as well as tools and resources to help guide other safety-net clinics considering their own patient portals.
Lots more with 2 useful video.
It is interesting to see people using such systems both mobile and on their PC’s at home and how happy they are with what they can do.
The message is actually pretty simple. If the NEHRS/PCEHR actually did what people value and want it would be adopted - until then it will just remain a white elephant - people running around in white tee-shirts or not .
David.

Saturday, April 13, 2013

Weekly Overseas Health IT Links - 13th April, 2013.

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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4 ways health IT can build trust

By Benjamin Harris, New Media Producer, Healthcare IT News
Created 04/04/2013
Medicine is a two-way street; it works best when the patient and the provider trust each other, and can work together for the best outcome. While technology can enable those outcomes, when improperly used -- consider the epidemic of patient data breaches -- it can also raise some eyebrows and scare some people away from embracing it. Scott Zimmerman, president at TeleVox Software, understands these concerns. But he sees technology offering a net gain on the road to improving patien-physician relationships and enhancing trust. He shares four ways health IT can improve the quality of care and enhance trust between the patient and the provider.
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Patients Like Online Health Records Access, Study Says

Veterans in study said the ability to view notes, lab results and other documents helped them communicate better with their doctors and led to better health.
When patients at the VA Medical Center in Portland, Ore., were given access to key parts of their electronic health records such as visit notes, lab results and discharge summaries, they believed that the ability to view their records helped them in many ways. They said they gained knowledge about their health, did a better job of taking care of themselves, had an easier time talking to their doctors and participated more fully in office visits, according to a new study in the Journal of Medical Internet Research.
On the other hand, some veterans were disturbed when they saw inconsistencies, previously undisclosed information, or derogatory language, said researchers. AdTech Ad
The study showed that common provider concerns about giving patients full access to their records appeared unwarranted. However, the authors said, record sharing "is likely to change providers' work, necessitating new types of skills to communicate and partner with patients."
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HIT Errors 'Tip of the Iceberg,' Says ECRI

Cheryl Clark, for HealthLeaders Media , April 5, 2013

Healthcare systems' transitions from paper records to electronic ones are causing harm and in so many serious ways, providers are only now beginning to understand the scope.
Computer programs truncated dosage fields, leading to morphine-caused respiratory arrest; lab test and transplant surgery records didn't talk to each other, leading to organ rejection and patient death; and an electronic systems' misinterpretation of the time "midnight" meant an infant received antibiotics one dangerous day too late.
These are among the 171 health information technology malfunctions and disconnects that caused or could have caused patient harm in a report to the ECRI Institute's Patient Safety Organization. Thirty-six participating hospitals reported the data under a special voluntary program conducted last year.
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American Academy of Pediatrics recommends electronic prescribing

April 3, 2013 | By Marla Durben Hirsch
The American Academy of Pediatrics has issued a policy statement recommending that pediatric healthcare providers use e-prescribing to improve quality and reduce costs. According to the statement, published in the journal Pediatrics, the prescription error rates for children range between 5 percent and 27 percent; moreover, these errors can create more severe complications for children because of their more narrow therapeutic profiles and the inability of some of them to communicate adverse effects.
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HIT unprepared for 'omics' onslaught

By Mike Miliard, Managing Editor
Created 04/04/2013
Data systems in healthcare are lacking when it comes to the storage and handling of increasingly complex medical information, according to a new study published in the Journal of the American Medical Association.
Physicians are moving en masse to electronic health records, but existing data systems aren't sophisticated enough to make optimal use of ever-expanding patient information, according to one of the report's authors, Justin Starren, chief of the division of health and biomedical informatics in the department of preventive medicine at Northwestern University Feinberg School of Medicine.
This problem that will only be exacerbated as data grows apace – fueled by innovations such as next-generation genomic sequencing – and becomes cheaper and more available to health care providers.
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Retrial begins for iSoft execs

3 April 2013   Central News court reporting agency
Three former senior executives of iSoft faced retrial today accused of ‘cooking the books’ to bury bad news about the company to boost its value.
Stephen Graham, Timothy Whiston and John Whelan are being retried at Southwark Crown Court after their first, four month trial ended without a verdict last August.
Patrick Cryne, a co-founder and former chief executive of the company, was not part of the first trial for medical reasons and was not before the court today.
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Why health data digitization is here to stay

April 4, 2013 | By Ashley Gold
Despite federal incentives and penalties, as well as payer demands, for health data digitization, some providers continue to resist the trend. One health policy and ethics analyst aims to address why in a recent Hospital & Health Networks article.
Emily Friedman, wondering if reluctant providers' concerns should be taken more seriously, says she can understand the resistance. She lists some of the arguments against digitization: primarily, lack of ease of use, citing a 2012 CompTIA survey that found 58 percent of respondents think systems are hard to use.

"Requiring busy people who might be technologically challenged to clamber up a steep learning curve is asking a lot, in or out of health care," Friedman writes.

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The big-data and analytics revolution in health care

Analytics is transforming many facets of the health-care industry, from drug research to patient care. “The big-data revolution in US health care: Accelerating value and innovation” traces the evolving role of analytics from retroactive reporting to prediction and intervention, and quantifies the potential benefits and organizational challenges. This article includes a video interview with McKinsey director Nicolaus Henke, who discusses the capabilities organizations will need to integrate analytics effectively.
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5 reasons to get sold on analytics

By Benjamin Harris, New Media Producer, Healthcare IT News
Created 04/02/2013
Welcome to the data world. Many secrets are hidden in big data, and now, with the computing power to unearth them, analytics promises to deliver transformative power wherever it is put to work. Still, the technology is a relative newcomer in the healthcare world. Brett Furst, CEO of Arbormetrix, says there is nothing to fear – and that analysis of clinical data has much to offer the medical world. Here, he shares his top five requirements to succeed with, or at least get excited about, the power of clinical analytics.
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President Obama’s Challenge: Map the Brain

APR 2, 2013 3:33pm ET
President Obama on April 2 launched a national public-private initiative to map the human brain, adding federal funds to private sector efforts as was done to map the human genome.
The federal government between 1988 and 2003 invested $3.8 billion into the Human Genome Project, with an economic return of $141 for every invested dollar, totaling $796 billion, the White House says.
The goal of the BRAIN Initiative is to discover new treatments, preventions and cures for such disorders as Alzheimer’s, autism, epilepsy, schizophrenia and traumatic brain injury, the President said.
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7 health technologies developed for veterans

April 3, 2013 | By Susan D. Hall
Technology has always played a big part in providing and improving healthcare for U.S. soldiers, both at home and abroad. For instance, the Blue Button, launched in 2010, initially was designed as a means for veterans to easily access and download their health information to use, as necessary. The technology, which since has been made available to non-veteran patients, as well, continues to evolve, with registration reaching one million patients last summer.
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Access to EHR data 'overwhelmingly' positive for patients

April 1, 2013 | By Marla Durben Hirsch
Providing patients with access to the information in their electronic health records "overwhelmingly" yielded positive benefits, according to a new study in the Journal of Medical Internet Research.
While patient review of their health data is an opportunity to engage them in their healthcare, some clinicians have expressed concern about such open access. The researchers, from the Veteran's Administration and elsewhere, sought to determine patients' actual experiences with such open access by studying the My HealtheVet EHR access pilot program.  They used focus group interviews conducted at the Portland Ore.-based VA Medical Center, which had the highest percentage (72 percent) of enrollees in the pilot.
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Press Ganey spotlights ways to improve the patient experience

By Diana Manos, Senior Editor
Created 04/02/2013
A new report from Press Ganey reveals the value of capturing every patient’s voice in order to focus efforts on enhancing the quality and safety of care.
The report, "2013 Strategic Insights: Targeted Performance Improvement," identifies new thinking and analytical approaches organizations can adopt to efficiently and effectively enhance performance, according to a news release. Press Ganey, a patient experience improvement firm, works with more than 10,000 health care organizations, including 50 percent of all U.S. hospitals.
“In order to continue to advance the patient experience and perform at the highest levels clinically, leadership will require continuous innovation,” according to Patrick Ryan, CEO of Press Ganey. “A new framework is needed, and every patient must be given a voice. Sustainability will require operational integration of advanced analytics to drive targeted, day-to-day improvement.”
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Study: Medication Errors in the ED Decreased With Computerized Provider Order Entry

Written by Sabrina Rodak | April 02, 2013
Computerized provider order entry systems in the emergency department can reduce medication errors, according to a study in Annals of Emergency Medicine.
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Commentary: EHR usability must amplify human potential

By Tim Andrews, Vice president, Booz Allen Hamilton
It's an exciting time for the health IT community: the wider use of electronic health records (EHRs), coupled by new integrated delivery models, clinical support systems, and mobile technology provides an amazing opportunity to dramatically improve care delivery while changing how patients and providers interact.
Unfortunately, this rapid change has wreaked a bit of havoc on health IT providers. Over the past few years, vendors have been consumed by EHR certification and support for Meaningful Use while continuing their own feature development. However, this rapid rollout of EHRs has laid a solid foundation from which we can build.
Now, I believe we need to turn our focus from critical internal development — the plumbing — to the user experience. As our healthcare system moves away from an ad hoc, fee-for-service system and towards an integrated care model, we must design and create health IT solutions that will enable and empower users — from patients to providers.
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Allscripts opens lab with Singapore IT org

By Anthony Brino, Associate Editor
The U.S. health IT company Allscripts is partnering with Singapore’s Integrated Health Information Systems (IHIS) to open a lab bringing information technologies to health systems in Singapore and possibly other Asian countries.
IHIS is an organization of the Singapore Ministry of Health’s (MOH) public holdings group, and has been helping bring IT tools to the country’s regional health systems, many also owned by the MOH.
“The joint laboratory will enable local clinicians and IT professionals to work closely with international experts to create software that will integrate seamlessly with our hospitals’ workflows and address our future healthcare challenges,” IHIS CEO Chong Yoke Sin said in a media release..
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Massive disparities in GP IT spend

28 March 2013   Rebecca Todd
Expenditure on GP IT varies enormously nationwide from between just 50p per head of population in Wiltshire to more than £10 in West Essex.
This massive disparity in spending, revealed in a Freedom of Information request to the NHS Commissioning Board, has left the board struggling to delegate GP IT funding to clinical commissioning groups.
However, enquiries by EHI reveal that for at least one primary care trust, the reported figure represents its entire IT budget rather than just money spent on GP IT.
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All change, please

At midnight, the latest reorganisation of the NHS finally took effect. Lyn Whitfield outlines the changes and their impact on NHS IT.
28 March 2013
It’s hard to believe that between 1948, when the NHS was established, and 1974, when regional and area health authorities were created, the health service was left un-reorganised.
Since then, the pace of ‘reform’ has picked up to the point where major changes, such as the introduction of general management and the internal market, can be expected every decade, and minor changes to purchaser or provider bodies can be expected every year.
Even so, the shake-up that took effect at midnight is bigger and far more hotly contested than most.
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Shaken NHS faces uncertain future

1 April 2013   Lyn Whitfield
The latest round of NHS reforms, which took effect at midnight, have been greeted with unease and concern about what they could mean for the future of the health service.
Mike Farrar, the chief executive of the NHS Confederation, which, as a management organisation might be expected to flag the more positive aspects of the changes, instead warned of the challenges ahead.
“We need to recognise the huge challenges facing the health service,” he said. “New structures alone won’t enable us to tackle these changes, and we should not see them as a silver bullet.”
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Marc Probst: Data standards, ICD-10 among healthcare's biggest hurdles

April 2, 2013 | By Dan Bowman
Among the biggest challenges currently facing the health IT industry, two in particular that stand out, according to Intermountain Healthcare CIO Marc Probst, are interoperability and ICD-10. With regard to the former, the outspoken Salt Lake City-based hospital executive, who also serves as a member of the federal Health IT Policy Committee, has made no bones about the fact that he thinks the government needs to set standards now.
"We've got to get things standardized, and it's not happening fast enough," Probst ( pictured right) told FierceHealthIT in a recent interview.
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Obama's BRAIN Initiative takes aim at Alzheimer's, Parkinson's

April 2, 2013 | By Ashley Gold
The Obama Administration's Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, first alluded to in the president's State of the Union Address in February, officially was launched by the White House this morning. In a press conference touting the announcement, Obama called the knowledge that potentially could be gained through the project's efforts "transformative."
"As humans, we can identify galaxies light years away … but we still haven't unlocked the mystery of the three pounds of matter that sits between our ears," Obama said. "The most powerful computer in the world isn't nearly as intuitive as the one we're born with."
Three organizations--the National Institutes of Health, the National Science Foundation and the Defense Advanced Research Projects Agency--will provide approximately $100 million in funding for the initiative beginning in FY 2014, according to a White House announcement. Additionally, according to the announcement, NIH will establish an academic working group to "define detailed scientific goals" of the program, as well as to create a "multi-year scientific plan" for the program.
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HL7 Makes Good on Offer of Free Intellectual Property

APR 1, 2013 4:26pm ET
Standards development organization Health Level Seven International in September 2012 pledged to offer much of its intellectual property via a free license, and that property now is available, effective April 1.
The free property includes all published standards, domain analysis models, profiles and implementation guides. HL7 also will make free other select intellectual property, such as implementation tools, on a case-by-case basis. The intellectual property will not be licensed on the open source market, under which developers may make enhancements. The freely available property means the content must be licensed for use but the license is free.
In September, HL7 CEO Charles Jaffee, M.D., said the property was being made freely available to advance interoperability across the globe and better align with other standards organizations that
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Tuesday, April 02, 2013

Could New Cancer Care Database Be a 'Game Changer' for Medicine?

by Kate Ackerman, iHealthBeat Managing Editor
WASHINGTON -- Experts say an announcement made last week by the American Society of Clinical Oncology could have significant implications for the future of health care delivery.
ASCO announced that it successfully completed a prototype of a cancer care database that leverages health IT to improve care.
CancerLinQ is a knowledge-generating computer network that will collect and analyze cancer care data from millions of patients and then combine that information with expert guidelines and other evidence to generate real-time, personalized guidance and quality feedback for doctors.
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Health IT Priorities Put Regulations Before Innovation

Implementing electronic records and meeting Meaningful Use rules are top of the list in our Health IT Priorities survey. Is there room for breakthrough technology?
The tension is palpable among healthcare IT pros, given how much change is happening at once in their industry. Lynn Witherspoon, chief medical information officer at Ochsner Health System in New Orleans, sums up the challenges: "Care delivery redesign and associated reimbursement changes, ongoing Meaningful Use and healthcare reform requirements, and the difficulty of developing new cultural norms will make next year a very busy one."
AdTech AdAnother respondent to our InformationWeek 2013 Healthcare IT Priorities Survey puts things more bluntly: "Most healthcare CIOs are supportive of the majority of the new functional requirements that are being forced on us. However, federal requirements are coming too many, too fast. … The rate of change is such that systems and changes are being implemented less than optimally."
This furious pace of change explains why tactical and regulatory objectives dominate this year's Healthcare IT Priorities Survey, just as they did last year. More than 60% of the health IT pros who responded to our survey cite managing digital patient data and meeting regulatory requirements among their top priorities, rating each a 5 on a 1-to-5 scale.
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Phishing a Real Threat to Healthcare, No Fooling

Scott Mace, for HealthLeaders Media , April 2, 2013

It was a long holiday weekend several years ago, and I received a message on Facebook from someone I trusted, a longtime acquaintance from a well-known high-tech company. He had posted something to my Facebook wall. I thought it was benign. But his Facebook account had been compromised, and now I had been phished.
I knew about phishing; essentially it's an email fraud scam or online con game. I thought I would be safe if I only opened messages from people I knew, on networks I believed to be safe. I spent the next day, however, profusely apologizing to my Facebook friends, who now had postings to their own Facebook walls, from me, inviting them to click and be sucked into the digital chaos. We all had a good non-laugh changing our passwords and apologizing on down the line.
I was lucky that the only harm I suffered was a little embarrassment. And I now I know I'm in pretty good company. Last week, we learned that Supreme Court Chief Justice John Roberts has been the victim of credit-card fraud. The court did not provide any other details, according to the Associated Press. But if you ask me, the odds are that Justice Roberts had been phished.
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Stanford researchers develop disease-detecting biological 'computer'

April 1, 2013 | By Ashley Gold
A new biological computer developed by Stanford University researchers could potentially detect disease and kill off rogue cells, according to a new study published in Science magazine.
The advancements, according to an article in the San Jose Mercury News, are described as "microscopic natural computers inside [human's] cells that could guard against disease and warn of toxic threats."
The achievement is a portent to computers inside the human body that could screen for cancer or toxic chemicals. Lead researcher Drew Endy told the Mercury News, "We're going to be able to put computers inside any living cell you want," which he said could answer any biological question within a cell, and count cells, too.
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Securing health data from hackers requires a holistic approach

April 1, 2013 | By Susan D. Hall
Though less common than breaches from lost laptops or other devices, hacking is on the rise in healthcare, experts say. Fending off cyber criminals, however, should go beyond treating security as a routine matter of protecting patient privacy, according to a recently published research report from CSC's Global Institute for Emerging Healthcare Practices.
"It needs to more of an ongoing, constant, holistic type of approach where you're looking at your systems from the perspective of someone on the outside," lead author and senior research specialist Jared Rhoads, pictured, told FierceHealthIT, speaking about the risk assessments the report recommends.
Rhoads described hacking as "still the kind of thing that statistically won't happen to you yet," but that "is happening often enough that we're taking notice of it." A recently published Wired article hypothesized that as health data increasingly is pushed online, hacking becomes less a question of "if" and more a question of "when."
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Enjoy!
David.