Quote Of The Year

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

or

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

Saturday, March 29, 2014

Weekly Overseas Health IT Links - 29th March, 2014.

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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Open, free popHealth at work on quality

Posted on Mar 21, 2014
By Anthony Brino, Editor, HIEWatch
An open source software program created with the help of the Office of the National Coordinator is now federally certified and ready to be used as a population health tool.
First developed in 2010, the program, called popHealth, imports data, then calculates, displays, and exports it as electronic clinical quality measures using Cypress, the same open source engine the ONC uses to certify eCQM functionality in EHRS.
Developed and certified in partnership with Northwestern University, popHealth “is in some ways a simple piece of software,” as ONC public health analyst John Rancourt wrote in a blog announcing its certification for meaningful use. "However, it is highly sophisticated and versatile because it is standards driven and it leverages the same quality measure engine as Cypress." 
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How hospitals can make big data pay big

Posted on Mar 21, 2014
By Donna S. Charles, principal consultant, Oron Healthcare Group
Hospital executives are faced with numerous challenges related to healthcare reform in general and the Affordable Care Act  in particular. Strategic decisions about how to address these challenges will significantly impact not only the financial and clinical performance of hospitals, but the perception of executive leadership itself.
Even though optimizing workflows and other processes are the main avenues available to executives to address these issues, it’s critical to understand the role that advanced information technology has in bringing these efforts to fruition.
Reduced payments to hospitals for avoidable readmissions began in 2012 under the ACA’s Hospital Readmissions Reductions Program, and the program is expanding in future years by increasing the level of payment reductions and expanding the scope of illnesses covered.
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FDA issues recall of McKesson Anesthesia Care Record

Author Name Kyle Murphy, PhD   |   Date March 20, 2014   |
Nearly a year after McKesson notified its customers about flaw in one of its health IT systems, the Food and Drug Administration (FDA) has moved to applying a Class I recall. The product in question is McKesson’s Anesthesia Care Record (ACR), a clinical decision support system aimed at helping anesthesiologists identify potential adverse drug events.
“The system is generally indicated in the anesthetizing environment when the anesthesia provider decides to perform a patient assessment, to generate a paper and/or electronic record of the administration of anesthesia to a patient, and to document care,” the FDA notes.
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ONC Launches Program to Foster Health IT Use by EMTs

Written by Helen Gregg (Twitter | Google+)  | March 20, 2014
The ONC has partnered with the Office of the Assistant Secretary for Preparedness and Response on a campaign to increase the use of heath IT by emergency medical technicians and other first responders.
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FDA Again Issues Recall Notice for McKesson Anesthesia Care Software

MAR 19, 2014
The Food and Drug Administration on March 14 issued a Class 1 recall notice to healthcare professionals for the Anesthesia Care software of McKesson Corp. The software collects, processes, and records data both through manual entry and from monitors which are attached to patients, such as in an operating room environment. San Francisco-based McKesson had initiated a voluntary Class II recall of the product last year.
The Class I recall is in the FDA’s highest risk category which is reserved for defects where “there is a reasonable probability that the use of or exposure” to the product “will cause serious adverse health consequences or death.” It is not often that the regulatory agency issues this kind of recall notice for standalone software that does not play a role in operating a medical device. However, the software “provides clinical decision support by communicating potential adverse drug event alerts proactively during the pre-anesthesia evaluation and at the point-of-care,” the FDA said in the notice.
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FDA Surveillance System Leverages Databases to Monitor Medical Products for Adverse Events

MAR 19, 2014
The Food and Drug Administration is actively searching more than 100 million health insurance records to uncover possible adverse events, rather than relying on doctors and patients to report them, according to Michael Nguyen, M.D., Acting Director of the Division of Epidemiology in FDA’s Center for Biologics Evaluation and Research.
The surveillance system, called Sentinel, is the result of a partnership between FDA and the Harvard Pilgrim Healthcare Institute, who are using the system to determine whether a certain type of immune therapy is associated with heart attacks or strokes, and to better define the true rate of acute lung injury after transfusions of certain blood components. 
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RAND: EHRs 'significantly worsened' doc satisfaction

March 18, 2014 | By Marla Durben Hirsch
Physicians' views of electronic health records are still mixed despite widespread adoption, seen as good in concept but that they "significantly worsened" their professional satisfaction, according to a new RAND Health report.
Conducted at the request of the American Medical Association, the report focused on determining the factors that lead to physician fulfillment. Its authors found that EHRs were a source of both promise and frustration. While they enabled doctors to improve quality of care and remotely access medical records, EHRs also:
  • Required time-consuming data entry that could be better accomplished by clerks and scribes;
  • Were difficult to use;
  • Interfered with patient face to face interaction;
  • Lacked interoperability; and
  • Degraded clinical documentation
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David Blumenthal: Benefits of HIT programs will surface with time

March 20, 2014 | By Dan Bowman
An "asymmetry of benefits" for providers has kept the healthcare industry from ubiquitous adoption of health IT--and electronic health records, in particular--and thus realizing its full potential, according to David Blumenthal, former national coordinator for health IT and current president of The Commonwealth Fund.
"From the patient's perspective, this is a no-brainer. The benefits are substantial," Blumenthal told The Atlantic in a recent interview. "But from the provider's perspective, there are substantial costs in setting up and using the systems. Until now, providers haven't recovered those costs, either in payment or in increased satisfaction, or in any other way."
While to that end, Blumenthal said, the medical marketplace is broken, he added that there is still some hope. He pointed to systems like the U.S. Department of Veterans Affairs and Kaiser Permanente as examples where technology has thrived due to "internalized" benefits that have led to better and faster adoption.
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When technology is a barrier to care

March 21, 2014 | By Ashley Gold
Are doctors suffering at the hands of the Herzberg principle--which says that the best way to discourage workers is to subject them to policies and procedures that don't make sense? 
An article in the Atlantic explores how changes in the healthcare payment model, health IT and the doctor-patient relationship are discouraging docs.
"It is easy for many healthcare leaders to forget that doctors go into medicine not because they enjoy entering data into complex electronic health records and ensuring that their employer gets paid for everything they do, but because they want to make good diagnoses, prescribe appropriate treatments and help patients," the article states.
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5 Steps to Preventing Security Breaches

Lena J. Weiner, for HealthLeaders Media , March 20, 2014

Medical records are a high-value commodity, fetching up to $50 each. Medical data breaches are being reported ever more frequently. Risk assessments and basic IT and social media policies can help protect your organization.

Eight computers were stolen from medical billing contractor Sutherland Healthcare Solutions in Torrance, CA, on February 5, 2014. A month later, the week of March 6, many patients received letters on Sutherland letterhead alerting them that their personal data, including first and last names, social security numbers, and billing information—and possibly their dates of birth, addresses and even their personal medical information and diagnoses—had potentially been compromised. As many as 173,900 patients may be affected.
Medical records are a high-value commodity. While social security numbers go for about one dollar each on black market websites, medical records can fetch as much as $50 each, according to the Medical Identity Fraud Alliance.
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IBM’s Watson finds a new challenge: personalised cancer treatment

March 19, 2014 8:33 pm by Richard Waters
For its most promising new technology, IBM has been searching for problems to solve that are both deep and broad enough. Now, with a clinical trial in the US aimed at personalising the treatment of cancers, it might just have found one.
The Watson question-and-answer system has felt like a solution waiting for the right problem. Winning the Jeopardy TV quiz show three years ago was a spectacular way to show off the new technology’s advances in pattern recognition and natural language. But how to make inroads into real business or social problems?
The big push CEO Ginni Rometty has given Watson this year suggests she’s impatient for some results. That has meant trying to apply the technology to broad issues in a way that can scale up quickly.
The announcement on Tuesday of a clinical trial to deliver more personalised care to brain cancer patients looks like a case in point.
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IBM's Watson Takes Aim At Cancer

3/19/2014 03:26 PM
Collaboration between IBM and the New York Genome Center will use Watson to match cancer mutations to potential treatments, compressing process from months to minutes.
IBM Research and the New York Genome Center want to prove that IBM's Watson can dramatically reduce the time required to identify the most effective cancer treatments based on an analysis of a specific patient's genetic mutations.
In partnership with regional hospitals, the NYGC plans to evaluate Watson's ability to help oncologists develop more personalized care for patients with glioblastoma, an aggressive and malignant brain cancer that kills more than 13,000 people in the US each year. The NYGC is a nonprofit consortium of the state's academic, medical, and university leaders working to advance the applications of genomics, the branch of genetics that studies complete DNA sequences rather than individual genes.
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3 tips to avoid BYOD breaches

Posted on Mar 19, 2014
By Diana Manos, Senior Editor
Without question, BYOD, or “bring your own device,” offers benefits to both healthcare employees and employers. It also presents security issues.
The benefits of BYOD are luring. To name a few, users are familiar and comfortable with their own devices, which increases productivity. No training is required. And employees provide the latest devices, saving hospitals the expense.
Yet, despite these benefits, security issues keep many hospitals from allowing BYOD, and with valid reasons. BYOD raises numerous red flags on the security and HIPAA compliance fronts and the bottom line is: No matter who owns the device, hospitals are responsible for any data breaches that occur.
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Patient monitoring technology market to reach $5.1B by 2020

March 19, 2014 | By Susan D. Hall
The U.S. market for patient monitoring technology--increasingly moving outside the hospital--is expected to grow to more than $5.1 billion by 2020, according to a new report by iData Research.
The report points to the growth of multi-parameter vital sign monitors, electroencephalograms (EEG), electromyograms (EMG), cerebral oximeters and pulse oximetry devices in particular for fueling that growth. The pulse oximetry-monitoring market alone is expected to exceed $1 billion by 2020, it according to an announcement.
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Health Information Exchanges May Reduce Hospital Admissions, Study Finds

Written by Ayla Ellison (Twitter | Google+)  | March 18, 2014
Weill Cornell Medical College in New York City has released the findings of a study that indicates health information exchange allows emergency departmentphysicians to treat patients more efficiently and effectively and could reduce unnecessaryhospital admissions.
 Using claims information collected from seven EDs in Rochester, N.Y., the researchers found that physicians and healthcare professionals who had access to patient data from other providers through the region's health information organization were better able to avoid hospitalizing patients who didn't need inpatient care.
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ICD-10 Deadline: Ready or Not, Here It Comes

MAR 17, 2014 11:20am ET
Today is St. Patrick's Day, a sobering reminder that there are less than 200 days left until the October 1 ICD-10 implementation deadline. Either way, if you are a provider that is concerned about being prepared to make the code switchover, no one could blame you for having a good, strong drink (or two).
With only the spring and summer months separating providers from the ICD-10 go-live date, many are asking themselves how far along they should be at this point in implementation activities. Well, the truth is that significant numbers of providers have not even begun to prepare for ICD-10, as terrifying and as stressful as that may sound. A recent poll of 1,200 practices with more than 55,000 physicians found that less than 10 percent reported significant progress in overall ICD-10 readiness.
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EHRs may help save lives from sepsis

Posted on Mar 18, 2014
By Erin McCann, Associate Editor
Here's another reason why those multi-million dollar electronic health record systems might be finally paying off, in terms of lives potentially saved. 
According to new research, EHRs can be used to predict the early stages of sepsis, one of the leading causes of death in the U.S., responsible for killing some 210,000 people each year. 
Researchers at UC Davis have found that routine health data – blood pressure, respiratory rate, temperature and white blood cell count – from the EHRs of hospitalized patients can detect the illness earlier in its infancy and help pinpoint what patients are at high risk of developing the disease. 
After analyzing the EHRs of some 741 sepsis patients, researchers were also able to determine that just three measures – lactate level, blood pressure and respiratory rate – can pinpoint the likelihood a patient will die from the disease.
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EHR data can predict sepsis

Beth Walsh
Mar 17, 2014
EHRs can be used effectively to predict the onset of sepsis, according to researchers from the University of California at Davis. 
Researchers used routine information of hospitalized patients, including blood pressure, respiratory rate, temperature and white blood cell count. Analysis of the data from the EHRs of 741 patients with sepsis revealed that vital signs combined with serum white blood cell count can accurately predict sepsis, which is associated with increased blood levels of lactate. They found that lactate level, blood pressure and respiratory rate could determine a patient’s risk of death from sepsis. 
Sepsis is a leading cause of death and hospitalization in the U.S., occurring in more than 750,000 patients annually and killing nearly one-third of all people who develop the immune system response to infection that can damage organs and cause permanent physical and mental disabilities. Sepsis-related deaths and serious consequences, however, are preventable for up to 30 percent of patients. 
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Evidence developed for IT investment

14 March 2014   Rebecca Todd
NHS England is working with McKinsey to develop an evidence base for the NHS to invest in technology.
The economic analysis will support the release of NHS England’s Transparency and Participation Call to Action, which is due out in the summer.
NHS England director of intelligence and strategy Christine Outram presented on the project with representatives from McKinsey at the Health and Care Innovation Expo in Manchester last week.
Outram said the Cabinet Office, Treasury and individual trusts “need persuading that it’s worth investing in empowering patients and the power of technology”.
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3 ways to enhance patient engagement

March 18, 2014 | By Zack Budryk
Engaging patients in their own wellness and care--as well as their personal health data--is necessary to qualify for new payment models and incentives and to improve outcomes. 
Looking for some creative strategies to engage patients? Tech reporter Allison Diana compiled a whopping 16 of them in a slideshow for InformationWeek. Here are just three of the recommendations:
Electronic messages to patients: "Meaningful Use Stage 2 mandates that more than 5 percent of patients communicate with healthcare providers via secure electronic messages," Diana writes. "Increased messaging saves on phone costs and pleases patients with its convenience and immediacy." At Children's Medical Center in Dallas, for example, patients and families averaged 480 messages monthly over six months in 2013, a number that is expected to increase, according to the article. 
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ICD-10 and EHR Fuel Clinical Documentation Improvements

Scott Mace, for HealthLeaders Media , March 18, 2014

The electronic health record is at the heart of efforts to improve clinical documentation. One effort strives to get disparate EHR software programs—and the physicians using them—to encode problem lists in a common way.

This article appears in the March 2014 issue of HealthLeaders magazine.
With the October 1 activation date for ICD-10-coded payments and the end-of-year move to meaningful use stage 2, this will be a watershed year for clinical documentation improvement.
Technology is playing a big role in both efforts. To an unprecedented degree, and with significant cost and effort, the electronic health record is becoming the heart of clinical documentation improvement—prompting doctors to enter more specific diagnoses, reducing the need for labor-intensive coding, and propagating a common vocabulary between disparate care coordinators to enhance decision support.
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RECs Won't Finish Mission Without More Funding

Scott Mace, for HealthLeaders Media , March 18, 2014

For many small and rural providers, Regional Extension Centers have been a low-cost or no-cost lifeline through the process of acquiring EHR technology and participating in the meaningful use incentive payment program. What happens to the stragglers as the RECs wind down?

Consider the plight of the nation's Regional Extension Centers, which serve as serve as support and resource centers to assist providers in EHR implementation and Health IT needs around the country.
Until late last year, the RECs' funding was due to run out. Recently, unspent portions of that previously allocated funding was freed up through February 2015 through an ONC ruling known as a "no-cost extension."
For many small and rural providers, RECs have been a lifeline of low-cost or no-cost source of advice and support through the daunting process of acquiring EHR technology and participating in the meaningful use incentive payment program.
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Online tool could be used to identify public figures' medical care, say critics

OmegaSolver's Patient Analyser tool has been taken offline after concerns over use of 'patient-level' data
An online tool that claimed to be able to use NHS patient hospital records to reveal treatment "right from initial diagnosis until the current day" has been pulled from the internet after privacy campaigners warned it could be used to identify the precise details of medical care for people in the public eye.
OmegaSolver, a company founded last year, had access to NHS hospital episode statistics and offered an "internal database [which] tracks actual patients within every hospital within England providing … up-to-date information for every disease area". The company said its clients included drugs firms.
However, the firm's website was closed down last week after press inquiries to the health authorities regarding the release of "patient-level" data to the company.
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Satnews Daily
March 17th, 2014

ITU—Health Data Exchange Spec Enabled (Comms)

 [SatNews] Following calls for increased global coordination of standards enabling e-health, ITU has offered first stage approval to an important specification enabling an exchange of multimedia health data between a health provider, a controlling function and patient.
The new standard will enable different e-health systems to smoothly exchange patient health data in both low- and high-resource settings, making it ideal for applications in both developed and developing countries.
e-Health experts explain that a combination of a common data definition with connectivity across different systems—ranging from the personal health and point-of-care devices described in Recommendation ITU-T H.810 to a range of health management back-ends—will provide simple, secure and scalable interoperability.
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Denmark tests new health IT systems

Posted on Feb 25, 2014
By Dillan Yogendra, Managing Editor, HIMSS Europe
Sixteen new hospitals are being constructed, including eight new super hospitals with a state-of-the-art health IT structure. US$7 billion will be spent over the next ten years. This means fewer, but more specialized hospitals and an expanded use of health IT, which will ultimately decrease the number of beds required by 20% and reduce the average duration of hospitalization from five to three days.
Keeping healthcare expenditure down with a growing aging population and an increase in chronic diseases is a challenge, but Denmark has managed just this. While US healthcare averages 17.9% of GDP, Denmark has kept its costs to 10.5% of GDP. This is in a large part due to expansion of health IT solutions throughout the sector.
The Danish Government Growth Plan leading up to 2020 has made available 12 billion DKK for core welfare services and is expected to bring substantial changes to the classical idea of healthcare provided primarily through hospitalization. Telehealth is seen as a tool to increase the quality of care for its populations while lowering public spending costs.
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Identity crisis looms for US healthcare

Posted on Mar 17, 2014
By Anthony Brino, Editor, HIEWatch
While the U.S. continues digitizing its healthcare industry, a huge challenge is arising: not only securing those systems but verifying identities.
With a steady stream of HIPAA-covered data breaches continuing over the past few years, not to mention the debacle of Target’s recent customer financial information loss, some argue that current identity security approaches just aren’t adequate -- especially considering that criminal attacks on hospitals are increasing substantially.
“Protecting sensitive personal information with passwords is akin to building a massive stone fortress and then securing the front door with the kind of lock I use to keep my two-year-old out of my bathroom,” said Jeremy Grant, a senior advisor on identity management at the National Institute of Standards and Technology, heading up the National Strategy for Trusted Identities in Cyberspace.
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Gamification comes to clinicians

Posted on Mar 17, 2014
By Mike Miliard, Managing Editor
There's been a lot of talk in the past few years – some would say too much, and way too excited – about gamification.
Using computer game design and mechanics to teach people, or encourage them to change their behavioral patterns, certainly seems to make some sense. Harnessing digital stimuli and score-keeping to make the most of a person's natural inclination toward fun and competition has some exciting potential benefits.
But it all depends on the game, and how it's put to use. As Gartner put it in a 2012 report on the phenomenon – which predicted that, by this year, as many as 80 percent of gamified apps would be doomed by poor design – "gamification is currently being driven by novelty and hype."
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Docs, nurses learn to get along in simulation game

March 17, 2014 | By Ashley Gold
A new simulation game aims to teach doctors and nurses how to work more collaboratively and avoid conflicts in order to prevent dangerous or sometimes fatal miscommunications.
Researchers at the University of Texas at Arlington College of Nursing, Baylor Scott & White Health and University of Texas at Dallas have developed a video-game simulation that can teach doctors and nurses to work together--helping them avert tense situations in the real world by playing them out in the game.
"Our hope is that this project will enhance patient safety and, ultimately, improve patient outcomes," Beth Mancini, a UT Arlington nursing professor, said in an announcement.
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Computer virus at Glenwood hospital may have jeopardized patient info

By Drew Munro
The Post Independent
Posted:   03/14/2014 12:39:00 PM MDT | Updated:   4 days ago
GLENWOOD SPRINGS —Personal information of more than 5,000 people who have been patients at Valley View Hospital may have been compromised by a computer virus that infected the hospital's computer system, according to officials there.
Hospital information technology (IT) officials discovered the virus in January, said Stacey Gavrell, Valley View Community Relations director, and steps were taken immediately to quarantine the virus and begin the process of determining what happened.
A forensic IT team was brought in to conduct the investigation, she said.
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Enjoy!
David.

Friday, March 28, 2014

Now Here Is The Practicalities Of Just How Bad Health IT Can Actually Contribute To A Patient Death.

This awful story appeared a little while ago.

UK Coroner Fingers NHS Computer System in Toddler’s Death

By Robert N. Charette
Posted 10 Mar 2014 | 20:36 GMT
The number of IT-related errors, ooftas, and deficiencies reported last week reverted back towards the mean from the previous week's overabundance. We start off this edition of IT Hiccups with a sad case of a child’s death in the UK. The tragedy is being attributed in part to the past effort to fully computerize the UK’s National Health Service.
According to the Bristol Post, a coroner in charge of the inquest into the death of Samuel Starr, aged three, indicated in a narrative verdict that, “Due to the failure of the [Royal United] hospital's outpatient booking system, there was a five month delay in Samuel being seen and receiving necessary treatment.”  It is very rare for a coroner to criticize a hospital IT system so directly.
Samuel Starr was born with “complex congenital heart disease” in 2009. His parents were told at the time of his birth that Samuel would need several operations before he was five, and in fact, Samuel underwent an operation when he was nine months old. The Post reported that he made a good recovery, and was due to have regular checkups and further treatment at the Pediatric Cardiac Clinic at the Royal United Hospital (RUH) in Bath. Samuel received a checkup in October 2010 and one in April 2011, at which time his parents were told by his doctor to schedule another in about nine months for a more extensive examination of his heart.
However, a new electronic health record system, called Cerner Millennium, was being installed in 2011 at the hospital as part of the NHS’s National Program for IT (NPfIT), which was shortly thereafter cancelled. Though the main program was cancelled, certain elements, such as its national Choose and Book system for patient scheduling, remained. (Hospitals, like at Royal United, that were already installing electronic health record systems were given the go-ahead to proceed if they wished).
According to the Daily Mirror, “glitches” in the Royal United patient booking system caused Samuel not to receive his scheduled appointment with heart specialists as required, despite pleas for an appointment by his parents and a primary care specialist. The Mirror stated that medical secretary for Samuel's doctor insisted that she had taken down the appointment details and forwarded them on to a dedicated appointments team, but they were apparently not logged in. “While Samuel's medical records had been created on the new Millennium computer program, no appointments had been transferred across [from the old scheduling system],” the Mirror explained.
By the time Samuel was eventually seen, his heart condition had taken a turn for the worse, and he required immediate surgery. Unfortunately, the child died after enduring a series of cardiac arrests a few weeks after his surgery.
The rest of the story is found here - along with some other mess-ups.
This is a sad story which shows just how there can be consequences if great care is not taken to ensure IT that is involved in patient care is not looked at a whole and that seamless end to end operation is assured. Also important is to carefully ensure that issues that emerge with respect to use of systems and IT are appropriately escalated and remedied.
This really feels like a glitch that should have been caught and it is sad that it apparently was not.
David.

Thursday, March 27, 2014

Pre - Budget Review Of The Health Sector - 27th March 2014.

As we head towards the Budget in Early to Mid-May 2014 I thought It would be useful to keep a closer eye than usual on what was being said regarding what we might see coming out of the Budget.
According to the Australian Parliament web site Budget Night will be on Tuesday 13th May, 2014.
Here are some of the more interesting articles I have spotted this week.
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What do the polls tell us about bulkbilling co-payments?

Jennifer Doggett | Mar 19, 2014 11:24AM |
The opinion poll released on Monday in the Fairfax media is being interpreted by some commentators as supporting the proposal for a GP bulkbilling co-payment, reportedly under consideration by the Abbott Government.   
Around half of the people polled said that they supported charging a means-tested co-payment for bulkbilled GP services.  The same proportion of people also supported the Government taking action to ‘curb the cost of Medicare’.
Opinion polls have their uses but caution should be exercised when interpreting the results of this poll as a vote for shifting health care costs from Governments to consumers. 
In fact, polls on complex policy issues such as this should be seen as akin to horoscopes – ambiguous enough for all readers to find confirmation of their existing biases and to justify the course of action they were going to undertake anyway. 
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Poll results confirm change is afoot within the electorate

Comment
Laura Tingle Political editor
As politicians spent a hectic day trying to persuade us which messages we should take out of the Tasmanian and South Australian elections, more mundane factors that might have actually motivated voters were not getting all that much attention.
The most mundane of those factors goes to the Labor governments in Tasmania and South Australia being not so much ageing as geriatric. Voters wanted a change.
In Tasmania voters were also over the Greens and minority government. All the talk of the Greens becoming the major opposition party at Labor’s expense ended up looking very sick.
Yet the two state polls – and the latest Nielsen federal poll – do tell us some very big changes are taking place in the electorate.
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Voters show appetite for tough medicine

Yet the latest poll shows the case for tougher access to Medicare, rather than protecting universal access, in the ascendency.
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Medicare means test and co-payment have public support

17th Mar 2014
PROPOSALS to curb Medicare costs have earned the support of voters, with the latest Nielsen poll showing about half of those surveyed support measures such as the $6 co-payment and means-tested bulk-billing.
The Coalition leads Labor 51% to 49% in the poll published by Fairfax on Monday, down 1% from February, with Tony Abbott remaining as preferred prime minister with 48% support versus 43% for Opposition Leader Bill Shorten.
Despite the Labor campaign against the possible introduction of a $6 GP co-payment, the poll provided a boost for government indications of a tough budget in May, with 52% backing a means test for bulk-billing and 49% supporting the introduction of a $6 co-payment.
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Primary healthcare spending rises 50%

21st Mar 2014
GOVERNMENT spending on primary healthcare per person increased by 50% over the last decade.
A report from the Australian Institute of Health and Welfare shows expenditure increased in real terms from $30.8 billion to $50.6 billion for primary healthcare over the decade from 2001–02 to 2011–12.
Federal government spending per person on primary healthcare rose from $669 in 2001–02 to $1005 in 2011–12 after adjusting for inflation.
But Professor Jane Hall, a health economist at the University of Technology, Sydney, said this did not back an argument to introduce a $6 co-payment to cover these rising costs.
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Government healthcare spending figures may bolster case for a GP co-payment

Date March 21, 2014

Dan Harrison

Health and Indigenous Affairs Correspondent

Federal spending per person on primary healthcare services, including visits to GPs, grew by 50 per cent over the past decade, according to new figures that may bolster the case for new fees to visit the doctor.
The analysis from the Australian Institute of Health and Welfare to be released on Friday shows federal government spending per person on primary healthcare - a measure largely made up of visits to doctors - rose from $669 in 2001-02 to $1005 in 2011-12 after adjusting for inflation.
Federal spending per person on all health services - a measure that takes in spending in hospitals as well as visits to doctors - increased from $1892 to $2620.
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Price of 121 medicines to plunge

·         March 20, 2014 12:00AM
·         SUE DUNLEVY and LISA CORNISH
·           News Corp Australia
THE price of 121 medicines will crash by up to $12 a script for general consumers from April 1 as the government stops overpayments to chemists.
And drug companies are urging Health Minister Peter Dutton to put the $20 billion it will save from the cuts towards subsidies for expensive new medicines.
The government has been paying chemists up to 80 per cent above the market price for generic medicines in a policy that has cost the taxpayers billions of dollars a year.
The overpayments have also hit general consumers who have been paying up to 63 times more for commonly used medicines than consumers in New Zealand or Britain.
A new price disclosure policy is gradually forcing down prices however.
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News Ltd reports misrepresent pharmacy: Guild

20 March, 2014 Nick O'Donoghue
Reports in several News Limited papers, today, are misleading the public into believing that they are overpaying pharmacists for the medicines, the Pharmacy Guild of Australia says.
A Guild spokesperson hit out at claims that PBS price cuts were a result of the Federal Government stopping “overpayments” to pharmacies.
“This is an unfair slur on hard-working pharmacists who continue to provide PBS medicines at the best possible price to patients within a system in which they have no control over the PBS price – which is determined by Government,” the spokesperson said.
“The vast majority of prescriptions dispensed under the PBS are directly subsidised and therefore the price to the consumer – the co-payment – is identical no matter which PBS approved pharmacy supplies the prescription.”
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Private health priority treatment 'against spirit of Medicare', AMA official warns, as scheme expands

By Elise Worthington
March 20, 2014
A private health scheme that guarantees members priority bulk-billed care contravenes the "spirit" of Medicare laws designed to ensure equal access to health care, an Australian Medical Association (AMA) official warns.
Medibank Private began trialling the program last November at six north Brisbane medical practices and aims to expand it to 30 more sites in Queensland, as well as other states.
Medibank national medical director Dr Ian Boyd says many of the 4,500 patients who have tried the scheme have done so more than once, and the feedback is positive.
"The service allows them to have access to a GP within 24 hours for a standard daytime visit, and also allows them to have access to a GP in the metro areas in the after-hours period for home visits," he said.
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Secret Health Department plan to slash bulk billing

Joanna Heath
A plan to means test bulk-billed GP visits and charge an extra $5 for medicine was estimated to save the government nearly $2 billion but would upset doctors, who have threatened a mass walk-out if it is implemented.
The proposal from the Department of Health to reduce medical subsidies was rejected by the Labor government before last year’s budget. But it is likely to be reconsidered by Health Minister Peter Dutton, who believes Australians who can afford to, should pay more for their healthcare.
Under the plan, which was leaked to The Australian Financial Review, there would be a major change in how GPs are repaid by Medicare for treating patients. Bulk billing would be limited to concession card holders and ­children, saving $860 million over five years.
A spokesman for Mr Dutton would not rule out the changes, saying only the government would not comment on deliberations for the budget, which comes out May 13.
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Qld doctors reject govt pay deal

20th Mar 2014
MORE than a thousand senior doctors working in public hospitals across Queensland have voted to reject the state government's offer on individual contracts.
The unanimous vote of no confidence in the government's last-minute compromise came after Queensland Health Director-General Ian Maynard acknowledged their concerns at a crowded gathering in Brisbane on Wednesday night.
"The concerns that I've been told you had were consistent wherever you worked in the state," he told the crowd of about 1200 doctors, including one holding a placard, "Trust Gone, Goodwill Lost".
Senior medical officers (SMOs) had met with Mr Maynard and Health Minister Lawrence Springborg last week to express reservations about working conditions.
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Medicare offices to close on Saturdays, Human Services Minister Marise Payne says

March 20, 2014, 9:06 am
Medicare offices will close on Saturdays around the country, the Federal Government has confirmed.
Human Services Minister Marise Payne says there has been a 60 per cent reduction in walk-ins into Medicare shopfronts on Saturdays.
There are currently more than 90 Medicare offices which trade on Saturdays, mainly in regional and suburban areas.
Ms Payne says more people are making claims online or electronically.
"I think what we're seeing is a change in the way people are doing business," she said.
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Dutton supports Medibank funding proposal

Jessica Gardner
Health Minister Peter Dutton has backed a proposal from Medibank Private managing director George Savvides that would change the way doctors are paid to treat the chronically ill to a per year basis, instead of a payment per visit.
Writing in Monday’s The Australian Financial Review, Mr Savvides says the system now failed “high needs” patients because there was no structure that pays doctors to provide extra care.
In what would be a major reform of Medicare, Mr Savvides said Medibank wants to fund a “capitation” model of funding for GPs alongside the government. “We’re not asking government to be the only source of that funding,” he told the Financial Review.
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18 March 2014, 6.37am AEST

Want Medicare savings? Stop paying for private hospitals

TThe polls this week suggest half of Australians think the Abbott government should reduce the cost of Medicare. My solution? Claw back some of the A$9 billion the government pays to private hospitals…
Peter Sivey
Senior Lecturer, School of Economics at La Trobe University
The polls this week suggest half of Australians think the Abbott government should reduce the cost of Medicare. My solution? Claw back some of the A$9 billion the government pays to private hospitals.
Consider my experience … A few years ago I twisted my knee playing football. My GP, maybe after estimating my salary, suggested a private sports physician to diagnose my injury. The sports physician pulled and prodded at my knee before telling me:
It doesn’t seem like any ligaments are torn, but I can’t tell for sure. Why don’t we get you a scan – you’ll only pay $60. And Medicare will pay the rest.
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Super clinics not accountable for performance, govt says

17th Mar 2014
SUPER clinic operators have no responsibility to ensure performance quality even though the centres were built with multimillion-dollar government grants, Health Minister Peter Dutton has said.
Mr Dutton told MO that contracts entered into by the Labor government with super clinic operators only ensured that the centres would provide primary and allied care for a minimum of 20 years.
"Nothing was retained to ensure the companies performed over the 20 years. So the Commonwealth can’t really enforce performance," Mr Dutton said.
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Dutton ‘can’t enforce’ performance of ALP’s super clinics

THE federal government fears it could be powerless to enforce the performance of Labor’s $420 million GP Super Clinics program, a third of which have yet to be built or are not operating.
This is despite the super clinics being cornerstone Labor election promises in 2007 and 2010.
The latest update of the progress of the program obtained by The Australian, shows 10 of the 64 super clinics planned are yet to be started with another 14 still under construction.
Despite its $420m price tag, Health Minister Peter Dutton has confirmed that under the program the federal government owns none of the assets at the super clinics. Instead, the government holds 20-year contracts for service provision from the recipients of the grants.
But Mr Dutton is concerned the front-end loading of funding in the contracts could compromise the federal government’s ability to guarantee performance.
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Competing private health insurers push up costs, inquiry told

Date March 17, 2014

Inga Ting

Data journalist

Countries that rely heavily on private insurance to fund healthcare have more expensive health systems, the federal government's Commission of Audit has been told.
In an analysis of the health expenditure by Organisation for Economic Co-operation and Development countries submitted to the commission, researchers from the Centre for Policy Development say competing private health insurers were unable to keep costs down.
The government has hinted at cuts to health spending, warning that private funding needs to play a bigger role in containing rising healthcare costs.
It has appointed the commission to examine all federal spending and recommend budget cuts.
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Comment:
It seems even clearer there is a significant change coming on the basis of this week’s news as well.
What has been interesting this week has been the emergence of Medicare means testing and criticism of private health insurance. Additionally we have polls suggesting co-payments are fine and discussion on how these polls can mislead. All good fun and grist for the mill!
Importantly there is also a great deal of useful discussion here from The Conversation.
As usual - no real news on the PCEHR Review.
More next week.
David.

Wednesday, March 26, 2014

I Have Seen Rent Seeking Before But This Is A Really Great Example!

There was a white paper produced a little while ago.

One in Four Lives

The Future of Telehealth in Australia

March 2014
·         Lisa Altman
·         Shehaan Fernando
·         Samuel Holt
·         Anthony Maeder
·         George Margelis
·         Gary Morgan
·         Suzanne Roche
Here is the direct link.
Here is an article on the release of the white paper.

Calls for national telehealth strategy

By Australian Ageing Agenda on March 6, 2014 in Technology

One In Four Lives group speaker Dr George Margelis presenting the white paper to MP Steve Irons, chair of the House of Representatives Standing Committee on Health
The Federal Government is being urged to develop a national strategy for telehealth as an effective way to help rein in Australia’s ballooning health budget deficit.
A collaboration of health industry stakeholders, One In Four Lives, released a white paper in Canberra on Wednesday to promote the adoption of telehealth nationally.
The group, whose members include the Australian Information Industry Association (AIIC), BT, anywhere healthcare, Philips, and the University of Western Sydney, said telehealth could save $4 billion a year in avoidable hospital presentations related to chronic conditions.
The group said its name reflected the fact that almost six million, or one in four Australians, were affected by chronic health conditions. This accounted for 60 per cent of all hospital bed days and an estimated $17 billion annually in public health costs, it said.
The white paper said that the Australian health system was not sustainable in its current form. It cited Treasury modelling that predicted healthcare costs would consume more than 100 per cent of the entire revenue collected by the states by 2046.
Chair of the body, BT’s director of health Lisa Altman, said the aim was to encourage industry participation in the large-scale adoption of telehealth – providing faster, more efficient healthcare solutions without imposing an additional burden on the health budget.
Ms Altman said the evidence base for telehealth already existed, through large scale deployments such as the Department of Veterans Affairs in the US and the Whole System Demonstrator Program in the UK.

Lots more here:
There is also coverage here:

Telehealth could save "unsustainable" federal health budget, according to a white paper

A national strategy for Telehealth could save the federal government about $4 billion
A national strategy for Telehealth could save the federal government about $4 billion and help rein in an unsustainable health budget.
One In Four Lives, a group of industry stakeholders, has released a white paper in Canberra, to stimulate discussion and is urging the government to start a national scheme to take control of a ballooning health budget.
The One In Four Lives group estimates that Telehealth has the ability to slash Australia’s public hospital costs by about $4 billion a year in avoidable hospital presentations related to chronic conditions and improve access to healthcare for the thousands of Australians who wait months to see a doctor.
The name of the new body reflects the fact that almost six million, or one in four Australians, are affected by chronic health conditions.
This is a major burden on the health budget, accounting for 60 percent of all hospital bed days and an estimated $17 billion annually in public health costs.
The white paper recognises that the Australian health system is not sustainable in its current form.
Treasury modelling predicts that on current trends health care costs will consume more than 100 percent of the entire revenue collected by the states by 2046.
One In Four Lives is a collaboration of organisations representing a broad range of the health industry, including The Australian Information Industry Association, BT, anywhere healthcare, Philips and the University of Western Sydney.
Lots more here:
Disappointingly the white paper is really sad.
It is 8 pages long - rehearses all the information we know about rising health costs and - with very little evidence - suggests all sorts of additional MBS funding for the sector to make money for all the providers of bandwidth, equipment and the clinicians.
All these experts somehow want the Government to develop a National Telehealth Strategy rather than doing to work to propose one themselves!
The white paper has a total of seven references
1. Australian Bureau of Statistics,  Profiles of Health , Australia,  2011-13 [excluding Cancer, Arthritis and Osteoporosis]
2. Towards a National Strategy for Telehealth in Australia 2013- 2018, Australasian Telehealth Society, 2013
3. A National Telehealth Strategy for Australia, Australian National Consultative Committee for Electronic Health, 2012
4. Caring for the last 3%: Telehealth Potential and Broadband Implications for Rural Australia, CSIRO, Nov 2012.
5. National Digital Economy Strategy, Department of Broadband, Communications and the Digital Economy, 2012.
6. Supporting a Telehealth Strategy for Australia, Medical Technology Association of Australia, May 2012
(Also: Developing a comprehensive Telehealth Policy for Australia, Medical Technology Association of Australia, Dec 2012)
7. Telemedicine in the context of the National Broadband Network, National ICT Australia report for Department of Broadband, Communications and the Digital Economy, June 2010.
I list these to point out none appear to be literature / evidence reviews and are all older than 12 months - i.e. created under a different Federal health minister. I can't see the present Government lifting a finger without a really high quality business case at the least!
Interestingly  calling a report One In Four Lives seems to have some rather absurd assumption that every person with a chronic illness needs and will benefit from telehealth!
As they say - Nothing to see or going on here, move on!
David.