Who Smells the NEHTA Spin?

Well the journalist who heads NEHTA is back to his roots! I wonder how long it took to craft this article? My spies tell me it was weeks! Desperate to manage the obvious outcomes of a deeply negative report card!

To confirm this just look at the carefully crafted collection of ‘alleged’ e-Health progress items.

Healing Australia via broadband

Jennifer Hewett | December 17, 2007

A health revolution is coming that will allow patients, doctors and specialists to use e-medical records, writes Jennifer Hewett.

IMAGINE going to a new medical specialist and not having to take the referral letter, your X-rays and details of your existing medications.

Imagine attending a new GP practice where the GP calls up your previous medical records at the click of a mouse rather than relying on your, er, memory.

Imagine ending up in the emergency room of a public hospital where doctors who have never seen you before can instantly see your entire medical history. Not to mention having your own GP able to immediately see all the comments from the hospital staff, the discharge papers and the recommendations for follow-up treatment. No waiting, no confusion, no falling between the paper cracks.

Yes the personal electronic health record is finally coming to Australia. The concept is relatively simple. It means individual medical details will be easily and always accessible on computer to both doctors and patients, should patients wish.

But while the appeal is obvious so are the complications, not least the privacy concerns.

For the past 2 1/2 years, a group of health and IT professionals has been quietly beavering away to make the idea workable. They staff the National E-Health Transition Authority, a non-profit company whose board includes all the heads of federal and state health departments, with a budget so far of $160 million.

Now comes the next phase.

Following criticism and an independent review that found NEHTA has not consulted widely enough, the company is now trying to work more closely with the medical profession and other potential users of electronic health records.

This week it will announce it has signed a contract with Medicare Australia to design and build the special identification markers for consumers and healthcare providers.

Although it won't be ready for Kevin Rudd's ambitious timetable for a snap meeting of the Council of Australian Governments on Thursday, NEHTA will put its business case to the first COAG meeting next year for the next stage of funding.

Continue reading the very long article here:

http://www.australianit.news.com.au/story/0,24897,22935859-24169,00.html

The plan for a Shared EHR ( it was called HealthConnect then) was knocked back by the Commonwealth Department of Health and Aging in 2005 and has now been resurrected, as a new idea, (which it is not!), to save those involved in the terrible NEHTA inaction and management of E-Health over the last 3 years.

The Shared EHR may be really good idea but it is much more complex and difficult to achieve than is even partially recognised in this transparent ‘puff piece’

What chance, with the surplus in meltdown, as we now hear, this will get funded now?

I am utterly sick of the spin, deception and rubbish we are seeing from this just totally dysfunctional organisation which as late as a week ago was suggesting to its executives that grass roots E-Health initiatives were to be observed and monitored rather than assisted and supported (and this directive was direct from the CEO I am told).

Sorry..we really need a fresh start with a new team! There is no sign anyone can see there will be the level of change and openness we all require.

I have seen some spin in my time – but this article takes the biscuit! That it was planted to try and minimise the impact of the BCG Report should be obvious to the most naive.

David.

The Boston Consulting Group Lets NEHTA off the Hook!

The report of the Boston Consulting Group on their formal review of NEHTA (undertaken August - October 2007) was released this morning:

It can be found at the following URL – along with NEHTA’s response

www.nehta.gov.au/index.php?option=com_docman&task=doc_download&gid=421&Itemid=139.

The report makes six main recommendations which are intended to ensure the delivery of the national E-Health agenda objectives over the next few years:

1. Create a more outwardly-focused culture.

2. Reorient the work plan to deliver tried and tested outputs through practical ‘domains’.

3. Raise the level of proactive engagement through clinical and technical leads.

4. Accelerate resourcing through outsourcing, offshore recruiting and more creative contractual arrangements.

5. Reshape the NEHTA organisation structure to address revised work plan priorities.

6. Add a number of independent directors to the NEHTA Board to be broader advocates of E-Health, and to counter stakeholder perceptions of conflict of interest.

A press release ‘spins’ the NEHTA response to the Review!

----- Begin Release

NEHTA HERALDS E-HEALTH MILESTONES

and announces its action plan for adoption success

17 December 2007

Australia's e-health reform agenda took a forward step today with the release of an action plan by the National E-Health Transition Authority (NEHTA).

The Board of NEHTA also endorsed a business case for developing a national platform for personal electronic health records to be put to the Council of Australian Governments (COAG) early next year.

The NEHTA action plan outlines key areas for ensuring the successful adoption of measures to improve the electronic communication of critical health information.

"After working to build foundations for electronic health since the organisation was established in 2005, we are now in a position to begin to deliver some concrete applications of our work," NEHTA's Chair Dr Tony Sherbon said.

"The new Federal Government has signaled health reform and improvements in state and federal relations as major policy objectives," said Dr Sherbon. "Given also the government's emphasis on

the provision and use of broadband communications, NEHTA is well-positioned to play its role in advancing e-health as part of this new agenda," he said.

"The recent independent review found NEHTA had made significant progress on our goals to date and made a number of recommendations about NEHTA's future. The action plan we are announcing today flows directly from our acceptance of all the recommendations in the review," Dr Sherbon said.

Dr Sherbon identified the action plan as also being an acknowledgement of where NEHTA now needs to go in order to expedite e-health reform in Australia.

"We have come to a point where many of the foundations to enable e-health are in a position where we can now move towards implementation and adoption. Seeking funding to establish a national system of personal electronic health records is also on our immediate horizon. The action plan that we have released will assist this process," he said.

Dr Sherbon said the case for personal electronic health records was compelling. "The safety and quality benefits are manifold. We understand the issues of equity and privacy and firmly believe that

the approach developed by NEHTA will address these to the satisfaction of all our stakeholders and the Australian public."

NEHTA's Action Plan for Adoption Success and the independent review of NEHTA conducted by the Boston Consulting Group are available on the NEHTA website at www.nehta.gov.au.

----- End Release.

Three major things concern me about all this.

My first major issue is that the last paragraph of the executive summary identifying the need for a national Health IT Strategy has simply been ignored by the Board.

"In parallel, planning for the next phase of eHealth coordination and implementation needs to commence now or momentum could be lost. An eHealth strategy and eHealth policies need to be developed. Further analysis and debate by NEHTA and its members on the future vision for eHealth and the role of a central agency (as described above) is needed now to generate a plan by mid 2008. Regardless of the funding scenario and any future role of NEHTA II, we believe that the ‘transition’ NEHTA is tasked to support has at least another five to ten years to run."

I welcome all the recommendations, cited above, as far as they go - but feel they do not point to where the real work is needed - i.e. a National E-Health Strategy.

My second major concern is that while it is clear there have been a very large number of issues with the way NEHTA has operated - there is no apparent accountability for the mis-steps being accepted by the Board and Staff of NEHTA.

That said the BCG report's findings seem to me to accurately reflect the view of external stakeholders (Health IT experts, Health Providers and the IT Experts) but the impact is diluted by continual use throughout the report of the views of the NEHTA staff on the quality of the job they are doing. The staff and Board are hardly likely to be objective regarding their own performance!

My third major concern is that we have NEHTA recommending a Business Case for a National Shared EHR to the Council of Australian Government – and the public has had no apparent input – other than by a discredited NEHTA Board and a few bureaucrats. This is hardly the new open, engaging and consultative NEHTA!

In summary, this report addresses some of the operational, cultural and engagement failures of NEHTA, while failing to firmly recommend the development of a national e-Health plan to achieve value from NEHTA's work. Without this NEHTA will remain an unguided missile operating without strategic context and at risk of continuing to underperform.

To let NEHTA escape without a clear articulation of the need for a National E-Health Plan is really very poor indeed.

I fear the whole BCG exercise has been an expensive piece of ‘window dressing’

David.

BCG Review Report of NEHTA Now Available.

The BCG Review of NEHTA has been published.

It is available here:

http://www.nehta.gov.au/index.php?option=com_docman&task=cat_view&gid=-1&Itemid=139

My comments in due course

David.

Useful and Interesting Health IT Links from the Last Week – 16/12/2007

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

Patient software deal 'threatens innovation'

The merger of patient software giants iSoft and IBA Health has left New Zealand's district health boards faced with reduced innovation and uncertain pricing, according to rivals.

But they say that while the new entity - to be called IBA Health Group - currently has no serious competition in the New Zealand patient management software market, there is room for challengers.

Australia's IBA Health recently completed its A$410.7 million (NZ$475.8 million) acquisition of financially troubled British company iSoft.

Sysmex national sales manager Colin McKenzie says IBA Health Group now supplies patient management software to 19 of New Zealand's 21 district health boards. "That's huge."

The group competes with Sysmex in the market for clinical data and laboratory software.

He says it’s uncertain what will happen to software prices in the wake of the merger.

"The Health Ministry controls a lot of pricing when it comes to reasonable IT spending but the general word on the street is that people are a bit concerned about what it might mean when there's that much market dominance."

He says it is likely the merged company, which offers five products in the health software range, will sunset some of its products and provide one package to DHBs - which will have to change their systems. In this situation, other providers will be able to offer alternative products.

Continue reading below

http://www.stuff.co.nz/stuff/4317183a28.html

It is interesting to see how a merger like this can have an un-intended consequence for a small market. One hopes IBA Health will work to continue to provide excellent service to New Zealand. There is clearly an opportunity here to have New Zealand have a level of system commonality that could help to improve Health Information Management throughout the country, as long as pragmatic and reasonable approach is adopted by all affected.

Second we have:

Software prevents patient overdose

Jennifer Foreshew | December 11, 2007

MELBOURNE-based Peter MacCallum Cancer Centre has become the first in Australia to employ new software that will prevent dosage errors in patient medication.

The centrally managed intravenous (IV) drug administration software, Hospira MedNetT, went live yesterday at the cancer research and treatment facility, which caters to 100 in-patients and 25 day ward patients.

The centre's pharmacy head, Sue Kirsa, said the US-developed software, which was running over the centre's Nortel wireless network installed earlier this year, would give greater protection from overdosage.

"We have been administering medications via pumps for many years, but the existing way requires the nurse to look at an order and do a calculation around how quickly the drug is administered to the patient," Ms Kirsa said.

"The vast majority of these items are delivered safely hundreds of times a day, but from time to time errors can be made and the patients can suffer an adverse effect from it. This gives that added amount of security to the nursing staff and to the patients that what they are doing is safe and effective."

Read the complete article here:

http://www.australianit.news.com.au/story/0,24897,22902404-5013040,00.html

This is another step, based on Health IT, to improve patient safety and it is good to see such technology is being adopted and deployed in Australia. Interestingly the company Hospira was the one that a few years ago bought Mayne Pharma – which was at the time a major player in generic cancer medications which had been established in Australia and was part of the old Mayne Health. Mayne Health partly also lives on as Symbion which is having an interesting time on the Australian Stock Exchange at present with a number of companies wanting to take it over.

Third we have:

Rebirth of the Access Card?

Fran Foo | December 12, 2007

THE decision to axe the Access Card program could come back and haunt the federal Government, an analyst from Frost & Sullivan said.

"I can see why Labor decided not to proceed but the idea behind the Access Card is good for patient records," Simon Hayes, Frost & Sullivan senior analyst, said.

Labor kept its election promise by scrapping the controversial $1.1 billion program. The card was intended to provide every Australian with a unique health and welfare number and biometric photo on a smartcard.

Mr Hayes said while the Coalition went too far with the Access Card, he believes Labor would, in future, have to introduce a more secure way for people and the federal Government to access e-health records.

"Any smartcard would sound like the Australia Card but this is something that has to be introduced eventually," he said.

Continue reading here:

http://www.australianit.news.com.au/story/0,24897,22911467-15306,00.html

I am surprised a senior analyst at Frost & Sullivan would not have made the obvious point that it would make sense with the change of government, and the plethora of different electronic ID systems which are in various stages of development and implementation around the country, that now might be a good time for a strategic review of the whole area to make sure we get an overall framework in place that will serve all needs, including the Health Sector.

Fourthly we have:

Building a personal medical database

New products help patients take charge of their health and medical history by organizing their records, but there are privacy concerns.

By Jan Greene, Special to The Times

December 10, 2007

Cathy Barnes of Bakersfield was traveling on business in Philadelphia a few years ago when she developed a terrible pain in her abdomen. Doctors at a major medical center there kept her overnight and carried out a battery of tests on her heart. The tests came up negative.

When she got home, Barnes went to her regular doctor, and an ultrasound exam found a mass in her kidney. A CT scan showed a kidney tumor, and she was immediately scheduled for surgery to remove it before the cancer spread.

Barnes believes she saved precious time in her treatment because she knew enough to ask for a copy of her medical records from the Philadelphia hospital and show them to her doctor at home -- eliminating the need to repeat all those tests. "Having copies of my cardiac tests saved all that time," she says.

Barnes, a database specialist, is unusual -- long before the tumor, she'd gotten in the habit of asking for copies of her records and meticulously tracking her vital signs on a spreadsheet to share with her doctor, who monitors her high blood pressure.

Although not every doctor would want that much detail, nor does every patient have the patience to accrue it, most people could benefit from routinely asking for a copy of their lab results and doctor's reports, says David Lansky, senior director of the health program for the Markle Foundation, a nonprofit that promotes application of technology to health problems.

Such a personal health record, kept either on paper or electronically, can help patients stay aware of their health, particularly if they have a chronic illness such as diabetes or hypertension. It can help a person weed out mistakes in the information, avoid unnecessary repeats of tests and ease the move to a new town or doctor's office.

And anyone who takes care of another person, such as an elderly relative or child with a health problem, can use the records to help advocate for the patient.

Health insurers such as Aetna have helped drive this trend in hopes that patients would pay closer attention to their health. They were among the first to offer some online access to medical claims. Kaiser Permanente -- unique in being an insurance company and a healthcare provider -- is probably the furthest along, offering members not only access to an abbreviated version of their medical records but other services too, such as the ability to e-mail physicians and set up appointments online.

Companies such as Wal-Mart are starting to offer their employees the option of saving personal health records as well.

Many people don't have such access, however -- and there's a downside, in any case, to using an online personal health record provided by an employer or insurer, even though it's free: If you leave that job, you may not be able to maintain access to the site. So people wanting a more detailed record may seek out a solution on their own, and today, they have a wide array of options.

Over the last few years, dozens of personal health record models have hit the market. Some include software that allows people to track their health on their own computers at home or to put it on a thumb drive to give to a doctor. Others are based online, using a secure server that a patient, or a relative or doctor with permission, can sign on to from any Internet-connected computer.

Before taking the time to type a lot of personal history into a product, consumers should think a bit about what they want from a personal health record.

They should also think about how private their records will remain.

Continue reading all of this long article and the associated suggestions here:

http://www.latimes.com/features/health/la-he-records10dec10,1,1863941.story?amp;track=crosspromo&coll=la-headlines-health&ctrack=1&cset=true

This is a useful, up to date, and pretty comprehensive review, from the consumer perspective, as to what is available in the way of Personal Health Records in the US. Well worth a browse.

Recently more on PHRs is also found at a couple of other places:

http://www.kiplinger.com/features/archives/2007/12/krrpersonalhealthrecord.html

Your Medical History at Your Fingertips

Need your history in a hurry? A personal health record can store your data in one place.

By Christopher J. Gearon
Kiplinger's Retirement Report

December 6, 2007

And here:

http://www.healthleadersmedia.com/content/201983/topic/WS_HLM2_TEC/PHRs-Fulfill-Consumer-Needs-for-Data-Access-and-Control.html

PHRs Fulfill Consumer Needs for Data Access and Control

Jodi Amendola, for HealthLeaders News, December 11, 2007

Until recently, personal health records have taken a back seat to electronic medical records as the healthcare industry continues its struggle to establish health data exchange standards. That prioritization is shifting as consumers demand a viable healthcare technology in which to store and access their personal healthcare information.

Fifthly we have:

Health 2.0: The next generation of Web enterprises

By: Joseph Conn / HITS staff writer

Story posted: December 11, 2007 - 5:59 am EDT

Part one of a two-part series:

In healthcare, where buzzwords tend to have the lifespan of fruit flies, "Health 2.0" is maybe a year old and already is growing cyber-whiskers, on a given day generating more than 130,000 hits on Google, outstripping "consumer-directed healthcare" at about 44,400 hits, but lagging "personal health record" at 294,000.

It has attracted a pair of entrepreneurial conference organizers, consultants Matthew Holt and Indu Subaiya, who put on their first show, the Health 2.0 User Generated Healthcare Conference, Sept. 20 in San Francisco, drawing about 480 attendees with a waiting list of another 100, according to Holt. The pair is planning a two-day, follow-up "spring fling" in March in sunny San Diego and a second, larger show next fall.

So what is Health 2.0? The term is the healthcare derivative of the far more ubiquitous "Web 2.0" (15.9 million Google hits) coined by Web pioneer Dale Dougherty, a vice president of O'Reilly Media, a publisher of computer technology books and magazines and the host of IT conferences. It was during a brainstorming session for a planned conference that the muse struck Dougherty, but it was company founder Tim O'Reilly who chronicled the genesis of Web 2.0, and popularized its use in a seminal, 16-page essay, What is Web 2.0: Design Patterns and Business Models for the Next Generation of Software, published in September 2005. The idea, according to O'Reilly, was to analyze the common traits of companies that survived the bursting of the dot-com bubble in 2001 for possible incorporation into the next generation of companies.

In his essay, O'Reilly shies away from giving a concise definition of Web 2.0, opting instead to provide seven basic principles. The first three of these principles are probably the most important and, arguably, the most applicable to healthcare, at least according to examples of companies cited by Web 2.0 mavens contacted for this story.

The first principle, O’Reilly says, is the software of a Web 2.0 company has to be Web-based, has to provide a service and that service has to be structured so that the more people use it, the better it becomes. He described it as "an architecture of participation." An exemplar is eBay; as more and more buyers and sellers participate, the broader the eBay market becomes, which creates more value to the customer.

O'Reilly calls the second key principle "harnessing collective intelligence," which also is referred to by others as "the wisdom of crowds." To avail themselves of this wisdom, Web 2.0 developers must create applications that are dynamic, with user participation designed into the systems, so that participation itself becomes an integral part of making the underlying database more valuable. Amazon.com adds value by enabling readers to write and post reviews of software and books and to be engaged in other ways, such as preparing wish lists.

O'Reilly's third principle, "Data is the next 'Intel inside,' " notes that specialized data, enhanced through analysis performed by the service provider as well as by the contributions of service users, becomes the core asset of a Web 2.0 company. The Amazon wish lists, for example, are aggregated by Amazon and used as buyer's guides.

Article continues here:

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20071211/FREE/312110003/1029/FREE

The second part of the article is found here:

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20071212/FREE/312120002/1029/FREE

These two articles nicely set the scene for Health 2.0 and what it may mean. Mandatory reading for all those who are interested in understanding where consumer Health IT is going.

See also the following:

http://www.health2blog.com/2007/12/health-20-commu.html#more

Health 2.0 Community Present and Vocal as Markle Foundation Policy Meeting Discusses "Consumer Access Practices for Networked Health Information" by David Kibbe

This meeting held by the Markle Foundation near San Diego over two days last week may turn out to be the most important health information and technology policy meeting of the past 5 years. So I'll try to choose my words for this post very carefully. If this increases the length somewhat, I apologize for that in advance.

Vital stuff also!

Lastly we have:

http://www.informationprescription.info/report.html

Interim report on the information prescriptions pilot project

The Department of Health (DH) white paper, 'Our health, our care, our say', published in January 2006, made a commitment to improving access to appropriate information for people with health or social care needs. It stated: 'we propose that services give all people with long-term health and social care needs and their carers an 'information prescription'.’

From 2008, information prescriptions (IPs) will be given, in consultation with a health or social care professional, to everyone with a long-term condition or social care need. IPs will guide people to relevant and reliable sources of information to allow them to feel more in control and better able to manage their condition and maintain their independence. IPs will be nationally recognised as a source of key information on services and care that is seamlessly and formally integrated into the care process.

To ensure the successful design and delivery of IPs nationally, DH has recruited 20 sites to test and provide evidence of their effectiveness and their impact on the public, professionals and organisations. The information and momentum built through this piloting phase will be used to develop the final strategy for delivering the full scheme in 2008, when IPs will be rolled out nationally.

The project is being supported and evaluated by a consortium of three organisations – OPM, the University of York and GfK – and overseen by a project board of key stakeholders. The programme of evaluation and learning support activities commenced in February 2007 and will run until March 2008 when the pilot programme will come to a close.

The aim of the evaluation is to assess the overall effectiveness of the pilot programme along with the specific approaches being adopted across the 20 pilots involved in the programme. More specifically, the evaluation will help inform the four main goals of the pilot programme:

1. To shape the practical design and delivery of IPs nationally, including how the delivery will be supported nationally at the locality level
2. To provide evidence on the effectiveness and impact on the public, professionals, and organisations alike
3. To contribute to successful national implementation of IPs by 2008 to people with a long term condition.
4. To inform the policy direction, ensuring that the implementation of prescriptions is integrated with other major policy drivers

This is the interim report of the evaluation, covering the developmental stage of the piloting programme. More evidence on implementation and on user responses will be covered in the final report.

• Interim report - executive summary
• Interim report - the full version
• Annex to the survey chapter

The Consortium will continue to gather evidence from the pilots through monthly data collection returns, a second round of evaluation site visits and the second wave of the survey of users, carers and professionals. This work will inform the final report and the design of the closing conference, both of which will be delivered early next year.

If you have any comments on the content or implications for national roll-out, please email: information.prescriptions@dh.gsi.gov.uk

This is a fascinating initiative to try and improve the patient’s understanding of their illness and what they can do to improve their situation. I hope the trials work out well as this would be easily replicable in Australia.

All in all some interesting material for the week!

More next week.

David.

Flash: BCG Report to Be Made Public

In the Financial Review this morning there is some very good news:

See this link for details.

In essence the Boston Consulting Group will be public next week and as yet the Govermment's attitude to the future of NEHTA has not been made clear.

Radical change is surely needed.

David.

Leaks From the BCG Report on NEHTA so Far!

Well it seems a few lucky souls have seen the Boston Consulting Group’s Review of NEHTA report.

From what I have heard, so far, the key recommendation, as expected, is for a dramatically improved engagement process with external stakeholders and for greatly improved transparency and public accountability.

With these recommendations being received by the Board – and seemingly now reaching a range of the more senior bureaucrats in NEHTA and the Jurisdictions - the time for the report to be acted on, and made public, has now arrived.

It will be a major test of both the Board and the NEHTA management to have a prompt release of the report, with an associated action plan. Preferably before Christmas! (What a nice present!)

Sadly I fear the signs are not good with news reaching me on the grapevine over the last week or two that Standards Australia and NEHTA Ltd signed a formal Memorandum of Understanding in February 2007 – but neither body bothered to let their volunteers, who do much of the actual work, know they had been ‘volunteered’ to undertake this role.

Just who will be the owner of the Intellectual Property created by the volunteers remains very vague indeed.

I am told that, because of this, at least some of Standards Australia volunteers are now actively reviewing their continued involvement. This comes just as the work is becoming increasingly important for any national e-health progress to be made.

Talk about a need for better engagement processes and openness!

I wonder when the we will start to see some changes for the better?

NEHTA should remember that a document this important will either be published or will leak - it is up to them which way we all find out about their pros and cons. We have a new Government and the fascist-like spin control they have practiced in the past - to the detriment of all - will no longer be tolerated. It is in their interest to come clean before they are forced to - and are then obliged to seek 'alternative career options'

David.

HL7 Seems to be Making Some Useful Progress for the End of 2007.

A couple of interesting articles have recently appeared on progress being made by HL7.

The first is from the UK – while reflecting activity that is happening globally.

Interoperability gets more complex

07 Nov 2007

The NPfIT Local Ownership Programme (NLOP) will create further pressure on health care interoperability specialists, both within the NHS and its suppliers, with a huge devolution of general design responsibilities about to commence.

NLOP and the new Additional Supply Capability and Capacity (ASCC) suppliers will inevitably lead to greater variety in the new systems offered (to say nothing of existing systems), whilst raising expectations that these systems will interoperate and provide joined up health care for patients.

If anyone still believes that interoperability can be safely devolved to a black box in the corner, they need to wake up to reality. Interoperability is hard and expensive, not because it is intrinsically difficult, but because you have to specify and deliver exactly what you want. As with all things digital, interoperating computer systems are intolerant of the slightest error.

…..

A key benefit of HL7 then, is to tame this exponential explosion by delivering relevant specifications and, equally important, an ecosystem of conferences, working meetings, and other activities to support their maintenance and use. HL7 is a community of practice, which shares a common interest in enabling healthcare interoperability. As with any community of practice the enthusiasts do most of the real work, the contributors actively participate and the consumers lurk silently in the background.

…..

In practice HL7 covers an increasingly broad domain. It all began with HL7 Version 2 (V2) about 20 years ago, well before Tim Berners-Lee had even thought of the worldwide web. The present version, 2.6, is still backward compatible with the original. Version 3 was developed to overcome the obvious deficiencies in V2 and has spawned CDA (Clinical Document Architecture), now adopted by NHS CFH for all clinical messages.

The most advanced version of CDA has the exciting title of “CDA Release 2 Level 3”, and provides most of the advantages of both human readable and coded documents. The human readable part is the basis of the National Care Records Service (NCRS), enabling a nationally readable clinical record, while the coded part populates the Secondary Uses Service (SUS), for use by the bean-counters.

Other recent HL7 developments are the new TermInfo Draft Standard for Trial Use (DSTU), which specifies how SNOMED CT is used with HL7 V3; new specifications for web-services and SOA (Service-Oriented Architecture); and functional specifications for both PHR (personal health records) and EHR (electronic health records).

…..

Link

www.hl7.org.uk

Read the full article here:

http://www.ehiprimarycare.com/comment_and_analysis/271/interoperability_gets_more_complex

Also we had in the last little while.

Draft PHR Standard Model Approved

HDM Breaking News, December 6, 2007

Standards development organization Health Level Seven has approved the Personal Health Record System Functional Model as a draft standard for trial use.

The model defines a set of functions and security features that may be present in PHR systems and offers guidance to facilitate data exchange among PHRs or with electronic health records systems. The model is designed to help consumers compare PHRs and select one appropriate for their needs.

A draft standard for trial use enables the industry to work with a stable standard for up to two years and refine it so it can become an official standard. This means consumers can start requesting functions within the draft standard and vendors can start incorporating such functions in their products. The functions also can be incorporated into PHR certification programs.

….

The PHR functional model is available at hl7.org.

…..

For the full article visit:

http://www.healthdatamanagement.com/news/standards_PHR25313-1.html

All this activity must be seen as real progress and is to be welcomed. The scope and importance of this work is not to be under-estimated.

Most important are the Draft Standards for Trial Use (DSTU) in the more advanced and complicated areas. These allow for a period of stability while implementations are attempted and lessons learnt as to what actually works and where the problems and ‘wrinkles’ are.

This approach is so far ahead of the nonsense of ‘ex-cathedra’ pronouncements we see from NEHTA as to really make their behaviour and lack of actual implementation experience a joke.

David.

Flash : Which E-Health Organisation Is Taking a Six Story Building in Canberra?

Just a heads up for the NEHTA watchers.

I am told, by a reliable source, that outside a six story office in the Canberra CBD NEHTA is announced as the new occupant!

Would love someone from the fair city to confirm such is the case!

Seems NEHTA is planning a long and comfortable stay in the Nation’s Capital. So much for the BCG Report and a ‘new NEHTA’!

David.

Technology and Nursing – A Good Fit

This is a useful discussion of the use of Health IT by nurses in a number of organisations. The point made is that while use of Health IT by nurses has started, it still has a good way to go.

Hospitals help nurses get more from IT

By Diana Manos, Senior Editor 12/04/07

According to results of a recent American Academy of Nursing survey, healthcare IT has a long way to go before it fully serves nurses in their environment. Yet some hospitals have already begun trying new ways to make healthcare IT more user-friendly to nurses, increasing the time they can spend with patients.

Genesis Health System in Davenport, Iowa began by establishing a nursing collaborative group to serve as a liaison between the hospital's IT department and nursing staff, according to Shirley Gusta, IT manager of application services at Genesis.The health system pilots new technology initiatives in one nursing unit prior to launching it facility-wide, whenever possible, Gusta said.

Jamie Allen, telecom supervisor at Genesis said the hospital emphasizes duality of ownership when it comes to IT. "We heavily engage the clinical staff in system selection and when we're building systems in order to meet their needs and we study their business practices," Allen said. "We're trying to learn from them."

…..

In Wilmington, Delaware, Alfred I. duPont Hospital uses wireless devices for communication in cardiac care, according to Lori Betts, nurse manager. Patients wear cardiac monitors that communicate through an IT platform to badges nurses wear.

…..

According to John Antes, president of Progress West Healthcare Center in St.Louis, nurses play a key part in advising the hospital on IT issues and the organization has increasingly looked for ways to provide more mobile technology to its clinicians.

The hospital uses Vocera, a communications product, to eliminate central nurse stations. The product helps nurses communicate hands-free with other nurses, doctors and other departments of the hospital. The units are voice activated so nurses don't have to remember phone numbers, Antes said. Progress West also uses the devices to notify daily assigned code blue teams. "It really has created some nice efficiencies and ease of communication for moving nurses," Antes said.

The hospital also uses bedside clinical electronic documentation, bedside bar-coding of patients and fingerprint notification to allow nurses to log onto several programs quickly. Medication is kept at the bedside in carts along with laptops, Antes said.

The use of effective healthcare IT has contributed to allowing nurses more time at the bedside, Antes said. "If you walk our floors, most of the nurses are in patients' rooms."

Read the full article here:

http://www.healthcareitnews.com/story.cms?id=8265#

I thought this article was worth pointing out – as a useful peg to remind us all just how important nursing staff are in all Health IT planning and implementations in the Hospital sector and progressively in the ambulatory sector as the numbers of practice nurses and physician assistants increase.

A wise old Health IT implementer made the point to me years ago that while it could make life difficult implementing systems if the doctors were off side – if the nurses were off side it was time to pack up and leave the field.

Key, to success, I believe, is to identify both nursing and clinical champions very early in the planning for new systems and to involve these people all the way through the requirements development, procurement and implementation phases.

The bottom line is that if you ‘ignore the nurses’ it is highly likely any substantial Hospital Health IT initiative will fail!

You have been warned!

David.

Canada Starts a Program to Explain Electronic Health Records to Its Population

I just came upon this release from Canada Health Infoway.

The site is found here

Electronic Health Records – Infoway Special Report in The Globe and Mail

"If Canadians want to realize the benefits of electronic health records, it's up to the public to demand them." - Richard Alvarez, CEO, Canada Health Infoway

Read new articles and learn more about how information technology is improving health care for Canadians today…

IT could be a matter of life and death

In downtown Toronto, an elderly man finds his way to an emergency ward late in the evening.

Doctors' offices and patients see benefits

When a drug is recalled, informing patients quickly is vital.

Technology overcomes geography

For the many Canadians who live outside of the major urban centres, accessing critical health care often involves the emotional and financial trauma of leaving family and home behind...

Better management, accountability improves access for patients

Grace De Jong's breast cancer was successfully treated by lumpectomy in 1999, but recently she began experiencing new symptoms.

SARS outbreak illustrates impediments of antiquated system

Forty-four people would die of SARS in Canada in 2003; a total of 442 probable and suspected cases would occur.

Online patient portal opens new doors

Experts say self-management combined with early intervention of health care teams can delay the progression of kidney disease in the pre-dialysis stage.

Kiosks a boon to triage nurses, ER patients

While many Canadians are familiar with using electronic kiosks to check in at airlines or do their banking – a ground-breaking project starting this month on both campuses of the Scarborough Hospital will use the idea in their emergency departments.

---- End Release

This seems to me like a sensible and worthwhile step to take and should be commended.

Just where the powers that be in Australia are up to in all this doesn't even bear thinking about. Heavens I hope that changes soon! Their problem is, of course, that they have few real successes to talk about!

David.

Ocean Informatics and the UK NHS – Making Archetypes Really Work?

Dr Ognian Pishev of Ocean Informatics sent me this press release a few days ago.

Begin Release -----

Ocean Informatics (Australia) Provides Clinical Content

Modelling Services to the NHS

Ocean Informatics (3 December, Sydney, Australia), a recognised leader in e-health strategy, interoperability and shared electronic health records (EHR), announces a new project with the National Health Service (NHS) in the United Kingdom.

The new project follows the successful completion of a pilot study, which tested content modelling as a technique for producing standardised structured clinical data specifications. NHS Connecting for Health (NHS CFH) has decided to continue to use the Ocean clinical modelling tools and openEHR archetypes and templates to help specify the information required to support safe and high quality health care across clinical systems in England. It is expected that over the next 6-9 months a national content models repository will evolve to provide significant support for the NHS in the specification of standardised content for clinical systems.

Using one of openEHR's key innovations known as archetypes, Ocean has developed a single source semantic modelling capability from which templates, forms, queries and other artefacts can be derived, significantly reducing work effort. openEHR archetypes and templates, being independent of the software, provide a basis for future-proof systems. Along with the reference model, they form an expressive 'DNA' of the health computing environment, without which computers cannot safely process health data. The power of the approach is recognised globally, with the CEN and ISO-standardisation of the archetype language and model.

“The real advantage of the openEHR methodology is that the clinical models are in a form that clinicians can understand and relate to, whether these are doctors, nurses or physio-therapists and social workers.” said Dr. Sam Heard, CEO of Ocean. “These detailed and fully computable specifications can be used to build applications and messages in a way that ensures the information can be understood by the receiving system”.

Significant cost savings from single source content models

The knowledge tools from Ocean enable the development of clinical content which can be used in all levels of the EHR technology, including GUI, business logic, persistence, queries, messaging and documents. This leads to a significant reduction in work effort. For the first time, queries can be used longitudinally over health data, regardless of the original source system or format. The standardised approach raises the quality of shared specifications.

The use of archetypes by the NHS has proved productive and accessible, justifying continued use in some areas of clinical specification. Work is being undertaken to position archetypes in the general EHR specification work, and alignment with other established standards in the areas of user interface, messaging (e.g. HL7 V3), clinical documents (e.g. CDA), and terminology binding (particularly SNOMED CT).

About NHS Connecting for Health

NHS Connecting for Health, which came into operation on 1 April 2005, is an agency of the UK Department of Health. NHS CFH supports the NHS to deliver better, safer care to patients, via new computer systems and services, that link GPs and community services to hospitals, and to maintain the national critical business systems previously provided by the former NHS Information Authority.

Accurate information is crucial if patients are to have choice and receive the right care at the right time. A key aim of the National Programme for IT in the NHS is to give healthcare professionals access to patient information safely, securely and easily, whenever and wherever it is needed.

The National Programme for IT is creating a multi­billion pound infrastructure, which will improve patient care by enabling clinicians and other NHS staff to increase their efficiency and effectiveness.

About Ocean Informatics

Ocean Informatics (Australia) is a leader in e-health strategy, semantic interoperability and shared EHR solutions. It has some of the most experienced clinical and technical experts in the health informatics domain, and a long history of involvement in e-health projects (in Australia and internationally), standards development (ISO, HL7, CEN, Standards Australia), and systems and tool implementation. Along with University College London, Ocean is one of the founding partners of the openEHR Foundation. openEHR is the first health computing platform to offer semantic integration of the GUI, persistence and querying, a powerful basis for higher level health computing including cross-enterprise workflow, decision support and medical research.

For background information, please visit www.oceaninformatics.com or contact Dr. Ognian Pishev, Ocean Informatics, Phone: 61295570352 Mobile 61431039291, ognian.pishev@oceaninformatics.com

Links:

NHS Clinical Models

Ocean Informatics

openEHR

NHS Connecting for Health

End Release -----

While this is a press release with the usual marketing ‘hype’ contained within it, it seems to me what is being done here is potentially very important.

Essentially what is planned is that use of the Ocean approach to clinical content modeling (based on archetypes and other openEHR attributes) will allow for standardized sharable clinical content to be defined and then those information specifications be further developed and deployed – presumably on the NHS “spine” to enable basic clinical information system interoperation within the NHS.

No one should underestimate the importance, scale and complexity of this undertaking!

There is clearly an large amount of work to be done in identifying the clinical information that needs to be defined and how the archetype related work will interact with SNOMED CT and HL7 V3 which have already been adopted by the NHS.

The NHS Clinical Models site is well worth a visit to appreciate, first hand, what is being attempted here. It is a bit of a pity so many of the links currently (Dec 9, 2007) seem to be broken.

I look forward, with interest, to seeing more details of the progress of this work over the next year and to understand how this work might assist other nations who are wrestling with similar problems in their own e-Health initiatives.

David.

Useful and Interesting Health IT Links from the Last Week – 9/12/2007

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

For medicinal purposes

Agnes King – Business Review Weekly – Issue of Nov 29, 2007.

Read a summary of the whole article here:

http://www.businessspectator.com.au/bs.nsf/Article/For-medicinal-purposes-9HV8X?OpenDocument

It is interesting that it is suggested that “Australian state government health departments are expected to spend upwards of $A1 billion on new IT. Their aims include making it easier to link patient records with health information networks, as well as to improve the flow of information between participants in the health system.”

The article provided after quite a long review

Four Lessons from the waiting room.

These were:

01 New information technology such as shared patient records is one of the few opportunities to contain and manage health-sector costs, which an ageing population could push to the point of system collapse.

02 IT-sector deals and projects have been launched, including a Facebook-style patient-managed health information service from Microsoft that could become a lucrative earner of health-related advertising.

03 Uniform standards are a big hurdle, and a federal body set up to create them has operated slowly. IT providers want to see more on ID, certification and compliance requirements before they rework systems.

04 Changes in the health system will need to deal with the unique power of GPs and other professionals in the sector, as well as the federal system.

This is a useful review from the BRW and is well worth following up in the physical magazine.

Second we have:

Is the Access card dead or changing its identity?

By Marcus Browne, ZDNet Australia

December 06, 2007

Labor needs to make an unequivocal commitment to that it does not plan to scrap the Howard government's proposed Access Card and replace it with its own, according to civil liberties advocates.

After speculation over the Labor government's plans for a national identity card in recent weeks, the government has said the existing project will be scrapped.

"Labor will not be proceeding with the Howard government's proposed Access Card," the Minister for Housing and the Status of Women, Tanya Plibersek, told ZDNet Australia yesterday.

Plibersek had been Labor's Shadow Minister for Human Services and the party's spokesperson on the Access Card throughout the Federal election. She has since shifted portfolios after Prime Minister Kevin Rudd selected his new cabinet.

Queensland Senator Joe Ludwig is now the Minister for Human Services, his office had not responded to ZDNet Australia's requests for comment at the time of publication.

Read the complete article here:

http://www.zdnet.com.au/news/security/soa/Is-the-Access-card-dead-or-changing-its-identity-/0,130061744,339284365,00.htm

I suspect this is a little bit of a beat up – but it really would be good to get clarity as to just what the new Labor Government is going to do about electronic identity. What is needed is a coherent national electronic ID strategy that is then implemented to meet the requirements of all those who need to confirm and manage electronic ID. This should cover the Health sector, Centrelink, the Passport Office, Attorney Generals and whoever else has a need.

Third we have:

Pharmacists hail patients' paperless win

Andrew McGarry | December 08, 2007

A LEADING pharmacy organisation expects to be able to double its patient load next year with the help of Australia's first mobile paperless patient record system.

Based in South Australia, HPS Pharmacies supplies medications to hospitals, aged care and correctional service facilities. Now, using a hand-held PDA as a platform, HPS Pharmacies is introducing the Clinpod program for its 100 clinical pharmacists around the country, allowing them to access and edit patient records.

Bruce Heal, the managing partner of HPS Pharmacies, says that the technology, which was 12 months in development, was expected to lead to a sharp rise in productivity.

"We anticipate we will be able to see another 500,000 patients next year, doubling the capacity of our clinical pharmacists because of this program," he says.

Heal says one of the primary beneficiaries of the new system will be Department of Veteran's Affairs patients, who are covered by his company.

"We believe every DVA patient in hospital will be seen without fail," he says, adding that the amount of paperwork required to process such patients had previously meant that not everyone could be seen by the pharmacists.

Continue reading here:

http://www.theaustralian.news.com.au/story/0,25197,22882885-23289,00.html

I thought this story was worth a little follow-up. The company has a useful website which is found at:

http://www.hpspharmacies.com.au/

Usefully the site provides (as well as Footy Tips!) the following explanatory FAQ that can be found here:

http://www.hpspharmacies.com.au/newscentre_mdiaclinpod.html

Clinpod FAQ

What is Clinpod?

Clinpod is Australia’s first paperless clinical review information system designed for clinical pharmacists in hospitals.

It allows pharmacists to record and retrieve medication information via a hand-held PDA device which offers email, internet and note taking functions.

The device is connected wirelessly via the web to a central database – Clinpod is hosted on a secured web server.

Clinpod stores patients’ clinical review records securely and confidentially for retrieval and checking by clinical pharmacists.

Previously this information was recorded manually using a combination of note taking and data entry.

What will Clinpod be used for?

Clinpod will be used by our clinical pharmacists to electronically record and retrieve patient clinical review notes.

Information in clinical review notes includes important clinical interventions picked up by the pharmacist, education provided and other activities performed throughout the hospital such as drug recalls. Pharmacists can access current drug information from the Australian Medicines Handbook at the patient’s bedside, using the internet function on the device.

Information recorded on the PDA device will be stored securely in the Clinpod database.

Where will Clinpod be used?

Clinpod will be used in hospitals serviced by HPS Pharmacies. HPS has around 100 clinical pharmacists working across Australia in 87 hospitals, servicing more than 15,000 hospital and aged care beds.

HPS services 56 hospitals in SA, 18 in VIC, eight in NSW, four in QLD and one in TAS.

What is the role of a clinical pharmacist?

Clinical pharmacists play a high level role in hospitals, providing critical advice to doctors about drug interactions, dosages and potential adverse drug reactions.

They identify and recommend specific drug monitoring for patients, provide therapy review and advise on specific medication compliance aids that may be required by a patient struggling to manage their multiple medication regime.

Clinical pharmacists play a role in monitoring prescribing and administrative errors through chart reviews to ensure greater patient safety.

Their role is particularly important in relation to high risk patients who are taking multiple medications and who are over the age of 70.

Why was Clinpod developed?

HPS Pharmacies was frustrated by the amount of time clinical pharmacists were spending on administration and wanted to develop a solution that enabled them to spend more time with doctors, nursing staff and patients.

Ultimately their role is to provide critical medication advice, contribute to better patient care and optimise patient safety.

Who will benefit from Clinpod?

Patients, doctors and clinical pharmacists will benefit from the introduction of Clinpod.

With less paperwork and improved access to drug information, clinical pharmacists will have more time to spend with patients providing education on medications and reviewing medication histories to ensure better patient outcomes.

Clinpod will give clinical pharmacists more time to educate hospital staff on effective use of medications. This will contribute to better patient care and will also maximize medication cost efficiencies.

How will Clinpod improve hospital efficiencies?

Ultimately more patients will receive more clinical care as less paperwork is required to manage each patient’s medication review requirements.

Improved reporting will contribute to hospital accreditation requirements and other reporting needs.

How much does it cost?

There will be no cost to the hospital or the patient.

HPS has and will continue to fund Clinpod to ensure our clinical pharmacists can provide a very high level standard of care.

If Clinpod is fully funded and serviced by HPS, what is the benefit for HPS?

Clinpod addresses a key frustration held by HPS’s clinical pharmacists – paperwork.

By introducing Clinpod, not only can we provide a better service to hospitals and patients, but we are also improving job satisfaction for our staff.

How much did HPS Pharmacies invest in the technology?

This was a service developed internally so we estimate the cost to be many thousands of dollars. For us it was an investment of staff time over 12 months to create a solution that enables us to provide a better service to hospitals and improve the job satisfaction of our staff.

Who developed this technology?

HPS Pharmacies developed this technology internally using the practical knowledge of our staff.

The idea for Clinpod was generated out of a long term frustration staff have had with paper-based recording systems in hospitals.

What is the technology?

Clinpod is a central database which is hosted on a secured server. It will contain all the information recorded on the PDA devices which will enable clinical pharmacists to call up past patient medication history and download new information immediately.

Is there a risk to patient confidentiality?

No. HPS’ IT staff have ensured that the database will only be accessed by required HPS staff. It has the necessary security in place to ensure that there is no risk to patient confidentiality.

When will Clinpod be introduced to Australian hospitals?

Clinpod and the PDA devices will be introduced to South Australian hospitals in November 2007 and will then be rolled out throughout NSW, QLD, VIC and Tasmania in the first half of 2008.

This roll out is phase 1 and like all HPS services, Clinpod will be continually reviewed and updated as the requirements of the health care environment changes and as technology improves. Designs and ideas for version 2 are already being developed.

How will Clinpod be introduced to hospitals?

The clinical pharmacist will be fully trained by HPS and will explain Clinpod’s function to patients and doctors where required.

The introduction of Clinpod will have no impact on hospital staff or patients, other than providing a more efficient clinical service.

End FAQ. -----

This is a fascinating initiative which it essentially providing an Shared Electronic Medication Record. Given the scale of the role HPS has in the medication management sector it will be interesting to see what issues emerge as the system is implemented and how issues of confidentiality and individual privacy are being addressed.

Fourthly we have:

Grand challenges in clinical decision support

Dean F. Sittig, Adam Wright, Jerome A. Osheroff, Blackford Middleton, Jonathan M. Teich, Joan S. Ash, Emily Campbell and David W. Bates.

Journal of Biomedical Informatics – In Press (December, 2007)

Abstract

There is a pressing need for high-quality, effective means of designing, developing, presenting, implementing, evaluating, and maintaining all types of clinical decision support (CDS) capabilities for clinicians, patients and consumers. Using an iterative, consensus-building process we identified a rank-ordered list of the top 10 grand challenges in clinical decision support. This list was created to educate and inspire researchers, developers, funders, and policy-makers. The list of challenges in order of importance that they be solved if patients and organizations are to begin realizing the fullest benefits possible of these systems consists of: improve the human–computer interface; disseminate best practices in CDS design, development, and implementation; summarize patient-level information; prioritize and filter recommendations to the user; create an architecture for sharing executable CDS modules and services; combine recommendations for patients with co-morbidities; prioritize CDS content development and implementation; create internet-accessible clinical decision support repositories; use freetext information to drive clinical decision support; mine large clinical databases to create new CDS. Identification of solutions to these challenges is critical if clinical decision support is to achieve its potential and improve the quality, safety and efficiency of healthcare.

Continue reading all of this important article here (if you have appropriate access).

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WHD-4PPW74B-1&_user=10&_coverDate=09%2F21%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=c7be526c27c40b9980afa4fc26ddee3d

This list looks to me to be invaluable in guiding where efforts need to be placed in the development of improved CDS. More power to the author’s arms for attempting this important study.

Fifthly we have:

iHealthBeat - December 04, 2007

“Leavitt Chats About Federal Government's Role in IT Adoption

In a Health Affairs Web exclusive interview published Tuesday, HHS Secretary Mike Leavitt said the federal government must use its purchasing power to promote health IT adoption now that key technical standards are in place.

The Bush administration has set standards "through a hard, collaborative process," according to Leavitt. He said the federal government "at some point in time" will have to require health care providers to meet certain standards to participate in Medicare and Medicaid.

However, Leavitt said, "We can't just go out and by fiat say, 'By January 1, 2010, everybody must have...,' because we're talking about a huge sociological change." He noted the importance of a large-scale health IT demonstration project "to prove up the business model" of incorporating IT into the health care sector.”

This seems to me the US Government is saying that their patience is wearing out and that the widespread deployment of e-Health will need to driven by some large financial sticks if the current incentives are seen to be inadequate.

This attitude certainly suggests the US Department of Health and Human Services is convinced of the importance of moving forward. More encouragement for our new Federal Government?

Further discussion on the same topic is also found here:

Leavitt: Doctors Need Electronic Records

By KEVIN FREKING, Associated Press Writer

Monday, December 3, 2007

(12-03) 14:44 PST WASHINGTON, (AP) –

The nation's medical doctors should have to adopt electronic record-keeping if they want to avoid a pay cut from Medicare next year, the Bush administration said Monday.

Article continues here:

http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2007/12/03/national/w144443S71.DTL&type=politics

Lastly we have:

HL7, AHIP, and BCBSA to collaborate on PHR standards

By Richard Pizzi, Associate Editor 12/04/07

Health Level Seven, Inc. , America's Health Insurance Plans, and the Blue Cross and Blue Shield Association today announced they have signed a Memorandum of Understanding to create a collaborative process for the maintenance of portability standards for personal health records.

The MOU expands the number of stakeholders involved in the standards development process to help facilitate data portability between health insurance plans to give plan members the ability to move their personal health data when their health coverage changes.

"We applaud AHIP and BCBSA for investing in the early development efforts of the PHR data portability standards and for entrusting HL7 to maintain the standards," said Charles Jaffe, MD, CEO of HL7. "PHRs will give consumers the power to integrate and manage their personal healthcare information and it provides a framework for standards-based interoperability between the consumer and the provider."

Health insurance plan-based PHRs contain claims encounter and administrative data drawn from health insurance plan data sources as well as individuals' self-entered information.

…..

In early 2008, HL7 intends to publish a PHR-S Functional Model Draft Standard for Trial Use version to allow the industry to work with a stable standard for up to two years while it is being refined into an ANSI-accredited version.

Continue reading this interesting article here:

http://www.healthcareitnews.com/story.cms?id=8267

This is really important stuff as it sees an effort to make sure that information held in a Person Health Record can follow the patient over time as they change location or PHR provider. An important brick in the wall in improving adoption of PHR technology.

All in all some interesting material for the week!

More next week.

David.