Wednesday, September 17, 2014

This Is A Very Interesting Article With Some Details On Where The PCEHR Is Developed And Supported.

This appeared a little while ago and a few paragraphs in the middle were very interesting:

Union hits out at proposed offshoring of ATO test & dev

Tax Office insists no financial data will be stored overseas.

It says the Department of Health has already confirmed that work contracted to Accenture as infrastructure partner to the Personally Controlled Electronic Health Record will be done from India.
Accenture has been paid more than $100 million to date for its PCEHR infrastructure support, and another $111 million for associated data warehousing.
However a Health spokesperson pointed out that this has been the case since Accenture was first engaged in 2011, and there are no plans to expand on the Bangalore-based support.
“Accenture does have an off-shore team that is involved in coding of changes to the system that are then shipped to Australia for testing, integration and implementation by the local team.
“This off-shore team does not have access to the operational PCEHR system and no PCEHR records are able to be accessed by any off-shore developers,” she said.
Lots more here:
I will leave it to the reader to figure out what implications these little revelations have but it does seem to me the development and bug-fixing loop is being rather extended by this cost cutting approach from Accenture.
I am interested to note just how long it has taken for these sort of arrangements have made it to the public domain.

Tuesday, September 16, 2014

There Is Something Pretty Odd Going On With Standards Australia And The Sale Of SAI-Global.

First a little background. SAI-Global is an ASX Listed company that has a long term license to sell Standards Documentation that us created by a huge range of organisations from that include the Australian Dental Association, the Australian Nursing Federation and Midwifery Federation, the Australian Steel Institute, Master Plumbers Australia and Telstra Corporation, among many others including some e-Health entities.
One set of publications are those created by Standards Australia’s IT-14 Committee which manages e-Health Standards in Australia.
Here is the relevant Standards Australia web site.
Close reading of this web site reveals that there has been no activity or work-planning since June 30, 2014 Additionally there has not been any Standards published since May 2014.
Over the last few years Australian e-Health Standards have been developed by volunteers (often pushed and maybe dominated by NEHTA ) and have had the publication sponsored by the Department of Health (It is not clear if this is happening after June 30 this year).
So maybe co-incidentally, or not, we now have the publisher of standards under offer by two private equity (PE) groups who seem to be offering up to $A 1 Billion for what is a monopoly publishing business.
Not surprisingly Standards Australia are a little concerned, as they see the potential for some profiteering. See this report.

SAI Global blocks buyer talks with Standards body as $1bn bids heat up

Simon Evans
Takeover target SAI Global has refused requests by private equity bidders and other potential buyers for official permission to speak to Standards Australia, which has an influence on the future profitability of a lucrative contract held by SAI.
SAI is understood to have reinforced to potential bidders that all of the pertinent information about the contract it currently holds with Standards Australia – under which SAI sells and publishes around 7000 standards on behalf of Standards Australia – is contained in the data room for potential buyers.
It has refused requests by potential bidders for official permission to speak to Standards Australia, itself an unlisted not-for-profit company that has a membership base of 74 organisations from a range of different industries.
Lots more here:
Indeed, so worried is Standards Australia that they might try to take SAI Global over themselves.

Standards Australia in surprise last-ditch buyout bid in SAI takeover tussle

Simon Evans and Sarah Thompson
Standards Australia, an organisation controlled by 74 member bodies including the Australian Dental Association and Master Plumbers Australia has, made a last-ditch approach to takeover target SAI Global, seeking to buy back a lucrative part of the business.
But the approach, understood to be preliminary, has come too late for Standards Australia to be admitted into the data room because deadlines for final offers for SAI Global are due on September 12 as private-equity bidders circle.
Standards Australia is understood to have made a pitch to buy back the lucrative Publishing Licensing Agreement business, a major profit contributor in SAI’s information services division. The division made up more than half SAI’s total earnings before interest and tax of $72.6 million for 2013-14.
Lots more here:
Blind Freddy can pick that is a PE group gets hold of these publication rights there is a real chance of sudden price increases!
So - right now - e-Health Standards setting seems to have stopped and the costs seem to be at considerable risk of going up. This all just adds to the disillusionment of most volunteers who have worked for IT-14.
Additionally there seem now to be some uncertainty as to how things will play out with SAI-Global in private hands.
Rumours and other intelligence more than welcome.

Monday, September 15, 2014

Weekly Australian Health IT Links – 15th September, 2014.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Lots of things going on - with the exception of resolution of what to do about the PCEHR.

Under the radar we have all sorts of silliness going on regarding Standards Australia and most especially in the e-Health space and all sorts of disconnected activity going on - most of which is destined to turn out to have been a waste of money and time - sadly!

Just so you know Orion - the makers of the interface to what is regarded as a hopeless user interface to the PCEHR are apparently getting close to suggesting NZ investors buy shares in them and assist the directors become rich - (An IPO - or Initial Public Offering). How you feel about this is up to you.

Hard to know what comes next - just as it is regarding IS, Ukraine, Gaza, Ebola, Boko Haram, Liberia and so on. Pretty sad I have to say.

Manly lifeguards test wearables for emergency information

Safe Mate is waterproof and does not require charging
The Manly Life Saving Club is trialling wearable wristbands for nippers, swimmers and surfers that quickly provide critical information in the case of an emergency.
The Club is conducting a pilot of Safe Mate, a waterproof silicone wristband that contains a near-field communications (NFC) chip that does not require charging.
Wristband wearers upload their emergency contact and medical information to the Safe Mate website. In an emergency, first responders can access the information by scanning the user’s wristband with an NFC-compatible Android smartphone running the Safe Mate Professional app.
The data itself is not stored in the wristband but rather a local Australian data centre.
The Manly Life Saving Club has deployed hundreds of the wristbands to the Manly Nippers and will provide the professional app, mobile devices and training to the Manly LSC.

Hooked on cloud - as Apple Watch debuts, new models step up

Socialisation technologies are inexorably drawing health and government into new models of industry engagement and industry-led protocols to protect health data. 
This week Apple CEO Tim Cook rolled out Apple's health-enabled smartwatch today amidst increasing scrutiny of healthcare apps and the storage of healthcare information in the cloud.
The new $US350 watch, known simply as Apple Watch, embodies a range of sensors, including pulse rate, workout intensity and the type of exercise. Using the HealthKit App, the watch is able to share the health information with healthcare providers and other associated apps, a move that has drawn interest in the US from players including Mayo Clinic and Memorial Sloan-Kettering.

3D-printed hearts will help surgeons better prepare for operations

Date September 8, 2014 - 12:00AM

Amy Corderoy

Sydney hospitals are preparing to use 3D printers to produce life-size replicas of their patients' hearts to prepare for surgery.
Within a year, patients at Liverpool and St Vincent's hospitals are likely to have access to the technique, which will help  surgeons  have a better understanding of a patient's problem  before they operate.
Doctors say the new technologies will reduce patient deaths and injury, by decreasing the time operations take and preventing unexpected problems.
Cardiologist and clinical faculty member at the Victor Chang Cardiac Research Institute, James Otton, said for the first time in Australia he had used a 3D printer to make a replica of a patient's heart.
  • 12 September 2014 08:09

Justice Health Deploys Orion to Support Better Patient Healthcare

The Orion Health product suite will provide a critical platform for the Justice Health electronic health system’s migration to a computerised record of a patient’s medical history.
Sydney, 12 September 2014 - Orion Health, a global e-health technology leader, today announced that the Justice Health & Forensic Mental Health Network (JH&FMHN) in New South Wales has gone live with the Orion Health EMR (electronic medical record) Suite to support the organisation goal to deliver complete electronic medical records across the New South Wales public health system.
The Orion Health product suite will specifically provide a critical platform for the Justice Health electronic health system’s (JHeHS) migration to a computerised record of a patient’s medical history related to the clinical care received while in JH&FMHN. This will contain a subset of information previously held in paper medical records including patient details, medical conditions, appointments, pathology results, electronic forms and medicines prescribed. The data is now held in one consolidated place and therefore available state-wide as opposed to being held in multiple paper files and stand-alone electronic registers.

Justice Health rolls out electronic medical records

More than 30,000 patient records compiled each year are being digitised
The Justice Health & Forensic Mental Health Network plans to deliver complete electronic medical records across the New South Wales public health system following the deployment of new software.
The NSW organisation – which provides mental health services to people in the criminal justice system – has rolled out the Orion Health EMR platform to eliminate manual information sharing between the organisation and other healthcare providers.
The new system contains medical records for more than 30,000 patients each year who are highly vulnerable and who have numerous and more complex health needs than people in the wider community, the organisation said.

Outsourcing Medicare: Is it as easy as π?

| Sep 09, 2014 11:29AM
Following on from the range of issues raised by Croakey contributors about the outsourcing of MBS and PBS payments, Margaret Faux discusses the most appropriate role for the private sector in supporting core government functions and the risks involved when private sector interests conflict with the central role of government. She writes:
In a U.S managed care styled initiative, private insurers have been given the right to tender to manage the operation of the government’s new Primary Health Networks, which will soon replace existing Medicare Locals. And recently, the government’s expression of interest from the private sector to provide outsourced claims and payment services for the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Schedule (PBS) was closed.

Question: FHIR release schedule

Posted on September 11, 2014 by Grahame Grieve
I’m using the Java version of FHIR release 0.81. A bug fix that I needed required a later version of the code. I downloaded the code (rev. 2833) from SVN and, following the directions on the FHIR build page, had no trouble recompiling all of FHIR. Since rebuilding and replacing FHIR in our application is time consuming, I have some questions concerning release management:
  1. Is there a published release plan and schedule for FHIR?
  2. Is there a mechanism for patching or updating FHIR code between releases?
Note: this question was originally asked on StackOverflow where it was (a little unfairly) ruled out of scope.

Union hits out at proposed offshoring of ATO test & dev

Tax Office insists no financial data will be stored overseas.

Australia’s public service union has kicked up a stink over a proposal being assessed by the Tax Office that would see its application development and testing sent to the Philippines.
The ATO has confirmed that it is thinking about handing its test and dev functions to Accenture, which already undertakes hundreds of millions of dollars worth of IT work for the agency. Under the deal, the work would be supported out of Accenture’s Philippines-based delivery centre.
The Community and Public Sector Union (CPSU) has described the proposal as a kick in the teeth for ATO staff, who have already been forced to deal with the prospect of thousands of job losses out of the agency.

OAIC cautions over app privacy policies

Not enough Australian iOS apps provide adequate privacy policies, OAIC says
Privacy Commissioner Timothy Pilgrim has urged Australian businesses and government agencies to improve their act when it comes to their mobile apps.
A study of 53 iOS apps by Office of the Australian Information Commissioner revealed that 70 per cent of them don't provide users with a privacy policy before the app is downloaded.
"This is not good privacy practice," Pilgrim said in a statement. "Organisations must have a clearly expressed and up to date privacy policy that tells people how their personal information will be managed.
"A user can't make an informed decision about whether they should download an app if they aren’t told up front what personal information that app will collect and how it will use, store and protect that information."

Email not worth the effort

12 September, 2014 Amanda Davey
The idea that patients can email their doctor fills most GPs with dread, a 6minutes poll shows.
When asked whether email communication between patient and GP was a good alternative to a follow-up phone, call 80% of respondents answered “no”.
Less than a fifth of respondents thought email communication in general practice was a good idea. Just 3% were undecided.

Controversy over new health secretary

5th Sep 2014
DOCTORS have criticised the appointment of a top immigration official to head the health department in the wake of the row over an asylum seeker put on life support after complications from septicaemia acquired at the Manus Island detention centre.
Queensland GP Dr Richard Kidd, who heads the group Doctors4refugees, criticised the appointment of former immigration and border protection secretary Martin Bowles, given the sustained controversy about the physical and mental health of asylum seekers in detention offshore.
Dr Kidd spoke to MO after returning from a lunchtime vigil for Hamid Kehazaei, a 24-year-old Iranian declared “brain dead” after being admitted to ICU with septicaemia from a cut to the foot.
It was vital the culture of secrecy surrounding asylum seeker affairs did not spread to health, Dr Kidd said.

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Stool smell test detects superbug infections

10 September, 2014 Hugo Wilcken
It may not be the most fragrant of solutions, but clinicians could soon have another weapon at their disposal in the fight against hospital infections.
UK researchers have come up with an “electronic nose” capable of sniffing out the highly infectious C. Difficile bacterium in a patient’s faeces.
The team from the University of Leicester used a mass spectometer to identify C. Diff’s unique “smell”, leading to an instantaneous diagnosis of infection.

Standards Australia turns up heat on in-play SAI Global

Edited by Sarah Thompson, Anthony Macdonald and Jake Mitchell
Australia’s peak standards body has written to takeover target SAI Global, concerned SAI has not adequately disclosed how the renegotiation of an important contract between the two parties could affect SAI’s value.
It’s understood Standards Australia chief executive Bronwyn Evans wrote to her counterpart Andrew Dutton last week, unimpressed that Dutton’s SAI Global failed to address the contract’s expiry accurately at its 2013-14 financial year results in August.
It comes as bidders, including private equity firms Pacific Equity Partners, KKR & Co and The Carlyle Group, work up $1 billion offers for SAI Global in time for Friday’s deadline.

SAI Global blocks buyer talks with Standards body as $1bn bids heat up

Simon Evans
Takeover target SAI Global has refused requests by private equity bidders and other potential buyers for official permission to speak to Standards Australia, which has an influence on the future profitability of a lucrative contract held by SAI.
SAI is understood to have reinforced to potential bidders that all of the pertinent information about the contract it currently holds with Standards Australia – under which SAI sells and publishes around 7000 standards on behalf of Standards Australia – is contained in the data room for potential buyers.
It has refused requests by potential bidders for official permission to speak to Standards Australia, itself an unlisted not-for-profit company that has a membership base of 74 organisations from a range of different industries. Those members include the Australian Dental Association, the Australian Nursing Federation and Midwifery Federation, the Australian Steel Institute, Master Plumbers Australia and Telstra Corporation.

Standards Australia in surprise last-ditch buyout bid in SAI takeover tussle

Simon Evans and Sarah Thompson
Standards Australia, an organisation controlled by 74 member bodies including the Australian Dental Association and Master Plumbers Australia has, made a last-ditch approach to takeover target SAI Global, seeking to buy back a lucrative part of the business.
But the approach, understood to be preliminary, has come too late for Standards Australia to be admitted into the data room because deadlines for final offers for SAI Global are due on September 12 as private-equity bidders circle.
Standards Australia is understood to have made a pitch to buy back the lucrative Publishing Licensing Agreement business, a major profit contributor in SAI’s information services division. The division made up more than half SAI’s total earnings before interest and tax of $72.6 million for 2013-14.

Droplet lens that turns smartphones into microscopes for $2 wins Eureka prize

Date September 10, 2014

Frances Mao

The inventors of a $2 smartphone microscope and Ebola-fighting resources have won the nation's top gongs at the Oscars of Australian science.
Sydneysiders Tri Phan and Steve Lee won the Innovative Use of Technology prize in Sydney at the Eureka Prizes for creating a plastic droplet that can be hooked into smartphones to create a cheap high-powered microscope.
"I think where this will have a lot of potential is in the delivery of medicine to remote and rural communities," said Dr Phan before the awards.

Funding for new children's health complex

Sept. 11, 2014, 2:19 p.m.
Bendigo Community Health Services will receive $2.6 million in funding from the state government to build a centre for children's health. 
Health Minister David Davis visited Bendigo Community Health Services in Kangaroo Flat on Thursday to announce the grant. 
Acting chief executive of Bendigo Community Health Services, Anne Somerville, said staff were delighted that plans for a new "Kidzspace Children's Precinct" would come to fruition. 
"People were just overwhelmed with excitement and a sense of validation that we know this is so needed in central Victoria," Ms Somerville said.

Google buys Lift Labs, maker of health tech for degenerative disease

Summary: Lift Labs has developed a high-tech spoon to replace frustration with fun for those who combat tremors and find eating a difficult experience -- and Google wants in.
By Charlie Osborne for Between the Lines | September 11, 2014 -- 10:18 GMT (20:18 AEST)
Google has acquired Lift Labs, makers of a smart spoon which combats tremors suffered by those with Parkinson's and other neurodegenerative diseases.
The tech giant revealed the purchase on Wednesday. In a blog post, Google said Lift Labs will join the firm's research arm, Google[X].
San Francisco-based Lift Labs is the developer of smart eating equipment laden with sensors which detect tremors in the hand and compensate accordingly. The creators of the product, which comes with multiple attachments including a spoon, fork, and deep soup spoon, say these sensors then relay tremor data to make the equipment stabilize itself in response.

Serious flaws in Turnbull's NBN cost-benefit analysis report

Date September 8, 2014 - 9:06AM

Rod Tucker

In their cost-benefit analysis of the national broadband network, the Vertigan panel predicts that in 2023, an average Australian household will require a broadband download speed of 15 megabits per second (Mbps).
Bill Morrow, the CEO of NBN Co said he is "curious" about this prediction. I would go further and say it is simply wrong, and calls into question the validity of the conclusions of the Vertigan cost-benefit analysis.
Let's look at the data. The chart below shows average broadband download and upload speeds in Australia from January 2008 to January 2024. The curves in the shaded region in the lower left of the chart are actual measured Australian average upload and download speeds, as reported by Ookla, and reproduced from page 103 of the Vertigan Panel's report.

NBN fibre trial document 'misguided': NBN Co

Date September 8, 2014 - 7:19PM

Lia Timson

NBN Co has acknowledged the existence of an internal document detailing results of a fibre-to-the-premises deployment trial but said it was written by a well-meaning member of staff and was misguided.
The company disputed an article published by Fairfax Media on Saturday detailing cost and rollout time-frame savings and recommendations based on a trial in Melton, Victoria. It dismissed the report as inaccurate in an online statement.
On Monday, an NBN Co spokeswoman said the document had not been endorsed by management "due to a number of shortfalls in the methodology and metrics", and had not been verified.

Coalition's NBN speed forecasts are on the right track

The Vertigan Panel has, on behalf of the Government, recently published a cost benefit analysis of various approaches to the NBN. One input to their work was a forecast of Australian bandwidth needs prepared by my firm. We found that by 2023 the top five per cent of households would require at least 43 Mbps, and the median household would require 15 Mbps.
At first blush these numbers may seem low. But it’s worth remembering that most Australian households have just one or two people. A household where two people were both watching their own HDTV stream, each surfing the web and each having a video call all simultaneously, then (in part thanks to improving video compression) the total bandwidth for this somewhat extreme use case is just over 14Mbps in 2023.

NBN Co fears fibre floodgates opening on TPG decision

Summary: NBN Co CEO Bill Morrow has said that should TPG roll out fibre networks along with Telstra and Optus in competition with the NBN, it would undermine the business model for the company.
By Josh Taylor | September 12, 2014 -- 05:43 GMT (15:43 AEST)
The Australian Competition and Consumer Commission's (ACCC) decision to allow TPG to roll out fibre to the basement to apartment blocks in Australia's CBDs could potentially undermine NBN Co's business model if other players follow suit, CEO Bill Morrow has said.
After four months of investigation, the ACCC decided yesterday that TPG's plans to upgrade 500,000 units across Sydney, Melbourne, Brisbane, Adelaide, and Perth are not in breach of the Telecommunications Act rules against allowing fibre companies to extend their existing networks by no more than 1km.

TPG's challenge: It's either a speedbump or the first step to ruin for the NBN

Date September 12, 2014 - 9:18AM

David Ramli

NBN Co staff would've spent Thursday morning muttering into their cooling cappuccinos as they read the competition regulator and government's plans to let TPG Telecom eat their lunch by building a rival broadband network.
They know better than most that letting TPG connect half a million apartments to a rival network by running fibre to the building's basement is a dangerous move for the $41 billion national broadband network.
This is why NBN fought tooth and nail to convince the Australian Competition and Consumer Commission to slam the breaks on TPG's project, arguing that the rival would destroy its business model and broke the spirit and letter of the laws protecting its monopoly over our broadband future.
Instead the ACCC gave it a go-ahead with warnings it would set a regulated price, while Communications Minister Malcolm Turnbull announced he'd also let it go through, calling for any company offering services to split their wholesale and retail divisions.

Stephen Hawking says Higgs boson has potential to destroy entire universe

  • September 08, 2014 3:51AM
  • News Corp - Australia
SCIENTIST Stephen Hawking has warned that the Higgs boson, the so-called God particle, could cause space and time to collapse.
But there is time for lunch: It may take trillions of years to topple.
The British professor said that at very high energy levels the Higgs boson – the subatomic particle which gives us our shape and size - could become so unstable that it would cause space and time to collapse.
Hawking made his comments in the preface to a new book, Starmus.

God particle a threat to universe: Stephen Hawking

  • The Times
  • September 08, 2014 12:00AM
THE Higgs boson, once hailed as the God particle, may have the potential to destroy the universe, Stephen Hawking has warned.
He suggests that, at very high energy levels, the Higgs could suddenly become unstable, causing a “catastrophic vacuum decay” that would cause time and space to collapse.
Such a disaster is, he stresses, very unlikely — and the fact that such a possibility even exists is exciting because it suggests a whole new realm of physics.
Professor Hawking’s comments are contained in his preface to a new book, Starmus, due out next month, containing lectures by renowned cosmologists and astronomers first given at a scientific conference of the same name.

Sunday, September 14, 2014

Plus ça change, plus c'est la même chose - How True This Is. I Am Amazed.

I spotted this a day or so ago and just could not believe it!

Advancing Health IT with Congressional Asks

by Alex Cohn, Institute for e-Health Policy Intern with the HIMSS Government Relations Office
Each year, a work group of HIMSS volunteers develops the organization’s “Congressional Asks” – formal requests to Congress to accomplish specific goals to advance health IT.
As the process goes, the HIMSS Public Policy Committee reviews, and the HIMSS Board of Directors approves, these Congressional Asks. A vital component of the HIMSS activities during NHIT Week, the Congressional Asks
  • represent essential messages presented to Congress during the annual HIMSS Public Policy Summit Day, Sept. 18, on the Capitol Hill; and
  • provide important issues and guidance used by HIMSS and many other organizations throughout the year.
This year, HIMSS focused on three very different, yet essential, topics within health IT. Our top three  2014 recommendations for Congress – the Congressional Asks – follow.
Ask #1: Minimize Disruption in our Nation’s Health System Emanating from Federally Mandated Health IT Program Changes.  To minimize disruption of healthcare to patients and avoid an undue burden on providers, Congress should require the Secretary of HHS to publish a review, evaluation, and recommendations on the five-year roadmap of all mandated, HHS-administered health IT requirements and program changes affecting patients and the operations of providers, payers, and/or health IT vendors.
Ask #2: Fund the National Coordinator for Health IT to Achieve Interoperability, Improve Clinical Quality, and Ensure Patient Privacy and Safety. Positively transforming our nation’s healthcare system requires, among other things, widespread, secure, interoperable exchange of health information. Congress should fund the Office of the National Coordinator for Health Information Technology in FY 2015 at sufficient levels requested in the Administration’s FY 2015 Budget Request.
Ask #3: Expand Telehealth Services to Improve Patient Access and Outcomes and Decrease Healthcare CostsTo expand access to quality care, help control costs, enhance secure interoperability of health information, and improve quality for rural and underserved populations, Congress should pass legislation that enables the nationwide realization of the full benefits of telehealth services.
Full HIMSS Post is here:

In summary what is being asked for is that Government stops springing surprises (like the PCEHR and a whole lot of standards and regulations) on the e-Health Community, that the focus be on safety and clinical information exchange and to see if teleheath - especially in remote areas can be supported.

The similarities of the analysis of the issues and what needs doing is just amazingly congruent with the situation in OZ!

Sounds like an agenda most in Australia could wholeheartedly support.

Seems like Government is hard to cope with all over!


AusHealthIT Poll Number 235 – Results – 14th September, 2014.

Here are the results of the poll.

How Would You Rate The Federal Government's First Year In Power As Far As E-Health Is Concerned?

Excellent 3% (3)

Not Too Bad 2% (2)

Neutral 15% (13)

Not Too Good 22% (19)

Awful 53% (46)

I Have No Idea 5% (4)

Total votes: 87

This is a pretty clear outcome. The Federal Government is getting a clear fail on this. We are all simply being let down.

Again, many, many thanks to all those that voted!


Saturday, September 13, 2014

Weekly Overseas Health IT Links - 13th September, 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.

Open Source Developer Enhances Blue Button Integration Technology

SEP 4, 2014 9:13am ET
Open source software developer Amida, based in Washington, D.C., has released the second version of its Data Reconciliation Engine (DRE), a Blue Button-branded software component that supports the aims of the Blue Button Initiative.
"The DRE is the first production-ready, format-agnostic open source health record interface in the health IT market," company executives said. "The second release extends the kinds of formats that the DRE can ingest, and now includes the CMS Blue Button file. It also supports the ability to export a Consolidated CDA record. The release includes technical enhancements that improve record matching, insurance modeling, and its deployment scripts."

FHIR Catching On as Open Healthcare Data Standard

SEP 4, 2014 8:46am ET
Fast Healthcare Interoperability Resources (FHIR) from standards development organization Health Level Seven is gaining momentum as an open healthcare data standard.
That is the consensus of a joint Health IT Policy Committee and Standards Committee task force. The committees advise federal agencies.
In a Sept. 3 HITPC meeting, David McCallie and Micky Tripathi, co-chairs of the JASON Report Task Force created to analyze interoperability recommendations by an independent group of scientists, made the case that the “growing industry adoption of standards-based [application programming interface] work such as HL7 FHIR, focused on high-value use cases, is the most appropriate and sustainable path to accelerated use of standardized data-level APIs across the industry.”

Why Congress must be cautious about spending more for HIT interoperability

September 5, 2014 | By Dan Bowman
Federal legislators should exercise caution in doling out more money for health IT interoperability efforts, as there is no guarantee that doing so will actually improve health data exchange, writes John Graham, a senior fellow at the National Center for Policy Analysis and the Independent Institute.
Graham, in a commentary for Forbes, called interoperability a "unicorn," saying that despite billions of dollars sunk into the Meaningful Use incentive program, data exchange between hospitals on disparate EHR systems remains difficult, if not impossible.
"[E]xchanging data with competitors is fundamentally against the self-interest of the part which created the data," Graham said. "Nobody would expect the U.S. Department of Transportation to set up a fund to incentivize car-makers to exchange data with each other, or the U.S. Department of Agriculture to set up a fund to incentivize grocery stores to exchange data with each other."

Technology Advances Boosting Telehealth, but Challenges to Widespread Use Remain

by Bonnie Darves, iHealthBeat Contributing Reporter Friday, September 5, 2014
Telemedicine -- or telehealth, as it's broadly called -- and emerging mobile health technologies are progressing, despite challenges related to logistics, regulations and reimbursement. Telehealth is also reshaping the health care delivery landscape through integration with clinical practice, largely because of IT advances and innovation.
The drivers and contextual forces propelling the shift, on one hand, are the usual suspects:
  • Cost-containment pressures from the Affordable Care Act; and
  • Attempts to reduce the inefficiencies and access issues that have long driven up care costs.
But there's a new force spurring telehealth advances that may prove just as powerful: consumers. As consumers pay more for medical services amid benefit plans change, they are demanding more access to convenient, technology-enabled services.

Automated Smoking Cessation Program Proves Successful

SEP 3, 2014 10:08am ET
A smoking cessation program developed at Massachusetts General Hospital increased the proportion of hospitalized smokers who successfully quit smoking after discharge by more than 70 percent.
The system used interactive voice response technology--automated telephone calls--to provide support and stop-smoking medication for three months after smokers left the hospital. The program was the focus of a study published in JAMA.
The program developed by the MGH team provides smokers with a series of interactive automated telephone calls beginning two days after discharge and up to three months’ supply of the patients’ choice of any FDA-approved, stop-smoking medication. At each call, the automated system asked patients to indicate whether they were smoking, gave advice on staying smoke-free, encouraged the proper use of medication and offered medication refills. Participants requesting additional help received a call back from one of the program’s tobacco treatment counselors.

Big data: The latest fad in health policy

Posted on Sep 04, 2014
By Kip Sullivan, Contributing writer
In case you blinked, big data is the newest new thing in establishment health policy. The July 2014 edition of Health Affairs carries on its spine the title, “Using big data to transform care.” It was funded by IBM and the UnitedHealth Foundation, among others. Last year McKinsey & Company published a paper entitled “The big-data revolution in US health care” in which the authors predicted big data will cut American health care costs by 12 percent to 17 percent. A public-private group called Health Data Consortium, which includes the Institute of Medicine, Hewlett-Packard, and Emdeon, was formed in 2012 to promote the collection of all forms of health data.
A late July 2014 article in Fortune testifies to the power of the hype promoting big data. Although the article quotes two experts in biology who throw very cold water on the notion that big data can make substantial improvements in cancer care, the article also reports that two very smart 28-year-old guys with business degrees from the Wharton School of Business have raised $138 million, $100 million of it from Google Ventures, for a company that will attempt to divine new treatments for cancer from massive amounts of data about cancer patients. Someone is going to be proven wrong here. Who will it be? The info tech wizards and their wealthy backers, or the biology experts (one of whom discovered the first oncogene)?

Taking out interoperability hurdles

Posted on Sep 04, 2014
By Tom Sullivan, Editor, Government Health IT
The Office of the National Coordinator for Health IT has been reshaping itself for the future and is working on its strategic plan alongside a 10-year roadmap for interoperability — and that is against the backdrop of health IT reports put out by other federal entities, notably JASON and PCAST.
In all the efforts interopeability is critical.
Documents from JASON, conducted by independent scientists at The MITRE Group advising the Agency for Healthcare Research and Quality, and the President’s Council of Advisors on Science and Technology delve into health infrastructure and information exchange, essentially pointing to what needs to be done.
ONC’s HIT Policy Committee established a JASON Report Task Force and on Wednesday, co-chair Micky Tripathi suggested, among other things, that ONC cross-reference both PCAST and its own ONC Interoperability Roadmap when deciding how to move forward.

Mapping a shared way forward for HIE

Posted on Sep 04, 2014
By Mike Miliard, Managing Editor
In part two of the Healthcare IT News Q&A with Micky Tripathi, he lays out the ways interoperability can finally be brought to fruition in the U.S. over the coming decade. Hint: the federal government and the private sector each have big jobs to do.
In our chat Wednesday with Tripathi, CEO of the Massachusetts eHealth Collaborative and co-chair of the joint HIT Policy and Standards Committee's JASON Task Force, he offered some perspective on how and why interoperability has historically been such a problem for healthcare – and discussed lessons that might be drawn from other industries that were able to make it happen.
With the Office of the National Coordinator for Health IT now redoubling its efforts to make seamless, wide-reaching data exchange a reality within the next 10 years, he gives some further thoughts on how it all might play out.

JASON task force: 'Parallel' architecture paths needed for interoperability

September 3, 2014 | By Marla Durben Hirsch
The Office of the National Coordinator for Health IT should consider some but not all of the findings of the JASON report in going forward with Stage 3 of Meaningful Use and interoperability, according to ONC's JASON task force.
In a report presented to ONC's Health IT Policy Committee on Sept. 3, the task force pointed out that the JASON report--which found Meaningful Use's Stage 1 and 2 had not achieved "meaningful interoperability" and stressed a need to create a unifying software architecture using application programming interfaces--is based on out-of-date data. 
"Current EHR systems have much more functionality ... than JASON gives them credit for," said Micky Tripathi, co-chair of the task force.

ICD-10 switch may raise issues for adverse event reporting

September 4, 2014 | By Susan D. Hall
The switch to ICD-10 poses the risk of under-reporting and over-reporting adverse events due to mismatches in codes for Patient Safety Indicators (PSIs), according to research at the Journal of the American Medical Informatics Association.
The researchers, from the University of Illinois at Chicago, looked at 23 types of PSIs. They found three had straightforward mapping between ICD-9 and ICD-10, while 15 had convoluted mapping and five had no mapping at all.
They pointed at two--PSI-15 and PSI-25 "Accidental puncture or laceration"--that pose significant challenges.

Health IT a new sweet spot for investors

September 4, 2014 | By Dan Bowman
As use of electronic health records by providers and health tracking devices by consumers becomes more ubiquitous, the health IT industry is gaining a reputation as an emerging sweet spot for technology investors, according to a Reuters report.
Several investors, according to Reuters, said they see health IT as more of a safe bet than an industry like biotechnology. While success in the former industry is linked to services and data being sold to insurers and providers, the latter's success hinges on the unpredictable drug market, the article notes.
"Healthcare is a massive market," Kevin Spain, a general partner at Emergence Capital Partners, tells Reuters. Spain says he invested close to $40 million in health technology startup companies like Augemedix, which is creating tools that can be used by providers wearing Google Glass to view EHRs.

Study: EHRs decrease number of patients seen, but increase revenue

Written by Helen Gregg (Twitter | Google+)  | September 03, 2014
EHR implementation may lead to a dip in patient volume but can boost revenue in the long term, according to a study in the Journal of the American Medical Informatics Association.
In the study, researchers compared patient volumes and revenues at 30 ambulatory clinics before and for two years after and EHR was implemented.
Over the two post-EHR years, patient volumes dropped across specialties to the tune of 108 patients less per quarter. However, the practices were billing for an average of an additional 94 ancillary procedures per quarter after the EHR implementation.

Interoperability: supply and demand

Posted on Sep 03, 2014
By Mike Miliard, Managing Editor
When Micky Tripathi and David McCallie deliver their draft recommendations to the Health IT Policy Committee today, they'll have some pointed things to say about the JASON report, and its ideas about the state of nationwide interoperability.
Tripathi, CEO of the Massachusetts eHealth Collaborative, and McCallie, senior vice president of medical informatics at Cerner, are co-chairs of the joint HIT Policy and Standards Committee's JASON Task Force – charged with digesting the report, "A Robust Health Data Infrastructure," prepared for AHRQ by the MITRE Corporation's JASON advisory group, and making suggestions to ONC about what to do with its findings.
In a presentation made to their own JASON Task Force on Sept. 2, Tripathi and McCallie offered their perspective about the dense, 69-page report, which assesses the U.S. healthcare's readiness for widespread and seamless data exchange.
How ready? JASON's verdict: not very.

CIO Chuck Podesta: 'No excuse for not encrypting' data

September 3, 2014 | By Katie Dvorak
There a three big risks when it comes to data security, Chuck Podesta, CIO at Orange County, California-based UC Irvine Health, says in a recent interview with the Institute for Health Technology Transformation. Those risks include internal breaches, external breaches and physical theft of data.
As far as information protection goes, Podesta, who served as senior vice president and CIO of Burlington, Vermont-based Fletcher Allen Health Care at the time of the interview, says there is "no excuse for not encrypting." He points to the HITRUST Common Security Framework as a way to reduce risk.

HIT groups applaud CMS telemedicine expansion proposal

September 3, 2014 | By Dan Bowman
Expansion to telemedicine coverage for Medicare beneficiaries recommended by the Centers for Medicare & Medicaid Services in its proposed update to the Medicare Physician Fee Schedule for 2015 generally was praised in comments recently submitted by industry stakeholders, including the American Telemedicine Association (ATA) and the American Hospital Association (AHA).
ATA CEO Jonathan Linkous, in a letter sent to CMS Administrator Marilyn Tavenner, said his organization "strongly supports" the recommendations, which include proposed coverage of annual wellness visits and psychotherapy. He added that ATA "appreciates CMS making explicit that two CPT codes for computer-based psychological testing are payable in the same way as other physicians' services, and not as telehealth services with accompanying severe restrictions."
Linda Fishman, senior vice president of public policy analysis and development at AHA, said her organization was "especially pleased" to see "certain behavioral health services" receive more attention.

Humorous ICD-10 Book Going Viral

SEP 1, 2014
An illustrated look at some of the more offbeat ICD-10 codes is starting to go viral. A group of Madison, Wis.-based health IT experts and artists combined to produce "Struck By Orca: ICD-10 Illustrated," a guide to some of the humorously obscure examples

Wearable computing at BIDMC

Posted on Mar 12, 2014
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
Over the past few months, Beth Israel Deaconess has been the pilot site for a new approach to clinical information technology, wearable computing.
In the Emergency Department, we’ve developed a prototype of a new information system using Google Glass, a high tech pair of glasses that includes a video camera, video screen, speaker, microphone, touch pad, and motion sensor.
Here’s how it works.
When a clinician walks into an emergency department room, he or she looks at bar code (a QR or Quick Response code) placed on the wall.  Google Glass immediately recognizes the room and then the ED Dashboard sends information about the patient in that room to the glasses, appearing in the clinician’s field of vision. The clinician can speak with the patient, examine the patient, and perform procedures while seeing problems, vital signs, lab results and other data.

10 things DoD wants in its next EHR

By Government Health IT Staff
Ending months of anticipation, the U.S. Department of Defense (DoD) released its official request for proposals to modernize its Electronic Health Records (EHR) system and enable the DoD to share health data with the private sector and the Department of Veterans Affairs.
The massive and ambitious project, called DoD Healthcare Management Systems Modernization (DHMSM), could cost as much as $11 billion and, Department officials hope, transform the DoD into a national healthcare technology leader.
Major technology companies and consultanices, among them IBM, HP, Computer Sciences Corp., and Epic Systems, have been gearing up and forming alliances for months to prepare to enter the RFP. The sense is that that DHMSM is more than a healthcare RFP, but a transitional step that will determine much of the future for IT in healthcare.

Half of Scottish GPs offer online meds

1 September 2014   Lis Evenstad
Just over half of GP practices in Scotland let patients order repeat prescriptions online or by email, a report by Reform Scotland shows.
EHI reported last week that figures from the Health and Social Care Information Centre suggest that only 5.6% of English patients have been “enabled” to use the same functionality.
The report from the Scottish think-tank shows that 51% of GP practices let patients order repeat medication electronically. It also says that 10% of Scottish GP practices let patients book appointments online.

3 per cent of patients have EPR access

29 August 2014   Lis Evenstad
Fewer than 3% of patients have access to their GP medical records online, according to figures from the Health and Social Care Information Centre’s indicator portal.
Patient access to medical records has been promoted by successive governments. The present administration promised that patients would have access to their full medical records online by April 2015.
However, the target has been scaled back, first to access to GP records, and then to access to a subset of the GP record; the information in the Summary Care Record.

Health IT education: 5 programs worth a look

September 2, 2014 | By Katie Dvorak
By Katie Dvorak
As the summer winds down and fall approaches, it's time to head back to school. For health IT professionals, or those looking to start a career in the industry, there are many education options.
Colleges and universities across the country now offer a wide variety of courses in healthcare information technology and healthcare information security. These courses, which range from certificate programs to graduate degrees, focus on the most current trends in healthcare IT--from health IT policy to data analytics. They offer students the opportunity to begin work as healthcare IT professionals or to take their careers to a new level. 

MU Stage 2 offers 2014 flexibility

Posted on Sep 02, 2014
By Bernie Monegain, Editor
The Department of Health and Human Services published a final rule for Stage 2 meaningful use August 29 that offers hospitals and physicians flexibility for 2014. CHIME and professional organizations had asked for even more flexibility. "Millions of dollars will be lost due to misguided government timelines," said CHIME CEO Russell Branzell.
Branzell went on to state: "Now the very future of meaningful use is in question.
The new rule allows eligible providers to use the 2011 Edition of certified EHR technology or a combination of 2011 and 2014 Edition for the 2014 Medicare and Medicaid EHR Incentive Programs.

EHRs: Expecting Too Much, Too Soon?

by Peter Kilbridge and Doug Thompson Tuesday, September 2, 2014
In 2014, health care record-keeping and communication are finally emerging from the Stone Age and entering the 21st century, moving away from the pen-and-paper processes abandoned by the rest of the modern world decades ago.
This revolution is driven primarily by the HITECH Act and accompanying meaningful use program. These initiatives drove greater adoption of electronic health records by doctors and hospitals in the last five years than in the previous 40. According to one estimate, EHR adoption by physician practices rose from 17% in 2008 to 48% in 2013 and hospital EHR adoption increased from 13% to 70% during the same time period. These EHRs will play a central role in the move to accountable care and population health management.

MU Final Rule Disappoints Some CIOs

Scott Mace, for HealthLeaders Media , September 2, 2014

Most hospitals are not ready to face the double-whammy of reductions in Medicare payments and the loss of meaningful use program incentive payments for the fiscal year that begins October 1.

As summer begins to lose its grip, the Meaningful use Stage 2 deadline continues to close in on U.S. hospitals.
Few are prepared.
As of August, only 3.1% of hospitals had cleared the Stage 2 threshold, according to industry analyst Frank Kelzon. And yet, a full reporting year begins in less than 30 days, on October 1.