Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
Kathryn Mackenzie, for HealthLeaders Media, August 26, 2008
A hospital executive in my home state of Texas was telling me about a fairly minor surgery she had about 18 months ago. One of the things she remembers most about her recovery time at the hospital was how quiet it was. "I work in a hospital, I know how noisy it can be. I thought to myself, what is this hospital doing that we aren't?"
Her question got me thinking about hospital noise and how technology is being used to help reduce it. In this case, she later found out the hospital was using wireless voice-activated communication badges instead of an overhead PA system for the majority of their communications—a tool she later adopted for use at her own hospital.
Hospital noise-level might not be on the forefront of many executives' minds, and generally when I ask about priority lists, keeping decibel levels down doesn't quite make it to the top. But think about this: a team of Mayo Clinic nurses studying hospital noise found that during the morning shift change at Saint Mary's Hospital in Rochester, MN, noise levels reached 113 decibels—that's equal to the noise a jackhammer makes. And this: during a two-year research project, acoustics experts Ilene Busch-Vishniac and James E. West learned that hospital noise is among the top complaints of both patients and hospital staff members. During their studies, the researchers found that over the past four decades, average daytime hospital sound levels around the world have risen from 57 decibels to 72; nighttime levels have increased from 42 decibels to 60. All of these figures exceed the World Health Organization's hospital noise guidelines, which suggest that sound levels in patient rooms should not exceed 35 decibels.
Fast, reliable communication is vital in a hospital setting, and, thanks to technology, hospital workers have a variety of tools available them to facilitate instant communication. Smartphones, pocket-PCs, laptops, tablet-PCs, instant message, e-mail, remote voice and video communication are just a tiny sampling of how technology is being used to communicate faster. But since technology is often blamed for the increase in noise over the last few decades, I'm curious about how it's also being used to communicate quietly.
One of the most common and effective methods I've heard of is replacing the overhead intercom system with wireless communication badges, which can page staff anywhere in the hospital. At the hospital I mentioned above, the staff reported improvements in the quality and ease of communication after they started using the badges and patient satisfaction increased to 93%.
This is really an interesting article and one that – when you think about it – is really important. My experience of hospitals (as a patient) has certainly been one where noise levels seemed to be virtually ignored and one where the staff used to love coming on duty, chattering loudly, just as one was hoping for a little peace and quiet.
Getting enough sleep is crucial to recovery and it’s time this issue was given a little more attention. Looks like my favourite Vocera communication badges (like the ones in Star Trek) can help! Next time you visit a hospital pay special attention for a few minutes and see just how loud it is!
Another approach to the same problem is discussed here:
A patient at Rochester General Hospital pushes the nurse call button in his room, and within moments, pagers on the hips of nearby nurses, aides and technicians go off. As a caregiver enters the patient's room, a sensor in her badge disengages the call and a green light goes on outside in the hallway to indicate that the person is receiving care.
The system is quick, efficient and silent — eliminating the noisy overhead pages that would constantly ring out through hospital halls.
Special Care Systems LLC has been installing these nurse call systems in area hospitals and nursing homes since 2002. Founders Ann and Myron Kowal of Webster saw the need for a communications company that specialized in health care systems.
There were "distributors that did some nurse call systems, and also security and fire and wander prevention." said Ann Kowal, president of the company. "They weren't all health care. They had a wide range."
The eight-person staff of Special Care Systems in Webster focuses solely on health care communications. In addition to the nurse call systems, a large portion of their business comes from personal emergency response systems, which they have installed in a number of independent senior communities, including Cherry Ridge at St. Ann's Community in Webster and The Highlands in Pittsford. These systems allow seniors to call for help using a button on their wrists from anywhere on the grounds.
Second we have:
22 August 2008
Thomson Reuters and CareEvolution are working together to deliver an alternative to the chronological medical record — an application that groups patient data by disease or medical episode. The web-based Medical Episode Groupe' provides current patient information — logically organised, at the point of care — to help physicians make sound medical decisions and enhance disease management and quality of care.
US company CareEvolution provides secure interoperability solutions that link diverse technology platforms for medical records. Under this collaboration, output from the Medical Episode Grouper (MEG), developed by Thomson Reuters, would be integrated into CareEvolution's 'clinical cockpit' to deliver comprehensive patient medical histories of all medications and treatments.
"Caregivers tell us they need access to a community-wide health history for a patient, but they are already overwhelmed with too much information. Dumping more data from more clinics and hospitals onto the doctor's desktop is not going to be accepted or effective," said Vik Kheterpal, MD, principal at CareEvolution.
"Organising the discrete, fragmented, healthcare data we get from medical claims, acute and ambulatory electronic medical records and other sources into disease-based clusters is critical to deal with this cognitive overload," he said. "Delivering patient information in this way enables clinicians to easily find the links between diseases and complications so they can better manage the patient's care."
Treatment of a given disease or medical complaint typically involves several healthcare events — such as a visit with a primary care doctor, prescriptions, visits to urgent care centres or the emergency room, consultations with specialists and perhaps admission to a hospital or surgery centre.
This is a very interesting idea I think. Trying to put some intelligence behind how longitudinal health records are organised to have the address the clinical need will certainly work better than a purely chronological approach. Good thinking 99!
Third we have:
Lisa Carty NSW Political Editor
August 24, 2008
PEOPLE phoning Sydney's overstretched hospital emergency departments will have their inquiries automatically diverted to a call centre staffed by registered nurses.
From Tuesday callers will have their symptoms assessed over the phone. The nurses will advise whether callers should go to the hospital, seek an appointment with their GP or take some other action.
Health Minister Reba Meagher will announce the plan today as part of a nationwide revamp of the way emergency departments are used.
The diversion of calls from Sydney emergency departments is the first stage of NSW's link to healthdirect, the new national health call centre network.
As part of the plan, people will be given health advice on everything from treating head lice in children to broken bones and suspected cancer.
It does not replace the existing triple-0 number for medical emergencies, but the call centre nurses can alert ambulances if necessary.
This is a good idea, and there is sound evidence from the UK (where such a service has existed for years as NHS Direct) that it can be made to work well. Odd that it has taken so long for the idea to move from Old Blighty to the Land DownUnder!
Fourth we have:
IBA opens up Lorenzo
25 August 2008 03:18 PM
Australian e-health software firm IBA Health today said it intended to follow the footsteps of companies like Apple and SAP, opening up its new Lorenzo platform for developers to write applications.
The company said Lorenzo, its service-oriented architecture-based healthcare platform, was due for a global launch in November. "We'll be opening it up to allow other people to write applications onto that platform," IBA Health executive chairman Gary Cohen said today at the company's annual results briefing for the year ended 30 June 2008.
In response to a query as to how open the company meant Lorenzo to be, Cohen said "it will be very open", calling the move a "core part of our strategy".
"If you look at companies like Apple and SAP, where they've been able to get significant growth is getting companies to write solutions [for their platforms]," Cohen said.
Cohen said that he believed that Lorenzo could gain scale by harnessing the power of external developers to write applications.
IBA slotted Lorenzo into its array of software when it completed its acquisition of iSoft last year in October.
This sounds like a good idea in principle. The more variety of expertise and skills that can be brought to the Health IT development task the better. It could also mean IBA will have a broader product line available more quickly that otherwise would have been possible.
IBA’s annual results for the 2008 year are found here:
Lorenzo to boost IBA group
Karen Dearne | August 26, 2008
Many more details are here.
IBA Health Group Limited (ASX:IBA) CEO on 2009 Outlook - Open Briefing
The usual disclaimer about my few IBA shares applies.
Fifth we have:
NSW privacy laws 'lagging behind others'
Posted Mon Aug 25, 2008 10:42am AEST
The Greens are calling on the State Government to reform privacy protection, saying New South Wales is lagging behind other states when it comes to ensuring people's privacy.
Greens MP Lee Rhiannon says Premier Morris Iemma has ignored the concerns of privacy groups by introducing a series of damaging laws on photo ID cards, electronic health records and workplace surveillance.
It’s good to see someone in the current NSW Parliament noticed just what a fiasco the privacy regime for NSW Health’s Healthelink was and is keeping after them about it. Speaking of Healthelink – I wonder where the evaluation report that was due months ago is? Any bets on it ever seeing the light of day?
Sixth we have:
Guide to handling personal information security breaches released
Karen Dearne | August 25, 2008
FEDERAL Privacy Commissioner Karen Curtis has released voluntary guidelines on how companies and government agencies should handle security breaches involving sensitive customer information.
The guide recommends individuals affected by a breach are notified directly, so that people can take steps to avoid potential financial fraud or identity theft.
"While voluntary, the guide represents good practice in handling breaches and I would urge all organisations to consider using it,” Ms Curtis said.
Mandatory data breach notification has been proposed by the Australian Law Reform Commission in its review of Privacy Act.
Ms Curtis said that when the Act was introduced 20 years ago, no-one envisaged the massive amount of personal and financial data routinely collected by businesses and governments today.
This is an important announcement for all in the health sector and those who are custodians of information should make sure they are across just what is expected in the event of information leakage.
An additional discussion of the topic can be found here:
Transparency key recommendation in new privacy guidelines
Privacy commissioner releases ‘Guide to handling personal information security breaches’.
Last we have our slightly technical note for the week:
Vista may still have its day -- just like XP (eventually) did
Think Windows Vista is a hopeless dog and XP was always the cat's meow among users? Think again.
Eric Lai 26/08/2008 08:25:00
Twenty-one months after its initial release, what do we know about Windows Vista? That home users hate it, businesses are uninstalling it and -- according to Gartner -- it's proof that the 23-year-old Windows line is "collapsing" under its own weight.
Meanwhile, predecessor Windows XP, which Microsoft stopped shipping to retailers and the major PC makers on June 30, has belatedly become so beloved that it's garnering more calls for "unretirement" than NFL icon Brett Favre did in his wildest dreams this summer.
But all of the griping about Vista and instant nostalgia for XP covers up a dry, statistical reality: XP itself was slow to catch on with users -- maybe even slower than Vista has been thus far. For instance, in September 2003, 23 months after its release, XP was running on only 6.6 percent of corporate PCs in the US and Canada, according to data compiled by AssetMetrix, an asset-tracking vendor that was later bought by Microsoft. (That information was helpfully pointed out by a Computerworld reader.)
In comparison, Forrester Research reported that as of the end of June -- 19 months after Vista's November 2006 debut for business users -- the new operating system was running on 8.8 percent of enterprise PCs worldwide. Forrester analyst Thomas Mendel, who authored the report, wasn't impressed: He compared Vista to the ill-fated New Coke.
However, even Gartner, that prophet of Windows' doom, forecasts that Vista will be more popular at the end of this year than XP was at a similar juncture -- with 28 percent of the PC operating system installed base worldwide, vs. 22 percent for XP at the end of 2003.
"The uptake of XP was slower than people remember today," said Michael Cherry, an analyst at Directions on Microsoft. He noted that many IT managers "labeled XP a consumer-only upgrade" at first.
This is an interesting article that shows how instinctively conservative people are in sticking to using things they know and are comfortable with! This lesson will not be lost on anyone in the e-Health space!
More next week.