It has been another of those weeks when just too much interesting stuff has been announced. The following are some pointers and brief comments on a few others that caught my eye.
First we have.
18 Sep 2008
The NHS Care Records Board will today confirm that patients will be asked for permission to share their record at each clinical encounter.
In a much-anticipated move, the board has acted on the recommendations of the May 2008 UCL report on the first primary care trusts to adopt the Summary Care Record.
Patients will still have to opt out of having a record created, but “consent to view” will become an integral part of using the SCR, the board agreed yesterday.
Dr Gillian Braunold, clinical director for the SCR and HealthSpace said the new consent model considerably simplifies that used in the five early adopter PCTs.
This is important as it moves the UK to the appropriate ‘opt-in’ consent model.
Second we have.
by Kate Ackerman, iHealthBeat Editor
Health systems nationwide are in varying stages of implementing personal health record applications. The thought is that the technology can provide clinicians with a gold mine of data that will be helpful in improving both efficiency and care quality, while providing consumers with the tools necessary to take a more active role in their health care. Despite the benefits, resistance remains.
At a Project HealthDesign conference in Washington, D.C., last week, health system leaders discussed their efforts to ease concerns and ultimately make PHRs a staple of their health care systems.
A review of the state of play with some useful links:
- Project HealthDesign
- Partners' Clinical Informatics Research and Development
- Kaiser Permanente's My Health Manager
- University Hospitals and Health Systems
Third we have.
BANGALORE: Healthcare provider iSoft on Thursday said that its Indian R&D team is developing a solution what it described as the world’s largest civilian IT healthcare project.
The Lorenzo software application, which will link nearly two-thirds of the hospitals in the United Kingdom, will also be launched in Europe, Australia and Germany in November, iSoft executive chairman & CEO Gary Cohen said at the opening of the company’s global centre here.
iSoft was acquired by Australia’s IBA Health Group in 2007. Hospitals will also be connected to general practitioners, allowing patients in the UK to get themselves treated at any clinic in the country without the need for re-entering data. The solution can be extended to any part of the world, managing director S Govind said.
Good to see plans are progressing – I wonder why this did not get an ASX Announcement? (Would seem to be a material step forward – and yes I have a few IBA Shares).
Fourth we have.
Proposed rules that would let doctors electronically prescribe controlled substances could raise the security bar in ways that frustrate health care providers
E-prescribing is in a bit of a bind. The practice is caught between a federal directive that aims to encourage adoption and another that serves to inhibit use.
On the promotional side, the e-prescribing provision of the recently passed Medicare bill provides incentives for doctors to use the technology for Medicare patients and a financial punishment for those who don’t. Doctors who adopt e-prescribing get a 2 percent bonus in 2009 and 2010; those who don’t use the technology face fee reductions.
On the other hand, the Drug Enforcement Administration prohibits e-prescribing of controlled substances. That restriction applies to about 10 percent of all prescriptions by DEA’s reckoning. The upshot is that physicians who use e-prescribing must also maintain a paper-and-fax-based system for controlled substances. At best, that dual system is inconvenient, and at worst, it is an impediment to the adoption of e-prescribing.
A lot more here:
The break out box is most telling.
A two-factor pitfall
The Drug Enforcement Administration’s proposed rules for e-prescribing call for two-factor authentication as a core security measure.
Richard Mackey, vice president of consulting at SystemExperts, said the method must be thoughtfully adopted to be effective.
“Many organizations want to have the feeling of security that comes from deploying two-factor authentication,” Mackey said. “But the security of a system is completely dependent on how well that [authentication] was integrated into the application.”
For example, organizations might let users bypass two-factor authentication through a weaker entry point, Mackey said. The goal might be to allow users into a system when they don’t have security tokens with them. But in that case, “it’s not clear they have provided any security,” he said.
Some related material here:
September 26, 2008
I hope the NEHTA National Authentication Service for Health Project has thought carefully about the workflow implications of their two factor ID plans. Could be a really serious issue I believe!
Fifth we have.
26 Sep 2008
The Dutch national electronic patient record project is progressing slowly, but steadily. Sixty five doctors have been connected to the infrastructure so far. By the end of the year, this number will increase to 200.
“We are confident that we can stick to our goal and have all 8,000 GPs using the national electronic patient record by the end of 2009,” said Reina Kloosterman, head of health and social issues at the Dutch embassy in Berlin. She gave an update on the project at a regional eHealth event organised by the industry association IHK in Berlin.
Kloosterman said two factors were critical for the success of the project. First of all, doctors would have to be connected to the infrastructure efficiently and without putting too much financial burden on them. And second, the public would need to be informed about the EPR and privacy issues would need to be addressed.
The EPR in the Netherlands will be a virtual EPR. The medical data will remain physically where it originates: it is not stored on a central server. This means that the IT systems of the doctors involved have to be brought online in a way that makes EPR-relevant data accessible 24/7.
Good to see the Dutch are moving forward as well!
Sixth we have:
Last update: 9:31 a.m. EDT Sept. 25, 2008
RICHMOND, Va., Sep 25, 2008 (BUSINESS WIRE) -- MedVirginia successfully participated in the live demonstration of the Nationwide Health Information Network (NHIN) Trial Implementation at the AHIC meeting in Washington, DC this week. During the event, MedVirginia and other health information exchanges established live connectivity with the Dept. of Defense, Veterans Affairs, Social Security Administration, and other health systems.
Michael Matthews, CEO of MedVirginia stated, "This was an historic day for our nation's health care system. This significant milestone proved that disparate health systems across the U.S. can securely connect and exchange health information in order to enhance the quality, safety and cost-effectiveness of healthcare to patients across geographic and organizational boundaries."
MedVirginia participated in several demonstrations, including the "Wounded Warrior" scenario. This demonstration showed how members of the armed services who receive care from military, veterans and civilian health care providers can have their health history accessible at any point in the care continuum. Another scenario showed how the Social Security disability determination process could be greatly accelerated via online access to claimant's medical records vs. the traditional paper method.
Again we see how, incrementally progress is being made in developing the US NHIN.
Last we have.
A federal panel will soon recommend that field usability be a primary goal for an electronic medical record system now in development for use in federal disaster response efforts.
The National Biodefense Science Board (NBSB) voted Sept. 23 in support of recommendations that the EMR system be integrated with future patient-tracking and medical resource availability systems and that it be interoperable with other EMR systems to the greatest degree possible.
The board also said the National Disaster Medical System (NDMS), which is developing the EMR, should take the lead in defining the minimal patient dataset required. The board plans to send its recommendations to the Health and Human Services Department soon.
Another area I am not sure we have a plan in place for to address. Certainly worth some thought!
All in all lots going on.