Monday, April 30, 2012

Weekly Australian Health IT Links – 30th April, 2012.

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

An interesting and rather varied week.
The way I read it we are seeing increasing clarity in the views of the various interest groups as the start-up date approaches, and a recognition that this might be coming ‘ready or not’ and that there are still a considerable number of rough edges that need to be smoothed.
The blog posted on Friday and found here has excited one reader:
The point I was trying to make is that patients need to be in control and  consent to what happens to them. They should also be able to - as they do now - be able to know what information is held about them. As for controlling what their carer records to assist in delivering their care - and for a host of other reasons - I see this as a professional responsibility and not something the patient should be controlling. Of course the carer has a responsibility to protect the information - keep it safe and only disclose it to anyone other than the patient when given permission and consent. As I say in the comments we have a preferred model of care delivery - based on a primary care driven model - and our Health IT should optimally support that. The PCEHR does not do that in my view.
It is also interesting the Allscripts seem to have hit a bit of a speedbump in the US. Given they support and are implementing in WA and SA there is some concern about how things will play out.

Security concerns over Australia’s e-health records

Medicos blame NEHTA’s "unreliable performance". But enough with lost data! Let’s criminalise negligent data breaches.
  • Stilgherrian (CSO Online (Australia))
  • — 23 April, 2012 11:34
As Australia grinds ever-closer to putting our health records online from (allegedly) 1 July, disturbing news is emerging. US hospitals are seeing more data breaches, and Australian medical experts warn that patient safety could be put at risk.
“It is not yet possible to make any definitive statement about whether the personally controlled electronic health record is safe or not," wrote three experts in the latest subscriber-only Medical Journal of Australia.
According to News-Medical.Net, the new e-health system has been subject to growing criticism based on privacy and security concerns, and that's down to the unreliable performance of the National E-Health Transition Authority (NEHTA).
There are "accusations of ineffective oversight and failure of administrators to acknowledge design flaws" and "warnings that the system will not succeed because its implementation has been ill-considered and rushed," according to the report — although NEHTA has pulled back the pace.

Are online medical records safe?

  • Leanne Hudson
  • National Features
  • April 28, 2012 7:00PM
THE Government wants to put your health records in cyberspace and you’ve already been given an ID. Leanne Hudson asks if it’s entirely safe.
Imagine if any medical practitioner could access your healthcare records at the click of a mouse. The emergency department could treat you more quickly, specialists could compare test results instantly and you wouldn’t have to remember the last time you had a tetanus shot.
Welcome to the world of eHealth, a program the  Government has invested $466 million in. Its aim is to create PCEHRs (Personally Controlled Electronic Health Records) that centralise a patient’s healthcare information and, with their permission, present it to registered healthcare providers.

Exposed: E-health log-on security risk

26th Apr 2012
GPs and other practitioners have been using their unique e-health identifying number as a log-on for the AHPRA website since 2010 without being given any advice on security provisions or even warned the two numbers are the same.
Practitioners will use their Healthcare Provider Identifier (HPI-I) number to access patient information under the personally controlled e-health records system (PCEHR) and the number will be used to track each practitioner’s use and access of that information.
An AHPRA spokesperson confirmed their website log-on was comprised of the last 10 digits of a practitioner’s HPI-I. The first six digits of the HPI-I are common to every AHPRA registered practitioner.

Test cases for e-health pay revealed

24 April, 2012 Paul Smith
Details of what MBS items doctors can claim for creating and curating shared e-health summaries were released by the RACGP on Tuesday.
Under the $467 million Personally Controlled Electronic Health Record (PCEHR) system, doctors will be expected to create shared health summaries listing patient’s diagnoses, medications, allergies and adverse reactions and immunisations.
The system is being rolled out from July. But there has been a protracted debate over the circumstances in which level B, C and D attendance items can be claimed by doctors for creating the summaries — summaries which will be shared with hospitals, doctors and other health providers who sign up to the initiative.

Working with e-health on the front line

17 April, 2012 Paul Smith
Dr David Guest is one of the doctors trialling key aspects of the personally controlled
e-health records system through the Improvement Foundation eCollaborative. He has prepared shared health summaries for about 100 of his patients.
At his practice near Lismore he creates a draft version of the health summary drawn from his patient records, asking the patient to read through the information in the waiting room before correcting the summary in the consultation.
“Going through the patient information and tidying it up before it gets uploaded onto to the PCEHR does involve some work,” he says. “For new patients with a long list of problems, it could take 30 minutes ... It’s about determining what is relevant to the patient’s ongoing care. My practice consists of a lot of elderly patients with chronic disease, [such as] diabetes and heart disease patients. So they can be fairly complex."

Doctors worry about patient data control

DOCTORS have raised concern over joining the Territory's original e-health revolution with a new national database.
The Personally Controlled e-Health Record "opt in" scheme will allow people to enter and control their own medical data from July 1.

When will ehealth record legislation be passed?

On 25 November 2011, on the recommendation of the Selection of Bills Committee, the Senate referred the provisions of the Personally Controlled Electronic Health Records Bill 2011 and the provisions of the Personally Controlled Electronic Health Records (Consequential Amendments) Bill 2011 to the Community Affairs Legislation Committee for inquiry and report by 29 February 2012. On 28 February the Senate extended the reporting date to 13 March 2012. The reporting date was again extended to 15 March and then 19 March 2012.
The report was tabled on 19 March 2012. With recommendations to review after two years of operation, the Community Affairs Legislation Committee has recommended that the Bills be passed – click here for the report.

Glancing forward: Prof David Glance

Professor David Glance, the director for software practice at the University of Western Australia, had some reservations. He was on the phone, straddling time zones, telling he is doubtful the summary care record in the PCEHR will make any real difference to Australian health consumers.
“Globally, there’s no evidence [a summary care record] will improve health outcomes,” he said.
Professor Glance has an extensive background in ehealth, heading the development of MMEx, a clinical software package. He’s also researched text analysis of clinical data, and the implementation of software in clinical settings.
The problems with a summary care record, said Prof. Glance, are myriad. If someone comes into an emergency department, there are a whole set of preconditions associated with getting a health care record to work properly.

Delayed choice for prescription alert platform

HEALTH Minister Tanya Plibersek's $5 million plan to crack-down on prescription painkiller abuse, which was announced in February, was originally funded under the fifth community pharmacy agreement with the Pharmacy Guild in 2010.
However, a decision on the platform was reached only late last year.
Ms Plibersek was responding to calls from a Victorian coroner for action on real-time prescribing and dispensing monitoring systems for controlled (Schedule 8) drugs, including the ability to alert doctors before new scripts are issued.
In February, coroner John Olle found James, a 24-year-old Melbourne man, had committed suicide by overdosing on morphine and diazepam; in the three years before his death, James had obtained S8 scripts from 19 doctors and medications from 32 pharmacies.

Bionic eye patient tests planned for 2013

UNSW launching new bionic vision labs
Bionic vision researchers intend to test a functional bionic eye on patients next year.
“Our primary aim is to complete the first prototypes of the bionic eye so they can be tested in human recipients in 2013,” said Gregg Suaning, a professor from the University of New South Graduate School of Biomedical Engineering, in a statement.
Suaning is also the leader of Bionic Vision Australia’s wide-view device, the first of two prototypes designed to restore vision in people with degenerative retinal conditions.

Soldiers need e-health records, review finds

24th Apr 2012
ELECTRONIC health records are needed to stop Australian soldiers wounded in war zones from falling through the cracks of bureaucracy during their rehabilitation, a review says.
A review by KPMG found the Defence system failed when it came to rehabilitation, transition to normal life, and compensation for soldiers wounded in Iraq, Afghanistan and other warzones.
But it was good at providing immediate medical care to wounded troops, the 280-page review released on Monday afternoon revealed.

Consider broad telehealth benefits

A NEW US study which showed “underwhelming” clinical outcomes from telemonitoring still adds to the knowledge base about telehealth and should not dissuade doctors from its benefits, according to Australian experts.
Professor Len Gray, director of the Centre for Online Health at the University of Queensland, said the study, published in Archives of Internal Medicine, was well designed but examined only clinical outcomes, when there were many other potential benefits of telehealth. (1)

Geeks use computer power to cure cancer

Anthony Agius
April 26, 2012 - 8:07AM
Technology enthusiasts are using the power of their computers to join the fight to cure diseases such as cancer, Alzheimer's and Parkinson's.
The human race agrees cancer is awful. Nobody wants it and nobody likes it. Cancer's impact also spreads to the minds of families and friends of those with the disease, who watch their loved ones try to cope with their own bodies trying to kill them.
The same applies for diseases like Alzheimers and Parkinsons. As people are touched by the effects of these diseases, they want to help. Some become scientists, doctors or nurses, actively working in the front lines to cure, treat and assist. The majority of us contribute to charities, either directly, by volunteering, or indirectly, by giving money, or raising awareness.

Privacy Act reforms — the implications for the digital environment

The Privacy Act reforms to create greater protection for online users
As Privacy Awareness Week kicks off this week, the Federal Government’s reforms to the Privacy Act, which began in 2006, seem to have fallen off the radar.
Roger Clarke, principal at Xamax Consultancy, attributes the slow government response to “complete apathy” and says the reason the inquiry began in 2006 was to “quieten down the backbenchers” around problems which had been identified in parliament surrounding privacy issues.
“They progressed extraordinarily slowly and they still haven’t really reached any point of resolution, and one has been brought forward from the second tranche, opportunistically and quite recently, but that one also seems to have stalled in the last few months as well,” Clarke says.

Woman in divorce row loses job fight

Natasha Rudra
April 26, 2012
A WOMAN who used Australian Federal Police databases to dig up dirt on her former husband during a bitter divorce has lost a claim for unfair dismissal.
Fair Work Australia heard the woman, who worked as a financial analyst for the AFP, also tried to rope colleagues into her battle against her former husband but was sacked in April last year after he hired a private investigator and complained to police.
She was found to have breached the AFP code of conduct after getting a co-worker to send her records on her former husband's businesses, which she described as ''gold'' and forwarded on to her mother.

Technology in the driving seat as Bosch's growth accelerates

THE $1 billion Australian business of Robert Bosch, the world's biggest automotive parts supplier, is evaluating several strategic acquisitions and launching a range of hi-tech growth initiatives to help it achieve its ambition to double in size in the next decade.
Bosch is renowned for its automotive components, power tools and household appliances, but Australian president Gavin Smith says the recent launch of new softwear and business outsourcing operations in Australia, as well as initiatives in solar energy and e-health, will underpin the extensive growth ambitions of the local operation.

Swiss scientists show off mind-controlled robot

  • From: AP
  • April 25, 2012 8:08AM
SWISS scientists have demonstrated how a partially paralyzed person can control a robot by thought alone.
It is a step they hope will one day allow immobile people to interact with their surroundings through so-called avatars.
Similar experiments have taken place in the United States and Germany, but they involved either able-bodied patients or invasive brain implants.
On Tuesday, a team at Switzerland's Federal Institute of Technology in Lausanne used only a simple head cap to record the brain signals of Mark-Andre Duc, who was at a hospital in the southern Swiss town of Sion 100 kilometers away.

Interview: Denis Tebbutt, Vendor Engagement, National E-Health Transition Authority (NEHTA)

Denis Tebutt is an adviser to the National E-Health Transition Authority (NEHTA). Denis has spent the last 40 years in high technology businesses with over 30 in the growing information technology sector working across the globe in manufacturing, finance and for the past 10 years in healthcare.
He is a dynamic leader with strong strategic and business development skills founded on a deep understanding of the technology and its role in supporting the development of a more agile and innovative business model for the industries that he has served. The challenge faced by the healthcare sector brings together the experiences and lessons of earlier industries.

Financial Decline, Departures Roil Allscripts

APR 27, 2012 11:44am ET
The stock price of physician/hospital software vendor Allscripts dropped 40.6 percent at the open of trading on April 27 after the company announced poor first quarter financial results, lowered expectations for the rest of 2012, and announced the departure of its chief financial officer and four board members including Chairman Phil Pead.
Pead was terminated and three board members opposing the decision resigned. CFO Bill Davis will leave in May to join another company outside the industry. Allscripts has named Dave Morgan, senior vice president of finance, as interim CFO.
Nearly 45 million shares traded hands during the first hour of trading on April 27, compared with a daily average of about 3 million shares. The stock had lost up to 45 percent of its value during extended trading after the market closed on April 26.

Allscripts in skid mode as shares plunge, chairman ousted

By Bernie Monegain, Editor
Created 04/27/2012
CHICAGO – It was no ordinary quarterly meeting Thursday for Allscripts. Its chairman Phil Pead was, by many accounts, forced out. Three board members apparently resigned in protest. And this morning, the EHR vendor's shares have plunged almost 43 percent to $9.15.
The company also reported that CFO Bill Davis would be exiting May 18 for another position outside the healthcare sector, leaving analysts downgrading the firm's stock from “buy” to “neutral.”
Sean Wieland, senior analyst from Piper Jaffrey was among those downgrading.
“Any one of these items would be a concern, but all three happening simultaneously leads us to question what else is there that we don't know,” he wrote in an analyst brief today. He added that a rule of thumb is to downgrade on any CFO turnover.

Who's accountable for IT failure?

By Michael Krigsman | April 16, 2012, 4:45am PDT
Summary: IT failures are a management crisis of serious proportions that have been largely ignored. Here’s what senior executives need to know - and do - right now.
This two-part series presents a structure for understanding why IT projects fail, in a way that goes far beyond project management alone. Part one elaborates the problem while part two discusses the need for greater accountability on the part of senior management.

AusHealthIT Poll Number 119 – Results – 30th April, 2012.

The question was:
Who Is Most To Blame For The Present Slow Rate Of Progress In E-Health In Australia?
-  15 (39%)
-  18 (47%)
The Private Sector
-  0 (0%)
The State Jurisdictions
-  3 (7%)
-  2 (5%)
Votes: 38
An interesting outcome with national bodies getting most of the blame, the states a tiny proportion and the private sector being seen as being guiltless.
Enough said.
Could the 2 other voters please leave a comment to tell us what other actually is? Please.
Again, many thanks to those that voted!

Sunday, April 29, 2012

I Wonder What This Outcome Means? It Does Not Look Good for E-Health In OZ.

This was released yesterday.
Media Releases and Communiques

Standing Council on Health - Communique - 27 April 2012

27 April 2012

Australian Health Ministers and the New Zealand Health Minister met in Canberra today to discuss a range of national health issue including workforce
, eHealth, Indigenous health and aged care. The meeting of the Standing Council on Health was chaired by WA Minister for Health, Dr Kim Hames.

Issues discussed today included:

MyHospitals – New cancer surgery and quality and safety data added

Ministers agreed that following the recent release of cancer treatment services information in March 2012 on the national MyHospitals website, information will also be published on cancer surgery waiting times from May 2012. Initially raw data will be provided with an accompanying narrative about variations in types of cancers along with information about numbers of reporting hospitals, until national benchmarks are developed.

Providing more information about the range and location of cancer-related treatment services and waiting times on MyHospitals enables patients to find out more about local services and helps to drive improvements in hospital performance.

Dementia – a National Health Priority

The meeting was addressed by the Federal Minister for Health, Tanya Plibersek who gave notice to the Council that the Commonwealth will be proposing that dementia be designated as a National Health Priority.

Ms Plibersek said the projected growth in the number of people with dementia will result in many challenges for the health sector. Making dementia a National Health Priority Area would help focus attention and drive collaborative efforts aimed at tackling dementia at national, local and state and territory levels.

The Commonwealth intends to formally bring a paper on this issue to the August 2012 meeting, at which the Commonwealth Minister for Mental Health and Ageing, Mark Butler, will join a substantive discussion on this issue.

Model of care for privately practicing midwives

Ministers today considered a West Australian proposed model of care for privately practicing midwives to provide Medicare-eligible services as part of planned homebirth for low risk women.

Ministers agreed to further discussion on this issue at their next formal meeting in August 2012.

Health Workforce 2025: Doctors, Nurses and Midwives

Health Ministers considered the Health Workforce 2025 Report, which models expected workforce demand and supply for doctors, nurses and midwives to 2025.

While there may be debate over the modeling in this report it identifies indicative broad trends well into the future and without strong reform intervention these estimates will mean services may be unsustainable.

Ministers agreed that the report presents the need for essential coordinated, long term reforms by Governments, professions and the higher education and training sector.

All Governments have made substantial investments in Australia’s health workforce and delivered more doctors and nurses than ever before. These investments have been significant; however, it is clear from the report that we must look further then just adding to the existing workforce profile. Other more innovative solutions are required. Looking further means new ways of thinking, new models of care and new roles and functions across the health workforce.

Aboriginal and Torres Strait Islander Health Worker Final Report – Growing Our Future

Ministers noted the Final Report on the Aboriginal and Torres Strait Islander Health Worker project being delivered by Health Workforce Australia. This report is timely because as of 1 July 2012, Aboriginal and Torres Strait Islander Health Practitioners will join the National Registration Scheme for the first time.

There is significant variability in the roles, functions and title of Aboriginal and Torres Strait Islander Health Workers across Australia and this report proposes a nationally consistent definition for Aboriginal and Torres Strait Health Workers which has been broadly supported by Aboriginal and Torres Strait Islander stakeholders.

The report provides a total of 27 recommendations which will help to inform the development of policies and strategies that will strengthen and sustain the Aboriginal and Torres Strait Islander Health Worker workforce to deliver care in response to the known burden and distribution of disease in the Aboriginal and Torres Strait Islander population.

The COAG National Action Plan on Mental Health 2006-2011 Fourth Progress Report Covering Implementation to 2009-10

Ministers endorsed the Report and agreed that it be submitted to COAG for final endorsement and public release. The report presents updated information on 11 of the 12 progress indicators, and provides details on changes in key areas targeted for reform.

Donate Life Network Progress Report

Ministers reviewed the organ and tissue donation and transplantation outcomes which showed a significant lift in organ donation rates last year.

In 2011 there were 337 donors who made a life changing difference to 1001 transplant recipients.

Ministers agreed on the national and jurisdictional donation targets for 2012 and the projected donation and transplant growth trajectories to 2018.

National Strategic Framework for Rural and Remote Health

Ministers released the new National Strategic Framework for Rural and Remote Health, the product of significant collaboration between the Commonwealth, States and the Northern Territory governments and community stakeholders.

The Framework is an important guide for all levels of government to enable a more consistent and coordinated approach for rural and remote health. The Framework aims to reduce the inequities in health outcomes and service delivery currently experienced by rural and remote Australians. The Framework will be publicly available at
The communique is found here:
What on earth are we to make of this?
All the issues mentioned in the introduction were discussed and outcomes were reached except for e-Health. Does this mean e-Health was discussed and no agreement could be reached to get a line or two in the communique or was the matter mention as being on the agenda but not actually discussed?
And why was the topic mentioned in the communique if there was nothing to say?
I think the most likely meaning is that e-Health was discussed and that either there were some budget implications so no comment was made or it was discussed and no agreement could be reached.
In that context this is interesting:

Health ministers warn of 'unsustainable' services

April 28, 2012

AUSTRALIA'S dependence on imported doctors and nurses - which faces rising international criticism - will continue to grow without reforms in supply and use of local graduates, the first national report on the health workforce says.

The report by HealthWorkforce Australia shows in recent years Australia has imported more doctors than it has produced local medical graduates.

That is despite endorsement eight years ago by health ministers of the goal of ''national self-sufficiency'' in health workforce supply.

The report was released after yesterday's meeting of state and federal health ministers, who warned that ''without strong reform intervention these estimates will mean services may be unsustainable''.

The ministers gave their support to the prosect of big changes in the working scope of doctors and nurses which is likely to include increased use of assistants and technology such as ehealth.

Reforms may include greater use of assistants, the introduction of ''new workforces'' and broader application of technologies such as ehealth and telehealth (the use of telecommunications for consultations, diagnosis and procedures).


More here:
It is interesting to see e-Health pointed out as a workforce issue in the taskforce report to Ministers.
I guess what is going on will all become clearer just 8 days from now if the fiascos around Mr Slipper and Mr Thomson are contained to the extent that the ‘dark clouds’ over the parliament as described by Ms Gillard today have lifted sufficiently to permit near normal operations to re-commence.
We really do live in interesting times!

Saturday, April 28, 2012

Weekly Overseas Health IT Links - 28th April, 2012.

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.

EHRs Often Lack Clinical Best Practices

Clinical decision support vendor Zynx Health finds electronic health records fall short in treating heart failure, pneumonia.
By Neil Versel,  InformationWeek
April 17, 2012
Hospitals with electronic health records (EHRs) barely earn a passing grade when it comes to following best practices in treating heart failure and pneumonia, according to an audit by a clinical decision support content provider.
Only 62% of hospitals' EHRs included clinical processes that have been proven to reduce congestive heart failure patients' mortality, hospital readmissions, and overall costs; 67% included clinical processes for treating pneumonia. That is good for an overall grade of D or D-minus from Los Angeles-based Zynx Health, a unit of Hearst Publishing. Company officials believe the study to be the first of its kind. AdTech Ad

iPad App Helps Kids With Autism Communicate

The older brother of a child with autism has released an iPad app designed to be a communication and therapy tool for people with autism.
AutisMate allows you to add your own pictures, videos and voice recordings to the app. The goal: to create visual scenes that help promote social skills and communication.
The app was created by Jonathan Izak to help his 10 year-old brother Oriel, and other children with autism who struggle with communication.

HHS' updated infection-fighting plan stresses health IT

By kterry
Created Apr 20 2012 - 10:04am
In an updated draft of its national action plan for fighting healthcare-associated infections (HAI), the Department of Health and Human Services (HHS) highlights the role of health IT.
"Monitoring and measuring HAIs is a critical component of the overall strategy to prevent and reduce HAIs," the plan [1] says." Advances in information technology (IT), harmonization of disparate data standards, incentive programs designed to promote the meaningful use of electronic health records (EHRs), and capabilities to connect with and integrate multiple data types and sources all provide opportunities to enhance national capacity to monitor, measure, and prevent the occurrence of HAIs."

Increased big data access could help lower health costs

By danb
Created Apr 20 2012 - 1:09pm
Continued efforts to use big data in healthcare and make it more widely accessible could play a significant role in lowering overall costs, the authors of a new report [1] published this week argue.
The report--rolled out by the Kansas City, Mo.-based Ewing Marion Kauffman Foundation, which promotes entrepreneurship--makes a number of specific recommendations, including points regarding data use in both patient care and medical research.

6 keys to making better use of your data

By Michelle McNickle, Web Content Producer
Created 04/19/2012
Recently, big data has been garnering attention as a potential problem-solver for today's industry woes. But, before jumping into the new "data-driven paradigm" of leveraging big data, a recent report by CSC suggests organizations take a look at their basic, data-centered strategy.
"Most organizations have more data to work with than they realize, but they need to recognize the challenges and plan to overcome them," the report reads. "For example, the data landscape is constantly changing. The size, scope, and types of data available are rapidly evolving, and so are the tools needed to make sense of it all. To identify competitive advantages and achieve better command and control over their data, entrepreneurial healthcare executives need to recognize this evolution."  
April 15, 2012

Crowd-Sourcing Expands Power of Brain Research

In the largest collaborative study of the brain to date, scientists using imaging technology at more than 100 centers worldwide have for the first time zeroed in on genes that they agree play a role in intelligence and memory.
Scientists working to understand the biology of brain function — and especially those using brain imaging, a blunt tool — have been badly stalled. But the new work, involving more than 200 scientists, lays out a strategy for breaking the logjam. The findings appear in a series of papers published online Sunday in the journal Nature Genetics.

Patient data missing for 315,000 Emory patients

The Atlanta Journal-Constitution
7:00 p.m. Wednesday, April 18, 2012
Personal and health information for about 315,000 patients is missing, Emory Healthcare announced Wednesday. The hospital system has been unable to find 10 computer discs containing the data.
The missing discs held information on all patients who had surgery at Emory University Hospital, Emory University Hospital Midtown and The Emory Clinic Ambulatory Surgery Center between September 1990 and April 2007. The discs contained protected health information, including patient names, along with the diagnosis, the name of the surgical procedure and the surgeon. Approximately 228,000 of the patient records also included Social Security numbers.

Health providers now have mobile access to e-health records

Better, quicker access means safer, higher quality care for patients
April 20, 2012 (Hamilton, ON) - Authorized health care providers can now use mobile devices to instantly and securely access their patients’ health information, accelerating the decision-making process and enhancing patient care, announced Murray Glendining, Executive VP, Hamilton Health Sciences Corporation and CIO of the Hamilton Niagara Haldimand Brant (HNHB) Local Health Integration Network (LHIN).
"The combination of a highly mobile device like the iPad, and comprehensive patient data spanning many hospitals through ClinicalConnect, brings effective, fast, secure and safe decision-making ability right to the bedside at any time, day or night," said Dr. Rafi Setrak, emergency physician, Niagara Health System.

EHRs increase malpractice risk

By mdhirsch
Created Apr 19 2012 - 11:04am
EHRs can wreak havoc on a practitioner's clinical documentation of patient care, exposing the provider to malpractice claims, warns HIT author Ron Sterling, in an article [1] posted on
"Regardless of the legitimacy of care and treatment, the inappropriate use of EHRs and/or EHR design vulnerabilities are exposing physicians to questions on the quality of care and physician due diligence," he writes.

Evidence that Meaningful Use dollars drive EHR adoption piles up

By mdhirsch
Created Apr 19 2012 - 11:20am
Another is a series of studies on what drives EHR implementation and use has found Meaningful Use incentives are driving adoption among primary care physicians.
A whopping 95 percent of respondents reported that they're adopting EHRs to achieve Meaningful Use. Meanwhile, 53 percent said they were doing it to improve patient quality of care, according to a survey [1] conducted by

4 tips for leveraging big data

By Michelle McNickle, Web Content Producer
Created 04/17/2012
Cost savings are always key drivers of new initiatives. And in today's healthcare industry, as priorities continue to shift and pressure is added to increase revenues and improve outcomes, one element could be a key player in making it all happen: big data.
"We think it's going to separate winners from losers in many markets over the next five years," said Russ Richmond, MD, CEO of healthcare solutions and consulting company Objective Health. "The institutions that are capable of first understanding where the market is going … are going to have tremendous advantages over the ones who can't or won't do this. We believe that over time, it's going to become a core competency for hospitals, and it won't be something seen as extra or nice to have – it's going to become a core part of how they operate going forward."

Top hospitals use more advanced IT: report

Posted: April 18, 2012 - 10:00 am ET
The hospitals named to Thomson Reuters' 100 Top Hospitals list use more advanced levels of information technology as compared with the broader U.S. hospital population, according to research conducted by a Healthcare Information and Management Systems Society subsidiary.
HIMSS Analytics, the organization's market-research arm, looked at hospitals that received the award in 2009 or 2010 and their HIMSS Analytics' electronic health-record adoption model scores.

Top hospitals use more advanced IT: report

Posted: April 18, 2012 - 10:00 am ET
The hospitals named to Thomson Reuters' 100 Top Hospitals list use more advanced levels of information technology as compared with the broader U.S. hospital population, according to research conducted by a Healthcare Information and Management Systems Society subsidiary.
HIMSS Analytics, the organization's market-research arm, looked at hospitals that received the award in 2009 or 2010 and their HIMSS Analytics' electronic health-record adoption model scores.

Epic Systems' Tough Billionaire

This is the expanded version of a piece that appears in the May 7, 2012 issue of Forbes Magazine.
More than 6,500 guests gathered in an overflowing auditorium at the Intergalactic Headquarters of Epic Systems this past September. The campus, nestled on 800 acres of farmland in tiny Verona Wis., was the site of an annual event for customers. The theme: “Once Upon A Time.” To loud applause, a dark-haired woman dressed in leather chaps with a bandana tied around her head strode on stage, where a Harley-Davidson a.k.a. gooseneck awaited. The modern-day Mother Goose in this fairy tale was Judith Faulkner–simply known as Judy in the health care galaxy, living up to her motto: “Do good, have fun, make money.”
She has made a fistful. From her remote midwestern outpost, Faulkner, 68, has quietly built Epic, which sells electronic health records into a $1.2 billion (2011 revenues) business—double four years ago. She has done it without outside capital, and no marketing. She remains the company’s single largest shareholder, rebuffing an attempt by her biggest client health care giant Kaiser Permanente to get a piece of equity, when Epic was much smaller. The company won’t disclose earnings, but says it’s profitable, and proudly proclaims to have zero debt. By next year, 127 million patients or nearly 40% of the U.S. population will have its medical information stored in an Epic digital record. Helping enrich Faulkner is also a piece of government legislation that subsidizes the adoption of electronic medical records, by paying millions to qualifying hospitals. (See Matthew Herper‘s story on Cerner here).

AHIMA: The new role of privacy officer

The role of privacy officer has changed since it was mandated in 2003 by HIPAA. New regulations, technology and data-sharing initiatives have reshaped the landscape, according to Chris Dimick, staff writer for Journal of AHIMA, who outlined the new role of the privacy officer in the April edition.
“Protecting patient health information has become much more complex since 2003, when nearly all healthcare organizations used time-tested systems to protect paper records,” Dimick wrote. “In turn privacy officers now require an expanding set of knowledge and skills, and as regulatory pressures and technological initiatives have advanced, their roles have grown in strategic importance within their organization.”

Global mobile health market worth $8B by 2018

By: Brian Dolan | Apr 16, 2012  
A recent report from Global Data pegged the global mHealth market as having a $500 million value in 2010 that will top $8 billion by 2018. The research firm argues that the rise of mobile health has been partially encouraged by the global financial crisis, which led to a focus on finding cost efficiencies in the system in addition to improved outcomes and quality of care.

KLAS: Smart Pumps Must Learn EMR Integration

04/12/2012 By Anthony Guerra
KLAS Finds Smart Pump/EMR Integration Lacking
“Despite years of discussion and promises,” KLAS reports that fewer than 10 providers in the country are doing EMR integration with their smart pump vendors, even though over half consider it key to future pump selection.
Report author Coray Tate commented, “Providers are looking at EMR integration as the next big step to make infusions safer. Drug libraries catch most errors, but mistakes can still be made.”

Commentary: How patient advocacy fortifies HIE

By Patty Enrado, Contributing Editor
Demand for healthcare information by patients and clinicians will help drive the business need for health information exchanges, according to Dr. Farzad Mostashari, national health IT coordinator. Clinicians and patients should ask for or seek relevant patient information whenever and wherever healthcare decisions are made. Mostashari's timely comments put a spotlight on the role of patient advocacy in care coordination and how that advocacy intersects and enriches health information exchange.
Used in a meaningful way by healthcare providers, health IT should help lower the cost of care, while improving the quality of care, patient satisfaction and the patient-provider relationship. Health IT in the form of personal health records or data-capturing devices for patients ideally should help them be knowledgeable of and manage their conditions. It should also empower them to be their own advocates in this complex healthcare environment. This is an ideal world and goals that the industry is trying to achieve.

Fridsma highlights doubling of digital docs

By Bernie Monegain, Editor
Created 04/17/2012
BALTIMORE – The number of physicians using electronic health records has doubled over the past two years, Doug Fridsma, MD, told an audience at AHIMA's ICD-10 Summit Monday.
“We are making real progress on EHR adoption and we are developing a workforce that is beginning to be trained to support this progress,” said Fridsma, director of the Office of Standards and Interoperability, part of the Office of the National Coordinator for Health Information Technology (ONC).

VC funding for health IT breaks record in Q1

By Bernie Monegain, Editor
Created 04/17/2012
AUSTIN, TX – Venture capital funding in the healthcare information technology sector for Q1 2012 totaled $184 million in 27 deals, the highest number ever recorded, according to Austin, Texas-based consulting firm Mercom Captal Group.
A total of 46 different VCs invested in Q1. Connecticut Innovations participated in multiple deals. The Health Information Technology for Economic and Clinical Health (HITECH) Act kick-started this larger implementation of IT in healthcare in the United States after it was passed in 2009, Mercom asserts.
By: Brett Norman
April 16, 2012 10:29 PM EDT
An onslaught of mobile health technology has forced an arranged marriage between smartphone app makers and the Food and Drug Administration — because someone had to regulate them.
There’s just one problem: Many of the tech wizards aren’t used to FDA supervision. And now, both sides are struggling to figure out how to live with each other.
Last year, the FDA suggested some ground rules: If you make an app that claims to diagnose or treat a medical condition, then you need to show that it’s safe and effective before you sell it, just as other medical-device makers do.

Glocs GPs paid £70 a telehealth patient

12 April 2012   Rebecca Todd
A £5m telehealth project in Gloucestershire has deployed less than a quarter of its 2,000 devices in its first ten months.
In June last year, Tunstall Healthcare and NHS Gloucestershire launched a project to provide telehealth to 2,000 patients with chronic obstructive pulmonary disease, chronic heart failure, chronic heart disease and diabetes.
The stated aim was to roll out the telehealth devices over 12 months, starting in the summer.

Primary care faces 'app explosion'

13 April 2012   Rebecca Todd
A primary care IT specialist has predicted an “explosion” of cloud based and app technology in the sector over coming years.
Dr David Jehring, chief executive of Black Pear Software, will be sharing his thoughts at the Primary Health Info Conference 2012 running from April 23-25 in Warwick.
Dr Jehring trained as a GP but has been developing primary care software for the past 25 years.
Speaking to EHI Primary Care, he predicted a move towards more cloud-based and app-based delivery of IT services, driven by the financial incentive to push more care out into the community.

Healthcare social media a 'moral obligation'

By danb
Created Apr 17 2012 - 1:37pm
As social media continues to grow as a communications medium, so too does its impact in healthcare. According to a report [1] published today by consulting firm PwC, patients increasingly are turning to social media sites such as Facebook and Twitter both to find and share medical information. What's more, of 1,060 surveyed consumers, 45 percent said that information obtained via social media could impact their decision to get a second opinion.

Researchers create firewall for wireless medical devices

By: Brian Dolan | Apr 16, 2012
Researchers working at Purdue University and Princeton University have developed a proof-of-concept device, called MedMon, that blocks hackers from hijacking or interfering with wireless medical devices, like pacemakers, insulin pumps, or brain implants. The researchers were motivated to work on the problem after discovering how easy it was for hackers to break into current wireless medical systems.
The researchers believe that hundreds of thousands of people using wireless insulin pumps or wireless-enabled pacemakers are currently vulnerable. Other devices, not yet in the market, like brain implants that manage epilepsy and “smart prosthetics” could also be hacked. Despite the potential for hacking, the researchers admit the chances that any given would be hacked is low.

Mayo Clinic doc’s real-time dashboard makes ER patient tracking easier

Waiting in the emergency room is not limited to patients.
Doctors and other ER staff are constantly waiting too — waiting to see if the X-Ray report is available, waiting to see whether lab results are back and waiting to see whether medication that was ordered was given to the patient.
And the only way to know whether any of this information is available is to go into each patient’s medical record individually and do a check. Repeat the same process for every patient that’s in the ER.
But Dr. Vernon Smith at the Mayo Clinic has come up with a real-time dashboard that is meant to take away all this repeated checking. It incorporates easy-to-understand icons — X for an X-ray, a drop of blood to represent lab results and mortar and pestle for medications – that are displayed on large computer screens throughout the emergency department.

New Express Scripts product aims to predict, solve problems with prescription compliance

By Associated Press, Published: April 16

Express Scripts aims to help patients stay on their meds with a product that predicts who will stop taking prescriptions before the person actually does it.
The pharmacy benefits manager is launching ScreenRx, a program that uses a computer to sift through hundreds of factors that affect patients and forecast who is most likely to forget a refill or simply stop taking their drugs. The company then plans to contact those patients to help them stick with their doctor’s orders.
Express Scripts executives say their new program is focused on a big target.

Researchers Develop Automated System to Improve Children’s Health

April 16, 2012
Researchers from Indiana University and the Indianapolis-based Regenstrief Institute have developed an automated system aimed at helping enable pediatricians focus on the specific health needs of each patient in the short time allotted for preventive care. The systems comes on the heels of a new study, “Automated Primary Care Screening in Pediatric Waiting Rooms,” in the May 2012 issue of Pediatrics which found personalizing and automating the patient screening process and then alerting the physician to positive results of risk factors enables them to direct attention to the particular needs of the individual child and the child’s family.
The automated system created by the Indiana University and Regenstrief researchers, called the Child Health Improvement through Computer Automation System (CHICA), aims to do exactly that.

Da Vinci Robot Surgical Risks Detailed

Cheryl Clark, for HealthLeaders Media , April 17, 2012

When something goes wrong after robotic surgery with the da Vinci surgical system, it's most likely due to co-morbidities in certain patients that make the procedure riskier, not flaws in the robot's technology itself, according to a study of 884 surgeries published this week in the Archives of Surgery.
"After reviewing all these cases, we can say for sure that there is no specific morbidity connected with the robot by itself, and that its mechanical failure is very, very rare," says lead author Pier C. Giulianotti, MD, of the Division of General and Minimally Invasive Surgery at the University of Illinois at Chicago. "We can now say that the morbidity and mortality that occurred in these patients was connected to the risk factors in the patients."
The authors wrote that by understanding which patients are at greater risk for robotic surgery complications, surgeons eventually can develop a scoring system to measure quality of care among providers and hospitals.

Safety Net Challenge Aims to Quash Readmissions

Scott Mace, for HealthLeaders Media , April 17, 2012

I've attended hundreds of Silicon Valley technology conferences, but last Saturday was the first one led by a hospital executive determined to disrupt how tech improves patient health.
Paul Tang, MD, is vice president and chief innovation and technology officer at the Palo Alto Medical Foundation (PAMF), a Sutter Health affiliate with 1,200 physicians in Palo Alto, CA.
What Tang is doing challenges our conventional thinking about how technology gets developed in healthcare, by borrowing from techniques that are all around Silicon Valley.

Urgent care centers in the market for EMRs

By Bernie Monegain, Editor
Created 04/16/2012
OREM, UT – Thousands of urgent care centers are looking for an EMR to adapt to increasing patient volume, and providers are finding success with three different types of EMRs, according to a new report from research firm KLAS.
Of the more than 9,000 estimated urgent care centers, many report plans to increase in size or location in the next 12 months. Many need an EMR.
Options for urgent care centers include ambulatory EMRs, ED solutions, and best-of-breed urgent care EMRs, KLAS reports.

Patient-centered care requires more than online technologies

By kterry
Created Apr 15 2012 - 10:56am
Patient-centered care is the mantra of the movement to reform the nation's healthcare delivery system. According to this credo, patients must be able to obtain copies of their medical records and visit summaries; they should have personal health records that they can share with their providers; they should have "patient-centered medical homes"; they should share in medical decision making; and, of course, the security and privacy of their personal health information must be rigorously protected.
All of this makes sense, both for the individual and for the healthcare system. Since about 90 percent of healthcare is self care, consumers must be involved--and must, in some cases, change their health behavior--to become healthier and reduce the overall cost of care. "Patient engagement" is also a key component of accountable care organizations, because ACOs' success depends on keeping patients healthy and out of expensive care settings. Only by educating patients and enlisting their cooperation can ACOs generate savings and remain within their budgets.

Another view: Neil Paul

Our GP columnist would like a Star Cops-style personal assistant. Or failing that, some agreed definitions of data and a decent dashboard to display them on.
3 April 2012
Did you ever watch Star Cops in the late 80s? I don’t really remember any of the plots; just that it involved a policeman solving crimes on the moon accompanied by his amazing PDA.
He would simply talk to this marvellous device and it would wirelessly access loads of other computers and databases and find out things for him, drawing conclusions and unearthing clues based on very little input.
I’m pretty certain that this led me to buy a Psion and numerous other PDAs since, most of which haven’t lived up to the dream. It wasn’t until a few months ago, when Apple demoed Siri, that the fantasy almost became reality.

Continua makes new design guidelines available to developers

By Mike Miliard, Managing Editor
Created 04/13/2012
BEAVERTON, OR – Hoping to drive more "plug-and-play" connectivity of personal health technologies, Continua Health Alliance has made available its most recent design guidelines as a free download for device vendors.
The design guidelines, called Adrenaline, aim to help technology developers build end-to-end systems more efficiently and cost-effectively by facilitating connectivity between personal connected health products such as smartphones, gateways and remote monitoring devices. They were previously available only to Continua members during interoperability testing.
  • Updated April 16, 2012, 11:38 a.m. ET

Numbers, Numbers and More Numbers

Health-care players are finding that crunching the numbers can pay off in both better care and lower costs


Under pressure to do more with less, insurers, pharmacy benefit managers and health-care providers are all pushing data analysis to new heights.
Insurers have been crunching numbers for years to figure out which patients are most likely to generate high costs. Now other groups are gauging probabilities of relapses, and the likelihood of a patient's not taking his or her medicine. Using models that draw on massive troves of medical and other data, some are also focusing on seemingly healthy individuals, trying to prevent problems before they occur.
Several insurers, including UnitedHealth Group Inc. and WellPoint Inc., are seeking to pinpoint who will develop conditions such as diabetes. Pharmacy-benefit managers such as Express Scripts Inc. and CVS Caremark Corp. are working on programs to predict medication compliance. Care providers, meanwhile, are trying to identify who is most likely to be admitted—or readmitted—to a hospital, and are adjusting their care to prevent such return visits.

Graying America gets wired to cut healthcare costs

WASHINGTON | Thu Apr 12, 2012 4:06pm EDT
(Reuters) - Baby boomers wired to their iPads and smart phones are giving U.S. health experts some new ideas about ways to cut the soaring costs of medical care in graying America.
Some of the ideas might sound like "Robo-Granny". An astronautical engineer at the Massachusetts Institute of Technology has made a skin-tight undersuit equipped with sensors that can constantly monitor the vital signs of its elderly wearer and feed the data into a computer that fires off health alerts. It was first designed for a landing on Mars.
There's also Paro, the robotic seal which has fur, big eyes and responds to voice commands, a low-cost companion that the AgeLab at MIT is testing to help calm elderly people with dementia. Then there is the magic carpet with a built-in sensor that monitors gait to check for risk of falling.
Other ideas are simpler and already are being tested by governments and private health insurers. Marilyn Yeats, 79, is suffering from congestive heart failure and uses a personal healthcare computer, Connect, provided by the health insurer Humana Corp. She calls it My Little Nurse for helping her keep track of her blood pressure, weight, temperature and whether she is taking her medicines on time.
4.15.12 | Chris Seper

The electronic medical record as Yelp, OpenTable and Skype

How powerful is the electronic medical record? Practice Fusion will stretch the EMR’s muscles over the next year as it tries to incorporate patient-friendly tools and make the product more social. Think one part Yelp and another part Facebook with a dash of telemedicine.
On Sunday night the company will launch a physician review portal built on feedback in surveys from the patients of doctors using Practice Fusion’s Web-based electronic medical records system. Then later this week the company will release ChartShare, which will allow doctors in and out of Practice Fusion’s network to chat with one another similar to using Facebook chat (except it’s HIPAA compliant).

UK Department of Health announces review into patient data protection

By Jamie Thompson, Web Editor
Created 03/21/2012
The Department of Health recently announced Dame Fiona Caldicott’s independent review into the protection of patient data. This announcement comes in response to the NHS Future Forum’s recommendation that the balance of patient protection and sharing of patient data needs to be addressed.
The last major review of the security of patient information occurred in 1997. Since then, there have been significant changes in the use and deployment of EHRs.
NHS is also undergoing a transformation in which electronic healthcare will become fundamental to every aspect of patient care. The radical reorganization of the NHS in England is giving local healthcare providers even more responsibility for their own EHRs, and for ensuring they are secure.