Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, June 17, 2009

International News Extras For the Week (15/06/2009).

Again there has been just a heap of stuff arrive this week.

First we have:

If All Doctors Had More Time to Listen

By JULIE WEED

WHEN Dr. José Batlle met his 93-year-old patient in her small Bronx apartment, she didn’t have much furniture beyond a small TV, a sofa and a wheelchair. What she did have in abundance were pills — 15 types from a variety of doctors, including a pulmonologist, a cardiologist and a gerontologist. He discovered that some medicines had expired, others were unnecessary and some were dangerous if taken together.

Sitting with his patient and her son, Dr. Batlle cut the number of her medicines to four. He also gave the family his personal cellphone number.

Before coming to see him, the woman had endured several emergency-room visits and hospital stays. With Dr. Batlle, she was able to avoid all of that.

Calling a doctor on his cell? No waiting for an appointment? It’s the type of service that Dr. Batlle tries to offer to all of his 1,500 patients. “I prefer to keep them healthy than treat them when they are sick,” he says.

The efforts of Dr. Batlle and other primary care physicians may get a boost at the federal level. The Obama administration is considering ways to persuade medical students to pursue careers in primary care by raising their pay, and is channeling them to work in underserved rural areas. And the White House has already set aside $2 billion for community health centers through the economic stimulus package.

But more far-reaching health care reform remains an uncertainty, and in the interim a small but growing number of doctors are trying to take matters into their own hands.

By stepping off the big-clinic treadmill, where doctors are sometimes asked to see a different patient every 15 minutes, Dr. Batlle has joined the vanguard of physicians trying to redefine health care. These doctors spend more time with patients, emphasize prevention and education to keep them healthy and can handle many medical problems without referrals to specialists.

In many cases, this kind of care can reduce a patient’s medical bills. That’s more crucial than ever: according to a study published online by the American Journal of Medicine, 60 percent of all bankruptcies in the United States in 2007 were driven by health care costs.

Exact numbers are hard to come by, but doctors involved in this movement, called “patient centered” practices, say its popularity is growing.

“I travel to a lot of medical conferences, and I’m meeting more and more doctors embarking on this path,” said Dr. L. Gordon Moore, who runs IdealMedicalPractices.org, a program to help small practices become more innovative and efficient. The Web site IdealMedicalHome.org has about 800 doctors who post and trade ideas, while more than 700 physicians have adopted methods from HowsYourHealth.org. Many of these doctors see fewer patients per day than they did before.

To make personalized care possible in an era when compensation is often tied to the number of patients they see, doctors use technology to streamline processes and reduce administrative costs. Dr. Batlle, for example, uses online appointment scheduling and manages his medical records electronically. He prescribes medications from his computer and offers virtual visits by phone and e-mail.

Much more here:

http://www.nytimes.com/2009/06/07/health/07health.html?_r=1&hpw

Technology enabled practice improvement is a major trend that appears to be gaining increasing strength.

Second we have:

Province getting with IT program

OKs software for electronic medical records

By: Martin Cash

6/06/2009 12:39 PM | Comments: 0

MANITOBA eHealth has tapped a B.C. medical software company to become one of the first players to participate in the long march into the electronic era of medical record-keeping.

But even Manitoba eHealth officials acknowledge that Manitoba has fallen behind other provinces in the develop­ment and implementation of informa­tion technology.

Optimed Software Corp. of Kelowna, B.C., is the first to have its electronic medical records (EMR) software ap­proved in Manitoba. Its software, Accuro EMR, provides digital sched­uling and billing as well as detailed patient record-keeping services for doctors' offices and clinics.

The province's qualification pro­cess is to be completed by mid-July and there may be as many as three more companies whose EMR soft­ware could get endorsed.

Optimed may have passed the entry hurdle, but now it has to go out and sell the technology to clinics and doc­tors' offices. That may be tougher for Optimed than it is elsewhere because Manitoba is the only province west of Quebec that does not provide a sub­sidy to help doctors cover the costs of implementing the technology.

Governments in some provinces are covering up to 70 per cent of monthly subscription costs that can run more than $300 a month per doctor.

Optimed has about 750 doctors using its software in B.C., Alberta and Saskatchewan.

Much more here:

http://www.winnipegfreepress.com/business/Province-getting-with-IT-program-47124577.html

At least some parts of Canada are really getting on with it..given the Ontario scandals we read about last week.

Third we have:

Amalga Helps Hospital Keep Swine Flu in Check

Elizabeth Montalbano, IDG News Service

Monday, June 08, 2009 12:00 PM PDT

When fears over the swine flu first broke out in many parts of the world in April, El Camino Hospital in Mountain View, California, was about to pull the trigger on an implementation of Microsoft's Amalga software.

Plans changed slightly, however, when hospital officials realized they might possibly have a flu pandemic on their hands, said Dr. Michael Gallagher, director of business intelligence and outcomes for El Camino.

The hospital did implement Amalga as planned, but with an addition to it designed to track patients that came to the hospital with flu-like symptoms -- as well as anyone else who may have been in contact with them in the emergency department, he said.

"We had to know who was exposed, how to track these patients," he said. "Because the Amalga system was extremely flexible, we put together a new application for tracking patients as they showed up in our emergency department."

Amalga is Microsoft's e-health aggregation software that helps health-care institutions like hospitals and other health-care service providers by capturing and storing patient and other information from disparate systems and presenting it in one place.

It took only three hours from concept to deployment to create the tracking software using Amalga, said Steve Shihadeh, vice president of the Microsoft Health Solutions Group.

While El Camino took the lead in conceptualizing, creating and implementing the tool, Microsoft showed them how it could be done through a feature of Amalga called User-Self Service, he said, which allows people to create a new application very quickly by re-using data aggregated by Amalga, he said.

Full reporting continues here:

http://www.pcworld.com/businesscenter/article/166310/amalga_helps_hospital_keep_swine_flu_in_check.html

Good to see the capability being developed to respond flexibly to emerging threats.

Fourth we have:

June 08, 2009

HIT Adoption - Alignment & Simplification

By

David Hartzband is a Lecturer in Engineering Systems at MIT, teaching courses in large-scale software systems and Director of Technology Research at the RCHN Community Health Foundation. In his role at the Foundation, Dr. Hartzband spearheads the organization’s continued evaluation, assessment and findings dissemination related to health information technology.

As if we didn't know already, most of the leadership of Health and Human Services has now weighed in on the importance of health information technology (HIT) in realizing goals for health care improvement and reform. HHS Secretary Kathleen Sebelius said in a House Ways and means Committee hearing on May 6th that “health IT is critical to health reform”. To her credit, she also said that “just shifting our paperwork to computers won't work, unless we make sure they can talk to each other.” We also know that substantial amounts of money will be available through the ARRA and other sources for acquisition of electronic heath care records systems (EHR) as well as incentives to Medicare and Medicaid providers for meaningful use of such systems. Those of us who have worked in HIT, for even short amounts of time, realize that there is a step missing in this progression: acquisition,-----, meaningful use. That missing step is the adoption of technology, and adoption is considerably more difficult than either of these other steps.

Many studies have been done on what impedes or facilitates adoption. The factors most often found are: 1) technical - system complexity and lack of integration with existing systems; 2) cost - initial investment, lack of funds for training, maintenance etc., unclear ROI; 3) social or cultural - unprepared workforce, lack of management commitment, privacy issues and finally; 4) alignment - technology not well matched to work flows and work styles of users, system not useful to users. AHRQ did a study several years ago on this (2006) and found that the biggest impediments to adoption of HIT were: cost-benefit misalignment, technological complexity, lack of data integration, lack of workforce preparedness & lack of motivation on the part of providers. Some things have changed since then, but not all that much.

OK - so we won't reach meaningful use of EHR technology, let alone other necessary and productive health information technologies, just by throwing money at the problem, even by paying incentives to providers. How can we ensure that EHR and these other technologies are adopted? After all, we'll realize no benefits from HIT even if it is acquired and deployed. This is just a lost sunk cost without adoption. As a technologist, I am most familiar with what can be done on the technology side, so I'll make some suggestions there first.

Much more here:

http://www.thehealthcareblog.com/the_health_care_blog/2009/06/meaningful-use-of-ehr---ask-the-users.html

This is a useful list of the factors impacting adoption – and some possible approaches. Well worth a browse.

Fifth we have:

NJ University Hospital EMS pilots smartphones for heart failure

Friday - June 5th, 2009 - 12:47pm EST by Brian Dolan | EMS | heart failure | University Hospital New Jersey |

Just yesterday we reported on the growing competition between wireless remote monitoring companies CardioNet and LifeWatch, which both help physicians monitor patients at risk for heart arrythmias via wireless devices and sensors. How can wireless health services help people who actually have heart failure, though? The University Hospital in New Jersey with help from Verizon Wireless and Medtronic created a program to determine how wireless technologies and improved operational processes could reduce the time it took to get a heart failure patient into a physician’s care and make better use of the time that first responders had with the patient while in transit to the hospital.

The program demonstrates how smartphones, Bluetooth-enabled monitors and pagers could all work together to create a system that reduces the time and increases the efficiencies involved in getting a heart failure patient the care they need. Here are some of the technical and operational issues the program dealt with — be sure to read the entire article over at EMS Responder for more.

Much more here:

http://mobihealthnews.com/2548/nj-university-hospital-ems-pilots-smartphones-for-heart-failure/

The move to mobile tools and techniques in E-Health is gaining pace.

Nortel's clinic in Richardson aims to improve medical care

07:39 AM CDT on Monday, June 8, 2009

By VICTOR GODINEZ / The Dallas Morning News
vgodinez@dallasnews.com

From pacemakers to prosthetic limbs, technology is a routine part of modern medical care.

But Nortel Networks is using a prototype medical clinic at its Richardson offices to demonstrate something a little different.

Rather than using technology to create new clinical tools, Nortel is using software and hardware to make hospital visits shorter, more productive and less nerve-wracking.

A tour of Nortel's new facility is eye-popping both for the ingenuity of the products and the relative simplicity of the underlying technology.

Forget 3-D holograms or electronic prescription pads or robot doctors.

Instead, Nortel's vision is built on tried-and-true consumer technologies such as Wi-Fi, cellular phones and RFID.

Wes Durow, Nortel's vice president of enterprise marketing in Richardson, said the technology in the clinic, which went live just a few weeks ago, is designed expressly to help health care companies make and save money.

"How do you overcome the nurse shortage?" he said. "How do you overcome the doctor shortage? How do you help a hospital that can't raise capital in this market do more with less?"

While the technologies are designed to make life easier for hospitals and doctors' offices, patients should be among the biggest beneficiaries.

Much more here:

http://www.dallasnews.com/sharedcontent/dws/bus/stories/DN-nortel_07bus.ART.State.Edition1.41155bc.html

This provides some interesting examples of how mobile technologies are envisaged as working to assist.

There is even more here:

http://mobihealthnews.com/2564/fda-approves-medapps-wireless-remote-monitoring/#more-2564

FDA approves MedApps wireless remote monitoring

Friday - June 5th, 2009 - 07:11pm EST by Brian Dolan | blood glucose monitor | Diabetes | FDA | MedApps | pulse oximeter | remote monitoring |

Seventh we have:

How the Government's Spending Spree on Electronic Medical Records will Reshape the Industry

Friday, June 05, 2009

· Analysis by: GLG Expert Contributor

· Analysis of: Electronic Patient Records will Force Consolidation in Health Care | bits.blogs.nytimes.com

· Source: www.glgroup.com

Implications:

The unprecedented spending by the federal government to support the implementation of electronic medical records (by some estimates as much as $36 billion in total federal outlays over a five year period starting at the end of 2010--a hundred fold increase over previous governmental subsidies) will also have profound effects on the industry itself, the shape of physician practices and the delivery and financing of healthcare.

Analysis:

The government's spending spree will set off an acquisition spree as large technology firms buy health IT companies to gain market share. Look for companies like General Electric, Siemens, IBM, Microsoft, Oracle, McKesson and Google (among others) to swoop in and devour Allscripts, Epic, Cerner, not to mention eClinical Works, Quality Systems, Inc., and Eclipsys in the next three to five years.

More here:

http://www.glgroup.com/News/How-the-Governments-Spending-Spree-on-Electronic-Medical-Records-will-Reshape-the-Industry-40085.html

There is no doubt the change provoked will be very considerable indeed!

Eighth we have:

Feds plan more health IT services, fewer networks

The federal health information technology community plans a significant upgrade to its NHIN Connect software in the coming year, including adding tools to manage patient identification and health documents via the Nationwide Health Information Network.

New enterprise services planned for Connect, a software gateway that gives federal health agencies access to the NHIN, include a master index for managing patient identities, policy engine to handle health records authorizations and registry to organize patient health documents.

In April the Federal Health Architecture released an open-source version of the Connect gateway software that included core NHIN services, including patient look-up and record retrieval.

Vish Sankaran, FHA program director, said the new services would help move the project a step closer to becoming a tool that would “make a real impact on the lives of ordinary Americans.” He spoke at a panel discussion on federal health information sharing at the Government Health IT conference yesterday.

“We now live in a world where you can get information at your fingertips on virtually every topic known to mankind," he said. "Yet the most important area of all — our health — can’t easily get info when we need it. It’s time to change this once and for all; federal agencies are committed to moving this forward.”

Full article here:

http://govhealthit.com/articles/2009/06/05/feds-plan-more-health-it-services-fewer-networks.aspx

The next step as the networks grow and coalesce.

Ninth we have:

Continua adds two wireless standards to guidelines

By Joseph Conn / HITS staff writer

Posted: June 8, 2009 - 11:00 am EDT

The Continua Health Alliance, a not-for-profit consortium of healthcare information technology companies and medical device manufacturers seeking to harmonize data transmission standards usage for home health appliances, has chosen two wireless technology standards for the second version of its Continua Health Alliance Design Guidelines, the organization announced today.

Much more here (with links – registration required):

http://www.modernhealthcare.com/article/20090608/REG/306089973

More activity on the mobile front as already mentioned above.

Lots more on Continua here:

http://www.modernhealthcare.com/article/20090610/REG/306109994

Progress made in data-transmission standards

By Joseph Conn / HITS staff writer

Posted: June 10, 2009 - 11:00 am EDT

Tenth we have:

Researchers to study data from VA EMR system

The initiative will allow VA-affiliated physicians to discover better ways to handle various diseases, including cancer and congestive heart failure.

By Pamela Lewis Dolan, AMNews staff. Posted June 8, 2009.

The U.S. Dept. Of Veterans Affairs for the first time is opening up its electronic medical records to allow researchers from across the system to look at the data.

The de-identified, aggregated data of veterans will allow researchers to pinpoint the most effective treatments for specific conditions, including posttraumatic stress disorder and antibiotic-resistant staph infection.

The VA says the result will be broader clinical studies that will provide physicians, both inside and out of the system, with better data on the best treatment methods for various conditions. The project will also show how the same data-mining methods could be used in other health information exchanges, including the national health information network, once it's fully up and running.

Matthew Samore, MD, an infectious disease and epidemiology physician from the VA Salt Lake City Health Care System, who is heading Utah's part in the project, said researchers with the VA, like those within other health care networks, have traditionally only had access to the data from their local facilities.

More here:

http://www.ama-assn.org/amednews/2009/06/08/bisa0608.htm

This is a continuing demonstration of the value of large quantities of detailed EHR information in carrying out clinical research .

Eleventh for the week we have:

Health Minister Receives Telemedicine Delegate

2009-06-09 18:04:58 | | Хэвлэх | Найздаа илгээх |

Ulaanbaatar,/MONTSAME/ The Minister of Health S.Lambaa received Tuesday Yunkap Kwankam, the executive director of the International Society for Telemedicine and e-Health (ISTMeH). Mr Kwankam who has been working for 8 years as the executive director is visiting Mongolia for the first time in order to give professional and methodical advice on working out documents for developing e-health sector in Mongolia.

More here:

http://www.montsame.mn/index.php?option=com_news&task=news_detail&tab=200906&ne=511

It is even happening in Mongolia! Not a place I would have expected to have even heard of e-Health. Just shows you how wrong and ignorant one can be!

http://www.thepeninsulaqatar.com/Display_news.asp?section=Local_News&subsection=Qatar+News&month=June2009&file=Local_News2009060963612.xml

ictQatar developing e-healthcare system

Web posted at: 6/9/2009 6:36:12

Source ::: THE PENINSULA/ BY CHRIS V PANGANIBAN

Qatar even!

Twelfth we have:

Tuesday, June 09, 2009

Using Twitter for EZ-HIT: Accessible, Fast Platform Has Much To Offer

by Jane Sarasohn-Kahn

"Twitter understands Web 2.0 better than Facebook," Tim O'Reilly told a group attending a Launchbox start-up confab in early June 2009.

Two weeks prior, I had offered testimony to the privacy subcommittee of the National Center for Vital and Health Statistics responding to the question, "What Will Consumer-Facing Health IT Look Like in five or 10 Years?"

In a nutshell, I said that health citizens (whom you can alternatively call consumers, patients, caregivers or people) would be engaged with their health and their health data, which would be more liquid, accessible, engaging, actionable and user-friendly.

While it may or may not be with us five or 10 years from now, Twitter has become a useable, engaging platform in health care. It's accessible, useable and fun.

More here:

http://www.ihealthbeat.org/Perspectives/2009/Using-Twitter-for-EZHIT-Accessible-Fast-Platform-Has-Much-To-Offer.aspx

Fun article with lots of links and ideas!

Thirteenth we have:

Technology Offers Real-Time Monitoring of Hand Washing

Carrie Vaughan, for HealthLeaders Media, June 9, 2009

Washing hands is a key component to preventing healthcare-acquired infections and improving patient safety. Yet, knowing which staff members are more compliant with hand washing policies is challenging at best for supervisors and senior leaders. Organizations often rely on observational studies to track and monitor hand washing, but if staff members know that they are being watched, they'll probably alter their typical behavior and wash hands more frequently.

I'm not suggesting that staff members are intentionally foregoing hand washing procedures, but given the pace of healthcare settings, it's an easy thing for clinicians to forget to do as frequently as they should. Soon, however, healthcare executives will have a new tool to track hand washing in their organizations and staff members will have a subtle reminder to wash hands if they forgot.

A new device, called HyGreen, is being developed at the University of Florida that can detect whether employees have washed their hands by "smelling" for alcohol, which nearly every hygiene soap product contains.

More here:

http://www.healthleadersmedia.com/content/234235/topic/WS_HLM2_TEC/Technology-Offers-RealTime-Monitoring-of-Hand-Washing.html

Now this could be taking monitoring clinician activity a step too far!

Fourteenth we have:

Decision Makers Differ on How To Mend Broken Health System

By Ceci Connolly
Washington Post Staff Writer
Tuesday, June 9, 2009

Nowhere else in the world is so much money spent with such poor results.

On that point there is rare unanimity among Washington decision makers: The U.S. health system needs a major overhaul.

For more than a decade, researchers have documented the inequities, shortcomings, waste and even dangers in the hodgepodge of uncoordinated medical services that consume nearly one-fifth of the nation's economy. Exorbitant medical bills thrust too many families into bankruptcy, hinder the global competitiveness of U.S. companies and threaten the government's long-term solvency.

But the consensus breaks down on the question of how best to create a coordinated, high-performing, evidence-based system that provides the right care at the right time to the right people.

During eight years in office, President George W. Bush took an incremental approach, adding prescription drug benefits to the Medicare program for seniors and the disabled and expanding the number of community clinics nationwide. President Obama, like the last Democrat to occupy the White House, contends that was insufficient and is pushing for an ambitious reworking of the entire $2.3 trillion system.

Lots more here:

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/08/AR2009060804125_pf.html

The associated graph shows just how large the problem the US has to address is!

Fifteenth we have:

First stage of Sweden’s e-health scheme deployed

More than 500 of clinicians and clinical staff in the Swedish region of Örebro now have authorised access to records of all patients’ in the area, with the successful implementation of the first phase of the country’s National Patient Overview (NPO) project.

NPO is Sweden’s national electronic health records scheme, which aims to improve patient security and the quality of care by delivering the solution nationwide in stages. Its core is the National Patient Summary (NPS), undertaken by the Swedish Healthcare Advisory Organisation (Sjukvårdsrådgivningen SVR AB).

More here:

http://www.futuregov.net/articles/2009/jun/04/first-stage-swedens-national-ehr-deployed/

Again we find a country rolling on as we stay in the mire!

Further information is found here:

http://www.ehealtheurope.net/news/4909/orebro_first_with_swedish_summary_record

Orebro first with Swedish summary record

Sixteenth we have:

Doctors: When tech improves the personal touch

Monday - June 8th, 2009 - 04:12pm EST by Brian Dolan | Apple | Better Health | Dr. Eric Topol | Dr. Natalie Hodge | Dr. Patrick Soon-Shiong | EMRs | Epocrates | iPhone | UCLA |

Doctors “know instinctively that the human side of medicine — the attentive listening, the visual cues, the continued eye contact, and the careful history and physical exam — is critical…” Dr. Val Jones, CEO of Better Health, wrote in a commentary piece last week. “The problem we have with EMRs is that they often interrupt the sensitive and intuitive parts of what we do. EMRs and other digital ‘tools’ designed to make our work more efficient, may do so at the expense of the human connectedness our patients deserve and need.”

Jones’ commentary is a must-read for anyone interested in new technology’s impact on the patient-doctor relationship. As she notes, a more efficient practice is not necessarily a more effective one.

Much more here:

http://mobihealthnews.com/2592/when-tech-improves-the-personal/

Worth a browse and to follow the link.

Fourth last we have:

US Oncology Launches Oncology-Specific EHR to the Open Market

By: PR Newswire

Jun. 10, 2009 12:33 PM

iKnowMed now available to community-based oncology practices

HOUSTON, June 10 /PRNewswire/ -- Today US Oncology, Inc., supporting the nation's foremost cancer treatment and research network and working with physicians, manufacturers and payers to advance cancer care in America, announces the launch of iKnowMed(TM) to the open market. iKnowMed is an oncology-specific electronic health record (EHR) system designed by oncologists for oncologists.

Developed in 1996, US Oncology acquired iKnowMed in 2004. The comprehensive collaboration between the oncology physicians since the acquisition has led to a technology excellence that is completely focused on the needs of community oncologists and their patients.

Today's iKnowMed goes beyond delivering standard EHR features by leveraging technology that helps physicians focus on clinical excellence and cost effectiveness in community cancer care. iKnowMed facilitates access to powerful new solutions such as US Oncology's Innovent Oncology program, which provides Level I evidence-based medicine pathways to help oncologists realize the benefits of pay-for-performance. For practices participating in the US Oncology Research network, iKnowMed can match patients to appropriate clinical trials, increasing access to the latest treatment opportunities across the nation.

Much more here:

http://in.sys-con.com/node/997514

This is a trend I am sure we will see more of..the emergence of speciality specific EHR solutions.

Third last we have:

Data Challenges on the EHR Agenda
By John Glaser

While preparing to adopt or expand electronic records, providers shouldn't overlook the quality of the data these systems will contain.

The health care information technology portions of the American Recovery and Reinvestment Act (ARRA) have led to heightened interest in the adoption and effective use of electronic health records. Given the importance of improving many facets of care and the magnitude of the stimulus funds, this attention is appropriate.

Most of the discussion about advancing EHRs centers on areas such as meaningful use, certification, interoperability and regional extension centers. Underneath these topics is the industry's focus on the software application called the electronic health record. For example, when the industry talks about adoption and effective use, it is referring to the EHR software application. And when the industry discusses interoperability, it is focusing on EHR applications being interoperable with each other.

This focus on the EHR software application should not distract us from also concentrating on the data in the EHR. Both the near and intermediate terms of the national EHR agenda pose several data challenges:

  • Large-scale information exchange among health care entities raises data management questions for both the senders and recipients of data. For example, under which conditions can data from one organization be used for clinical research by another organization? And if one organization needs to amend data it has exchanged with others, how is that amendment propagated?
  • Changes in privacy regulations will require improvements in data access controls and tracking data movement within and between organizations.
  • Broad EHR adoption will open the door to a diverse set of secondary uses of data for clinical research, care improvement, population health and post-market medication surveillance. Early efforts to leverage EHR-based data to accelerate clinical research, and to dramatically improve the efficiency of post-market surveillance, show promise but have also exposed data quality problems.
  • Widespread EHR adoption may accelerate use of personal health records. Patients using PHRs will likely increase their contributions of data, such as measurements from home monitoring equipment, to their EHRs.
  • Federal efforts to improve safety and quality will increase the use of clinical decision support. This, in turn, will heighten the focus on data that drives support algorithms and rules. For example, if the problem and medication lists are incomplete, the potency of drug-drug interaction warnings in the EHR can be seriously diluted.

Much more here:

http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/06JUN2009/090608HHN_Online_Glaser&domain=HHNMAG

This is a very important point and one that can be easily overlooked!

Second last for the week we have:

'Dysfunctional work plans' prompted firm to cut ties with eHealth

Well before spending scandal erupted, Stevenson Kellogg chose to leave thousands of dollars on the table, rather than continue its association with the organization

Lisa Priest and Karen Howlett

Toronto — From Wednesday's Globe and Mail,

A consulting firm abruptly terminated its lucrative contract with eHealth Ontario last February after only four weeks on the job, citing delays, wasted time and dysfunctional work plans.

Well before the scandal erupted over eHealth's lavish spending on consultants, Stevenson Kellogg chose to leave thousands of dollars on the table, rather than continue its association with the organization.

“We terminated the contract because of my severe discontent with most aspects of the work, including the dysfunctional work plans, the delays and waste of time, and the personal styles of the team leaders,” Nigel Kelly, a partner and chief administrative officer at Stevenson Kellogg, confirmed in an e-mail to The Globe and Mail.

Mr. Kelly said in a telephone interview Tuesday that it was the only time in his 30-year career he has ever terminated a contract. He was to receive $113,250, documents show, but got only a portion of that after quitting two months early.

More here:

http://www.theglobeandmail.com/news/national/dysfunctional-work-plans-prompted-firm-to-cut-ties-with-ehealth/article1175691/

Sounds like a smart and principled consultant to me. A lesson for all involved in consulting about how to come out well when you know things are just not OK! The lessons from eHealth Ontario just keep coming!

Last, and very usefully, we have:

Map of Medicine use cuts poor referrals

08 Jun 2009

Use of Map of Medicine in primary care has led to a significant reduction in inadequate referrals from GPs, according to a new study.

Doctors from the Institute of Nephrology in Cardiff looked at the impact of a patient care pathway for chronic kidney disease on Map of Medicine.

They found use of the knowledge management tool cut inadequate referrals by almost 50% and also led to a slight reduction in overall referrals.

The researchers studied referrals for chronic kidney disease (CKD) from GPs in five local health boards covering 550,000 people in South Wales following the inclusion of CKD in the Quality and Outcomes Framework in 2006.

The doctors reported that there was an abrupt increase in referrals from the inclusion of CKD in the QoF with an overall increase of 61% across 30 months since April 2006.

Much more with link here:

http://www.ehiprimarycare.com/news/4911/map_of_medicine_use_cuts_poor_referrals

This is something recommended for implementation in the Deloittes National E-Health Strategy that has just been ignored by Ms Roxon and her hopeless Department. Big impact for low cost!

There is an amazing amount happening. Enjoy!

David.

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