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."

Sunday, June 06, 2010

Weekly Australian Health IT Links - 07-06-2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. 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 payment.

General Comment:

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There seemed to be two big issues this week in e-Health.
First we had the Senate Estimates hearing last Thursday.
I have provided some preliminary comment here:
When Hansard is published I may provide some additional details. I also plan a second blog on the whole Portal idea sometime this week.
The second was the abrupt drop in the shares of our largest e-Health Company (iSoft) after a profit warning and downgrade.
We can only hope the recovery will be reasonably swift – as I see it as important we have at least one substantial e-Health IT provider in OZ.
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All eyes and ears on march of the cyborgs

DEBORAH SMITH SCIENCE EDITOR
June 5, 2010
''THE first generation of cyborgs is alive, well, [and] walking among us,'' says Roger Clarke, a visiting professor at the school of computer science at the Australian National University.
Heart pacemakers and mechanical hands have been the ''leading wave'' in a rapid process of cyborgisation - the development of high-tech implants and prostheses that will benefit many people but will also raise new issues for society, Professor Clarke said.
Already the deaf can hear with cochlear implants. Deep brain implants that alleviate the disabling tremors of Parkinson's disease are also in use.
On the horizon are bionic eyes to let the blind see, and muscle implants that could allow paraplegics to stand and even walk, said Rob Shepherd, director of the Bionic Ear Institute and professor of medical bionics at the University of Melbourne.
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Only three software vendors sign up to e-health identifier tests

Healthcare identifier testing environment goes unutilised over contract disagreements and lack of final specifications
Minister for Health and Ageing, Nicola Roxon, has announced amendments to the Healthcare Identifier Bill, which is expected to be passed before Parliament later this month.
A total of three software vendors have signed a developer agreement to take part in the National eHealth Transition Authority's (NeHTA) software testing environment for the proposed national healthcare identifier (HI) service.
The figure was announced in Senate budget estimates by a spokesperson for the Department of Health and Ageing, after a raft of berating questions from senators on the committee about e-health spending, and whether the healthcare identifier service would be able to meet its initial 1 July deadline.
One of the department's spokespeople, Raelene Thompson, assured that Medicare Australia continued consultation with the industry over the healthcare identifiers, but said it is yet to begin live testing of the system.
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Just 3 test vendors for health identifiers

By Josh Taylor, ZDNet.com.au on June 4th, 2010
Just three software vendors have signed a developer's agreement with Medicare Australia to test the Federal Government's health identifier system ahead of its planned launch in July.
In the Federal Budget last month, the Federal Government allocated $466.7 million to e-health. Individual health identifiers, unique numbers to be issued to willing Australians to help link medical information, are necessary in order for the initiatives funded by the budget to go ahead. The legislation to enable the introduction of the identifiers is expected to be entered into parliament later this month.
However, during a Federal Budget estimates hearing yesterday, it was revealed that only a small number of software providers had signed on to test their product's interoperability in Medicare's health identifier test environment.
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No strong safeguards in HI Bill, says Australian Privacy Foundation

  • Karen Dearne
  • From: Australian IT
  • June 01, 2010 3:33PM
THE Healthcare Identifiers Bill will allow health authorities to link every piece of a person's medical information to a single number, without strong safeguards against deliberate or accidental abuse, the nation's peak privacy body warns.
"Amid all the fuss about networked privacy problems, consumers can't afford to overlook the bill currently before the Senate,'' says Australian Privacy Foundation health spokeswoman Juanita Fernando.
"The bill authorises health services and workers to index all of your health information - and to use and disclose it, whether you want them to or not.
"Have you ever used medication for a mild bout of depression, taken Viagra or had an STD? Sensitive information like this is already accidentally exposed all too often.
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Queensland Health pay goes to dead nurses in new bungle

THE bungled Queensland Health payroll system has paid two dead nurses.
That is the latest admission in a series of blunders to hit the system, which has been plagued with problems since it was brought online in March.
Former Queensland Health workers have also received pays under the new SAP/WorkBrain payroll and rostering system.
Queensland Nurses Union assistant secretary Beth Mohle said the two cases of deceased nurses being paid were "totally unacceptable".
She said both had died early into the implementation of the payroll system and had subsequently received more than one fortnightly pay.
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Dead nurses paid in payroll debacle

Queensland Health has been embarrassed by revelations that two dead nurses continued to be paid as its payroll woes continue.
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Queensland Health pay keeps coming after nurse's death

NURSE Val Wright died 10 weeks ago but Queensland Health continues to send fortnightly payslips to her home.
The executor of her estate, Richard Oliver, said Mrs Wright had been paid five times since her death on March 23, despite repeated calls to the Royal Brisbane and Women's Hospital to stop her pay.
"We're getting a payslip every fortnight. It's upsetting enough . . . without that happening," said Mr Oliver, a friend of Mrs Wright's for 35 years.
"The superannuation and the tax has been taken out, the whole bit, as if she was still alive.
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The Scoop - eHealth on life support?

Posted: Tue 1 Jun 2010 10:29AM
The federal opposition has vowed to cut the Rudd government's $467 million in e-health spending, citing structural flaws in the program. Just how critical is the future of e-health and what needs to be done? Joining The Scoop for a lively debate is Dr Mukesh Haikerwal, clinical lead at NEHTA; Malcolm Thatcher, CIO at The Mater Hospital Group; and Professor Graham Greenleaf, co-director of the Cyberspace Law and Policy Centre at the University of NSW. [audio only]
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E-health bill modified, with doctors’ input


2-Jun-2010
By Sarah Colyer
The Federal Government has announced last-minute changes to fundamental legislation for the e-health system in the hope the amendments will allow it to pass the Senate in the coming days.
The Federal Health Minister, Nicola Roxon, announced proposed changes to the Healthcare Identifiers bill this morning. The changes are aimed at increasing public confidence in the system’s privacy safeguards.
The bill sets out the legislative basis for the new 16-digit numbers for the identification of every Australian healthcare consumer and provider, in a system run by Medicare Australia.
Among the amendments, the government has proposed increased parliamentary oversight of the system, so that any changes to Medicare Australia’s role in running the system could be made only through legislation.
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Govt boosts safeguards for e-health identifiers

2nd Jun 2010
THE Federal Government has stepped up security measures within its national healthcare identifier legislation.
The revised draft of the Healthcare Identifiers Bill – which has remained stalled in the Senate since March this year – now streamlines administration requirements that healthcare providers will have to meet under the legislation.
There is also greater clarity on how they will be expected to liaise with the new Healthcare Identifiers Service, which will be responsible for issuing and maintaining the national database of Unique Healthcare Identifier (UHI) numbers for both patients and providers.
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Labor jumps the gun on e-health changes

June 3, 2010 - 12:19AM
AAP
The Rudd government is trying to stop the coalition from meddling with its plan to give every Australian an individual healthcare identification number by proposing its own changes to the regime.
The opposition in May announced it would move seven amendments to Labor's Healthcare Identifiers Bill in an effort to boost privacy and parliamentary oversight.
Opposition health and wellbeing spokesman Andrew Southcott said if the government was "bloody-minded" and refused to negotiate, "it may not have a bill" at all.
But on Wednesday, Health Minister Nicola Roxon said the government had revised the draft regulations outlining how the healthcare identifier system would work.
"The government will also propose amendments to the bill to respond to issues raised during public consultation," Ms Roxon said in a statement.
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Nicola Roxon amends health identifiers bill

  • Karen Dearne
  • From: Australian IT
  • June 02, 2010 3:16PM
HEALTH Minister Nicola Roxon has agreed to amend the controversial Healthcare Identifiers Bill to address key industry and medical provider concerns, in a last-minute bid to achieve Coalition support in the Senate this month.
But opposition e-health spokesman Andrew Southcott said the government had not gone far enough, and Coalition senators would insist on further changes to ensure all outstanding concerns were addressed.
Ms Roxon agreed to two Coalition demands: to increase parliamentary oversight of the compulsory HI regime and ensure that any change in service operator - initially Medicare Australia - is made through legislation, rather than regulation; and to create more flexible arrangements for the assignment of identifiers to some healthcare providers, including a right of review.
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Calling in the experts

4-Jun-2010
General practice today relies on sophisticated computer systems, so do-it-yourself maintenance can be a risky approach. By Heather Ferguson
WHEN computers first landed in general practice, GPs with a passion for IT revelled in managing their systems. But the days of a GP looking after patients and a server are fast disappearing, according to IT experts.
General practice computer systems are now too complex for GPs to manage effectively, the experts say.
"Our advice is use an outside IT company. You are GPs, work at being GPs," says Noel Stewart, Australian Doctor computer columnist and IT manager at the North East Valley Division of General Practice in Melbourne.
"A lot of practice managers can do day-to-day stuff, such as back-up … but to set up [a computer system] we advise an outside IT company."
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HealthSMART grows on virtual servers, apps

Sixty per cent server virtualisation rate in two years
Rodney Gedda (CIO) 01/06/2010 13:43:00
Victoria's whole-of-health ICT strategy, HealthSMART, has grown from eight to 1000 servers in four years as it gears up to provide application services to some 140,000 end-users across the state, including the occasional iPad-wielding clinician.
HealthSMART program director, Bruce Ryan, said from an ICT perspective, Victoria's health sector consists of more than 40 discrete departments, each with its own IT infrastructure.
"About 10 years ago a number of issues were identified, including application end-of-life, a lack of standardised processes, and some important business processes were not IT-enabled," Ryan said.
"We now have an emerging focus on technology services. HealthSMART had a number of business drivers like establish DR and business continuity facilities that didn't exist, increasing IT efficiency across the sector and we are now looking at enhanced integration and middleware."
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Vic's HealthSMART keen for iPads

By Josh Taylor, ZDNet.com.au on June 1st, 2010 (17 hours ago)
Bruce Ryan, program director of Victorian e-health IT infrastructure project HealthSMART, said today that there is "considerable interest" in bringing the Apple iPad to hospitals and health departments across Victoria.
Established in 2003, as the "whole of ICT strategy" for Victorian health, HealthSMART is a state-wide project bringing together some 272 sites, 67,500 full-time employees, 150,000 users and 12,500 beds across the Victorian health system. The network now connects 40 wide area networks and two datacentres. Roaming desktops are employed throughout the network using a combination of the Citrix XenServer and XenApp virtual desktop software. Citrix is also used for bedside clinical systems that contain information such as an electronic drugs chart for patients.
Ryan told the Citrix iForum audience in Sydney today that HealthSMART was now "looking for support for emerging device formats" including the iPad.
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Medicare yet to sign contract for looming health identifier deadline

ONE month out from the start of the Rudd government's mandatory Healthcare Identifiers regime, Medicare is yet to sign a contract for service delivery.
The $57 million, two-year contract for Medicare to design and build the service on behalf of the National E-Health Transition Authority expired in January, but the system is yet be tested live.
To date, only 22 medical software firms out of 200 have expressed interest in building interfaces between doctors' systems and the identifier service, with only four signing a contract.
It is understood no vendors have begun work on interfaces, as technical details are not confirmed.
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NBN cost-benefit analysis would take just three days: Economist

Economic consultants call for NBN Co or Communications Department to release economic details underpinning implementation study
A full cost-benefit analysis of the Government's $43 billion National Broadband Network (NBN) would take just three days to complete, according to economic consultants.
Speaking to a Senate select committee on the NBN, consultants, Dr Henry Ergas and Dr Mark Harrison, agreed that the NBN Implementation Study was highly optimistic in its brief analysis of rate of return compared against government bond rates. However, the lack of a proper cost-benefit appraisal, as well as the lack of details that underpinned the study preventing a proper analysis becoming available.
"That is not what the implementation team were asked to do, it's not what they have done," Ergas said, "but, it would be certainly possible, indeed readily possible based on the great detail of information they have generated, to come to a more robustly based and contestable view as to whether the benefits from this proposed NBN exceeds its opportunity costs."
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http://phx.corporate-ir.net/External.File?item=UGFyZW50SUQ9NDg3NzJ8Q2hpbGRJRD0tMXxUeXBlPTM=&t=1

iSOFT achieves key Lorenzo milestone at Morecambe Bay

Sydney – 4 June 2010 – iSOFT Group Limited (ASX: ISF) – Australia's largest listed health information technology company, today announced that Lorenzo Release 1.9 is now installed at University Hospitals of Morecambe Bay NHS Trust.
Morecambe Bay becomes the first acute NHS trust in England to receive iSOFT’s integrated patient management and clinical solution. With its partner CSC, iSOFT completed the implementation of this next-generation solution on 3 June 2010 at all trust sites including Furness General, Westmorland General, and Royal Lancaster Infirmary.
The project involved the training of over 3,500 staff and the migration of approximately 80 million data transactions to the new system.
Lorenzo Release 1.9 also replaces an existing iSOFT patient administration system and follows an earlier implementation of Lorenzo Release 1.0 across all surgical wards at Morecambe Bay.
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 Market Update

Sydney – Wednesday 2 June 2010 – iSOFT Group Limited (ASX: ISF) – Australia's largest listed health information technology company has achieved a significant milestone with the ‘go live’ of the University Hospitals of Morecambe Bay NHS Trust, however delays in the rollout (which were beyond the control of iSOFT), uncertainty associated with the change in UK government and a weak European economic environment have created the need to clarify iSOFT’s earnings outlook for the current fiscal year.
The ‘go live’ at Morecambe Bay, which occurred over the weekend of 29 to 31 May 2010, is a significant milestone as it represents a validation of the core underlying Lorenzo platform and the first implementation of Lorenzo Release 1.9 in a complex hospital environment.
At the same time, political uncertainty in the lead up to the recent UK election and the subsequent change in government, have together led to the deferral of decisions in relation to the English NPfiT program particularly for our partner Computer Sciences Corporation, Inc. For iSOFT, this has affected the timing and conclusion of negotiations surrounding the potential of an agreement with CSC in relation to the market opportunities in England and in particular the Southern cluster of English hospitals, as well as delays in milestone payments. The revenues associated with this agreement had been anticipated in fiscal 2010 and are now anticipated in fiscal 2011. However, as with any commercial negotiation, there is no certainty that revenues will ultimately flow.
Typically the Company earns disproportionately higher revenues in the final quarter of the fiscal year. The factors outlined above, which together with currency impacts as a result of the strong Australian dollar, have resulted in revised revenue, EBITDA and cash flow expectations for the period. Revenue for the 2010 fiscal year is being revised to the range of $440m to $455m. 2010 fiscal year EBITDA is likely to be in the range of $45M - $60M, before exceptional items. 2010 fiscal year operating cash flow has been impacted accordingly.
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iSOFT Group Limited (ASX:ISF) Appoints Dr. James Fox As Deputy Chairman

Sydney, May 31, 2010 (ABN Newswire) - iSOFT Group Limited (ASX:ISF), Australia's largest listed health information technology company today announced the appointment of Dr. James (Jim) Fox as Deputy Chairman. This decision affirms the Board's commitment to the continual process of review and development of the Company's overall corporate governance position and the composition of the Board.
Dr Fox, 57, has more than 25 years' experience as a public company director, with a track record of building technology-based companies in international markets. He is Chairman & Non-Executive Director at Biota Holdings Limited (ASX:BTA) (OTC:BTAHY), Non-Executive Director & Deputy Chairman at Elders Limited (ASX:ELD) ; and Non-Executive Director at Air New Zealand Ltd. (NZE:AIR) (PINK:ANZFY), MS Research Australia and TTP Group (U.K).

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iSoft revises down fiscal 2010 results

Comes despite reassurances in March that revenues were on track
iSoft (ASX:ISF) has revised its revenues down for the full 2010 fiscal year by as much as $30 million following a confluence of market events.
In an ASX update, the e-health provider said its revenue for fiscal 2010 was now in the range of $440 to $455 million while EBITDA was now likely to be in the range of $45 to $60 million. In February the company reported a full fiscal 2010 outlook of $470 million and an EBITDA of $113 million.
The company also reported a first half fiscal 2010 results which included revenues of $237.3 million and an EBITDA of $40.8 million.
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Morecambe Bay goes live with Lorenzo 1.9

01 Jun 2010
University Hospitals of Morecambe Bay NHS Trust has gone live with Lorenzo Release 1.9 across its five hospital sites, E-Health Insider can exclusively reveal.
The implementation of the iSoft software, a key part of the NHS National Programme for IT, was carried out by local service provider CSC.
The trust has confirmed that it has become the first acute hospital to use the Lorenzo software with patient administration functionality. The software is being used by 3,500 staff across its five hospitals for all clinical activity.
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Enjoy!
David.

Friday, June 04, 2010

Weekly Overseas Health IT Links 02-06-2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. 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 payment.

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http://www.healthcareitnews.com/news/study-health-it-care-coordination-key-meeting-national-cholesterol-guidelines

Study: Health IT, care coordination key to meeting national cholesterol guidelines

May 14, 2010 | Molly Merrill, Associate Editor

DENVER – Kaiser Permanente is crediting healthcare information technology and care coordination as helping more than 40 percent of very high-risk patients reach national cholesterol guidelines – a feat that past studies indicate is difficult to achieve.

In 2004 the National Cholesterol Education Program issued revised cholesterol goals recommending people at very high-risk for heart disease move their target LDL or "bad" cholesterol from 100 mg/dL to 70 mg/dL to reduce the risk for another heart attack.

Many health experts have questioned the legitimacy of such an aggressive goal. Previous research has found only between 15 and 30 percent of patients were able to get their cholesterol to the recommended goal.

The study, which is the largest to date demonstrating how many patients can get to the lower goal, found that of the 7,247 Kaiser Permanente patients studied, 43.4 percent lowered their bad cholesterol to less than 70 mg/dL. The majority of patients who attained an LDL less than 70 mg/dL in the study were receiving a statin or a combination of statin and other cholesterol-lowering therapies.

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http://www.fiercehealthit.com/story/battle-over-privacy-de-identified-data-continues/2010-05-24

Battle over privacy of de-identified data continues

May 24, 2010 — 12:03pm ET | By Neil Versel

Think the tug-of-war between vendors, health systems and privacy advocates over data mining and de-identification of patient records is subsiding? Think again.

The outspoken Dr. Deborah Peel has a memorable line that she often repeats: "Once your information is released, it's like a sex tape that lives in perpetuity in cyberspace," she says in a Dallas Morning News story. "You can never get it back." The Morning News last week took a look at the contentious struggle for control of data that must be resolved before the healthcare industry is to fulfill President Obama's vision of a nationwide, interoperable system of EMRs and health information for all Americans.

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http://www.modernhealthcare.com/article/20100524/NEWS/100529968/1029

Working on IT

By Joseph Conn / HITS staff writer

Posted: May 24, 2010 - 12:01 am ET

The American Recovery and Reinvestment Act of 2009, commonly known as the stimulus law, has a host of tight deadlines for its myriad health information technology subsidy and IT network development initiatives.

Nearly all of them are timed to help fulfill the ambitious goal set by former President George W. Bush in 2004 and adopted by President Barack Obama last year to make electronic health records available to most Americans by 2014.

Not surprisingly, a federally funded health IT workforce training effort is both part of the overall program and caught up in its mad rush.

“We are moving fast,” said Patricia Dombrowski, director of the Life Science Informatics Center at Bellevue (Wash.) College, which is leading a consortium of community colleges that applied for and won $3.4 million in workforce training grants funded by the stimulus law—covering career paths from information management to IT hardware installation.

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http://www.modernhealthcare.com/article/20100525/NEWS/100529949

50,000 new health IT workers might be needed

By Joseph Conn / HITS staff writer

Posted: May 25, 2010 - 12:01 am ET

Part two of a two-part series (Access part one):

Along with the push to ramp up the use of health information technology in hospitals and doctors' offices comes the need for a highly skilled labor force to get the job done.

Claire Dixon-Lee is executive director of the Commission on Accreditation for Health Informatics and Information Management Education; the CAHIIM is a division of the American Health Information Management Association that accredits 281 health information management certificate and baccalaureate degree programs at schools across the country. In the past, health information management workers dealt with managing paper records, but their jobs have changed with the times.

Dixon-Lee said that today many AHIMA members are doing the work of IT specialists at their hospitals and physician offices while others can be retrained for these new positions. CAHIIM-accredited programs graduate between 3,000 and 3,500 students a year, of which 600 receive bachelor's degrees and the rest associate's degrees, she said.

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http://www.vintoniowa.org/Business/article738.html

Training for a New Health Care Information Era

By Steve Carpenter, Kirkwood Tuesday May 25th, 2010

Training for a New Health Care Information Era:

Kirkwood receives major Federal grant, part of regional and nationwide program

Kirkwood Community College will soon launch a training program to boost skills and advance careers in health information technology. A grant from the U.S. Department of Health and Human Services will put more than a half million dollars toward training programs for IT professionals in hospital, clinical and other health care settings.

Kirkwood is one of 17 community colleges across the Midwest putting the training program into action. The grant provides $512,000 in Kirkwood support for two years of training sessions. The educational program will focus on non-credit, short-term training.

Cuyahoga Community College of Cleveland, Ohio is the lead institution in the Midwest portion health care information training project. The total grant award to the 17 Midwest community colleges totals $36 million, with an overall goal of more than 50,000 new health IT professionals in the workforce by mid-2012. The larger scope of this grant includes 70 community colleges across the U.S.

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http://www.healthcareitnews.com/news/interoperability-key-better-patient-care

Interoperability key to better patient care

May 20, 2010 | Kyle Hardy, Community Editor

ANDOVER, MA – Interoperability is a major part of the HITECH Act, the healthcare IT portion of the American Recovery and Reinvestment Act, passed in February of 2009. And according to Dale Wiggins, chief technology officer of Philips Healthcare Patient Care and Clinical Informatics, it all starts with modalities.

"It's important to providers that modalities (PACS, MRI, CT scans) integrate with the other legacy systems at their facilities," said Wiggins. "Providers have orders that need to be filled and Philips is moving to make sure work flow is not interrupted."

Interoperability has been touted as having much potential in improving the quality of care for patients. Providers are looking at integrating new systems with their existing IT infrastructure to reduce waiting room times, provide clinical decision support for physicians and ultimately reduce costs.

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http://www.healthcareitnews.com/news/automated-home-monitoring-lowers-high-blood-pressure-study-finds

Automated at-home monitoring lowers high blood pressure, study finds

May 21, 2010 | Mike Miliard, Managing Editor

DENVER – The use of at-home blood pressure monitors and Web-based reporting tools that connect patients and clinicians appears to significantly improve patients’ ability to manage their hypertension down to healthy levels, according to new research.

The study, which was led by Kaiser Permanente Colorado in collaboration with the American Heart Association and Microsoft, followed 348 patients, ages 18 to 85, with uncontrolled high blood pressure. The initial study data was presented today by Kaiser Permanente Colorado researchers at the American Heart Association’s 11th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.

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Performance Monitoring Aims To Improve EHR Satisfaction

By monitoring system performance on the backend, an Alabama health system hopes to make its e-health record rollout go smoother for users.

By Marianne Kolbasuk McGee, InformationWeek

May 25, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=225200081

When rolling out a new e-health record system, the last thing a healthcare organization wants is for clinicians to complain about how slow the system is, or even worse, being unable to access digitized patient information.

As it is, making the switch from paper records -- and paper-based processes -- to computerized record keeping, prescription ordering, and a digitized workflow can be disruptive and challenging enough for a doctor practice or hospital department. Throw in systems performance problems on the backend and the frustration will only escalate.

Avoiding those kinds of problems from the get-go is the plan at Baptist Health System of Birmingham, Ala., which operates four hospitals in the state and about 35 doctor practices and health centers.

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http://www.un.org/apps/news/story.asp?NewsID=34802&Cr=itu&Cr1=

UN urges improved access to information technology in hospitals, schools

25 May 2010 – Health institutions and schools in developing countries continue to have limited access to information and communications technology (ICT), the United Nations telecommunication said in a report issued today, calling for greater efforts to improve access to high-speed Internet services.

“The health sector stands to benefit greatly from the use of ICTs and ICT applications, for example through the more efficient delivery of health-care services and the provision of health information to the general public,” the UN International Telecommunication Union (ITU) said in its 2010 report.

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http://www.who.int/goe/ehir/2010/25_may_2010/en/index.html

e-Health Intelligence Report

25 May 2010

Scientific Articles

:: eHealth portals: who uses them and why? (Am J Health Promot. 2010 May-Jun;24(5):TAHP1-7, iii.)

The role of the Internet and specifically ehealth portals continue to expand at a significant pace. The various major functions of ehealth portals are identified, along with the results of an online survey conducted among employees of eight major U.S. employers. Demographic variables, job characteristics, reasons for use of the portal and selected behavioral outcomes are presented from a sample of more than 20,000 employees, with a response rate in relation to the entire employee population of 19%. Major implications from the survey findings are then identified, with an intention of enhancing the health improvement effectiveness of the ehealth portal.

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http://www.zdnet.com/blog/healthcare/intel-health-trying-carrier-strategy-in-europe/3677

Intel Health trying carrier strategy in Europe

By Dana Blankenhorn | May 26, 2010, 6:57am PDT

Intel Health, which is struggling to find a winning business model in the U.S., is entering Europe with a carrier strategy.

The company announced marketing deals with Telefonica of Spain, BT of England, and Orange in France as part of its entry to the continent’s e-health market.

Other strategic partners listed in the release are GE Healthcare, which will work with it in England, and Asklepios Hospital Group of Germany, one of the region’s largest private hospital groups.

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http://news.discovery.com/tech/are-electronic-medical-records-safe.html

Are Electronic Medical Records Safe?

By Cristen Conger | Wed May 26, 2010 01:56 PM ET

In 2008, a hospital employee at UCLA Medical Center was fired for leaking details of Farrah Fawcett’s cancer treatment.

But the information didn’t come from someone directly involved with the late actress’s caretaking. Instead, the person in question hacked into Fawcett’s electronic medical record in the hospital’s patient database.

As the national initiative to create electronic medical records for every American moves forward, the Fawcett incident exemplifies the worst-case scenario for putting people’s most personal and sensitive health records in a digital format.

Unless electronic medical records are safe, they could end up in the wrong hands, opening the door to medical identity theft, insurance fraud and other breaches of privacy.

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http://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/571-community-pharmacies-to-be-linked-with-launch-of-provincial-pharmacy-network

Community pharmacies to be linked with launch of provincial Pharmacy Network

May 26, 2010 (St. John’s, NL) – Newfoundland and Labrador has officially begun connecting community pharmacies to the provincial Pharmacy Network, the Honourable Jerome Kennedy, Minister of Health and Community Services announced today. Minister Kennedy was joined by Mike Barron, CEO of the Centre for Health Information, Don Rowe, Newfoundland and Labrador Pharmacy Board, Don Sweete, Canada Health Infoway’s Executive Regional Director for the East, and Paul LePage, Vice President and General Manager of Healthcare Delivery Solutions, TELUS. The Pharmacy Network is a provincial drug information system that contains a record of patient medication information and comprehensive drug information which will assist pharmacists in identifying potential adverse drug interactions.

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http://www.blogher.com/how-electronic-medical-records-will-improve-your-health-care?wrap=blogher-topics/office&crumb=32392

How Electronic Medical Records Will Improve Your Health Care

May 25, 2010 8:41 am by in Tech

There are fewer things in life more important than our health. And yet, most of us have never even peeked at those records. In the five -- make that nearly six decades -- that I've been seeing physicians, I have never once looked at a single page in my medical record. Not one page. Ever.

How bizarre is that? What if there is something in there that's inaccurate? What if there is something in there that I should know but have forgotten? Until recently, it never even occurred to me that I should review these records. It just wasn't on my radar.

My medical records probably are skinnier than most. I have no chronic diseases. Don't take medications on a regular basis. Have had a couple of surgeries. A concussion. A couple of pregnancies. The most significant medical event was a case of shingles on my facial nerve that created a rather thick file for my ophthalmologist. To the best of my knowledge, that file has never been shared with my regular physician. Maybe there is something in there in how I responded to treatment that would be important for future medical episodes.

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http://govhealthit.com/newsitem.aspx?nid=73799

Privacy panel advocates encryption for simple HIE

By Mary Mosquera

Monday, May 24, 2010

Healthcare providers should encrypt patient information when they share it with another provider, even in a case of the direct exchange of personal health information or data that is not facilitated by a health information exchange or other third-party organization.

The recommendation for guarding patient information privacy in a simple health information exchange was made by the privacy and security workgroup of the Health IT Policy Committee at a May 19 policy committee meeting.

In recent weeks the workgroup has been wrestling with determining at what point in a health information exchange it becomes necessary for providers to obtain consumer consent to approve an exchange a transaction.

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http://www.healthcareitnews.com/news/what-do-data-top-mind-healthcare-execs

What to do with data top of mind with healthcare execs

May 24, 2010 | Bernie Monegain, Editor

BOSTON – No issue is more important to healthcare providers than data management, according to a new global survey of healthcare executives, conducted by BridgeHead Software, which develops and markets healthcare storage virtualization solutions.

Forty-four percent of respondents to BridgeHead Software's Healthcheck 2010 Survey of hospitals and healthcare organizations worldwide indicate that data backup/business continuity/disaster recovery is their top IT investment priority throughout 2010 and likely beyond.

The Healthcheck 2010 survey gauged the opinions of 133 healthcare executives on their most pressing IT needs. Nearly 50 percent of respondents were from the IT executive or director/manager level, and approximately 10 percent were non-IT executives. The rest included technology and medical professional with a spattering of titles and responsibilities.

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http://online.wsj.com/article/SB20001424052748704113504575264340355395642.html#mod=todays_us_marketplace

Internet Tool to Curb Waiting-Room Time

Web Alerts When Doctors Run Late

By SHIRLEY S. WANG

A new Web-based tool seeks to help patients spend less time in the waiting room before seeing their doctor. The application, called MedWaitTime, allows patients to check before their appointment whether their doctor is running late, akin to getting a flight-status update before going to the airport.

Patients can access the site, medwaittime.com, up to two hours ahead of their appointment. If the doctor is running late, patients can be instructed to arrive later than their scheduled appointment.

Patients can also enter their cellphone number into the system for alerts through text messaging.

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Dossia Expanding EHR Platform Reach

The employer consortium is offering its e-health record software to other companies via the cloud and is also developing an EHR package for small and mid-size businesses.

By Marianne Kolbasuk McGee, InformationWeek

May 24, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=225100002

Dossia, the consortium founded several years ago by nearly a dozen large employers to develop and offer e-health records to their workers, is now making that software platform available to other companies.

Via a software-as-a-service, multi-year subscription-fee model, the Dossia Personal Health Platform is now being offered to a wider range of employers that want to provide EHRs to their workers, said Steve Munini, Dossia chief operating officer. Those customers will be offered the same bells and whistles that founding members are provided, he said. That includes an array of applications that have been developed for or are available via the Dossia platform by third parties, including Mayo Clinic, Allviant, and MediKeeper.

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http://www.ehealtheurope.net/news/5938/ec%E2%80%99s_puts_health_on_digital_agenda

EC puts health on Digital Agenda

26 May 2010

The European Commission has set out its Digital Agenda, which includes measures to use technology to address rising healthcare costs and help member states to cope with their ageing populations.

The action plan says the smart use of technology and the exploitation of information will help to address these and other challenges facing society, including climate change.

The EC will set up wide-scale pilots to take forward the ideas in the Digital Agenda. One of these will aim to give Europeans secure, online access to their medical health data so they can share it with doctors. The action plan says the planned delivery date for this initiative is 2015-20.

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http://www.ehiprimarycare.com/news/5930/nhs_it_pros_urged_to_%E2%80%98keep_the_faith%E2%80%99

NHS IT pros urged to ‘keep the faith’

21 May 2010

The head of Kaiser Permanente’s Innovation Centre has urged NHS professionals engaged in health IT implementations to ‘keep the faith’, as the benefits to patient care are worth the effort.

In an exclusive video interview broadcast today on EHI TV, Dr Yan Chow of leading US healthcare network Kaiser Permanente tells EHI editor Jon Hoeksma, how KP has just completed a seven year $4 billion implementation of electronic medical records that is already proving transformational.

Dr Chow, the director of innovation and advanced technology, Kaiser Permenente Information Technology, says that his organisation has completed the roll-out of EMRs in the last few weeks and already has hundreds of published studies showing the benefits to the quality of patient care, patient experience and delivery of services.

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http://www.fierceemr.com/story/study-emr-speeds-treatment-stds/2010-05-27

Study: EMR speeds treatment of STDs

May 27, 2010 — 1:52pm ET | By Neil Versel

Sex sells. Apparently, that's even true when it comes to EMRs. How else to explain U.S. News & World Report picking up a HealthDay News report on the effect an EMR has on treatment? That's because the disease in question is chlamydia.

A study published online today in the journal Sexually Transmitted Infections finds that an EMR cut the average treatment start time to 3.5 days from 11.5 days following a chlamydia diagnosis at a sexual health clinic in the UK. The percentage of patients getting treatment within two weeks of their diagnosis rose to 94 percent with the EMR from 38 percent before the clinic installed the system.

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http://www.fierceemr.com/story/new-book-focus-emr-adoption-not-just-implementation/2010-05-27

New book: Focus on EMR adoption, not just implementation

May 27, 2010 — 11:29am ET | By Neil Versel

Anyone in the biz knows that you don't just put in an EMR and expect success. The federal subsidies, which require "meaningful use" of EMRs, up the ante. Still, implementations continue to fail, or at least not live up to expectations.

A new book, Beyond Implementation: A Prescription for Lasting EMR Adoption, examines the pitfalls of EMR projects and discusses why and how organizations should focus on user adoption, not just implementation. The authors, Heather Haugen and Dr. Jeffrey Woodside, spoke at length about the book with CMIO magazine.

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http://www.fierceemr.com/story/srssoft-exec-most-emrs-are-poorly-designed-complicate-meaningful-use/2010-05-27

SRSsoft exec: Most EMRs are poorly designed, complicate 'meaningful use'

May 27, 2010 — 12:07pm ET | By Neil Versel

It's likely a combination of reluctance to change and poorly designed systems that has held back wider EMR adoption, though opinions do differ greatly. Jack Callahan, executive VP at "hybrid" EMR vendor SRSsoft, Montvale, N.J., clearly believes that systems design is more at fault.

In response to a recent discussion of slow EMR uptake on the EMR and HIPAA blog, Callahan wrote what blog author John Lynn calls a "passionate" email, which Lynn published on his related EMR and EHR blog. "A major reason why the rate of EMR adoption is so slow is that, despite vendor claims, the actual needs and priorities of the busy, practicing provider are not built in," Callahan says. "I've worked closely with three EMR companies, and am aware of more than 300 EMR products, almost all of which, like lemmings, have decided to follow the old CCHIT design-and-development pathway over the cliff," adds Callahan, clearly no fan of the prevailing certification process.

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http://allafrica.com/stories/201005280149.html

Rwanda: We Can Make e-Health a Reality-Rector

Stevenson Mugisha

28 May 2010

Kigali — The Rector of Kigali Institute of Science and Technology (KIST) has called on all stakeholders in the e-health sector become a global reality.

Addressing a workshop organised for e-Health Centre of Excellence stakeholders in Kigali yesterday, Prof. Abraham Atta Ogwu told participants that the centre is meant to help improve the health sector in the country.

"The main objective of this workshop is to bring together you as stakeholders in your respective capacities to create awareness that Rwanda has progressed and has become a part of the Global Health Informatics programs"

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http://www.modernhealthcare.com/article/20100528/NEWS/100529922

Health IT panel gets an earful on plan

By Joseph Conn / HITS staff writer

Posted: May 28, 2010 - 12:01 am ET

The federally chartered Health IT Policy Committee heard last week from its Strategic Plan Workgroup, which delivered advice to the Office of the National Coordinator for Health Information Technology for an annual update to the Federal Health IT Strategic Plan.

At a full-committee meeting May 19, the Health IT Policy Committee took under advisement the work group's recommendations to make several tweaks to the plan. ONC head David Blumenthal said a final vote on the recommendations could come at the policy committee's next meeting, scheduled for June 25. The Health IT Policy Committee was created under the American Recovery and Reinvestment Act of 2009 to advise the ONC on IT policy issues.

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http://govhealthit.com/newsitem.aspx?nid=73807

Health data exchange build starts this summer

By Nancy Ferris

Wednesday, May 26, 2010

By early July, the Office of the National Coordinator will announce the winners of 11 contracts for developing a health information exchange framework based on a model originated by federal homeland security agencies for sharing sensitive information over the Internet.

The National Information Exchange Model, or NIEM, is a technical approach to information sharing that federal agencies developed during the last decade, prompted by the need to share homeland security information quickly and securely. It is based on XML standards.

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http://www.healthdatamanagement.com/news/mobile-ipad-content-webmd-40338-1.html

WebMD Supports iPad

HDM Breaking News, May 27, 2010

Medical information content vendor WebMD has introduced a free mobile application to access its content on the Apple iPad.

The WebMD for iPad application is in addition to the New York-based vendor's previous offering for iPhone users, called WebMD Mobile. Both services feature the company's Symptom Checker, content on more than 1,000 conditions, drug information including side effects and interactions, and first aid information.

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http://www.healthcareitnews.com/news/enterprise-hie-market-poised-soar

Enterprise HIE market poised to soar

May 25, 2010 | Diana Manos, Senior Editor

FRAMINGHAM, MA – A recent study of health information exchange solution vendors shows enterprise HIEs serving integrated delivery networks, health, or hospital systems will be the fastest-growing market segment of HIE organizations in the coming two years.

The study, "Vendor Assessment: Industry Short List for Health Information Exchange Technologies," was conducted by IDC Health Insights, a Framingham, Mass.-based market research firm.

IDC researchers said enterprise HIEs are unlike regional health information organizations (RHIOs) and statewide or national HIEs, because they can establish a sustainable business model and are not as encumbered by organizational and data governance issues.

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http://www.healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications::Article&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=011CD5973F724C74813149F25301C2F7

Issue Date: June 2010

CPOE Revelations

Results of an important new study dispel some major assumptions about clinical IT implementations

by Mark Hagland

The logic in the argument would appear to be unassailable: given that there is inevitably a range in the experienced functional quality of various electronic health record (EHR), computerized physician order entry (CPOE), and other clinical IT products on the market, the better the quality of particular clinical IT products, the more fully those individual products should help hospital organizations to achieve better patient safety and care quality, correct? Indeed, such assumptions would seem to be supported by the results of such important industry resources as the regular reports coming out of the Orem, Ut.-based KLAS Research, for example.

Yet the results of a new study by researchers at the Falls Church, Va.-based CSC Healthcare seem to portray a far more complex picture of what actually happens once hospitals implement clinical information systems. Despite the strong value of knowing the quality rankings of various products, some CSC researchers recently found that, when it comes to the end results around reductions in physician order entry-related medical errors, researchers found only a slight correlation between buying a “quality” EHR/CPOE product and error reduction. In other words, the bulk of the difference in actual error reduction relates to a complex knot of processes and issues separate from the brand name of a particular system an organization is implementing or has implemented. But very bluntly, a hospital can buy a very “high-quality” EHR product and customize it very poorly; or take a “mediocre” product and achieve considerable success with it.

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http://www.kaiserhealthnews.org/Stories/2010/May/24/Blumenthal-Health-IT.aspx

Obama’s Health IT Leader Says Doctors Will Embrace Change

David Blumenthal Guides Billions Of Stimulus Dollars To Help Doctors And Hospitals Adopt Electronic Medical Records

May 24, 2010

Dr. David Blumenthal was not happy to find a new computer installed on his desk when he showed up for work one morning eight years ago at Massachusetts General Hospital in Boston. He knew the hospital had been hard at work on developing an electronic medical record (EMR) system, but Blumenthal wasn't keen on changing practices that had served him and his patients just fine over the years.

Quickly, though, he found himself to be odd man out at staff meetings where younger colleagues eagerly exchanged tips on how to retrieve patient histories, test results and consults with other physicians.

"I realized I was going to have to get on board," Blumenthal recalled in an interview. Still, he approached the task of converting paper-based notes and patient records to the electronic system as more obligatory than clinically useful. The "aha" moment, which Blumenthal frequently mentions in speeches, came on the day he entered orders for a CT scan and his computer screen flashed a reminder that the patient had already had one.

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http://industry.bnet.com/healthcare/10002791/healthcare-it-even-the-experts-cant-figure-out-whats-going-on/

Healthcare IT: Even the Experts Can't Figure Out What's Going On

By Ken Terry | May 24, 2010

Trying to follow the ins and outs of healthcare information technology — a complicated morass of electronic health records, patient and medical-management systems, federal subsidies and mandates and a whole lot more — has been like assembling a giant jigsaw puzzle whose pieces are delivered in random order. It’s some comfort, though not much, to realize that this mess baffles the experts, too.

A recent Microsoft (MSFT) press conference that included David Brailer, the first national health IT czar, put the current state of this jigsaw puzzle in a high-level perspective. But it was only slightly less confusing after Brailer and Peter Neupert, vice president of Microsoft Health Solutions, expounded on their views.

Let’s start with electronic health records, or EHRs. Last year’s stimulus bill included incentives for physicians and hospitals to acquire EHRs — but healthcare providers first have to show they’ll be using the information systems in “meaningful” ways. The draft “meaningful use” regulations, published in January, drew negative comments from many medical societies and other healthcare organizations. Providers believe it will be too difficult for them to meet the criteria within the specified time frame, and they feel it’s unfair that they have to satisfy every requirement to get the government funds.

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http://www.healthleadersmedia.com/content/LED-251355/Patient-Information-Breaches-Leaderships-Responsibility.html

Patient Information Breaches: Leadership's Responsibility

Philip Betbeze, for HealthLeaders Media, May 21, 2010

Let's stipulate, before I go on, that I don't know much about technology or how computers work. I can run routine maintenance on my computer, but that's about it. In fact, a good (and patient) friend of mine is coming over tonight to help me hook up my wireless internet router, which really isn't all that difficult for him, but gives me hives just thinking about it. Give me a lawnmower engine to rebuild or a set of brakes to change, and I'm your man. Give me a computer to work on, and you'll get a blank stare in return.

I'm guessing many of the readers of this column fit the same mold, minus perhaps, the car repair abilities, and plus the overwhelming responsibility of being in charge of a health plan, a hospital, a physician practice or health system. No, you're not likely a computer security guru, but given the almost weekly news item about embarrassing and costly patient health information breaches in healthcare, it's appropriate to remind those of you who are in charge of your hospital, health system or physician practice: protecting this data is YOUR responsibility. I know you depend on delegates to get these jobs done, and you pay them well. You can't micromanage this stuff.

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http://www.healthleadersmedia.com/content/TEC-251483/Ready-or-Not-TechSavvy-ePatients-are-Coming.html

Ready or Not, Tech-Savvy e-Patients are Coming

Gienna Shaw, for HealthLeaders Media, May 25, 2010

The patient of the future—also known as the e-Patient—is technologically savvy, information hungry, and has a sense of entitlement about the level of service and the types of services they want. They'll demand up-to-date, easy-to-understand, and easy-to-access information about the cost of care and billing, online appointment scheduling, the ability to e-mail their physicians, and hospital Web sites that have more information than can be found on Google maps. The patient of the future will put plenty of demands on healthcare organizations in general and healthcare IT departments in particular.

Donna Cryer is one such patient. A liver transplant recipient who's had to deal with multiple and complex health issues starting when she was just 13, she wants to be cared for in ways that can only be delivered with data-sharing and expedited communication.

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http://www.healthdatamanagement.com/news/certification-ehr-comment-ehnac-edi-40327-1.html

EHNAC: Move Certification Beyond EHRs

HDM Breaking News, May 25, 2010

The Secretary of Health and Human Services should consider creating information technology certification programs beyond those being adopted for complete electronic health records systems and EHR modules, according to the Electronic Health Network Accreditation Commission.

Farmington, Conn.-based EHNAC, which certifies transactions processors for meeting specific performance criteria, in a comment letter makes the case for certification of other I.T. services. These could include claims clearinghouses and value-added networks, financial services, electronic prescribing, and health information exchanges, among others.

The organization understands the reasoning for the proposed certification rule's definition of an accredited certification body that is limited to certifying EHRs and EHR modules. EHNAC, however, is concerned that a "minimum" definition in a final rule will eliminate itself and other entities from consideration if HHS designates organizations to certify HIEs.

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http://www.ihealthbeat.org/perspectives/2010/has-the-time-come-to-embrace-telehealth-as-a-system-solution.aspx

Monday, May 24, 2010

Has the Time Come To Embrace Telehealth as a System Solution?

A growing number of health care providers say that telemedicine is the key to health reform, arguing that the technology can enhance record keeping, reduce waiting times, cut unnecessary hospitalizations and reduce costs.

There also are those who view telemedicine as an expensive, intrusive technology, ostensibly a gimmick promoting exotic health care reform.

U.S. Health Care Spending

As background, the U.S. devotes 16% of its gross domestic product to medical care --- more per capita than any other nation. The total U.S. health care spending in 2009 was $2.5 trillion --- some $650 billion above expected levels. Two-thirds of the "excess" health care spending went toward outpatient care -- the fastest-growing categories being same-day hospital care and physician office visits.

Looking at the issue from another dollar perspective, reportedly 20% of all ailments represent 80% of the health costs. Typically, health care for the elderly and treatment for chronic diseases account for 75% of health care spending. The high costs are attributed to multiple readmissions caused by a fragmented health system focused on acute care.

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Enjoy!

David.

AusHealthIT Man Poll Number 21 – Results – 4 June, 2010.

The question was:

Has NEHTA Spent The Funds It Has Been Allocated Effectively and Wisely?

You Bet!

- 5 (11%)

Probably

- 6 (13%)

I am On the Fence

- 1 (2%)

Not Really

- 7 (16%)

No Way

- 24 (55%)

Votes: 43

Poll closed

Comment:

This is a pretty clear result. 76% are essentially saying NEHTA has not been spending wisely and 24% say it has.

Again, many thanks to all those who voted

David.

Thursday, June 03, 2010

Senate Estimates Hearing - June,3 2010 - Preliminary Notes.

The e-Health component ran from about 3.00pm up until about 3:40pm

Questioning began by Senator Boyce at 3.00pm.

Others who asked most questions were Senator Furner and Senator Fierravanti-Wells.

The two main areas of questioning were around the Personally Controlled EHR (PCEHR) and the HI Service.

Personally Controlled EHR

We discovered the following:

A PCERH is a personal health record owned and controlled by the patient.

It will be voluntary to have one.

The PCEHR is apparently planned to be accessible via a portal.

Access will be possible by anyone who has been authorised by the patient and it is planned access via the internet will be possible from home, public libraries.

It was suggested that maybe Google or Microsoft would offer the service and this was denied. (Note: a correspondent has suggested that I may have misheard - and that the question was not really answered directly) The net outcome is I think it is possible but not plan A at the moment - time will tell!

DoHA has not yet worked out how infrastructure for the PCERH will be built.

When asked about the relatively small amount of money, we were told the $467M was consistent with Larger PCEHR Business Case which ran for more years. It was also clear that there was, as yet, no real idea as to how the money would be spent and on what.

It was made clear that e-Health development would be “incremental rather than small steps”. (Whatever is meant by that!)

Comment:

No comments made on where the health information to populate the record would come from and no real discussion on what functionality the portal would provide.

I was left with the distinct impression that the Business Case that was talked about was not the IEHR plan developed by NEHTA.

Health Identifier Service

Use of HI Service Number.

The plan it to allocate the IHI numbers once the legislation is passed and regulations are approved.

It was the plan that provider would be also allocated numbers and they would be major users initially.

It was quite clear there would be little happen for a good while after July 1, even if legislation is passed.

Status

To date no live system had been tested.

Amazingly only 3 software providers had signed ‘Developers Licences’ to access the Medicare HI Service Development system.

No indication was provided on how promotion of the HI Service would be undertaken of funded but Senators mentioned that NEHTA had released an Implementation and Communication Plan.

See here:

http://www.nehta.gov.au/component/docman/doc_download/1012-hi-service-implementation-approach

And here:

http://www.nehta.gov.au/component/docman/doc_download/1011-hi-service-communication-plans

If legislation not passed – impact on scheme was recognised to be substantial and it was agreed that it was being talked about rather optimistically.

Other Matters:

Senator Fierravanti-Wells asked a number of details on NEHTA funding, plans etc (Other questions were also asked on the total cost of e-Health since 1993) so the answers on notice to those will be interesting when they arrive.

Senator Furner asked a good set of questions based on the Booz E-Health Report. All the bureaucrats agreed E-Health was vital and important in saving lives and money. That was good to get on the record!

See here:

http://aushealthit.blogspot.com/2010/05/major-study-confirms-value-from-e.html

Overall:

Not really enough time but some interesting points. We really need more time than this and we need NEHTA to turn up!

David.

Wednesday, June 02, 2010

The Government Moves a Little on HI Service Legislation. – A Good Start?

The following release appeared a little while ago.

ANDREW SOUTHCOTT MP

Shadow Parliamentary Secretary for Regional Health Services, Health and Wellbeing

Federal Member for Boothby

012/10

Roxon Masters the Backflip and Backdown

02 June 2010

The Coalition welcomes the decision of the Rudd Labor Government to adopt some of the amendments put forward by the Coalition on the Healthcare Identifiers legislation.

This is an admission by the Rudd Government that their initial legislation was too broad and too loose.

“We’ve come to expect little more than policy on the run from this Government”, Andrew Southcott said.

The Coalition’s amendments aim to improve privacy of information and protect against function creep, by enshrining provisions on the use of healthcare identifiers within the legislation, as opposed to the regulatory approach previously favoured by the Government. Whilst the Government has attempted to address these concerns, they have failed to adopt some of the other key amendments put forward by the Coalition. These are outlined below:

· ‘The requirements for assigning a Healthcare Identifier to a healthcare provider or to a healthcare recipient shall be prescribed in the Bill as a schedule’;

· confirming the operator of the health identifying service could only be changed by legislation;

· There is no guarantee of a right of appeal or review under section 9 of the proposed legislation. This is a serious omission; and

· deleting the provisions which allows the health identifier to be released if allowed under any other law.

We are pleased Labor has adopted some of our amendments, however, the Coalition will still proceed to move and insist on any amendments the Government hasn’t addressed.

End Release.

Good to see some talking is actually happening on all this.

Here is the Government Press Release:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr118.htm?OpenDocument&yr=2010&mth=6

Healthcare Identifiers

2 June 2010

The draft regulations for the national healthcare identifiers have been revised and the Government will propose amendments to the Healthcare Identifiers Bill to respond to issues raised during public consultation.

The amendments will make the legislation safer and more secure and increase parliamentary oversight of the Healthcare Identifiers Service.

The changes to the proposed regulations will provide:

  • greater clarity for healthcare organisations in how they would liaise with the new Healthcare Identifiers Service;
  • streamlined administrative requirements for healthcare providers that would maintain appropriate processes, monitoring and enforce penalties for unauthorised access; and
  • a new right-of-review provision for healthcare providers without healthcare identifiers in relation to some decisions.

In proposing amendments to the Healthcare Identifiers Bill and regulations, the Government has considered recommendations by coalition members of the Senate Community Affairs Committee and the changes specifically address two of these recommendations.

The first proposed change will give increased parliamentary oversight of the Healthcare Identifiers Service, ensuring that any change to Medicare Australia’s role can only be made through legislation.

The second will create more flexible arrangements for review of the assignment of identifiers to some healthcare providers.

Other Coalition recommendations would make it difficult for the Healthcare Identifiers Service to operate or are contrary to the intent of the legislation and have not been adopted.

The Government will also propose an amendment to the Bill to enable information management services that are contracted to support healthcare providers to continue to provide those services but within the strict security and privacy protections of the new system.

The legislation has strong provisions to restrict the use of healthcare identifiers. No uses of the identifiers will be permitted other than those set out in the Bill. Any additional uses would require changes to the legislation, providing strong protection against ‘function creep’.

More on the DoHA Site

David.

Senate Estimates Alert – e-Health Moved to Thursday Afternoon.

I have now been told e-Health will be on a bit later than initially notified.

It will be on Thursday, June 3, 2010 in a slot between 2.30pm and 4.30pm.

It is in DoHA Session – Outcome 10 (Health System Capacity and Quality).

Sadly there are other programs being covered apart from “e-Health implementation”; namely Chronic Disease-Treatment; Health Information; International Policy Engagement; Palliative Care and Community Assistance; Research Capacity and Health Infrastructure.

This may mean there is not as much time as we may like spent on our favourite topic.

The following link provides access to a .pdf of the program.

http://www.aph.gov.au/Senate/estimates/budget1011/schedule.pdf

Senate estimates hearings are broadcast live over the Internet. Details can be found at www.aph.gov.au/live

Enjoy.

David.

Tuesday, June 01, 2010

NASH - This is A Sleeper Of a Problem I Believe – Cost and Implementation Timetable Wise!

In parallel with the implementation of the National Health Identifier Service (Hi Service) we have been led to believe there will be implemented a robust individual provider authentication system (termed the National Authentication Service for Health – NASH for short).

The intent of having this authentication service is so that access to the planned HI Service for now, and later for the proposed, but still a bit vague, PCEHR Service, can be robustly controlled and appropriate audit trails put in place to assure public confidence as to who has accessed their private health information and who has modified and update information contained in such a system.

It is clear that without NASH (or some equivalent) this system being available there will be major issues and concerns about how any information leakage or abuse can be properly detected.

From this link you can read what was initially planned for NASH.

http://aushealthit.blogspot.com/2010/03/for-all-those-who-think-it-will-be-easy.html

More recently (AAPP Forum – March 11, 2010) we have been told:

The National Authentication Services for Health (NASH) provides the required strong authentication of healthcare providers and organisations, and is an important foundation service in the developing e-health community.

Establish a national supply of trusted digital credentials available to all entities in the health sector

(Slide 20). Logo of NEHTA, DoHA and IBM at the bottom of the slide.

We are also told (next slide) NASH will:

Support software vendors to transition their products to use nationally recognised digital certificates;

Provide sufficient flexibility to leverage investment from organisations such as Medicare Australia; and

Encompass the current use of PKI by Medicare and in the future National Individual credentials.

Services will be available to support required functionality of HI Services and Secure Messaging

(Slide 21)

You can review the whole presentation from here (other interesting stuff also):

http://moreassoc.com.au/downloads/AAPP%20Presentation-Forum11-3-10%20vSumm.pdf

For some reason, it does not seem to be on the NEHTA’s web site but it is also here:

http://www.communiogroup.com/aapp/AAPP%20Presentation-Forum11-3-10%20vSumm.pdf

It is not clear why the Communio Group is hosting the file.

Even more interesting when hunting around for hints of progress with NASH I came across brief descriptive resume for a developer of the NASH.

Gil Carter

.....

Previous roles with the National eHealth Transition Authority (NEHTA) included undertaking the development of successful multi-million business case proposing the development of a new smartcard service to be used by doctors when accessing sensitive electronic health information. The NASH program is noted as a key piece of national e-health infrastructure in the National E-Health Strategy (2008) and is leveraged by a number of other e-health programs, including NEHTA's Unique Healthcare Identifiers service.

Gil has been a frequent public presenter on NEHTA and NASH program - e.g., CeBIT (May 2008) and Australian Smartcards Summit (July 2008), Identity Management Summit (Feb 2009).

See here:

http://www.businessaspect.com.au/key-people

So NASH is to be smartcard based, funding for millions has been secured and those who are to use this service (Docs, Nurses and So on) are still in the dark! Additionally a key manager (Gil Carter) in the area seems to have left.

I understand there are upwards of 600,000 professionals and support staff who may need to be issued a smart card. The cost of those cards, checking ID’s and maintaining all the infrastructure – your guess is as good as mine. Even $2 per card + $5 per 10 mins to confirm ID get to close to $5M. Then of course there is the mandatory ‘public information campaign’ at who knows how much .

With just one month until the HI Service is meant to start, the chance of any real security around it looks a bit illusory to me.

Just typical is all one can say.

David.