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."

Thursday, April 05, 2012

Weekly Overseas Health IT Links - 5th April, 2012.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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New imaging technology shows promise in clinical setting

By mdhirsch
Created Mar 26 2012 - 1:05pm
Photoacoustic tomography (PAT) may provide better, deeper imaging photographs and improve patient care--without the health hazards associated with X-rays.
That's the upshot of a study [1] recently published in Science by researchers from Washington University in St. Louis. PAT enables users to take images deeper in the body than more conventional forms of imaging and to form images that are clearer and multicolored due to light absorption by colored molecules, such as hemoglobin. X-rays also can take deep images, but they're harder to read and pump radiation into the patient.
"The trick of photoacoustic tomography is to convert light absorbed at depth to sound waves, which scatter a thousand times less than light, for transmission back to the surface," an announcement [2] for the study from the school says.
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Monday, March 26, 2012

E-Health Records: Are We Safe(r) Yet?

Electronic health records haven't exactly been touted as health care's Holy Grail. But there are high expectations for the technology's ability to fix some of health care's major comorbidities -- information unavailability, poor interprovider communication and inconsistent (or no) documentation -- and thereby improve patient safety across the board. Too high, some experts claim.
"If EHR systems didn't have value, no one would use them," Edward Fotsch -- CEO of PDR Network, a distributor of drug-labeling and safety systems -- said, adding, "There's no doubt that HIT -- and EHRs -- are keeping patients from being injured.
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Physicians Get Another Chance to Avoid E-Prescribing Penalty

Robert Lowes
March 23, 2012 — Physicians recently notified that they will be penalized this year for not electronically prescribing for their Medicare patients have been given another chance to get off the hook, although it promises to be a slim chance.
The Centers for Medicare and Medicaid Services (CMS) has been giving bonuses to physicians and other clinicians for e-prescribing — defined as sending a script directly from their computer to a pharmacy's computer — under an incentive program created by Congress in 2008. However, the program also calls for CMS to reduce a physician’s Medicare reimbursement by 1% — a “payment adjustment” — in 2012 if he or she failed to meet the agency’s e-prescribing requirements in 2011.
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Healthcare Industry Not Ready For ICD-10: Survey

Workgroup for Electronic Data Interchange (WEDI) report confirms that many health organizations wouldn't have met Oct. 1, 2013 deadline.
By Nicole Lewis,  InformationWeek
March 23, 2012
The decision to postpone the Oct. 1, 2013 deadline for ICD-10 implementation gained greater currency this week with the release of a poll showing that nearly half of health providers don't know when they will complete their impact assessment, a key milestone that should have been met in 2011, according to the Workgroup for Electronic Data Interchange (WEDI), which conducted the survey.
The poll took place in February and interviewed nearly 2,600 respondents including 2,118 providers, 231 vendors, and 242 health plans. Results showed that although one third of providers expected to begin external testing in 2013, another half of respondents said they didn't know when testing would occur. AdTech Ad
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In age of gadgets, doctors try to keep human touch

WASHINGTON – As the United States moves to paperless medicine, doctors are grappling with an awkward challenge: How do they tap the promise of computers, smartphones and iPads in the exam room without losing the human connection with their patients? Are the gadgets a boon or a distraction?
"That's the tension I feel every day," says Dr. Vincent WinklerPrins, a family medicine specialist at Georgetown University. The medical school is developing one of a growing number of programs to train new doctors in that balancing act, this one using actors as patients to point out the problems ahead of time.
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28 Mar 2012
FRAMINGHAM, Mass., March 28, 2012 –The universe of smart connected devices, including PCs, media tablets, and smartphones, saw shipments of more than 916 million units and revenues surpassing $489 billion dollars in 2011, according to the International Data Corporation (IDC). These numbers reflect the combined total from IDC's Worldwide Quarterly PC Tracker, Mobile Phone Tracker, and Media Tablet Tracker.
"Whether it's consumers looking for a phone that can tap into several robust 'app' ecosystems, businesses looking at deploying tablet devices into their environments, or educational institutions working to update their school's computer labs, smart, connected, compute-capable devices are playing an increasingly important role in nearly every individual's life," said Bob O'Donnell, vice president, Clients and Displays at IDC.
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5 tips for creating a strategic plan for IT

By Michelle McNickle, Web Content Producer
Created 03/29/2012
A strategic plan is crucial to the success of an organization's IT, but today's healthcare landscape is calling for a more patient-centered approach to planning for information technology. In fact, Sue Sutton, president and CEO of Tower Strategies, believes the future of IT planning should focus on an inclusive approach -- all while optimizing workflows, playing up social media, and keeping staff needs in mind.
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Fewer lab test sought by docs with HIE access

By kterry
Created Mar 30 2012 - 4:44pm
Physicians who had access to a health information exchange (HIE) ordered fewer lab tests for patients with prior test results after the HIE was formed than they did previously, according to a new study [1] published in the Archives of Internal Medicine.
This finding appears to contradict the results of a controversial paper recently published in Health Affairs [2] in early March. In that study, researchers determined that physicians with access to the results of a patient's previous imaging and blood tests in an electronic health record (EHR) ordered more tests than those who did not have an EHR.
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ONC Releases I.T. Training Materials

MAR 29, 2012 4:00pm ET
The Office of the National Coordinator for HIT has made available at no cost an updated version of teaching materials used in the HITECH-funded community college health I.T. training programs.
The materials are available for all institutions of higher education and the general public. The materials were designed to support training for six I.T. roles: practice workflow and information management redesign specialist, clinician/practitioner consultant, implementation support specialist, implementation manager, technical/software support staff and trainer.
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March 28, 2012

Healthcare Data Security Costs, by City

Healthcare data security spending is growing rapidly, and is expected to reach $40 billion in 2012—a 22-percent increase from 2011. The higher cost of maintaining data centers has led healthcare organizations to consider lower cost cities in which to locate these operations, according to a recently released report by The Boyd Company, Inc., Princeton, N.J. The study estimates that data security spending will top $70 billion by 2015, much of it stemming from investments in electronic healthcare systems, mobile health applications,, and efforts to comply with new government standards.
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7 mobile myths, debunked

By Mike Miliard, Contributing Editor
Created 2012-03-28 09:54
Speaking at the Healthcare Experience Design on Monday, Josh Clark, founder of Brooklyn, N.Y.-based Global Moxie, debunked a list of myths that mHealth developers would be wise to avoid.
Clark, whose firm bills itself as specializing in "design strategy and user experience for a mobile, multiscreen world," sought to help designers and developers steer clear of some of the "pitfalls of the last few years" as the market for smartphones, tablets and apps has exploded.
Different platforms and screen sizes and network capabilities mean that "mobile's pretty exciting, but it's also a huge pain," Clark joked.
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White House launches 'big data' initiative

By Bernie Monegain, Editor
Created 03/29/2012
WASHINGTON – Healthcare stands to reap big rewards from the government's $200 million "big data" project, launched March 29 by the Obama Administration.
Aiming to make the most of the fast-growing volume of digital data, the Obama Administration announced a “Big Data Research and Development Initiative,” pledging to “extract knowledge and insights from large and complex collections of digital data,” to help address the nation’s most pressing challenges.
“In the same way that past federal investments in information-technology R&D led to dramatic advances in supercomputing and the creation of the Internet, the initiative we are launching today promises to transform our ability to use big data for scientific discovery, environmental and biomedical research, education and national security,” said John P. Holdren, assistant to the president and director of the White House Office of Science and Technology Policy.
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Ministry tells city administration to expedite work on e-ID program

Andreas D. Arditya, The Jakarta Post, Jakarta | Fri, 03/30/2012 11:57 AM
With only a little over a month left before the deadline for the completion of the electronic identity (e-ID) data collection, the Home Ministry has asked the Jakarta administration to step up its work.
.....
The card will contain information of marital status, blood type, parent names, employment, physical or mental disabilities, birth certificate, divorce certificate, place and date of birth, biometric fingerprints and a photo.
The government has recently announced its intention to add a health feature to the electronic identification (e-ID) card program, which will store each card holder’s personal health records.
The Assessment and Application of Technology Agency (BPPT) plan to implement an e-health program, which will also coincide with the launch of the second generation of e-ID cards, will use microchips to hold owners’ personal data, including their health records.
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UK government launches e-health research service

30 Mar 2012
The UK has launched a new online research service that will give life sciences companies unprecedented access to large sets of anonymised NHS patient data.
The government wants to provide “a world-class health research service” with the new Clinical Practice Research Datalink, which it says will also provide “novel and powerful ways” to undertake clinical trials.
Minister for universities and science David Willetts said: “The UK is a world leader in life sciences, but both the research base and industry tell us that we could make better use of data in order to drive medical breakthroughs.
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Internet-Based CBT Is Effective for Obsessive-Compulsive Disorder

A randomized, controlled trial shows this treatment's superiority to online supportive therapy.
Cognitive-behavioral therapy (CBT) is effective for obsessive-compulsive disorder (OCD), but few patients have access to this treatment. Internet-based CBT is effective for other psychiatric conditions, such as panic disorder and social anxiety disorder. Now, researchers in Sweden have conducted a randomized, controlled, 10-week trial of Internet-based CBT, with therapist support, among 101 adults with a primary diagnosis of OCD (mean age, 34; mean duration of illness, 18 years).
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Cloud-based EHRs raise unique HIPAA challenges

By mdhirsch
Created Mar 29 2012 - 11:04am
Cloud-based electronic health record systems have become increasingly popular [1]. But they raise security issues that providers need to address, according to attorney Howard Burde, speaking at the 20th National HIPAA Summit in Washington, D.C. this week.
"The healthcare information is stored, used, and analyzed remotely from the users, and accessed through the Internet," Burde said. "It's going somewhere you don't know."
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Six in line for £600m Leicester deal

29 March 2012   Chris Thorne
University Hospitals of Leicester NHS Trust is looking at a shortlist of six suppliers for a hugely ambitious strategic and commercial partnership worth £600m over 15 years.
The trust issued a tender notice last November saying that it was looking for a partner to “support the delivery of world class information management and technology services”, implement a new electronic patient record, and “form a commercial arrangement to deliver services to other organisations.”
Leicester is completing the final ‘invitation to tender’ phase of the procurement process and anticipates having a partner in place by the end of August.
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Spending on security of health data breaches to hit $70B by 2015

By danb
Created Mar 29 2012 - 3:24pm
With the cost of healthcare data breaches continuing to rise year after year [1], it shouldn't come as a surprise that spending on the security of that information is estimated to hit $40 billion this year, and balloon to $70 billion three years from now, according to a recently published report [2] from Princeton, N.J.-based consulting firm The Boyd Company.
Specifically, investments in electronic health records and mobile technology to meet government compliance standards are cited as key to the expected spending splurge. Because of the inevitable increase in medical records sharing, new and improved efforts will be mandatory to keeping health data safe.
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Smart Card Use Surging in Health Care, Government

The market for smart cards in health care and government will reach $72 billion in value by 2016, according to a report by ABI Research.

Smart cards, which are used for everything from health insurance to national identification cards, are poised for big growth, according to a new report by ABI Research.
The March 22 report, "Smart Cards in Government and Healthcare Citizen ID," concludes that the smart card market will peak in 2014 and then level off at close to $15 billion.
Smart cards are common in Europe and could appear in the United States by 2014, ABI analyst Phil Sealy told eWEEK. Countries in which smart cards are used include France, Brazil and Poland.
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Patient monitoring market pegged at $4.2B by 2018

By Bernie Monegain, Editor
Created 03/28/2012
VANCOUVER, BC – The U.S. patient monitoring market, valued at more than $3.1 billion in 2011 is expected to grow to nearly $4.2 billion by 2018, according to to a new report by iData Research.
Researchers say the growth will be driven by the rapid adoption of wireless ambulatory telemetry monitors, and low-acuity vital signs monitors as well as telehealth for both remote monitoring of chronic conditions and for patients with cardiac implantable devices. Traditional monitoring products including multi-parameter vital signs monitoring, telemetry, fetal and neonatal monitoring will continue to grow to replace outdated systems.
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Interoperability Nirvana Nowhere In Sight

Despite attempts to find a common standard for healthcare data communications, it still feels like the Tower of Babel.
By Paul Cerrato,  InformationWeek
March 27, 2012
Syntactic interoperability. Not exactly a popular topic of conversation at most dinner parties. But it's an important concept to grasp if you're in medical informatics.
It helps if you understand the concept of syntax in the English language itself. The best way to explain syntax is by listening to someone who ignores it. Jedi Master Yoda, for instance, was famous for lines like "Truly wonderful, the mind of a child is" and "Much to learn, you still have." AdTech Ad
XML, HTML, and other formatting languages likewise have their own structures, or syntax. XML is used to identify different pieces of information and structure that information so that it forms a meaningful document. One advantage of XML over HTML is that it serves as a set of guidelines rather than a rigid set of tags, which means you can define your own tags depending on what you need to accomplish. So if you're putting a cake receipt on the Internet, you can create separate tags for food, calories, and so on.
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From the Center for Clinical Technology: Technologies to Watch in 2012 [Expert Insight]

  • By Henry Soch, Vice President, Sg2
  • March 28, 2012 at  11:26 AM
While technology-based market leadership was the dominant strategy a decade ago, the transition from volume-based to value-driven care requires a fundamental rethinking of technology's future role in care delivery. New investment decisions come at a time when payment models are shifting to reward low-cost, high-value care. Simultaneously, technology is being expanded for critical service lines and complex chronic disease management is taking center stage. Continued success will be determined less by what technologies you have and more by how well you use these technologies across the care continuum.
Effectively adopting and deploying clinical technology across the organization will require a value-driven technology planning approach that formally evaluates each technology's impact on both growth and performance. Aligning technology adoption with organizational strategy and operations is part of the systematic process at the foundation of value creation. Finding the intersection of these areas (technology adoption, organizational strategy and operations) is essential to leveraging internal strengths and responding to emerging opportunities.
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Vocera Goes Public in a Big Way

MAR 28, 2012 11:38am ET
Vocera Communications had a spectacular start to its initial public offering of stock on March 28, pricing above expectations at $16 per share and opening at $24.
The San Jose-based firm sells wireless, one-touch voice communication and documentation software that works via wearable badges. It serves more than 800 hospitals.
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10 qualities of stellar CIOs

By Michelle McNickle, Web Content Producer
Created 03/27/2012
The demands placed on CIOs have grown within the past decade, but since the HITECH Act, these demands have exploded, making the role that much more crucial to the success not only of IT, but also the organization as a whole. 
In a recent whitepaper, Pamela Dixon, managing partner at HIT recruitment company SSi-Search, helped outline the top 10 qualities today's CIOs need to have. 
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Telemedicine improves medication management, patient care

Internet-based telemedicine systems appear to lead to more appropriate and effective pharmacotherapy, better blood pressure control and an overall reduction in cardiovascular risk compared to conventional, periodic office visits, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.
Patients who reported blood pressure readings more frequently via a web-based portal received more timely treatment decisions and medication adjustments from their health care team compared to a control group of hypertensive patients who had routine office visits. These findings have important implications for clinical practice given that – aside from lifestyle changes – antihypertensive medications are the most effective way to help patients lower their blood pressure. As many as 65 million American adults have high blood pressure, and roughly 74 percent take medication for it, according to the Centers for Disease Control and Prevention.
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4 Best Practices in Telemedicine from IU Health

Written by Kathleen Roney | March 27, 2012
IU Health offers telemedicine in many specialties and services including pediatric, neurology, pre- and post-transplant, dermatology, sleep analysis and stroke care. The stroke telemedicine program is quite robust with seven sites currently live and 14 sites set to go live over the next two years. With the IU Health telemedicine network, patients who live in the farthest reaches of Indiana have access to comprehensive care.
Doug Lawrence, MSM, PMP, is the manager of telemedicine at IU Health. He has witnessed mistakes and successes while setting up IU Health's statewide telemedicine network. Here he discusses four best practices that made IU Health's experience in telemedicine implementation successful.
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By Joseph Conn

FTC recalls old legal wisdom for a problem with new wrinkles

Why is privacy a big deal?
To explain why, the Federal Trade Commission, in its recent report on privacy, harkened back to 1890 and a seminal article in the Harvard Law Review.
"The Right to Privacy" was jointly written by Samuel Warren, who finished second in his class at Harvard law, and his law firm partner and classmate, Louis Brandeis, who finished first, and went on to become a Supreme Court justice.
To Warren and Brandeis, the right to privacy, the "right to be let alone," the right of "an inviolate personality," flowed not merely from contract or property rights, since "it was clear that only a part of the pain, pleasure and profit of life lay in physical things."
More universally, they reasoned, the right to privacy, evolved from "the intense intellectual and emotional life, and the heightening of sensations which came with the advance of civilization. Thoughts, emotions, and sensations demanded legal recognition, and the beautiful capacity for growth which characterizes the common law enabled the judges to afford the requisite protection.”
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Choose and Book use on downward slope

27 March 2012   Fiona Barr
Usage of Choose and Book has fallen from a high of 57% to 50%, with some areas almost halving their use of the Department of Health’s e-booking system.
Figures for NHS Hertfordshire show use of Choose and Book has dropped from a high of 60% of referrals to 35%.
In Bedfordshire, usage has fallen from 53% to 27%, and in Eastern and Coastal Kent it has fallen from 58% to 32% in January this year.
Some areas have maintained or increased usage. In Bournemouth and Poole, Choose and Book is used for 100% of referrals. However, the overall national trend is downwards.
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IT identified as key risk in NHS reforms

27 March 2012   Lyn Whitfield
Dealing with the aftermath of the National Programme for IT in the NHS has been identified as one of the risks to the government’s latest reforms of the NHS, in a leaked draft of the risk register for the changes.
The undated draft, which was leaked to former NHS chair and health writer Roy Lilley, opens by noting that “the policy design for some aspects of the future organisation is incomplete” which means the Health and Social Care Bill will proceed “on the basis of incomplete / flawed design.”
The register specifically mentions the “future design of informatics” as one of the aspects of the new set-up that “comes too late to feed into the overall system definition / architecture.”
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Idaho data exchange helps patients, providers get a handle on medical records

By AUDREY DUTTON — adutton@idahostatesman.com
Posted: 12:00am on Mar 24, 2012; Modified: 12:26am on Mar 24, 2012
The Idaho Health Data Exchange has an existential problem: People keep getting it confused with the Idaho health insurance exchange, which doesn’t exist, at least so far.
The data exchange is a nonprofit corporation with a board of directors and a staff of six, and the only thing it buys and sells is information access.
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Remote patient monitoring set for domestic, international growth

By danb
Created Mar 27 2012 - 12:27pm
A pair of recently published reports assess the expected financial value of the patient monitoring market both on a national and a global scale. In the U.S., an iDataResearch report [1] predicts, the patient monitoring market will be worth nearly $4.2 billion by 2018. Meanwhile, its worldwide counterpart is expected to grow to $8 billion by 2017, according to GBI Research report [2].
Specifically, the former report's authors point to increased awareness of the benefits of remote monitoring, as well as big spending by the Department of Veterans Affairs, for domestic growth thus far. Smartphone compatible monitoring products also are seen as a potential goldmine, particularly with regard to pulse oximetry and blood pressure monitoring products.
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Improved EHR usability requires a new look at how these systems work

By kterry
Created Mar 24 2012 - 3:00pm
The usability of electronic health records has become a major concern, partly because of safety problems that may, in some cases, be attributed to poor EHR design. In addition, observers have pointed out that physicians are more likely to use EHRs that are well designed and easy to use.
These are among the reasons why the National Institute of Standards and Technology (NIST) devised a technical guidance document [1] to help vendors and other parties evaluate the usability of EHR systems. NIST offers some valuable ideas on a technical level, but it does not address the main reasons why many physicians still find EHRs unusable or less usable than they should be.
One major issue is documentation--in other words, data entry by clinicians. Many physicians, for example, find it difficult to input data using point-and-click templates; most users find it challenging to get data into the system when an EHR is new and few patient visits have been documented on it; and some EHRs require physicians to switch to different portions of the record when they have to document their treatment of multiple problems.
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March 26, 2012

EHR Technical Evaluation Guidance Released

The National Institute of Standards and Technology (NIST) has recently released formal protocol procedures for evaluating the usability of EHR systems.  The goal, the agency says, is to encourage a user-centered approach to the development of EHR systems. NIST says the usability protocol will attempt to provide methods to measure and address critical errors in user performance before those systems are deployed in a medical setting.
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'Striking' Data Links Periodontal Care to Lower Diabetes Costs

John Commins, for HealthLeaders Media , March 27, 2012

An insurance industry study, touted as the largest of its kind, shows that medical costs can be reduced by more than $1,800 a year for each diabetic patient who receives periodontal care.
The study examined medical records from more than 1.6 million people who were covered by both United Concordia Dental and Highmark Inc. and identified about 90,000 Type 2 diabetics.  About 25% of those diabetics elected to receive periodontal treatment in 2007 and the study compared their medical costs over the next three years with the 75% of diabetics in the group who declined the oral care.   
"The data is striking. In 2007 you had fewer than half the inpatient admissions if the patients had periodontal surgery when compared with the patients who did not," says Marjorie Jeffcoat, DMD, with the University of Pennsylvania, the lead author of the study.
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Readmissions Battle Gets Help from Tech

Scott Mace, for HealthLeaders Media , March 27, 2012

Last week's column on the shortcomings of some EMRs hit a nerve, and introduced what will be a continuing theme for me going forward: pointing out technology that makes other industries look good, but has yet to really impact healthcare.
The example I gave last week of such a technology was "big data," which marketing mavens are tapping to delve into the psyches of their customers to help them figure out what customers want even before the customers know.
This week's example comes from the travel and leisure industry, where a cornucopia of online choice and scheduling make vacation planning a breeze—a far cry from the days when travel agents (however skilled) made vacation planning tedious at best, and woefully misinformed excursions at worst.
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Smart phones, iPads may be distracting, Halamka warns

By Kaiser Health News
Created 03/26/2012
BOSTON – Dr. Henry Feldman is a mobile technology evangelist. He struts boldly around Beth Israel Deaconess Medical Center, where he works as a hospitalist and programmer, armed with an iPhone and iPad. His nickname is the iDoctor.
Mobile technology, he argues, has made him a better, faster physician. "It lets me do everything I could do if I was sitting at my desktop at the patient's bedside, and actually some things I couldn't easily do," he explains enthusiastically. That includes showing patients impressive new animated apps, diagrams, medical records and even photos from their own surgeries as they recover. 
Beth Israel, a teaching hospital for Harvard Medical School, is one of the most technically advanced hospitals in the country, especially when it comes to mobile technology.
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Enjoy!
David.

Wednesday, April 04, 2012

A New Report on the NEHRS (PCEHR of Old) from The Parliamentary Library. Very Useful Stuff!

There is a new newish report available (only made public a few days ago I am told as it was written as a ‘crib-sheet’ for parliamentarians for the recent PCEHR Debate.):
 BILLS DIGEST NO. 100, 2011–12
7 February 2012

Personally Controlled Electronic Health Records Bill 2011

Dr Rhonda Jolly Social Policy Section
The report can be found and downloaded from here:
To me the most important part of the report is the last box and the concluding remarks:

Box 4: brief summary of points of contention

Opt in, that is people choose to register to have a PCEHR, or Opt out, that is people who do not wish to have a PCEHR request to be excluded from the system
- Most stakeholders consider the Government’s option to make the PCEHR system opt in is a mistake because it will be difficult to reach a critical mass of participants. This in turn, will make the system more costly, and patients will miss out on the potential benefits from the system.
- Those who argue for opt in consider that the option will ensure that consumers have more confidence in the system if registration is voluntary.

Consumer control

- Those in favour of more consumer control over records in the PCEHR note that the intention of the system is implicit in its title—a personally controlled records system. They consider consumers will not be confident in the system unless they are able to impose controls on who can access information in their records. They are concerned that a no access control option has been removed from the current Bill.
- Opposition to this view mostly comes from health professions who are concerned that practitioners will be denied access to information which is relevant to the treatment of patients and from accessing information to deal with health emergencies.

Who can be a healthcare provider

- A number of the health professions are concerned that they will not be eligible to be nominated as a healthcare provider. They argue that their services are just as essential to overall patient health as those of medical practitioners, nurses and certain aboriginal health workers, those professions currently eligible.

Government stewardship of private information

- Most stakeholders are concerned about the extent to which bureaucrats in the Department of Health and Ageing will exercise control, at least initially, over the PCEHR system. Objections have been raised also that the System Operator will not be required to take the advice of advisory committees or to provide reasons why it has chosen not to do so.
- The Department of Health and Ageing argues that it is not unusual for the Secretary of the Department to have such power and that placing the administrative machinery of the PCEHR in the hands of a responsible government agency will ensure appropriate governance of the system is achieved.

Rules and regulations

- Many stakeholders are concerned that rules and regulations which will accompany this legislation have yet to be revealed; that in fact there is no real indication of how the system will operate in practice. They consider that draft regulations should have been released in conjunction with the primary legislation.

Financial incentives

- Health organisations and health practitioners, particularly medical practitioners, are unhappy that the Government will not provide financial incentives to assist them in converting systems and establishing records for patients. Practitioners complain also about the overall burden of administration the PCEHR will impose on their practices and organisations.

Timing and limited capabilities of the system

- Medical software organisations in particular are concerned that the PCEHR system is being rushed into operation. They believe that more work needs to be done to ensure that the components of the system function effectively before implementation. They consider the date proposed for implementation should be delayed until the full functionality of the system can be guaranteed.

Risks from breaches of the system

- Some practitioners are concerned that the penalties for breaches of the system are too high and that they will be punished unjustly for unintended breaches.

Privacy

- Many stakeholders have stressed that ensuring privacy issues are adequately addressed is fundamental to achieving community trust in the PCEHR system. A general consensus is that without consumer confidence the system will not succeed.
- Government agencies argue that provisions in the legislation will ensure the privacy of individuals through technical controls, effective and transparent governance and legal protections.
- Opposition to this view notes the potential conflict of interest that may arise from handling of private health information by bureaucrats. Concerns continue to be raised also about how secure consumer health information will be within the PCEHR system, particularly in light of concomitant concerns about possible flaws in the design and proposed function of the system.

Concluding comments

As has been revealed throughout this digest, there are a number of bottom line key issues in relation to the PCEHR upon which the various stakeholders have commented.
For consumer organisations, that the PCEHR ensures the protection of the privacy of individuals is paramount to all consideration of the system. Hence, these groups argue that the PCEHR cannot be successful unless it first and foremost serves the interests of health consumers. They consider that if the system is to do so, there must be assurances that consumers will participate in the system governance, that its administration and operation will be transparent and accountable and that consumers will have access to, and ultimate control of their health information.
Other stakeholders argue that privacy must be compromised in some instances to ensure the efficient operation of the PCEHR. Medical professionals view consumer control as dangerous—both from the perspective that important information may not be available to them to deliver effective treatment and for medico legal reasons.
Further to these concerns, for consumer groups (and, indeed many stakeholders), there is the issue of what will actually be in rules and regulations which accompany the Bill (once enacted). While it is usual for regulations to be made following the passage of legislation, in this instance it may have been circumspect to have produced a companion document detailing proposed rules and regulations, given that sensitive information relating to all Australians is the ultimate focus of the legislation. Previewing such rules and regulations may have alleviated some of the more important concerns which have been expressed about the privacy of individuals generally and the potential lack of accountability, specifically that of the principal PCEHR administrator, the System Operator.
While it is not strictly the subject of this digest, concerns about how the technical aspects of the PCEHR system will function and, indeed, whether they will actually function, have been raised in submissions to the Exposure Draft legislation, to the Senate inquiry into this Bill and in other instances and these represent a bottom line in terms of whether Australia has taken the right approach to e health records.186
Concerns have been raised by the medical software industry about the overall design of the PCEHR system and consumers and medical professionals have also expressed disquiet about certain aspects. As this digest has noted in passing, there have been complains from industry ranging from accusations of ineffective oversight and failure of administrators to acknowledge design flaws, to warnings that the system will not succeed because its implementation has been ill considered and rushed. In terms of rushing the implementation of the system for instance, disquiet over the role of the System Operator noted in the previous paragraph may have been dispelled if time were available to establish a specific body for this purpose before the system is implemented. As noted in the Parliamentary Library paper on e-health, taking time to get the whole system right has worked well in jurisdictions such as Denmark where a series of strategies for an overall e health system have been progressively shaping implementation and engaging health professionals and consumers.
The PCEHR Bill has attempted to address the issues which stakeholders have indicated are critical to their acceptance of the PCEHR and it is clear that consultations have produced some concessions and changes to the original PCEHR proposals. However, despite these compromises there continues to be uncertainty surrounding how the privacy applications and administrative and technical machinery of the PCEHR system will affect those who provide it, those who consume it and those who monitor it. As such, the potential for the system to improve health outcomes, a claim which is rarely questioned, has become almost a secondary consideration in discussions of the PCEHR.
----- End Extract.
To me, given the long list of unresolved issues that are raised, what is needed is a detailed set of real consultations with relevant stakeholders to actually reach an agreed position around each of these topic areas. If that is not done I think you can kiss the half a billion spent on this goodbye!
All in all a very useful summary of the issues we need to see discussed and resolved.
David.

Tuesday, April 03, 2012

What On Earth Is Happening With the National Authentication Service for Health? SFA Is Seems.

It is now over a year since we had this announcement.

National Authentication Service for Health

The National Authentication Service for Health (NASH) is a key foundational component for eHealth in Australia. It is essential that the identity of people and organisations involved in each eHealth transaction can be assured, and this requires high quality digital credentials. The NASH,  Australia’s first nationwide secure and authenticated service for healthcare delivery organisations and personnel to exchange sensitive eHealth information, will provide this.
In March 2011 the contract to design and build NASH was awarded to IBM, and NEHTA began working with stakeholders to develop its Concept of Operations and solution design.
The service will issue digital credentials, including digital certificates managed through the Public Key Infrastructure and secured by tokens such as smartcards. These credentials will validate identity when used to access eHealth systems that are enabled to use NASH authentication.
Specifically, NASH will:
  • provide a governance approach that would allow health sector participation in the operational policies and services NASH develops
  • establish the standards framework for national tokens/smartcards in healthcare delivery
  • establish a national supply of digital credentials available to all healthcare delivery entities in the health sector, allowing the traceability of eHealth transactions to trusted identities
  • allow healthcare communities to issue and manage authentication credentials locally, supported by national infrastructure
  • support software vendors in transitioning their products to use nationally recognised digital credentials
-----
Here is the link:
Here is the release that is mentioned above:

NEHTA Selects IBM to Secure the National E-Health Agenda

1 March 2011.  IBM awarded $23.6M dollar contract to develop nation-wide authentication system for electronic health records. 
 IBM (NYSE: IBM) today announced it has been awarded a $23.6M dollar contract with the National E-Health Transition Authority (NEHTA) to design and build Australia’s National Authentication Service for Health (NASH) project.
The NASH will provide the first nationwide secure and authenticated service for healthcare organisations and personnel to exchange e-health information. The project will act as a cornerstone in transforming Australia’s health system including the establishment of a Personally Controlled Electronic Health Record (PCEHR), and will help drive the smarter use of data, information and communications in healthcare delivery.
Under the agreement, IBM will utilise its combined hardware, software and services capabilities to manage the project delivery of the NASH system for Australia’s healthcare providers. This includes industry and technology consulting expertise, security and access management technologies, and IT infrastructure management services.
In order to facilitate the rapid adoption of NASH by the healthcare software community, NEHTA is providing a software development kit (SDK) that will allow existing healthcare systems and deployments to quickly and seamlessly integrate with NASH. This SDK will also ensure that transactions are properly authenticated and audited in accordance with Australian standards.
Together with clinical terminology, messaging standards and unique healthcare identifiers, the NASH will provide one of the fundamental building blocks for a national e-health system, as well as providing security credentials for use at the organisational and local level.
“Our agreement with IBM enables NEHTA to build a system that will give healthcare professionals timely and secure access to appropriate patient information,” said Peter Fleming, Chief Executive Officer, NEHTA. “In turn, the NASH program will take us one step closer to broader healthcare access for all Australians.”
Andrew Stevens, Managing Director for IBM Australia and New Zealand, said the agreement represented a vital step in promoting the broader take-up of e-health, enabling a more patient-centric healthcare system and improved health outcomes for Australians
“This programme will benefit over 600,000 Australian doctors, nurses and allied health providers and accelerate the delivery of smarter healthcare across the entire healthcare system,” said Mr Stevens.
“By partnering with IBM, NEHTA gains access to IBM’s deep healthcare industry expertise and proven record in delivering complex business transformation projects,” Mr Stevens added.
IBM’s work with NEHTA is another example of how IBM is building powerful new systems around the world that improve the delivery of healthcare. IBM is creating smarter, more connected systems that deliver better care with fewer mistakes, predict and prevent diseases, and empower people to make better choices.
This includes integrating data so that doctors and patients can share information securely, seamlessly and efficiently. IBM also helps clients apply advanced analytics to improve medical research, diagnosis, and treatment to improve patient care and reduce healthcare costs.
NEHTA was established in 2005 by the Australian federal, state and territory governments to identify and develop the foundations necessary for an e-health system.
-ENDS-
There is only one problem with all this. Where is it? Where are the progress reports, plans, overviews, cost estimates, implementation timetables and so on? Not a ‘dicky bird’ on the NEHTA website and deathly silence from IBM.
Those familiar with the present status are telling me that the whole thing is delayed yet again.
This is hardly the first time:
Here is a quote from an April 2009 blog.

Outcome statement of the Stakeholder Reference Forum March 18, 2009

Opening by the CEO

NEHTA CEO Peter Fleming opened the meeting and advised that six Reference Groups had been formed and that the first NEHTA Reference Group Co-Chair meeting took place on Tuesday 17 March 2009.
· Diagnostic Services Reference Group:
· Medications Management
· Identification and Access Reference Group
· Continuity of Care
· Terminology Services
· Architecture and Technology
In an operational update he said by the end of 2009 the IHI, HPI, HPI-O and the National Authentication Service for Health (NASH) would be technically sound. Work has also begun in conjunction with Jurisdictions regarding the National Product Catalogue.
Three years later zilch is working etc.
Given the centrality of NASH to the National E-Health Record System (NEHRS) one really wonders just what is going on.
My suspicion is that they are struggling to work out how to fund the identification, credentialing, token issuance and ongoing maintenance of a system of this sort for 600,000 people. A dollar fifty will simply not cover it. That issue is, of course, separate from all the technical issues which they also seem to be struggling with.
Different I know but I found this amazing. Looks like Indonesia is a better implementer than NEHTA and the IBM!

Ministry tells city administration to expedite work on e-ID program

Andreas D. Arditya, The Jakarta Post, Jakarta | Fri, 03/30/2012 11:57 AM
With only a little over a month left before the deadline for the completion of the electronic identity (e-ID) data collection, the Home Ministry has asked the Jakarta administration to step up its work.
Home Ministry spokesman Reydonnyzar Moenek said on Thursday that the administration had only been able to collect identification data from less than 5.5 million people from a target of around 7.4 million.
.....
The central government has targeted to establish a single identity number for every citizen and distribute e-ID cards to more than 105 million citizens by the end of 2012.
According to the civil registration law, citizens over the age of 17 years or who are married should apply for an ID card.
The card will contain information of marital status, blood type, parent names, employment, physical or mental disabilities, birth certificate, divorce certificate, place and date of birth, biometric fingerprints and a photo.
The government has recently announced its intention to add a health feature to the electronic identification (e-ID) card program, which will store each card holder’s personal health records.
The Assessment and Application of Technology Agency (BPPT) plan to implement an e-health program, which will also coincide with the launch of the second generation of e-ID cards, will use microchips to hold owners’ personal data, including their health records.
-----
We have to really wonder just what is going with all this. It is really hopeless that NEHTA is so obscurantist and secretive. At what point do we get our money back for failure to deliver?
David.

Monday, April 02, 2012

Weekly Australian Health IT Links – 2nd April, 2012.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

My view is that last week was a ‘biggie’. We discovered that the Government was so worried about GP support of and for the PCEHR is suggested it was actually prepared to pay something to help encourage adoption and we heard that the system, when it went live would not be national and would essentially be functionless behind a registration screen. The truth seems slowly to be coming out.
What is really interesting is that there is no actual amount specified for the incentives so it is very hard to make any assessment as to how serious the Government is with all this. Potentially it could cost a huge amount I suspect.
In other news we have NEHTA ‘junketing’ to Malaysia to chat with a whole lot of surgeons who are the least likely of the clinician population to engage with the National E-Health Records Service (NEHRS) - as we are now told it is called.
Last, SA seems to be trying to do a Queensland, with its implementation of a Financial System in its health system.
Lots more fun as you scroll down.
-----

NEHTA joins the ASC

Last Update: 28/03/2012 17:11
The National E-Health Transition Authority (NEHTA) will have a major exhibition presence at the Annual Scientific Congress (ASC) in May in Malaysia. Delegates will get to experience a model eHealth community that demonstrates how eHealth and the Personally Controlled Electronic Health Record will work throughout the patient health journey.
NEHTA's National Clinical Lead and past AMA President Dr Mukesh Haikerwal AO is also joining the ASC to contribute to the eHealth program at the ASC convened by Melbourne vascular surgeon and NEHTA Clinical Lead, Dr Gary Frydman.
-----

Directing doctors is like herding cats

Emma Connors
If you want a successful system in health, don’t try telling doctors what to do. That’s one of the key findings of a KPMG analysis that found the most successful systems had several factors in common.
A Hong Kong system that tracks 44 indicators and prompts nurses to call patients identified to be at risk has helped reduce hospital re-admissions by 25 per cent. Five of the largest health systems in North America, including Kaiser Permanente and the Mayo Clinic, have agreed to link up patient data in what they will hope will be a model for a national system. The US Veterans Health Administration has built an enterprise-wide system focused on electronic health records. All were designed by clinicians.
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Tanya Plibersek MP, Minister for Health, visits eHealth truck

The Hon Tanya Plibersek MP, Minister for Health, saw eHealth in action when she visited the recently launched Model Healthcare Community (MHC) truck.
At the 'Health e Nation' Conference on 28 March 2012, the Minister received a briefing and tour from NEHTA's National Clinical Lead Dr Mukesh Haikerwal. The eHealth Truck will tour Australia showcasing the NEHTA eHealth foundations, clinical documents and the personally controlled electronic health record.
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SA Health falls behind on its bills

  • by: Political Reporter Daniel Wills
  • From: The Advertiser
  • March 28, 2012 11:00PM
SA HEALTH'S financial performance deteriorated to the point where it failed to pay even half its bills on time.
The Auditor-General is expected to reveal there was inadequate managerial oversight of account reconciliation.
Health and Ageing Minister John Hill yesterday tabled the department's long-awaited 2010-11 annual report, about six months later than forecast, and foreshadowed findings in a looming Auditor-General's report.
The Government has been under attack from the Opposition for months over management of the rollout of Oracle, a new accounting system taken up by the department.
-----

Restructure Of Clinical Representation In Nehta Work Programmes

NEHTA National Clinical Lead, Dr Mukesh Haikerwal, has led a preliminary review of clinician representation on Program Reference Groups in NEHTA. As developments move rapidly it is important to constantly monitor where and how resources and skills are allocated. Reference Group clinical leads are extremely important in providing clinical leadership. The work they do in Reference Groups is somewhat at the coalface of developments in specific areas of NEHTA work, for example, Medication Management, Continuity of Care and PCEHR.  These clinicians devote a good deal of their time away from their practices and it is essential we employ their passion, knowledge and skills efficiently and effectively.
------

MSIA: There and back again: an eHealth journey

Written by Dr Geoffrey Sayer on 26 March 2012.
This article is published in the forthcoming April 2012 edition of Pulse+IT Magazine.
As the journey to the PCEHR begins its approach to the station, is the end result going to be a smooth disembarkation or an absolute train wreck? The answer may lie somewhere in between, but whatever occurs, it is important that the work already done on standards, terminologies and the foundation pieces of eHealth are not lost for the future.
With apologies to the Bard, this has been a summer of malcontent. In Sydney it feels that we have missed out on summer altogether due to the constant wet weather. No one can remember having a sunny day at all and yet you can feel the eHealth debate getting hotter and hotter as we get closer to the infamous July 1, 2012 deadline.
Let’s recap what we are actually going to get delivered — the ability to register for a personally controlled electronic health record (PCEHR). We will be reminded of that with greater frequency as we close in on that date, and as ambition is tempered by reality. There is a palpable sense that there is a push to deliver a working system so that the ambition and opportunity is not lost before political attention and interest is diverted elsewhere.
-----

Ramsay Healthcare signs up for social media

Ramsay Healthcare has embarked on a social media program to communicate with clients, plus educate and support staff.
The Challenge: Embrace social media to serve and reach clients and staff.
The Approach: A social media “guru” was employed. The company uses LinkedIn, Twitter, Facebook and YouTube.
The Outcomes: A higher level of interaction and service to clients.
-----

Plibersek confirms Medicare rebate for e-health records

DOCTORS will be paid a Medicare rebate of up to $101 to set up an e-health record for their patients as the government warns its e-health scheme due to start on July 1 may take years to reach its full potential.
Health Minister Tanya Plibersek says she is "determined not to rush it'' and warned that just as the Snowy Scheme took years to build the e-Health system would "grow and evolve in a similar way'' and not "happen overnight''.
"This isn't a matter of flick a switch on 1 July and away you go,'' she told the Health e- Nation conference on the Gold Coast yesterday.
-----

Doctors to be paid for PCEHR set-up

28th Mar 2012
GPs will be allowed to bill Medicare for the creation and maintenance of shared e-health summaries according to Health Minister Tanya Plibersek, who confirmed for the first time today "nominated providers" would be paid for their time.
The minister made the announcement during a speech to the Health-e-Nation conference on the Gold Coast this morning and said GPs would be welcome to claim existing level B, C or D consultation items to cover the cost of setting up summaries when the Personally Controlled Electronic Health Record (PCEHR) goes live on 1 July.
RACGP e-health spokesperson Dr Mike Civil said the announcement was “fantastic news” and due recognition of the “vital role GPs will play” in creating and maintaining e-health records.
-----

PCEHR set-up payments still in doubt

29th Mar 2012
CONFUSION is lingering among GPs and doctor’s groups in the wake of Health Minister Tanya Plibersek’s announcement yesterday that MBS consultation items would be available for ‘nominated providers’ creating electronic shared health summaries.
The news was welcomed by the RACGP and AGPN but AMA president Steve Hambleton and readers responding to the story on the MO website said there was nothing new in the minister’s announcement.
A spokesperson for the minister confirmed to MO this morning that a GP making what would normally be a level B consultation would be entitled to claim a level C if the extra work involved in creating a shared health summary made the consultation longer than 20 minutes.
-----

PCEHR and the MBS – more work for and no reward for GPs

AMA President, Dr Steve Hambleton, said today that the Health Minister’s announcement about Medicare rebates for preparing shared health summaries for the personally controlled electronic health record (PCEHR) raises more questions than answers.
Dr Hambleton said it is still unclear whether Medicare rebates will be available for this new clinical service that GPs are being asked to provide for their patients.
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RACGP welcomes recognition of GPs’ vital role in PCEHR roll-out

28 March 2012

The Royal Australian College of General Practitioners (RACGP) warmly welcomes the government’s announcement today that funding will be available to recognise GPs who act as nominated healthcare providers when the Personally Controlled Electronic Health Records (PCEHR) roll out from 1 July 2012.
RACGP President, Professor Claire Jackson, said she was very pleased with this outcome and thanked the Hon Tanya Plibersek MP, Minister of Health, for listening to the profession on this critical issue.
-----

Govt finally offers e-health incentive for GPs

GPs participating in the PCEHR program will have access to the Medicare Benefit Schedule
The Federal Government has confirmed it will provide incentives for GPs to participate in its $467 million national e-health record system, scheduled to go live on 1 July, following a prolonged period of lobbying by industry.
Minister for Health, Tanya Plibersek, confirmed that amendments have been made to the Medicare Benefits Schedule (MBS) to enable access for GPs who participate in the Personally Controlled Electronic Health Record (PCEHR).
“I am pleased to confirm MBS consultation items will be available to GPs as part of providing continuity of care to a patient, and if they are creating or adding to a shared health summary on an eHealth record which involves taking a patient’s medical history as part of a consultation,” Plibersek said.
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PCEHR upgrade needs e-health PIP payment: AGPN

29 March, 2012 Michael Woodhead
More flexible MBS arrangements for the PCEHR have been welcomed by the AGPN, but it says practices will also need an eHealth PIP incentive to help set up PCEHR infrastructure.
Health minister Tanya Plibersek told an e-health conference this week that MBS longer consultation items would be available to GPs “if they are creating or adding to a shared health summary on an eHealth record which involves taking a patient’s medical history as part of a consultation.”
“I want to confirm that the use of the longer consultation items will be seen as appropriate by the Medicare Australia Practitioner Review Process and the Professional Services Review in circumstances where there is clear evidence of patient complexity and there is documentation of a substantial patient history,” she told the conference.
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GPs to receive support for e-health

By Michael Lee, ZDNet.com.au on March 29th, 2012
Health Minister Tanya Plibersek has announced that general practitioners (GP) will receive additional support from the government if they use e-health records as part of a consultation.
Addressing the Health E-Nation Conference on the Gold Coast yesterday, Plibersek outlined the three levels of support that GPs would receive if taking a patient's medical history was required.
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MBS will fund GPs for e-health work: Plibersek

28 March, 2012 Paul Smith  
GPs will be able to claim Medicare attendance items to fund the work in creating and curating patients' e-health summaries, the Federal Government has revealed.
The shared health summaries will form a key part of the Personally Controlled E-health Records system being rolled out from July this year. They contain a list of patients' diagnoses, medications, adverse reactions and allergies, as well as immunisation history.
But there has been concern from doctors groups about the workload involved in GPs ensuring the information uploaded onto the shared summaries is accurate, up-to-date and fit for clinical use.
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No ehealth Big Bang: Halton

Australia won’t see an ehealth big bang once the deadline for the introduction of the personally controlled electronic healthcare record passes on July 1. “Our strategy is about demonstrating capability,” said health department secretary Jane Halton, in an exclusive interview with eHealthspace.org.
According to Ms Halton, the focus immediately post July 1 will be on the existing Wave 1 and 2 sites, which were paused earlier this year due to a software specification issue.
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Nurses to train with robots at UTS

By Luke Hopewell, ZDNet.com.au on March 30th, 2012
Nursing students at the University of Technology Sydney (UTS) are set to benefit from next-generation training sponsored by the Federal Government, which will see them looking after talking, breathing, moving robots.
The robots resemble mannequins, designed to have realistic features to accurately recreate the care process. The robots will display pain symptoms and speak to nurses about where they hurt and what it feels like. The robots will even have rising and falling chests to simulate breathing.
The new labs will also house audio-visual equipment that can record and replay situations for later study.
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Scan problem delayed SA girl's treatment

Updated: 06:05, Tuesday March 27, 2012

The lack of digital records at a major Adelaide hospital delayed life-saving treatment for a 10-year-old girl who later died from a brain seizure, a coroner has ruled.
But South Australian Deputy Coroner Anthony Schapel said he could not determine if an earlier diagnosis of a blocked shunt in the girl's brain could have saved Amber Sweetman.
'It may be that her chances of survival ... would have been greater,' Mr Schapel said in his findings on Monday.
'But, in my view, there is no evidence upon which a positive finding can be made on the balance of probabilities that Amber would have survived.'
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PIN and token needed to access system

DOCTORS will have to enter a PIN with their hardware token each time they log on to the personally controlled e-health record system.
The electronic signature processes for individual health providers and organisations were revealed in a paper released by the National E-Health Transition Authority last week.
The paper says federal, state and territory governments have differing electronic transaction laws and requirements for doctors' signatures on prescriptions. "During 2011, the Electronic Signatures initiative gained consensus on the personal e-signing of clinical documents like e-referrals, specialist letters, diagnostic requests and reports, and hospital discharge summaries.
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E-health data system is 'vulnerable to attack' from fraudsters

THE Health Department has conceded the Gillard government's personally controlled e-health record system is vulnerable to attack at the users' end.
Health chief information officer Paul Madden said clinical data would be encrypted during transmission between medical providers or patients and the national infrastructure, "so that it cannot be interfered with or intercepted".
"But at the point of viewing, the security risks start to turn into the level of protection on the PC," he told a Cybersafety for Seniors inquiry last week in Sydney, where he also touched on the future of the National E-Health Transition Authority.
"The mitigations are about consumer or health-provider information and education about securing and eradicating the risks that exist at the PC level," he said.
-----

PCEHR data will be safe: NEHTA

Written by Kate McDonald on 26 March 2012.
The National E-Health Transition Authority (NEHTA) has moved to allay fears over the security of the PCEHR system and who has access to personal health information.
Addressing the joint select committee on cybersafety for senior Australians in Sydney on March 23, NEHTA's head of architecture David Bunker said that in the design and development of its eHealth systems, NEHTA is implementing risk controls to safeguard both services and those who will be using them.
Mr Bunker told the committee that NEHTA had developed a National eHealth Security and Access Framework (NeSAF) to support both public and private organisations in national eHealth.
------

eScript payments automatic from April 1

ePrescribing achieves a major milestone on 1 April with the launch of real time claiming through PBS Online, removing the need for payment claims to be lodged manually by pharmacies.
According to Jason Bratuskins, Pharmacist and Product Manager of eRx Script Exchange, “We congratulate Medicare on this significant step. ePrescribing is vital in supporting the work of pharmacy and health professionals, and in keeping pharmacy part of the connected health team of the future.”
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E-medical records help streamline Sydney's new cancer centre

LOCAL oncology software developer Charmhealth will supply a $5 million e-medical record system for the $230m Lifehouse cancer treatment and research facility under construction in Sydney.
Cancer patients are typically treated by a diverse team of medical specialists, and the oncology-based e-medical record (EMR) system will support secure sharing of patient information across the facility.
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Network identified as dearest in the world

LABOR'S $36 billion National Broadband Network has been branded the most expensive rollout of its kind in the world, according to new research by the Economist Intelligence Unit.
The NBN was ranked the world's eighth-best plan (out of 13) by the study because of the limited private-sector involvement and its "outstanding example of extreme government intervention", new analysis showed. That places it behind Singapore, which ranked first; South Korea; Japan; Finland and Estonia.
"Countries topping the index are deemed to have the most ambitious speed, coverage and rollout targets, the most appropriate regulations for realising targets and fostering a competitive broadband market, and where public-funding commitments are putting the least amount of pressure on public-sector finances," the report says.
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Opinion: Why Linux on the desktop is dead

Do yourself a favour and stick with Linux servers. The desktop OS market is a two-horse race, and Linux was not invited to the party
Linux is awesome. It's a powerful, capable, flexible operating system with tremendous potential. But, it's never going to be a factor on the desktop, so don't even waste your time considering it.
On the server side, Linux is kicking ass and taking names. An IDC report from 2010 claims that Linux made up more than 20 percent of the server market. I've seen some estimates claiming it could be significantly higher than that today. Recent reports claim that Amazon alone is using as many as half a million Linux servers in data centers around the world to power its cloud services--a strong indicator of just how established Linux is.
That's great, but on the desktop side of the fence Linux is a non-issue. Compared to Microsoft Windows, even Mac OS X has trivial desktop market share, but it's enough to put it on the radar, and Mac OS X has been growing strong in recent years. Linux, on the other hand, has never really been more than a rounding error. It is up slightly, but it generally makes up about one percent of the desktop OS market.
-----

Meet the father of the email attachment

Patrick Kingsley
March 28, 2012 - 7:55AM
As his invention celebrates its 20th anniversary, Nathaniel Borenstein explains how and why he revolutionised modern communications.
Twenty years ago this month, 100 American web geeks opened their inbox to find a bizarre email.
Inside the message were two attachments. The first was a photograph of the Telephone Chords, an a capella quartet comprising four hirsute IT researchers (see above).
The second: the Chords' recording of an old barbershop favourite, Let Me Call You Sweetheart (click the play button above).
-----
Enjoy!
David.

AusHealthIT Poll Number 115 – Results – 2nd April, 2012.

The question was:
Is The Market Power Of NEHTA and DoHA Unfairly Harming The Small E-Health Companies In Australia?
Not At All
-  5 (14%)
A Little
-  1 (2%)
Quite A Bit
-  8 (23%)
Really Badly
-  20 (58%)
Votes: 34
A crystal clear outcome - readers think there is considerable damage being done to our industry by NEHTA and DoHA.
Again, many thanks to those that voted!
David.

Sunday, April 01, 2012

Health IT Vendors Need To Now Take Steps To Rebalance The Way E-Health Programs Are Being Delivered. Program Costs and Benefits Need To Be Better Spread Between Stakeholders.

This blog aims to make a really simple point. The point is that the influence of the Medical Software Industry (in all its forms) has somehow been sidelined over the last few years and the balance between the software providers, their customers and the Government agencies has got out of whack! The governance and leadership has been just awful and really needs to change. Additionally the costs and benefits of the program need to be better spread.
In the last week we have seen the clinical lobby manage to take some small steps to re-assert their centrality to the National E-Health Record System Project (NEHRS) (formerly the PCEHR) and its overall success.
This outcome was reported here:
and there was further commented upon here:
This has led to a situation where the clinicians have been essentially offered an uncapped level of funding to support the introduction of the NEHRS. Of course the mechanics and impact of this announcement won’t become clear until more details are provided, but it is clear the user lobby has had an impact.
A year or two ago we also saw the rather bizarre e-Health  PIP announcements where clinicians were paid (reasonably generously) to purchase and use software that the providers had agreed would be made compliant with some future to be determined at some time in the future.
This really now has the feeling of having been ‘money for jam’

Eligible Suppliers


To be considered an eligible supplier, software suppliers agree to participate in consultation processes with NEHTA to develop and implement secure messaging standards and specifications. The actual development of these standards and specifications by NEHTA, in consultation with the medical software industry, does not impact on a practice’s eligibility for payments through the eHealth Incentive.
The Department of Health and Ageing has advised NEHTA that practices should not be concerned if their supplier does not appear on the current listing but should recheck the website periodically. Practices are also reminded that they have until 31 July 2009 to comply with the secure messaging requirement and this timeline was developed with the particular needs of vendors in mind.
For further enquiries please contact NEHTA at 1300 901 001 or email your enquiries to pip@nehta.gov.au.
-----
As far as I know most GPs are using providers such as Argus, Medical Objects and HealthLink for their secure messaging and to date implementation of NEHTA specifications has been hampered by the lack of an End Point Location Service, a provider directory and NASH.
You can read here to see just where implementation of the NEHTA specifications is here:
So, the docs have been pretty well funded. What about the Software Industry as they respond to the deluge of NEHTA and Tiger Team specs and documentation and all the associated demands and pressure - created by nonsense ‘political’ deadlines. While I am sure some funds from the Wave 1 and 2 projects has helped what is needed is a much more robust and thought-out approach to assisting Industry to respond to Government expectations.
The Government claims it will save money and consumers will be better off - but nowhere does it say we will share the gains - at least in part - with the industry. Until this happens, with other lobby groups having their needs addressed, there should be a sensible quid pro quo.
According to the survey presently running on the blog there is a strong view the industry is being harmed by the ‘elephants in the room’ of NEHTA and DoHA.  All this needs to change and I cannot see a better time than the present to start making the point clearly and strongly to those who seem so fond of just assuming the world is all take and no give as far as dealing with Health Software Providers is concerned.
David.