Warung Online

Minggu, 31 Juli 2011

Weekly Australian Health IT Links – 01 August, 2011.

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 subscription payment.

General Comment

The first article concerns an apparent technology innovation which, if true, will certainly have a major impact on the NBN build out and does demonstrate the broader lesson that picking ‘technological winners’ is a fool’s game. This is a perfect example of why this is the case.

This is certainly a story to watch!

What follows is links to all sorts of interesting stuff that really seems to show we have a small groundswell of activity happening the e-Health space. A good thing.

All in all not a boring week at all!

Late Note: The results for the Infrastructure Partner for the PCEHR will be announced very soon. Only a few legal issues to be sorted I am told. Watch this space!

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http://www.theaustralian.com.au/national-affairs/wireless-challenge-to-future-proof-nbn/story-fn59niix-1226104623595

Wireless challenge to 'future-proof' NBN

A TECHNOLOGY guru who has been described as the Thomas Edison of Silicon Valley claims to have developed a new wireless technology that could one day rival the download speeds on the National Broadband Network.

The new technology, called DIDO, allows internet users to access download speeds up to 1000 times faster than possible on conventional wireless networks, without any fall in speed as more users get on to the network.

Opposition communications spokesman Malcolm Turnbull said the wireless breakthrough underlined the importance of being "technology agnostic" when it came to choosing broadband solutions to meet the nation's needs.

The federal government has pledged to spend $36 billion to roll out a fibre-to-the-premises network to 93 per cent of the nation over the next 10 years. The remaining 7 per cent will be served with a mix of wireless and satellite broadband technologies.

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http://www.smh.com.au/technology/technology-news/thousands-of-privacy-breaches-going-unreported-20110727-1hzes.html

Thousands of privacy breaches going unreported

Asher Moses

July 27, 2011 - 12:49PM

Privacy breaches affecting Australians are flourishing but laws provide inadequate protections.

There has been a 27 per cent jump in the number of incidents of stolen or lost personal information reported to the Privacy Commissioner in the past year but inadequate laws mean thousands of incidents go unreported.

At a seminar held this morning by the International Association of Privacy Professionals, the Privacy Commissioner, Timothy Pilgrim, revealed his office had received 56 data breach notifications in the year to June 30 - up from 44 in the previous year.

However, Pilgrim warned that this only included responsible companies that voluntarily owned up to losing personal information as the government had failed to introduce mandatory data breach notification laws.

The worst offenders often got away with little accountability and forensic investigators say almost all incidents they investigate on behalf of companies are not made public.

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http://www.brisbanetimes.com.au/opinion/society-and-culture/the-truth-that-sets-us-free-20110729-1i44u.html

The truth that sets us free

Frank Moorhouse

July 30, 2011

Opinion

Illustration: Michael Mucci

Revealing more about our lives helps break down stigma. Privacy law threatens to reinforce it.

I think we would agree - in some hazy way - that privacy as a value, and behaviour surrounding the idea of privacy, are considered fundamental in a good society and to our sense of self. But the more I've thought and conversed about this haziness the more I have had reason to be fearful about the enterprise of legal codification of privacy and have, ultimately, come to oppose it.

Some of my thinking is also, I suspect, wishful thinking springing from my own unorthodox values about candour, but even wishful thinking is part of the ethos-making process. The word ''privacy'' is a conceptual and semantic labyrinth and while, in some relatively rare situations, it can be used precisely, its use generally requires much discourse to establish that precision.

The report by the Australian Law Reform Commission on privacy laws was delivered to Parliament in 2008 and it has taken a long time to gain wider public attention but even there it is stalled by complexity. The defeating complexity is illustrated by the physical report itself. The result of two years' research, consultation and analysis, it runs to 2700 pages in three volumes and put forward 295 recommendations for change. In 2009 the Federal Government accepted 141 of the recommendations - 34 with qualification - and two others were noted. Acceptance does not mean that action will be taken. That is, less than half of the recommendations were accepted, which itself illustrates how far we are from clarity or a consensus on the questions of privacy.

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http://www.australiandoctor.com.au/articles/96/0c071d96.asp

GPs top health website referrers

28-Jul-2011

David Brill

GPs are ahead of other Australian health professionals when it comes to embracing websites as a source of information for their patients, research finds.

A new survey reports that 86% of GPs routinely recommend a health website to their patients -- a higher proportion than psychiatrists, pharmacists, dietitians, social workers or chiropractors.

And just 42% of physiotherapists and 33% of optometrists typically recommend websites to their patients -- making these the most reluctant groups to recommend websites, the study found.

HealthInsite was the top site recommended by GPs, followed by the beyondblue and Diabetes Australia websites. Psychiatrists, meanwhile, favoured the Black Dog Institute, beyondblue and MoodGYM websites.

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http://www.computerworld.com.au/article/395251/australian_it_health_spending_tipped_reach_2_1_billion_ovum/

Australian IT health spending tipped to reach $2.1 billion: Ovum

Technology infrastructure development will drive growth by 2016, says analyst firm Ovum

Local IT health expenditure is expected to reach $2.1 billion by 2016, according to a report by analyst firm Ovum, which is driven by increased spending on electronic health records (EHRs), picture archiving and telehealth services.

In the firm’s latest IT healthcare market forecast, the drive to cut costs in the sector, as well as improve patient services were highlighted as key reasons for increased spending.

Ovum analyst, Cornelia Wels-Maug, said telehealth services, such as the monitoring of conditions via telecommunications technology and EHR, were predicted to provide the strongest growth.

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http://www.smh.com.au/entertainment/tv-and-radio/q--pay-thats-the-answer-20110730-1i5k5.html

Q & pAy, that's the answer

Andrew Taylor and Jim O'Rourke

July 31, 2011

TONY JONES, host of the ABC program Q&A, is being paid to run mock versions of his influential discussion show at business conferences.

Prominent figures in the healthcare and information technology industries, as well as senior federal government bureaucrats, will be at the ''HIC 2011 Q&A with Tony Jones'' - promoted as one of the premier events at the conference on e-health opening in Brisbane tomorrow. Jones hosted a similar Q&A at the HIC 2010 conference in Melbourne last August.

The ABC, which gave Jones permission to conduct the sessions, says the moonlighting does not amount to media training or breach any of its editorial policies covering independence and conflict of interest.

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http://www.6minutes.com.au/news/pcehr-targets-unrealistic-say-software-companies

PCEHR targets unrealistic, say software companies

It is unrealistic to expect the government’s planned Personally Controlled Electronic Health Record system (PCEHR) to be up and running by next year, according to medical software makers.

The Medical Software Industry Association says it is a “very tight” timeframe to expect the system to be introduced by July 2012 and immediate action is needed to ensure more “appropriate” timeframes are developed.

In a submission to the consultation on the PCEHR system, (link) the MSIA criticises the government’s draft proposal which it says does not cover some key matters including how it intends to educate Australians about the benefits of the system.

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http://www.computerworld.com.au/article/395081/info_sa_hospital_inpatients_online/

Info on SA hospital inpatients online

Shows information on bed occupancy, length of stay and number of surgical or critical care patients

  • AAP (AAP)
  • 27 July, 2011 11:08

Real-time information about the number of patients being treated in South Australia's metropolitan hospitals is now available online.

South Australian health minister John Hill said the inpatient dashboard featured on the SA Health website provides information on the number of patients at each hospital.

The link which is updated every thirty minutes, includes information on bed occupancy, average length of stay, as well as the number of patients in each area of the hospital including surgical or critical care.

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http://ehealthspace.org/news/telehealth-gets-racgp-partner-boost

Telehealth gets RACGP partner boost

The Royal Australian College of General Practitioners (RACGP) has met with leading telehealth providers to discuss telehealth opportunities for its members.

The College met with a range of organisations including IBM, Medibank, Microsoft, Telstra and Optus. NEHTA clinical lead and federal government broadband champion, Mukesh Haikerwal, chaired the meeting.

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http://www.racgp.org.au/standards/telehealth

RACGP Telehealth standards project

The Royal Australian College of General Practitioners (RACGP) recognises that telehealth provides considerable opportunities to improve health outcomes and access for patients to 'attend' a consultation without some of the personal inconvenience and personal or travel costs ordinarily involved in a typical face-to-face consultation.

To guide GPs through telehealth consultations and provide a safety and quality framework for patients and GPs, the RACGP is working on a number of telehealth initiatives, including the development of standards for general practices offering video consultations and an online training and education module on video consultations that will be available next year.

The College is pleased to announce that the Department of Health and Ageing has engaged the RACGP in a project to develop standards for general practices offering video consultations.

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http://www.theaustralian.com.au/australian-it/opinion/time-to-use-nbn-to-deliver-better-cheaper-e-health/story-e6frgb0o-1226101599483

Time to use NBN to deliver better, cheaper e-health

AS the infrastructure for the National Broadband Network rolls out across the nation, work is ramping up on the applications that will leverage the power of high-speed broadband to drive economic growth and improve our quality of life.

Of these applications, one of the most critical is e-health, which promises to reduce the cost of healthcare while improving access to health services for all Australians, regardless of location.

The risks, and need for diligence around implementing e-health systems, are high in light of recent failures both locally and overseas.

According to the Australian Bureau of Statistics, annual health expenditure grew by 45 per cent between 1997 and 2007 to reach $4507 per person. With the rising incidence of chronic conditions such as heart disease, cancer, asthma, obesity and diabetes, combined with our ageing population, heath costs are set to soar.

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http://www.medicalobserver.com.au/news/data-danger

Data danger

25th Jul 2011

The blueprint on how the national e-health records scheme will be stored and managed is a minefield of medico-legal concerns, writes Leigh Parry. Leigh Parry

IN JUST one year, your patients will have unprecedented access to their medical records – not only will they be able to view their records online, but they will be able to control who sees them, and even add their own notes.

In theory, the personally controlled electronic health record (PCEHR) scheme will drive safer, more efficient and better quality healthcare – as Health Minister Nicola Roxon says, “Patients will no longer have to remember every immunisation, every medical test and every prescription as they move from doctor to doctor.”

Doctor groups are generally supportive of the scheme, which aims to address the fragmentation of medical records that exist across a vast array of different systems.

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http://www.6minutes.com.au/news/gp-software-gets-nehta-accredited

GP software gets NEHTA accredited

Plans for the $467 million personally controlled e-health record system are getting under way as a GP practice software becomes NEHTA accredited.

iSOFT which runs the practiX GP software says it is the first NEHTA conformant desktop software (link) as part of the implementation personally controlled e-health record (PCEHR) system.

It says the software will enable communication between GPs and hospital-based doctors, by allowing the exchange of clinical information through discharge summaries, specialist letters, referrals, health summaries and medications management.

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http://ehealthspace.org/news/racgp-inks-precedence-ehealth-deal

RACGP inks Precedence ehealth deal

The Royal Australian College of General Practitioners’ (RACGP) business arm, RACGP Oxygen, has inked a deal with clinical software provider Precedence that will see it offer the cdmNet online service to GPs treating chronically ill patients.

According to RACGP Oxygen chief executive Mark Donato, the new software will make it easier for GPs to interact with other members of the patient’s care team along with the patient.
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http://www.australiandoctor.com.au/articles/af/0c071daf.asp

Medicare Local in ASIC probe

28-Jul-2011

Paul Smith

ONE of the Federal Government's Medicare Locals appears on the brink of collapse after the Australian Securities and Investment Commission was called in to investigate a planned merger between two divisions to create the new organisation.

Murrumbidgee General Practice Network was to merge with the Riverina Division of General Practice to create one of the 19 new Medicare Locals due to be launched on 1 July. The current chair of Riverina is Dr Tony Hobbs, former AGPN leader and who is considered the architect of the government’s $460 million Medicare Local reforms.

But the board of Murrumbidgee claimed in a statement this morning there were "apparent failures in due process and inadequate disclosure of information by certain parties on matters of material significance to the merger".

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http://www.smh.com.au/technology/security/software-takes-brain-power-out-of-hacking-20110727-1i076.html

Software takes brain power out of hacking

Asher Moses

July 28, 2011

Self-taught hacker driven by ego

The Federal Government is warning businesses to better protect themselves after a man was charged with allegedly hacking into the National Broadband Network.

EVEN if David ''Evil'' Cecil is guilty, he is not necessarily a hacking mastermind. Computer security professionals say breaking into websites and computer networks is now as simple as downloading free software, selecting a target and hitting ''run".

Even without a specific target in mind, a method called ''Google hacking'' allows hackers to find target servers running vulnerable software using just the search engine.

''If an attacker wants to get in, it's just a matter of time really,'' Ty Miller, the chief technology officer at Pure Hacking, said.

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http://www.theaustralian.com.au/national-affairs/electronic-health-files-secure-despite-nbn-hacking-minister-insists/story-fn59niix-1226103013428

Electronic health files secure despite NBN hacking, minister insists

  • Sean Parnell and Ben Packham
  • From: The Australian
  • July 28, 2011 12:00AM

THE Gillard government has moved to assure Australians, and the booming e-health industry, that even if the National Broadband Network is hacked, sensitive medical records will be safe.

The NBN has long been promoted by its backers and the government as a potential driver of e-health initiatives, such as telemedicine and the Personally Controlled Electronic Health Record System (PCEHRS), due to be delivered next year.

But the hacking case now before the courts has reignited privacy and security concerns and raised doubts over the National E-Health Transition Authority's commitment to resolve such problems.

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http://www.ehi.co.uk/news/ehi/7059/morecambe-bay-says-lorenzo-works

Morecambe Bay says Lorenzo works

28 July 2011 Shanna Crispin

University Hospitals of Morecambe Bay NHS Foundation Trust appears to have turned the corner with its troubled implementation of Lorenzo as part of the National Programme for IT in the NHS.

In an update on the single patient record project, delivered to the trust’s board last week, head of informatics Steve Fairclough, headed the ‘key messages’ slide of his presentation: “It works!”

He also said that staff feedback was “encouraging” although there is still work to be done, and further improvements in performance and usability are planned.

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http://www.theaustralian.com.au/business/world/european-study-sees-no-mobile-phone-cancer-link/story-e6frg90o-1226103330514

European study sees no mobile phone-cancer link

  • Gautam Naik
  • From: The Wall Street Journal
  • July 28, 2011 11:34AM

A EUROPEAN study involving nearly 1000 participants has found no link between mobile phone use and brain tumours in children and adolescents, a group that may be particularly sensitive to phone emissions.

The study, published in the Journal of the National Cancer Institute, was prompted by concerns that the brains of younger users may be more vulnerable to adverse health effects -- such as cancer -- from mobile phones.

In the past two decades, mobile phone use has soared among children in developed countries, with one study suggesting that most youths start to use mobile phones by age 9 or 10. Children have a developing nervous system, and cellphone emissions penetrate deeper into their brains. Studies have indicated that the outer brain tissue of children ages 5 to 8 may absorb twice the amount of cellphone energy absorbed by adult brains.

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Enjoy!

David.

AusHealthIT Poll Number 81 – Results – 1 August, 2011.

The question was:

Is Senator Boyce Correct In Calling for a Pause and Review of the PCEHR Program?

Definitely

- 29 (58%)

Probably

- 6 (12%)

Probably Not

- 9 (18%)

Definitely Not

- 6 (12)

With 70% leaning to the need for a pause and review of the PCEHR Program a pretty clear outcome!

Votes : 40

Again, many thanks to those that voted!

David.

Sabtu, 30 Juli 2011

The Frog Is Slowly Boiling And Sadly It Is Not Noticing Its Inevitable Fate. It Will All End in Tears!

It is now only 11 months to go until we will all be able to register for our own Personally Controlled Electronic Health Record (PCEHR).

Additionally I am told that pretty soon we will have an announcement of which consortium has won the tender to build the technical infrastructure to have this all happen, and which will underpin the central components of the PCEHR. This will be the last major tender as the others covering such things as marketing, change management, benefits realisation and so on have recently been announced.

Of course there is a fair number of pieces still missing. These include the technical standards to be used, a revised concept of operations following all the submissions which closed a few weeks ago and any explicit definition of just what is going to be delivered July 1, 2012.

For what it is worth I agree with the MSIA as quoted here:

PCEHR targets unrealistic, say software companies

It is unrealistic to expect the government’s planned Personally Controlled Electronic Health Record system (PCEHR) to be up and running by next year, according to medical software makers.

The Medical Software Industry Association says it is a “very tight” timeframe to expect the system to be introduced by July 2012 and immediate action is needed to ensure more “appropriate” timeframes are developed.

In a submission to the consultation on the PCEHR system, (link) the MSIA criticises the government’s draft proposal which it says does not cover some key matters including how it intends to educate Australians about the benefits of the system.

More here:

http://www.6minutes.com.au/news/pcehr-targets-unrealistic-say-software-companies

I believe what we will see is what I would describe as a ‘political switch on’ of the PCEHR at the due date - much as we saw a little over a year ago with the IHI service. All fanfare and then pretty much nothing,

This issue is more than a sleeper I believe as well.

Data danger

25th Jul 2011

The blueprint on how the national e-health records scheme will be stored and managed is a minefield of medico-legal concerns, writes Leigh Parry. Leigh Parry

IN JUST one year, your patients will have unprecedented access to their medical records – not only will they be able to view their records online, but they will be able to control who sees them, and even add their own notes.

In theory, the personally controlled electronic health record (PCEHR) scheme will drive safer, more efficient and better quality healthcare – as Health Minister Nicola Roxon says, “Patients will no longer have to remember every immunisation, every medical test and every prescription as they move from doctor to doctor.”

Doctor groups are generally supportive of the scheme, which aims to address the fragmentation of medical records that exist across a vast array of different systems.

But shared health summaries, in which multiple health providers and the patients themselves will be able to contribute information, opens the prospect of an unprecedented deluge of data – and a medico-legal nightmare for GPs.

In their responses to the recently completed consultation on the blueprint, or the Concept of Operations (Con Ops), both the AMA and RACGP raised concerns about the medico-legal ramifications of the scheme.

A key concern is how patient information will be shared and interpreted.

More here:

http://www.medicalobserver.com.au/news/data-danger

It is also highly relevant that we have just (27th July, 2011) had a new statement on the PCEHR from the Royal Australian College of GPs.

The full statement is here:

http://www.racgp.org.au/AM/Template.cfm?Section=ehealthPCEHR&Template=/CM/ContentDisplay.cfm&ContentID=43401

The relevant part of the Statement is this part.

“2.6 Potential risks

There are a number of potential risks associated with the PCEHR that will require further clarification and resolution. These include:

  • The increased workload, responsibility and role of the GP as the nominated healthcare provider
  • Risk to clinical safety and fragmentation of care if the patient changes their nominated healthcare provider
  • The perception by the patient of the consumer portal as a communications channel for medical assistance and associated risk that they may not seek medical assistance as the functionality of the consumer portal increases
  • Treating a patient when faced with limited access to information within a PCEHR, such as in circumstances where the patient has chosen to suppress certain clinical documents and/or information
  • Clinical risks arising from both the quality and the volume of data which may lead to information not being complete, accurate or current
  • The medico-legal ramifications associated with the burden of maintenance placed on the general practitioner.

3.0 Conclusion

The RACGP supports the principles of a PCEHR as recommended by the NHHRC,1 however the RACGP acknowledges that there are potential risks which will require clarification prior to uptake by general practice.

The RACGP acknowledges that a PCEHR can improve access to health information, improve coordination of preventive health and health maintenance activities, and support emergency and after hours care. Core to the success of a PCEHR are access, information availability and quality, data exchange, privacy, security and trust. Patients need to trust that their privacy will be preserved and clinicians need to be able to trust the data quality which includes accuracy, completeness and timeliness. It is imperative that this mutual trust is preserved by a safe system.

A PCEHR system needs to build on the foundation of the GP e-health summary. General practitioners are the coordinators of patient care and the gatekeeper to the healthcare system. The RACGP supports the PCEHR as an e-health innovation that will reduce fragmented care and provide timely and accurate information at the point of care.

The RACGP supports the sharing of a medical record that:

  • Supports a person-controlled electronic health record
  • Contains reliable and relevant medical information
  • Aligns with clinical workflows and integrates with clinical software
  • Aligns with National Privacy Principles and the overarching National E-Health Transition Authority (NEHTA) Privacy Framework and Security Access Framework
  • Is governed by a single national entity
  • Is fully funded by governments and supported by appropriate incentives, education and training.”

This all makes for the most qualified support and politest possible this is really going to cost you and needs a great deal more work you’ will ever see. Frankly, from an information management perspective, I simply do not think what the College is asking for is actually doable! As far as cost, it isn’t in the budget and won’t be cheap.

I think it is probably time to put a stake in the ground on all this. Essentially I think we are all being treated like the unfortunate frog and we will be frog’s legs before we notice what an enormous con the spin being put out by NEHTA and DoHA is. The con really has two parts. The first is the claim that anything useful will be delivered in eleven months and the second is that the PCEHR is the optimal model to progress e-Health in Australia. They will fail on two out of two.

As I wrote in an e-mail to a mate:

“We need to be clear this whole (PCEHR) thing emerged as a 'thought bubble' from a single NHHRC member (who is an enthusiastic e-health amateur) in 2009 and has been grasped by NEHTA and DoHA as a way of 'doing something' without any real review or cost benefit analysis of the proposal. All that was done was to warm over their older NEHTA IEHR business case and then suggest the same benefits would flow - which was, and is, just wrong, as they well know.

I am 100% sure that in 2 years those that make this clear, and that the plan is conceptually deeply flawed, will have quadrupled their credibility by being the clearest in pointing out how badly flawed all this is. Equally those that are spruiking it are going to look pretty dumb.

This all reminds me of the times when many thought you could not do without slavery, that evolution was just a theory and when it was obvious that women should not vote - until eyes opened and we can now understand what nonsense was being foisted on us.”

It is time for DoHA to explain just how the technical, standards, adoption, consent and medico-legal issues will be addressed in credible detail.

It is also time for DoHA to explicitly explain just how much will be delivered on July 1, 2012 and, even more important, if and when the authorisation for ongoing funding of the project and NEHTA is going to be announced. This ignores the huge extra that will be needed to get the GPs on board (100s of millions I estimate).

This whole disastrous project is being given far too much support by all sorts of vested interests as increasingly e-Health experts and clinicians are seeing just how silly the whole thing really is!

We have already seen some stirrings of political concern about all this and , unless some real review is undertaken to test out the practicality and viability of the PCEHR plan, this will only get stronger.

David.

Jumat, 29 Juli 2011

Weekly Overseas Health IT Links - 31 July, 2011.

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 subscription payment.

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Mayo Clinic Builds Next-Gen Health Information Exchange

Open-source natural language processing software will provide additional context so that clinicians and researchers can better use patient data from a variety of sources.

By Ken Terry, InformationWeek

July 20, 2011

URL: http://www.informationweek.com/news/healthcare/interoperability/231002212

Using a Beacon grant provided by the Office of the National Coordinator of Health IT, the Mayo Clinic is building what may be the next generation of health information exchanges (HIE) with a group of healthcare providers in southeast Minnesota. In this real-world demonstration, Mayo will apply the computer tools it is developing through a federal SHARP grant to create new methods of mining electronic health record (EHR) data.

"We're building a patient data repository for southeast Minnesota that will execute on a lot of the promise and principles we're articulating in our SHARP grant," said Christopher Chute, MD, a Mayo Clinic epidemiologist and the principal investigator on Mayo's SHARP grant.

Mayo is using the government's CONNECT software to establish the HIE. The world-famous group practice also is working with the pioneering Indiana Health Information Exchange to build a data repository like the one in Indianapolis. "We'll use that to do population health management, aggregate outcomes analysis, and comparative effectiveness research pooled across healthcare encounters by different providers with the same patients," said Chute.

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When Health IT Meets Bugs Bunny

HHS seeks vendor to produce cartoons to educate the public about the benefits of EHRs and other types of IT in healthcare.

By Neil Versel, InformationWeek

July 21, 2011

URL: http://www.informationweek.com/news/healthcare/patient/231002359

The U.S. Department of Health and Human Services is looking to educate the public about health IT issues as simply as possible. That simple avenue might just be a cartoon.

HHS, via the Office of the National Coordinator for Health Information Technology (ONC), is looking for a contractor to produce one or two video animations no longer than 10 minutes in length to help educate the public about the value of health IT and how technologies such as electronic health records will change how the public interacts with healthcare organizations. At least one video must be in "plain language," as defined by federal contracting standards.

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http://www.technologyreview.com/biomedicine/38021/?nlid=nldly&nld=2011-07-13

Tuesday, July 12, 2011

Helping Patients Test Treatments for Chronic Illness

Customizable tools will let patients, and their doctors, track various health metrics.

A new set of tools could help patients with chronic illnesses track their condition and monitor how they respond to different treatments.

The tools are designed to let physicians run experiments tailored to an individual patient's needs, a faster and more quantitative way than infrequent office visits to determine a treatment's benefits or side effects.

"The idea is to try to make interactions between patients and doctors more continuous, and to provide patients with more information so they can participate more actively in their care," says Peter Margolis, a physician at Cincinnati Children's Hospital. The project is part of the Collaborative Chronic Care Network (C3N), whose goal is to collect real-time data and use it to change how chronic illnesses are managed.

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http://www.iwatchnews.org/node/5146/

Doctors skittish about health technology despite promise of big federal bucks

Cleveland area physicians worried about big hassles, big risks and a big commitment of time they don't have

By Susan Jaffe

6:00 am, July 7, 2011

CLEVELAND — In Dr. Sandra Berglund’s well-stocked waiting room, there’s a box of children’s toys and picture books and, on either side of a magazine rack, framed photographs of sacred places: the stadiums of the Cleveland Browns and Cleveland Indians. And in clear view behind the receptionist’s desk is something the Obama Administration will actually pay her to clear out: folders of paper medical records stuffed into shelves from the floor almost to the ceiling.

The administration is offering what sounds like a pretty good deal. If Berglund, a family medicine doctor in her own practice, transfers the information in those folders to an electronic health record system run on a computer, she could earn a $44,000 bonus over the next five years tacked on to the payments she gets for treating patients in Medicare. Or, if she cares for a certain number of low-income Medicaid patients, she could earn as much as an extra $63,750 over six years.

The doctors still have to buy the system — which can cost roughly $20,000 per physician initially — but the bonus payments are designed to get them interested. The payments are part of a $27 billion incentive program included in the 2009 economic stimulus law. The program also offers health care providers free technical support from new regional extension centers, a certification process to highlight suitable electronic systems, workforce training and a national health information exchange network, among other benefits.

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http://www.healthdatamanagement.com/news/aafp-physician-patient-survey-portal-42828-1.html

AAFP Portal Eases Patient Satisfaction Reporting

Joseph Goedert

HDM Breaking News, July 21, 2011

The American Academy of Family Physicians has launched an online patient survey portal that its members can buy for $150 a year to gather, organize and report satisfaction information from patients.

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http://your-story.org/emr-adoption-to-drive-e-health-market-growth-in-us-254934/

EMR Adoption to Drive e-Health Market Growth in US

July 22, 2011

According to our latest research, “US e-health Market Analysis”, the US represent world’s largest and one of the fastest growing e-Health markets. Past few years have been phenomenal for the industry and it remained almost immune to the economic slowdown. A number of segments, EMR in particular has witnessed excellent market expansion during the last 4-5 years and helped overall industry to post double digit CAGR growth. The research further revealed that e-Health market will follow the same growth trajectory by 2015 and will emerge as one of the most lucrative sector in the US for investment and business execution.

The study identified that EMR is currently the most dominant market segment. The segment growth has largely been benefitted by Government policies and regulations which encouraged public healthcare professionals and private practitioners to adopt and use electronic medical records product and services. It is anticipated that government incentives along with various private sector initiatives as discussed and analyzed in the report will drive the market growth to achieve new heights.

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When Social Features Meet Personal Health Records

Employer consortium Dossia takes cues from social networking and games as it vies to boost usage of its personal health record site.

By Marianne Kolbasuk McGee, InformationWeek

July 20, 2011

URL: http://www.informationweek.com/news/healthcare/EMR/231002035

Employer consortium Dossia is adding new functionality to its personal e-health record system to improve engagement with users and help them better manage and improve their health.

The new Dossia Health Manager is an "intelligent" health management system that further extends Dossia's original e-personal health record capabilities beyond being a platform for individuals to store and track their health information to one that enables users' health data to become "actionable," said Dossia CEO Mike Critelli, in an interview with InformationWeek Healthcare.

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http://www.modernhealthcare.com/article/20110721/NEWS/307219975/

Express Scripts will buy rival Medco for $29.1 billion

By Jaimy Lee

Posted: July 21, 2011 - 7:45 am ET

Express Scripts said it will acquire Medco Health Solutions, a rival pharmacy benefits management company, for $29.1 billion in cash and stock.

St. Louis-based Express Scripts will form the Express Scripts Holding Co.; Express Scripts shareholders will own 59% of the new company while Medco shareholders will own about 41%, according to a news release. Medco, which is based in Franklin Lakes, N.J., has 20,000 employees and reported $66 billion in revenue in 2010.

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http://www.fierceemr.com/story/ehrs-too-cumbersome-eye-docs/2011-07-21

EHRs too cumbersome for eye docs

July 21, 2011 — 8:07am ET | By Janice Simmons

An information technology committee organized by the American Academy of Ophthalmology this week released a list of special requirements to help electronic health record (EHR) systems be used more "intuitively and efficiently" by ophthalmology practices.

In a report now available online in the journal Ophthalmology and forthcoming in the Aug. 1 issue, AAO committee members note that many EHRs currently used by ophthalmologists are "large, comprehensive systems that originally were designed for other medical specialties or large enterprises," such as hospitals or health plans. As such, the systems pay little attention to the needs of ophthalmologists.

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http://www.fierceemr.com/story/your-emr-privacy-policy-first-and-foremost-should-be-practical/2011-07-20

Your EMR privacy policy, first and foremost, should be practical

July 20, 2011 — 5:19pm ET | By Janice Simmons

It's not hard to find recent examples of privacy and security at odds with electronic medical records (EMRs). Just this week, for instance, a federal grand jury indicted a former employee of University of Maryland Medical Center with stealing patient identities. Wake Forest Baptist Health in North Carolina, meanwhile, notified 357 people (including employees and patients) that a former employee was hoarding their medical records at home.

Headlines such as these can be scary. What may be even more frightening, however, is that many providers or healthcare organizations unwittingly are violating the trust of their patients every day--without consciously trying.

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FCC Criticized For Not Spending On Telemedicine

American Telemedicine Association urges action on measures to achieve the National Broadband Plan's goals.

By Nicole Lewis, InformationWeek

July 19, 2011

URL: http://www.informationweek.com/news/healthcare/policy/231002124

The American Telemedicine Association (ATA) has fired off a letter to the Federal Communications Commission (FCC) urging that more money be spent on expanding telecommunications services, which will boost telemedicine projects at rural healthcare facilities.

The letter, which was sent last week to FCC chairman Julius Genachowski, noted that 16 months had passed since the FCC adopted the National Broadband Plan, which included an entire chapter on the positive effects that broadband expansion can have on healthcare delivery. The letter also stated that eight months ago the U.S. Government Accountability Office (GAO) issued a report sharply criticizing the Commission's management of the Rural Health Care Program.

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http://www.ehi.co.uk/insight/analysis/763/e-prescribing:-safer-than-paper

E-prescribing: safer than paper?

Alex Jennings, deputy chief pharmacist at University Hospital, Aintree, reflects on the pros and cons of an e-prescribing roll out; and outlines some of the questions other trusts should be asking.

18 July 2011

We have just completed the roll-out of an electronic prescribing and medicines administration system (EPMA) at an 800 bed teaching hospital in the North West, going from zero to full inpatient coverage in 18 months.

We certainly don’t consider ourselves “know it alls’ in this field, but we are hoping that we can raise awareness of some of the issues that we have come across.

We hope that after reading this article, you will have a greater understanding of some of the limitations and potential misconceptions/risks of EPMA - to balance against the more bullish articles that have recently been published.

We also hope that you will be armed with the type of questions that need to be asked of electronic prescribing suppliers, so that informed decisions can be made.

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http://govhealthit.com/news/why-shuttered-rhio-caresparks-chairman-not-giving

Why shuttered RHIO CareSpark's chairman is not giving up

July 19, 2011 | Patty Enrado, Contributing Editor

In June 2011, CareSpark's board of directors voted unanimously to terminate the nonprofit regional health information organization (RHIO), which serves 17 counties in eastern Tennessee and southwestern Virginia.

"It was very devastating," said Jerry Miller, MD, founder of Holston Medical Group and board chairman of CareSpark, of the decision, which was announced last week. The RHIO was burdened with legacy debt and ultimately, he said, "We did not have a sustainable plan."

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http://articles.boston.com/2011-07-19/business/29791294_1_social-security-numbers-hospital-computer-medical-record-numbers

Beth Israel data breach may affect over 2,000

Virus sent records to unknown location

July 19, 2011|By Hiawatha Bray, Globe Staff

Beth Israel Deaconess Medical Center is notifying more than 2,000 patients that some of their personal information may have been stolen from a hospital computer.

The hospital said yesterday that an unnamed computer service vendor had failed to restore proper security settings on a computer after performing maintenance on it. The machine was later found to be infected with a virus, which transmitted data files to an unknown location.

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http://govhealthit.com/news/fda-lays-out-regulation-certain-mobile-medical-apps

FDA lays out regulation of certain mobile medical apps

July 19, 2011 | Mary Mosquera

The Food and Drug Administration has proposed regulation of some medical applications that run on smartphones and other mobile computing devices that could affect the operations of other medical devices already under its governance.

The agency’s draft guidance released July 19 outlines its “current thinking” and focuses on a small subset of mobile medical apps because they can influence the performance or functionality, and potentially the safety, of currently regulated medical devices.

The mobile medical apps that FDA has in mind are those used as accessory to a medical device already regulated by the agency, such as one that enables a provider to make a diagnosis by viewing a medical image from a picture archiving and communication system (PACS) on a smartphone or other mobile device.

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http://www.ihealthbeat.org/perspectives/2011/include-mental-health-addiction-providers-in-meaningful-use-incentives.aspx

Wednesday, July 20, 2011

Include Mental Health, Addiction Providers in Meaningful Use Incentives

When Congress passed legislation in 2009 creating new Medicare and Medicaid incentive payments to encourage health care providers to use electronic health records, much of the health care community applauded. The Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as part of the American Recovery and Reinvestment Act, was long overdue recognition of the importance of health IT in improving care for patients, while also reducing health care spending.

But amid much fanfare for the HITECH Act, a notable group of providers was left with little to cheer about. The nation's mental health and addiction treatment providers were excluded from the incentive payments. So while some providers continue to be offered financial incentives to use health IT to increase health care quality, reduce medical errors and better coordinate care, providers at psychiatric hospitals, mental health and addiction treatment facilities, and community mental health centers are being told to fend for themselves.

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http://www.cmio.net/index.php?option=com_articles&view=article&id=28706

Report: Healthy growth for hospital info systems; U.S. leads way

Written by Editorial Staff

July 18, 2011

The worldwide hospital information system (HIS) market reached a value of $7.4 billion in 2010, and is expected to achieve a value of $14.7 billion by 2017, according to companiesandmarkets.com.

The London-based market researcher predicted worldwide growth of 10 percent annually. “Advancements in technology, combined with increased investment in public and private healthcare sectors, are driving the hospital information systems market,” the company stated.

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New MGMA Chief Brings Patient Safety, EHR Expertise

Medical Group Management Association recruits Wisconsin Medical Society's CEO and the founder of two data-exchange bodies as new leader.

By Neil Versel, InformationWeek

July 18, 2011

URL: http://www.informationweek.com/news/healthcare/leadership/231001993

The Medical Group Management Association has selected a new chief with as strong a background in health IT as practically any other leader of a healthcare organization not specifically dedicated to IT promotion.

MGMA, an Englewood, Colo.-based organization comprised of group physician practice administrators and leaders, has named Dr. Susan L. Turney to succeed Dr. William F. Jessee as president and CEO. Jessee, himself a vocal advocate for IT adoption in healthcare, will retire after 12 years in charge. MGMA says its 22,500 members lead 13,600 healthcare organizations that provide more than 40% of the healthcare services delivered in the United States.

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http://www.govhealthit.com/news/va-launches-contest-expand-blue-button

VA launches contest to expand Blue Button

July 15, 2011 | Mary Mosquera

The Veterans Affairs Department will launch a developers’ competition to expand the deployment and use of its Blue Button functionality that enables patients to download their health information to all veterans who receive care from providers outside of the VA.

Blue Button is a simple, convenient and secure method over the Internet for a patient to retrieve his or her information in plain text ASCII format.

The competition starts July 18, and VA will announce the winner Oct. 18, VA said. The first prize is $50,000.

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http://www.healthleadersmedia.com/print/TEC-268721/5-Steps-to-Successful-CPOE

5 Steps to Successful CPOE

Gienna Shaw, for HealthLeaders Media , July 19, 2011

In the 1990s, big bang rollouts of electronic health systems were all the rage. But have you ever heard the phrase "only fools rush in?" Many organizations learned that while that approach got complete systems up and running, it didn't guarantee that clinicians would like them.

So the industry tried a more drawn-out approach, forming vast committees to get buy-in from every last stakeholder. In the end, though, that didn't guarantee adoption, either. In fact, it created new problems, such as alert fatigue.

Today, organizations are finding a balanced approach to launching systems such as computerized physician order entry that lets them get buy-in and get to go-live faster and more efficiently. I spoke to leaders at several organizations in various stages of implementing CPOE for an article in this month's issue of HealthLeaders magazine.

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http://www.ehi.co.uk/news/EHI/7033/no-national-it-system-for-appraisal

No national IT system for appraisal

19 July 2011 Fiona Barr

The Department of Health had said there will be no national IT system for revalidation when it begins next year. Instead, employers and doctors will be able to choose IT systems locally.

The Department of Health’s Revalidation Support Team has published an evaluation of its Pathfinder Pilots for revalidation, which looked at the experiences of more than 3,000 doctors in the ten pilot areas.

The evaluation found that 96% of organisations expected revalidation to lead to improved quality of care.

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http://www.modernhealthcare.com/article/20110719/BLOGS02/307199999

By Joseph Conn

Only connect—meshing home devices and electronic health records

I won't go into all 11 of the recommendations in a report this week from the National Research Council on improving the connections between electronic health-records systems and home health-care monitoring devices, and the usability of those devices by nonclinicians.

You can read them all in a free copy here.

But two key recommendations in the 203-page report, “Health Care Comes Home: The Human Factors,” were directed at the Office of the National Coordinator for Health Information Technology, and I'll deal with those two in this post.

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http://www.healthdatamanagement.com/blogs/health_care_technology_news_HIE-42805-1.html

HIE Challenge: ‘Breadth of subjects’

Gary Baldwin

Health Data Management Blogs, July 15, 2011

As I mentioned in my initial report covering the MetroChicago HIE, some three-fourths of Chicago-area hospitals have signed on with one of the nation’s most ambitious data exchange projects. To learn more about what has propelled the HIE, I caught up recently with Terri Jacobsen, the project’s director. She’s part of the Metropolitan Chicago Healthcare Council, a long-standing Chicago-based membership organization that is spearheading the data exchange. Some 69 area hospitals have joined, signing letters of intent to participate as dues-paying members. Unlike some data exchanges, which had to build from scratch not-for-profit organizations and boards to operate, the council has enjoyed relationships with Chicago-area providers for years. “Our pre-existing relationships have helped facilitate the effort so far,” Jacobsen says. (click here for a video interview MCHC conducted with Terri).

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http://www.healthdatamanagement.com/news/webmd-stock-online-consumer-content-42813-1.html

WebMD Downgrades Expectations, Investors Bail

Joseph Goedert

HDM Breaking News, July 18, 2011

The stock price of online health information content vendor WebMD Health Corp. fell 30 percent on July 18 after the company downgraded its financial performance for the rest of 2011.

The stock fell in the morning after the announcement and did not recover much after the company issued a follow-up statement from Chairman Martin Wygod saying he has the "utmost confidence in WebMD's growth prospects and the future value of the company." However, speculators came in during early after-hours trading and boosted the stock by 13 percent.

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http://www.healthdatamanagement.com/news/google-health-microsoft-healthvault-phr-42812-1.html

Microsoft HealthVault Ready to Accept Google Health Accounts, Apps

Joseph Goedert

HDM Breaking News, July 18, 2011

Microsoft Corp. has launched a Web page where consumers using personal health records from Google Health can have their personal health information transferred to a Microsoft HealthVault account.

Google Inc. also will support the migration to HealthVault of applications that third-party developers have created for Google Health. Additional information is available here.

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http://news.cnet.com/8301-10805_3-20080403-75/microsoft-offers-transfer-tool-to-google-health-users/

July 18, 2011 10:49 AM PDT

Microsoft offers transfer tool to Google Health users

by Jay Greene

For the seeming handful of people who signed up to use the soon-to-be-shuttered Google Health online medical records service, Microsoft has an answer: join its service.

Microsoft released a tool today that lets Google Health customers transfer their personal health information to a Microsoft HealthVault account. To protect patient privacy, the tool uses the Direct Project messaging protocols established by the Office of the National Coordinator for Health IT that authenticate and encrypt the data, sending it only to known, trusted recipients.

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http://esciencenews.com/articles/2011/07/19/e.health.records.should.play.bigger.role.patient.safety.initiatives.researchers.advocate

E-health records should play bigger role in patient safety initiatives, researchers advocate

Published: Tuesday, July 19, 2011 - 12:37 in Health & Medicine

Patient safety researchers are calling for the expanded use of electronic health records (EHRs) to address the disquieting number of medical errors in the healthcare system that can lead to readmissions and even death. Their commentary is in the July 6 issue of JAMA, The Journal of the American Medical Association . "Leading healthcare organizations are using electronic health records to address patient safety issues," said Dean Sittig, Ph.D., co-author and professor at The University of Texas Health Science Center at Houston (UTHealth) School of Biomedical Informatics. "But, the use of EHRs to address patient safety issues hasn't hit the mainstream yet and we think everyone should be doing this."

One way to fast-track the use of EHRs to address patient safety issues would be to incorporate the annual patient safety goals of The Joint Commission, a healthcare accreditation organization, into the criteria for the certification of EHRs, said co-author Ryan Radecki, M.D., who is scheduled to join the UTHealth faculty Aug. 1.

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http://www.gazette.com/articles/health-121643-records-accessing.html

Peeking at medical records an issue for health centers

BARBARA COTTER

2011-07-15 22:23:26

A Colorado Springs city health employee recently accused of inappropriately accessing about 2,500 Memorial Health System patient records claimed that “it’s pretty damn common” for medical professionals to peek at files for unwarranted reasons.

“Common” might be overstating things, but statistics suggest it happens more often than patients might realize.

Since 2008, Memorial Health System has had 22 employees who either resigned or were fired in connection with patient privacy issues, including a woman who lost her job earlier this year for breaching 135 patient records to create a database of her friends’ birthdays. Penrose-St. Francis Health Services declined to provide information on breaches at its facilities or discuss the issue.

Nationwide, the U.S Department of Health and Human Services’ Office for Civil Rights has recorded 292 incidents of electronic medical record breaches involving 500 or more patients since 2009. That excludes the hundreds, if not thousands, of incidents that don’t meet the 500-patient threshold for public reporting.

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http://www.fiercehealthit.com/story/scanning-expensive-nightmare-many-hospitals/2011-07-12

Hospitals spend up to $100M to scan paper

July 12, 2011 — 3:14pm ET | By Ken Terry

Nearly one-fourth of the 200 facilities surveyed said they are spending $100 million or more to scan paper documents. What's more, 36 percent of those hospitals plan to hold onto their paper records after they're digitized, according to document management and storage firm Iron Mountain.

The government's criteria for Meaningful Use of electronic health records (EHRs) does not mention document management. During the transition to EHRs, however, providers need some way to access electronically the paper charts of patients who have been discharged, at least for some years back. Moreover, hospitals continue to generate new paper documents and receive them from other sources. All of this requires high-speed scanners and staff time to operate them and ensure that the documents are correctly filed.

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http://www.fiercehealthit.com/story/imaging-diagnosis-may-represent-best-use-scenario-ibms-watson/2011-07-18

Imaging diagnosis may represent best-use scenario for IBM's Watson

July 18, 2011 — 11:30am ET | By Dan Bowman

Radiology may very well prove to be a sweet spot for IBM's supercomputer Watson.

At heart, Watson is an electronic health record reader. Once that technology is correctly combined with picture archiving and communication system (PACS) technology, diagnosis times for patients could be shortened tremendously, according to Dr. Eliot Siegel, a radiology professor at the University of Maryland's School of Medicine. "There's great potential for Watson to...[also] offer treatment summaries, synthesize charts and perform safety checks," Siegel says, according to a report by Diagnostic Imaging.

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http://www.ihealthbeat.org/features/2011/stimulus-money-still-flowing-to-health-it-projects.aspx

Monday, July 18, 2011

Stimulus Money Still Flowing to Health IT Projects

The federal government continues to implement various provisions of the American Recovery and Reinvestment Act, which included the Health Information Technology for Economic and Clinical Health Act. This update summarizes key developments during the second quarter of 2011.

ONC Leadership Changes, Committees March Onward

Farzad Mostashari replaced David Blumenthal as national coordinator for health IT. Mostashari, formerly deputy national coordinator at the Office of the National Coordinator for Health IT, took over the top job in April.

At its June meeting, the Health IT Policy Committee approved the Meaningful Use work group's revised Stage 2 objectives and criteria and the recommendation to delay the transition from Stage 1 to Stage 2 by one year for providers who qualify for meaningful use incentives in 2011. The committee passed on its recommendations to ONC.

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http://www.fiercehealthcare.com/story/security-patient-records-breached-across-country/2011-07-18

Security of patient records breached across the country

July 18, 2011 — 11:38am ET | By Karen M. Cheung

Security breaches of patient records have been popping up in the news recently, with some breaches affecting hundreds.

A federal grand jury on Thursday indicted a former employee of University of Maryland Medical Center, with three others accused, of stealing patient identities to open credit accounts, according to a WBAL TV report.

The Medical Center said, "Protecting our patients' personal information is a top priority. We have policies and procedures in place to ensure that patient information remains strictly confidential. This breach was a result of a crime, and not a lapse of hospital procedures."

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Enjoy!

David.

 

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