Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
http://www.baltimoresun.com/news/health/bal-te.records02mar02,0,5955838.story
'Going digital' going slowly
Cost and complexity keep most medical records on paper
By David Kohn
Sun Reporter
March 2, 2008
For two decades, electronic health records have been the Next Big Thing in health care: a way to simultaneously improve care and reduce waste in a system clogged with paper and manila folders. In 1994, President Bill Clinton announced that all doctors would use computerized records within 10 years. In his 2004 State of the Union, President Bush called for universal use of digital health records.
The result of all these grand declarations: 90 percent of U.S. doctors and more than two-thirds of U.S. hospitals still use paper for patient records.
"Health care is at least a generation behind the rest of society in terms of technology," says David Merritt, director of the Center for Health Transformation, a think tank based in Washington. "Doctors and hospitals don't use the technology we take for granted everywhere else."
The reasons for this lag are many: a colossal, inertia-filled health care system, a paucity of good software, no incentives to adopt new technology and a lack of government leadership. There is also concern, which advocates of digitization say is overstated, about the security and privacy of records containing the most intimate of personal details.
But almost everyone agrees that moving from paper to bits will improve health care. Numerous studies and reports, including one last month from the Maryland Health Care Commission, have found that electronic health records can reduce medical errors, save lives and save perhaps hundreds of billions of dollars if all doctors and hospitals went digital and were networked together.
Electronic health records also speed up service. After the emergency room at Beth Israel Deaconess Hospital in Boston went completely digital, the average length of stay dropped by 45 minutes.
Continue reading this quite long article here:
http://www.baltimoresun.com/news/health/bal-te.records02mar02,0,5955838.story
This article offers a range of useful insights into the progress being made in the US as well as some interesting international comparisons. Well worth a read.
Second we have:
Many Ontario physicians still allergic to electronic records
E-health in Ontario has certainly made great strides from where it was just a few years ago. But industry experts are not ready to celebrate yet.
3/4/2008 5:00:00 AM
by Nestor E. Arellano
E-health in Ontario has certainly made great strides from where it was just a few years ago.
But industry experts are not ready to celebrate yet.
They note that despite undeniable advances, resistance to digitized patient information still remains quite high among the province's healthcare practitioners.
Such resistance is one of the problems Smart Systems for Health Agency (SSHA) has had to overcome in its quest to deploy a province-wide e-health infrastructure.
This Agency of the Ontario Ministry of Health is now five years into its mandate.
So far SSHA has connected more than 5,000 locations to its ONE Network that enables healthcare providers to securely store, access and share patient data online, and collaborate with one another.
However, many physicians operating in individual offices remain hesitant to commit their records to the system.
Continue reading here:
http://www.itbusiness.ca/it/client/en/home/News.asp?id=47385&cid=11
Seems, while Canada is making good progress in EHR adoption there are still many holdouts. The problem of how to achieve optimal adoption is still a major one with somehow those who ultimately have the most to gain – patients and funders – needing to get their clinicians on board!.
Third we have:
Latest: Online health records put patients in charge
4-Mar-2008
By Sophie McNamara
A NEW patient arriving at the surgery with few details about their health history may be less of a problem in future, thanks to the development of several secure online sites where patients can store health information.
One such resource, Australian-developed miVitals, allows patients to upload test results; record information about their health history, immunisations and allergies; keep track of appointments; and add reminders for preventive health checks or immunisation updates.
The system allows patients to access their health information from anywhere with an Internet connection and share it with health professionals.
miVitals Technology CEO Ms Jude Foster said one aim of the free service was to encourage patients to take more responsibility for their health care.
“We are encouraging people to be proactive in their health care as a partner with their doctors,” she said, adding that the system used the same level of security protection offered by the four major banks
Possible revenue streams for the site could include advertising and subscriptions for premium services.
Continue reading here:
http://www.australiandoctor.com.au/articles/0D/0C05470D.asp
It is interesting the a NEHTA spokesman (Dr Mukesh Haikerwal) is quoted as saying “there was a desperate need for these online storage facilities. People use electronic stuff everywhere. There’s a big unmet demand out there for this. People are frustrated; as medical professionals we’re frustrated too.”
The spokesman then goes on to say this is a “stepping stone” to an interoperable, uniform health record”
It is not clear to me just how the variety of totally non standardised approaches will be somehow unified. It is also not clear just how such records will be made available easily, when needed. We will need to wait and see how the PHR space evolves and what actually works and what doesn’t.
Fourthly we have:
Canberra eyes EU research project
Stuart Kennedy | March 07, 2008
AUSTRALIA could be part of a multi-billion-dollar European Union technology research program.
Federal Innovation, Industry, Science and Research Minister Kim Carr met officials associated with the Framework program in Berlin
The project could give local researchers and IT companies a chance to participate in cutting-edge projects.
The European Commission Framework program, funded by EU member states, is a highly organised structure for applied information and communications technology research to benefit EU states.
Each Framework program runs for seven years with a two-year overlap. The program is into its seventh round and the ICT component alone is worth more than E9 billion ($14.7 billion).
The eighth round, expected to start in 2012, is expected to be worth up to E18 billion. It is possible for non-EU states to participate in the research pool as full partners if they are prepared to stump up funding, which for Australia would be in the region of $200 million a year. Israel already participates.
Continue reading here:
http://www.australianit.news.com.au/story/0,24897,23334483-15306,00.html
Australia getting involved in these research programs would be really useful in terms of capacity building in e-Health in Australia in terms of expert staff and experience. The EU Framework Programs have provided a range of very useful contribution to the status of e-health globally and their major programs are always of great interest.
Fifth we have:
Easyclaim a difficult sell
Andrew Bracey - Thursday, 6 March 2008
DOCTORS have snubbed Medicare’s EFTPOS Easyclaim system, according to government data on the scheme’s first eight months of operation.
So far just 1123 medical practices (specialist and general practices), have made a total of 355,000 claims through the system since it was introduced in June last year.
The number reveals low uptake among the 7356 general practices recorded in a government services report earlier this year.
AMA president Dr Rosanna Capolingua, who has campaigned against the system since becoming president last year, said the figures were a case of ‘I told you so’.
In its recent federal Budget submission, the AMA called for Easyclaim to be scrapped to save $200 million annually, despite government incentives to encourage use of the scheme (MO, 28 September 2007).
Practices receive 18 cents for each transaction processed through the system and start-up grants of $750 and $1000 are given to metropolitan and rural practices respectively.
Continue reading here:
http://www.medicalobserver.com.au/medical-observer/news/Article.aspx?s_id=2126
This was a much publicised initiative of the previous Health Minister (Mr Tony Abbott). This report suggests it has not been as great a success as it was hoped.
The most important implication I see in this relative failure to achieve widespread adoption is what that might means for Medicare Australia’s skills at interacting effectively with the Health Sector and achieving adoption of important initiatives.
The implication for the NEHTA identity management initiatives is the most important area that needs to be watched closely. One can only hope Medicare can do better with these initiatives than Easyclaim.
Sixth we have:
Google, Microsoft eye lucrative market for healthcare IT
Posted: 03/03/08 07:10 PM [ET]
The technology giants Google and Microsoft are entering the growing market of electronic medical record-keeping just as the government is accelerating its own efforts to apply information technology to healthcare.
Broader use of health information technology, and electronic medical records in particular, is a centerpiece of healthcare reform proposals from policymakers of all political stripes, from President Bush to Sen. Edward Kennedy (D-Mass.). The three leading presidential contenders, Sens. John McCain (R-Ariz.), Hillary Rodham Clinton (D-N.Y.) and Barack Obama (D-Ill.), also back these technologies.
The Bush administration, led by Health and Human Services (HHS) Secretary Mike Leavitt, has been working with technology companies and healthcare providers since 2004 to establish interoperable technical standards for storing and transmitting personal medical information. To the same end, numerous lawmakers, including Kennedy and Rep. Edward Markey (D-Mass.), are pushing legislation to promote health IT.
Meanwhile, the technology sector has been moving forward.
Last month, Google unveiled the first phase of its Google Health application. The company partnered with the prestigious Cleveland Clinic in Ohio to provide personal health records for its patients through a Web-based platform with an appearance and interface similar to its e-mail and news reader applications. Google CEO Eric Schmidt personally announced the product’s launch in a speech at a health IT conference in Florida.
Continue reading here:
This is interesting in the way it provides a view from ‘the Hill’ on just where the national e-Health effort in the US is up to and what the drivers are.
Last we have
Plans for limited Lorenzo delivery slip
06 Mar 2008
Dates for the implementation of new Lorenzo clinical software in parts of two NHS trusts are continuing to slip, despite assurances made by health minister Ben Bradshaw two weeks ago that the software would be installed by June.
The delays are the latest in a long line stretching back to the original planned delivery date at the end of 2004.
Delivery dates for two, and possibly all three, of the Lorenzo pilot sites – Morecambe Bay Hospitals NHS Trust, Bradford Teaching Hospitals NHS Foundation Trust and South Birmingham PCT - have slipped to July with the possibility of further delays to come.
E-Health Insider has been told by Bradford it will now not implement before July. South Birmingham PCT also says July, while Morecambe Bay says ‘June or July’.
The software under development by iSoft is to be delivered to NHS trusts in the North, East and Midlands by Local Service Provider Computer Sciences Corporation (CSC) under the NHS IT programme.
Continue reading here:
http://www.e-health-insider.com/news/3535/plans_for_limited_lorenzo_delivery_slip
This is a bit ominous and I hope it does not become part of a pattern – if it does my small investment in IBA will start to be a little problematic – not that any share investment is not problematic at the moment!
More next week.
David.
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