Useful and Interesting Health IT Links from the Last Week – 29/06/2008

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

Urgent Survey Response Needed!

In a comment on the blog this week I had the following comment:

“The Deloitte eHealth strategy is available online. Perhaps you should ensure that they receive a good response.

https://www.deloittedtermine.com/SPSSMR/ImageCache/ImageCache.aspx?project=NESAUDEL001&file=default.htm

What is actually on line is a short questionnaire. I suggest all those who read the blog quickly make their contribution to the survey. This is despite the fact that I find the survey both very constrained, quite confusing and lacking any apparent discussion of the drivers of the new e-Health Strategy. There are a range of ‘strategic choice’ questions the survey could and should have addressed.

Second we have:

Behind the Curtain

Epic's unwavering commitment to its unique values has created an unusual recipe for success. What's behind Epic's gains in the clinical IT sphere?

by Mark Hagland

When readers of HCI were asked what vendor they most wanted to read about, respondents picked one company by a wide margin (see graphic on page 28). The results weren't surprising, as one clinical information systems vendor has a truly unusual profile, and its very unusualness has given it a certain cachet. What's more, that company is different not just in one way, but in many. It has a unique operating methodology, sales approach, market strategy, history, and culture. It's even been described by some over the years as a “cult.” That company? The Madison, Wis.-based Epic Systems Corporation.

Of course, there are ways in which Epic does resemble its competitors. It sells corporately designed clinical systems software, which it implements in patient care organizations; it has a team of internal software developers and a team of implementers; and it competes with other core-clinical companies for the same essential base of customers, in both the inpatient and outpatient spheres (though Epic started in the outpatient sphere and moved into the hospital, while most have done the opposite). And it makes money — lots of money ($500 million in annual revenues as of late 2007 — see Epic's entry in the HCI 100, page 52).

Very much more here:

http://www.healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=125CB9E22CE6403F9A68D87839295283

This is a fascinating review of the mysterious Epic – which is the provider of core clinical system for organisations such as Kaiser Permanente. They are being amazingly successful and there are lessons in how they go about their work that should be carefully reviewed and discussed.

Third we have:

IBA's Lorenzo health system in tests

Karen Dearne | June 27, 2008

THE long-awaited Lorenzo clinical software suite by IBA Health will be launched in Australia within three to four months and will be available for general release in early 2009.

Despite continuing political sniping over missed deadlines, Lorenzo has been installed in three British National Health Service hospital trusts - Morecambe Bay, Bradford and South Birmingham, and are undergoing final testing ahead of go-live next month, Gary Cohen, IBA Health Group executive chairman said.

Two early adopter sites, in Germany and Holland, have already proven Lorenzo's real-world capabilities and reliability.

"We're starting with these three trusts with Lorenzo release one, and after three to four months' actual operation it will be rolled out to a larger number of hospitals," Mr Cohen said. "The intention is to use these as a staggered and stepped approach, so it will probably take two years to roll it out to all trusts in the three regions.

"So a delay of a few weeks in going live is nothing. The reality is, significant progress has been made in the past 12 months, there are no major issues and we're just getting on with delivering."

More here:

http://www.australianit.news.com.au/story/0,24897,23930668-15306,00.html

Another report is found here:

IBA Health set for Lorenzo release

June 26, 2008 - 1:15PM

IBA Health Group Ltd says it is on track to meet its 2008 financial year earnings guidance and has revealed it will release its flagship software, Lorenzo, in Australia in coming months.

Australia's largest health-care information technology company said it remains on track to meet its earnings before interest, tax, depreciation and amortisation (EBITDA) guidance of between $85 million and $95 million.

The company delivered EBITDA of $32.27 million in 2006/07, up 70 per cent from 2005/06.

IBA Health said its revenue was being impacted by the surging Australian dollar against the British pound.

More here:

http://news.smh.com.au/business/iba-health-set-for-lorenzo-release-20080626-2x87.html

Clearly IBA Health is now getting close to the ‘put up or shut up’ time with Lorenzo. If we don’t see real delivery in the next few months confidence in the company’s capability is likely to be severely eroded. (The usual disclaimer that I own a few IBA shares applies) .

Fourth we have:

IT waste a 'major challenge' to human health: UNEP

June 26, 2008 - 10:29PM

Millions of discarded mobile phones and computers are posing a "major challenge" to human health, the chief of the United Nations Environment Programme said Thursday.

Achim Steiner told a UN conference on waste management on the Indonesian resort island of Bali that 20 million mobile phones were thrown away each year in China.

Meanwhile, the global number of personal computers was expected to double to two billion by 2015.

"The rapid growth and rapid redundancy of all this equipment ... represents a major challenge to the international community in terms of human health and the environment," he said.

He said 20 to 50 million tonnes of electronics waste was produced every year -- enough to load a train that would stretch around the world.

More here

http://news.smh.com.au/world/it-waste-a-major-challenge-to-human-health-unep-20080626-2xkp.html

This is a reminder of a major downside to all the gadgets and computers. There are some really nasty metals and toxins locked up in this stuff that really should be addressed more systematically.

Fifth we have:

Mobiles and internet link to help the mentally ill

Louise Hall Health Reporter
June 29, 2008

MOBILE phones and the internet will be used to help up to 2 million Australians manage their mental health problems.

People can use the technology to track their wellbeing on a day-to-day basis by recording their mood, sleep, activities, medication, physical activity and drug and alcohol use.

The $1.88 million system is being developed by Sydney's Black Dog Institute as part of a growing move towards "e-therapy" as a way to cope with the chronic shortage of services for the mentally ill.

Using secure messaging via the internet or SMS on their mobile phone, patients report their condition daily. Information is fed back on their condition and alerts are sent to their phones or computers when things aren't going well, along with links to appropriate self-help tools.

Black Dog's senior research fellow Judy Proudfoot said the system would assist those at risk of depression, anxiety or stress to recognise symptoms and seek support, as well as help existing sufferers manage their illness.

More here:

http://www.smh.com.au/news/technology/mobiles-and-internet-link-to-help-the-mentally-ill/2008/06/28/1214472837799.html

I also came across this press release in the last few days.

http://www.swinburne.edu.au/corporate/marketing/mediacentre/core/releases_article.php?releaseid=1142

Internet therapy helps treat panic disorder

Online psychological treatment (etherapy) can be as effective as face-to-face therapy for treating mental health disorders, according to a new study by Swinburne researchers.

Published in the Journal of Medical Internet Research, the study found that therapist assisted etherapy is highly effective for the treatment of panic and panic-related symptoms.

It revealed that when online treatment programs are supported by health professionals they can achieve patient outcomes comparable to best-practice face-to-face therapy.

“Mental illness is a growing problem worldwide,” said lead author and psychologist Kerrie Shandley. “In Australia, it accounts for 13 per cent of health problems and one in 10 adults report that they suffer from a long-term mental or behavioural problem.”

“The management of anxiety and depression generally falls to family doctors who may lack the time and resources to deliver appropriate psychological treatment to their patients, so other methods for delivering effective therapy need to be developed.”

The study found that when panic disorder sufferers used the etherapy program ’Panic Online’ in conjunction with support from a general practitioner, their panic disorder and panic-related symptoms were reduced with around 30 per cent losing their symptoms altogether.

The study followed 96 people with a primary diagnosis of panic disorder who completed the Panic Online program over 12 weeks. Fifty-three of the participants had face-to-face assistance from their GP, who had received specialist training in cognitive behavioural therapy, and 43 had assistance from a clinical psychologist via email.

The participants completed a telephone interview conducted by a psychologist and a series of online questionnaires to assess panic-related symptoms over the course of the treatment and at a six-month follow-up.

“Both groups were shown to significantly improve over time”, Shandley said. “There were no noticeable differences between the participants who had assistance from their GP and those who had assistance from a clinical psychologist.”

----- End Release.

I also understand that “Internet based mental health therapy (has) received a boost thanks to a $.1.5m Federal Government grant to establish the National e-Therapy Centre for Anxiety Disorders (NeTCAD).

The service, based in Swinburne, will offer internet based clinical treatment programs for anxiety disorders, train postgraduate psychology students in the science and practice of e-therapy and develop online treatment programs for other psychological problems.”

This is all really good news to see studies that are showing such techniques can work – but even better that these services are certainly very accessible as well as being cost effective.

Sixth we have:

Backflip over OneSchool online student database

James O'Loan | June 23, 2008

THE controversial OneSchool online student database is being watered down after a public backlash against its instigator, Education Queensland.

School principals are leading the erosion, with one northside Brisbane primary school principal writing to parents advising them that photos of students do not need to be posted on their profiles.

The photos were, according to Education Queensland, to be posted along with students' academic performance, career aspirations and extra curricular activities.

The move follows Education Minister Rod Welford's defence of OneSchool when he dismissed the idea that hackers would target the database of nearly half-a-million students as "ridiculous, extreme and hypothetical".

Eatons Hill State School principal Clyde Campbell's letter to parents stated OneSchool was a "fundamental component of the Government's Smart Classrooms strategy".

He said the decision to omit photos was "a decision taken by the school" and reassured parents the new centralised system would be even more secure than the individual student management system it used previously.

More here:

http://www.australianit.news.com.au/story/0,24897,23907719-16123,00.html

Well it seems there has been the outbreak of just a little common sense here. It is clear Education Queensland needs a student management system..the issue is really about how much information is needed in that system and what protections are in place to prevent abuse. I hardly see how recording extra-curricular activities and career aspirations should be compulsory! If people volunteer such information fine..compulsion is just silly!

Last we have out slightly technical note for the week:

Third of IT admins admit snooping with privileged passwords

Power and anonymity equals risky business, says password management vendor.

Gregg Keizer 23/06/2008 08:36:30

One in three IT administrators say they or one of their colleagues have used top-level admin passwords to pry into confidential or sensitive information at their workplace, according to a survey by a password-management vendor.

Nearly half also confessed that they have poked around systems for information not relevant to their jobs.

"We asked these questions last year, too," said Adam Bosnian, vice president of product strategy and sales for Cyber-Ark, a Newton, Mass.-based maker of password file security management software. "And we got similar results. So on one hand, the results weren't surprising. What was surprising initially -- and this time around, too -- is that people admit to it."

Last month, Cyber-Ark polled approximately 300 senior IT professionals at a London security conference and trade show, asking them a dozen questions about their password practices. The majority of those surveyed said they work for companies with more than 1,000 employees.

The fact that a third acknowledged they had abused an admin password to access out-of-bounds information shouldn't surprise anyone, said Bosnian. "Everyone thinks that IT administrators are the trusted ones, and it's all the rest that we need to worry about. But admin passwords not only give administrators a lot of power, they also provide a lot of anonymity."

More here:

http://www.computerworld.com.au/index.php?id=1907566447&eid=-255

This is a worry, but not unexpected. What it tells me is that we need to have systems that foster the maintenance of security while at the same time making sure all those who have such roles understand (through education etc) the trust and responsibility they carry – to keep all the things they discover in the course of their work to themselves. This should be backed up by regular review of audit trails to detect bad behaviour and a clear and transparent penalty process for abuse.

More next week.

David.

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