News Extras For the Week (04/12/2008).

Again there has been just a heap of stuff arrive this week.

First we have:

Md. health officials track flu with e-mail queries

By Frank D. Roylance

November 21, 2008

You're all achy, coughing and feverish. Work is out of the question, but you're not sick enough to see a doctor. How nice it would be if someone checked in to ask how you're feeling.

The Maryland Department of Health and Mental Hygiene won't send over a pot of chicken soup. But state epidemiologists have a first-in-the-nation, Web-based project to ask thousands of residents whether they've been laid low by flu symptoms.

The Maryland Resident Influenza Tracking Survey is designed to augment reports from the doctors, hospitals and medical laboratories traditionally used to gather data on the geography and intensity of the flu season. The health department sends a weekly e-mail to people who sign up, asking them such questions as whether they've had a fever or a sore throat.

"We're looking at ways to fill in the gaps of our existing surveillance system," said Rene Najera, an epidemiologist at the health department. "We're trying to get at people who don't go to the hospital or do not see physicians. When those people do not seek care, they don't get reported to us."

More here:

http://www.baltimoresun.com/technology/bal-te.md.flu21nov21,0,5604173,print.story

Also we have:

For World's Sick, Care Via E-Mail

By Kevin Sullivan

Washington Post Foreign Service

Monday, November 24, 2008; A08

WINGHAM, England -- Geese honked happily outside as Pat Swinfen sat in the study of her 16th-century farmhouse, cozy and warm amid thick Oriental carpets and a glowing wood fire.

Pure English countryside idyll -- except for the critically ill pregnant woman in Iraq desperately in need of a neurologist.

Swinfen, a retired nurse in her early 70s, sat at her computer and tapped out an e-mail, trying to connect doctors in Basra working on the woman, who had suffered a brain hemorrhage, with a renowned neurologist from Northern Ireland trekking in Nepal.

She soon had an e-mail response from the neurologist, who told Swinfen to forward details of the case.

The Swinfens run the Swinfen Charitable Trust, a telemedicine charity that uses e-mail to link sick people in poor, remote or dangerous parts of the world with hundreds of medical specialists in some of the world's finest hospitals.

Doctors in about 140 hospitals and clinics in 39 nations use the organization to seek help for patients requiring specialized care beyond their capabilities. Through the trust, they can be put in e-mail contact -- often within hours -- with one or more of the 400 specialists who work without pay as part of the trust's network.

More here

http://www.washingtonpost.com/wp-dyn/content/article/2008/11/23/AR2008112302629.html

Seems there is a lot of news on how e-mail can make a difference! Good stuff.

Second we have:

Balancing Privacy with Progress
Health care IT continues with the struggle between access and security.

By David St.Clair

One of the primary roadblocks in the advancement of health information technology (IT) is the ongoing debate about the privacy and security of personal health information. Many maintain that the timely exchange of patient information among the various entities in the health care process - which is essentially the backbone of effective health care IT - increases the risk of that very personal data falling into the wrong hands. These claims have gained resonance in recent years with the all-too-frequent reports of cybercrimes and high-profile security breaches involving the medical records of various celebrities.

Privacy and security concerns are by all means legitimate. But are they significant enough to warrant slowing the vast improvements to health care quality, safety and affordability that technology can generate? Indeed, the greatest potential danger to the health care system may not be the misuse of personal health information, but the non use of it.

Right now, valuable clinical data sits idle in various places throughout the health care system when we could be deploying it through electronic health records (EHRs) to improve the system and perhaps even save lives. Delivering a greater breadth and depth of actionable information to the point of care furnishes clinicians with a much more thorough and complete picture of a patient and his or her medical history. The EHR fills in important blanks; it essentially makes known to a physician that which is otherwise unknown. As a result, doctors can make faster and more accurate decisions, which can snowball into a wealth of related benefits: better outcomes, increased operational efficiencies, less waste, lower costs and so on.

Given these almost certain benefits, one must consider whether we're approaching the point in the privacy debate where fear of the misuse of information needs to be overcome in order to prevent the nonuse of information, and whether the somewhat misdirected fear of potential security breaches is really worth stifling health IT progress and all it has to offer - especially at a time when the country is grappling in earnest for solutions to the high cost of quality health care.

Much more here:

http://health-care-it.advanceweb.com/Article/Balancing-Privacy-with-Progress.aspx

This is a very useful view and the full article is worth a read!

Third we have:

Germany’s GEK picks Atos for e-health card

20 Nov 2008

German health insurer, Gmünder ErsatzKasse (GEK), has signed a five-year deal with Atos World line, to implement and operate the new German electronic health card (EHC) on its behalf.

During 2009, GEK plans to issue 30,000 cards per day in order to provide its 1.7million members in Germany with the new e-health card.

Due to be rolled-out nationally in 2009, the electronic health card is one of Germany’s most important public sector IT projects. The card is designed to guarantee the secure exchange of data between insured parties, doctors, pharmacists and health insurance companies and will serve to validate patient’s identity, rather than hold their electronic medical record.

The introduction of the new electronic health card is intended to help connect citizens, pharmacists, doctors, hospitals as well as the private and statutory health insurance companies. Use of the card will help simplify and accelerate information exchanges, reducing and in some cases eliminating current paperwork.

Atos Worldline, a division of Atos Origin, has been selected by GEK to implement and operate the issuing and management of e-health cards. Services include the implementation of the health insurance data, the running of the card application and management system.

Atos will provide its card application management system for the electronic health card ‘Worldline eGK KAMS’.

Atos says its Public Key Infrastructure ensures that patient data is securely stored. The keys for the e-health card Atos Origin will supply are approved as trusted services by Gematik (Gesellschaft für Telematikanwendungen der Gesundheitskarte mbH), the national body overseeing the German e-health card project.

More here:

http://www.ehealtheurope.net/news/4344/germany%E2%80%99s_gek_picks_atos_for_e-health_card

It is important to understand just how the Germans are proceeding on e-Health. Here is a useful article to get started.

Fourth we have:

DOD, Veterans Affairs will use SOA to increase EHR interoperability

By Peter Buxbaum
Published on November 24, 2008

The Defense and Veterans Affairs departments will migrate their respective electronic health record systems to a service-oriented architecture to enhance the interoperability of outpatient clinical data.

Stephen Jones, principal deputy assistant secretary of Defense for health affairs, made the announcement at a Pentagon press conference this morning.

SOA means that the systems will rely on Web services that connect loosely coupled, reusable components.

A study by Booz Allen Hamilton recommended the use of SOA, and officials accepted that recommendation, Jones said.

The decision came on the heels of speculation that DOD might ditch its EHR — AHLTA — in favor of VA’s Veterans Health Information Systems and Technology Architecture or another alternative.

“The Booz Allen study looked at three different options: building on the current approach, replacing AHLTA with VistA and replacing both with another commercial off-the-shelf solution,” Jones said.

Booz Allen recommended the first option, which would allow DOD and VA to “move forward with information sharing in a compatible way,” Jones said. He added that he could not provide cost or schedule information because the implementation effort is just beginning.

More here

http://www.govhealthit.com/online/news/350692-1.html

Interesting where these large organisations think SOA fits.

Last for this week we have:

Joint Commission outlines ‘hospital of the future’

Posted: November 20, 2008 - 3:30 pm EDT

The Joint Commission released a white paper urging the healthcare industry to consider specific actions within five core areas of hospital development.

In its paper, Health Care at the Crossroads: Guiding Principles for the Development of the Hospital of the Future, the commission maps out steps hospitals should take in the areas of economic vitality, technology adoption, patient-centered care, staffing and design to better meet the needs of patients. “The importance of hospital-based care will not diminish in the future, but hospitals will have to meet the high expectations of the public and all stakeholders in an increasingly challenging environment,” said Mark Chassin, a physician who is president of the commission, in a written statement. Aramark Healthcare supported the development of the white paper.

Full article here:

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20081120/REG/311209972/-1/TODAYSNEWS

This is a useful study – and shows where technology can help future hospital developments.

David.

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