News Extras For the Week (18/12/2008).

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

First we have:

Obama announces electronic medical-records plan

Posted: December 8, 2008 - 5:59 am EDT

President-elect Barack Obama outlined a plan to electronically link hospitals, physician offices and the patients who rely on them as part of a multipronged approach to help boost the U.S. economy.

Though still measured on details, Obama sketched out a plan in a weekend radio address to “make sure that every doctor’s office and hospital in this country is using cutting-edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes and help save billions of dollars each year.”

In Washington last week, congressional aides confirmed that health information technology is being considered as part of a larger economic stimulus package, though it’s unclear which bill would be used as the framework to such a proposal. One Senate aide said that the Wired for Healthcare Quality Act, sponsored by Sens. Edward Kennedy (D-Mass.) and Michael Enzi (R-Wyo.), could make the cut. But other bills are likely to be in contention as well, including one passed by the House Energy and Commerce Committee earlier this year and another proposed by Rep. Pete Stark (D-Calif.), chairman of the House Ways and Means Health Subcommittee.

More here:

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20081208/DOSE/312089950

And he is backing it up with billions – No comment!

Second we have:

Electronic vs. paper

Are your medical records secure?

Sunday, December 7, 2008 3:28 AM

By Suzanne Hoholik

THE COLUMBUS DISPATCH

You might expect health-care providers and insurance companies to use the best security measures to keep your medical information private.

But a national expert on patient privacy said it's naive to think that your health record is secure. And with the federal government pushing for more electronic records, security will only get worse.

"Because of the primitive state of health technology, there are a lot of risks with electronic records, frankly far more than paper," said Dr. Deborah Peel, founder of Patient Privacy Rights, a nonprofit organization based in Austin, Texas.

Peel, who recently spoke at a health-policy conference in Columbus, said most people don't know about all of the nonmedical staff people who have access to their electronic health information.

And she questions providers who promise privacy.

Much more here:

http://www.dispatch.com/live/content/local_news/stories/2008/12/07/EMR.ART_ART_12-07-08_B1_LOC5H3M.html

Bit of a silly debate – but I must say I prefer audit trails to undetectable snooping of paper records any day!

Third we have:

Perfect vision for health informatics

10 Dec 2008

Representatives of international and regional e-health advocacy groups are meeting at the Wellcome Trust in London this week to agree plans for building “capacity” in the global health informatics workforce, thanks to a €0.9m ($1.2m) grant from the Bill and Melinda Gates Foundation.

The American Medical Informatics Association (AMIA) announced on Monday that it received the grant to promote health informatics and biomedical education and training worldwide, particularly in developing countries.

AMIA is convening the meeting with the European Federation for Medical Informatics (EFMI) and the Asia Pacific Association for Medical Informatics (APAMI), under the umbrella of the International Medical Informatics Association (IMIA).

This will be planning the first project of a programme called 20/20, in which IMIA and its regional affiliates will attempt to train 20,000 informatics professionals globally by 2020. This is an outgrowth of the well-established AMIA 10x10 programme to train 10,000 people in informatics in the US by 2010. The 20/20 effort is chaired by Dr NT Cheung, head of IT for the Hong Kong Hospital Authority.

The Gates money is intended to develop “scaleable” approaches to e-health education, including a replicable blueprint for training informatics leaders, including physicians, medical records specialists, computer scientists and medical librarians.

More here:

http://www.ehealtheurope.net/news/4396/perfect_vision_for_health_informatics

Good to see some effort being devoted to this area. Right now I really think Australia is a bit behind in many aspects of HI Professional development.

Fourth we have:

Jordan EHR project could have global effect: experts

By: Joseph Conn / HITS staff writer

Posted: December 10, 2008 - 5:59 am EDT

Part one of a two-part series:
The recently announced decision by the Middle East nation of Jordan to install the Veterans Affairs Department’s VistA electronic health record in its government-run healthcare system probably won’t be a dam-breaker for VistA in the private sector in the U.S., but it could have a huge impact on information technology globally, people close to the project said.

Under terms of the contract for the pilot project, Perot Systems Corp., Plano, Texas, is to install WorldVistA EHR, an open-source version of the VA’s system, at 488-bed Prince Hamza Hospital, a teaching hospital opened in 2006 in Amman, the capital of Jordan.

Perot also is to install the software at the hospital’s affiliated outpatient Amman Comprehensive Medical Clinic and at the King Hussein Cancer Center, which was founded in 1997 and is undergoing a renovation due to be completed this year, increasing its capacity to 200 beds.

Physician Rami Farraj is chairman of the board of directors of E-Health Solutions, a not-for-profit Jordanian company created to oversee the government’s IT development program. Farraj said the Jordanian government chose the WorldVistA version that runs on GT.M, an open-source iteration of the Massachusetts General Hospital Utility Multi-Programming System, or MUMPS, database and programming language. GT.M is developed by Fidelity National Information Services, Jacksonville, Fla. The VA runs VistA on Cache, a proprietary version of MUMPS from InterSystems Corp., Cambridge, Mass.

Much more here and in the second article

http://modernhealthcare.com/article/20081210/REG/312109996/1134/FREE

It is really good to see headway being made with WorldVistA. The developing world can now access some very useful software for much lower than the commercial costs.

Fifth we have:

Many U.S. Hospitals Do Not Share Information on Medical Errors, Survey Finds

[Dec 10, 2008]

Most hospitals nationwide collect information about patient injuries or deaths that result from medical errors, but only one in five shares the data with managers and others who could implement measures to address the problems, according to a survey conducted by the Agency for Healthcare Research and Quality that appeared on Monday in the journal Quality and Safety in Health Care, the Newark Star-Ledger reports. The survey included responses from risk managers at more than 1,600 hospitals nationwide.

According to the survey, 32% of U.S. hospitals have established "supportive environments" that allow staff to report anonymously patient injuries or deaths that result from medical errors, and 13% have broad staff involvement in such reporting. The survey found that physicians often do not participate in such reporting because of concerns about liability, professional embarrassment and time requirements.

More here:

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=56020

This is a real worry indeed – I wonder do we know how Australian hospitals perform?

Last for this week we have:

The Link Between Genetic Medicine and IT

Kathryn Mackenzie, for HealthLeaders Media, December 9, 2008

The premise behind personalized medicine seems astonishing and yet simple at the same time: Each of us receives medical treatment tailored to our unique genetic makeup. By using molecular analysis to better manage a patient's disease or predisposition to disease, physicians are able to choose the approach best suited to the patient's genetic profile. The benefits of genetic and molecular medicine are so many, says outgoing Health and Human Services Secretary Michael Leavitt, that personalized healthcare should be an "explicit goal of President-elect Barack Obama's healthcare reform plan."

In the second report from his Initiative on Personalized Health Care, Leavitt says that personalized medicine could be one of the key measures to reduce waste and overuse of prescription drugs and health resources. "We have developed powerful pharmaceuticals, yet most drugs prescribed in the United States today are effective in fewer than 60% of treated patients," he writes, noting that the "trial-and-error" approach remains the most common process for diagnosing and treating patients.

Leavitt also stresses the need for links between information technology and personalized medicine. "The base of interoperable health information technology is critical and remains far from complete. It is not merely a matter of electronic health records, but equally the capacity to exchange information securely," he writes.

More here:

http://www.healthleadersmedia.com/content/224660/topic/WS_HLM2_TEC/The-Link-Between-Genetic-Medicine-and-IT.html

This is an area that is only going to become more important over time – worth a read.

David.

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