Again there has been just a heap of stuff arrive this week.
First we have:
Review calls for shake-up of pathology
22 Dec 2008
The Department of Health should put in place IT connectivity for NHS pathology services as a matter of priority, a two-year review has concluded.
The review of pathology services, chaired by Lord Carter of Coles, calls for DH electronic order communications pilots for primary care to be rolled out as soon as possible and suggests they should be extended in future to cover pharmacies in primary care settings.
The independent review emphasises that good electronic communication is an essential element of any efficient and effective service.
“In pathology, it can help to address unnecessary and inappropriate demand and reduce the risk of errors. The collection and analysis of IT-based data can improve the way that pathology enables decisions about diagnosis and treatment to be made,” it adds.
The report is the second produced by the review team since the DH commissioned Lord Carter to review pathology services in 2005. It focuses on improving quality and efficiency and identifying the mechanisms for change.
More here:
http://www.ehiprimarycare.com/news/4434/review_calls_for_shake-up_of_pathology
Seems the same issues with pathology information communication exist everywhere!
Second we have:
NI completes barcode prescriptions project
22 Dec 2008
Northern Ireland has announced that it has successfully completed its 2D barcoded prescription project.
The Electronic Prescribing and Eligibility System (EPES) was launched just over two years ago, when a £6.8m contract was awarded to Hewlett-Packard to provide 2D bar-coded prescriptions to counter fraud.
The system works by printing paper prescriptions with a two-dimensional barcode at the GP’s surgery. This encodes all of the information written on the prescription.
At the pharmacy, the prescription is logged into a database, eliminating transcription errors and reducing the opportunities for prescription fraud.
Pat Davis, project manager at NI’s directorate of information systems, said that since 1 May the Family Practitioner Service of the Central Service Agency has been using the system to capture, record and validate prescription information on all prescription forms in Northern Ireland; generating monthly payment files for community pharmacists and monitoring the prescribing process.
Since 17 November, the new Counter Fraud Unit Case Management System has also been operational to support the identification of discrepancies in prescription, ophthalmic and dental claims processes and challenge the individuals concerned.
Davis said the project meant that Northern Ireland now has at its disposal a single, patient centred, electronic history of prescribing and dispensing and the ability to electronically call up and view each of the 16.8m prescription forms returned annually to the CSA.
More here:
http://www.ehiprimarycare.com/news/4431/ni_completes_barcode_presciptions_project
This is really very depressing. I suggested Australia adopt a similar approach to DoHA (another suppressed report) in 1996 and we are still essentially no-where in the communication of prescription data. Jinx this can all be frustrating.
Third we have:
The doc is in -- with wireless monitoring
Home systems track a patient's vitals, providing quick feedback, better care and less travel time
Wednesday, December 24, 2008
DON COLBURN
The Oregonian Staff
When Tom Martin steps on the bathroom scale in his Beaverton apartment, there are no secrets.
The telltale weight zips automatically to a Kaiser Permanente computer, where his case manager will see it. Ditto for the blood-pressure reading when Martin wraps the cuff around his arm and presses the squeeze button.
If any of Martin's numbers are amiss when the nurse checks the Web site each morning, an alert pops up.
That happened Nov. 17. Martin's weight had jumped to 259 after he put on nine pounds, mostly "water weight," over the weekend. A yellow exclamation point showed up on Susan Duman's computer screen.
The nurse called Martin to confirm the weight gain and see how he was feeling. They decided to double his dose of the diuretic Bumex, and the weight drained off within a couple of days.
"It helps us catch things earlier and avoid unnecessary emergency room visits and hospitalization," says Duman, a nurse at Providence St. Vincent Medical Center and case manager for 120 Kaiser congestive heart failure patients, including Martin.
Martin has heart failure from a structural heart defect. At 46, he has been through a heart attack, triple cardiac bypass surgery and a stroke. He is on disability, unable to drive or work.
His heart's inefficient pumping boosts his blood pressure, congests his lungs and leaves him feeling chronically sluggish and short of breath. A delicate balance of medications -- Martin takes 15 pills a day -- keeps the symptoms in check.
Martin is an ideal candidate for home-monitoring because he has a chronic disease that can be controlled most of the time but puts him at high risk of medical crisis if he spins out of control. Heart failure sends more patients to the hospital than any other condition.
The system automatically relays data on weight, blood pressure and heart rhythms so case managers can flag subtle early signs of trouble and intervene to prevent an emergency.
"It's an extension of the hospital and clinic into the patient's home," said Dr. Homer Chin, Kaiser's medical director for clinical information systems. "Basically, we can see when they're getting into trouble before they get into trouble.
"It's better care and it saves us money."
Home-monitoring also cuts down on travel and appointment time and unclogs medical office schedules. And it gives patients more of a personal stake in their care.
"The more control they have, the better they feel," Duman says.
Sudden extra "water weight" is a first critical checkpoint for patients with high blood pressure and heart failure. It leads to fatigue and swollen ankles.
"It's difficult to move, to breathe, everything," Martin says. "For example, this morning I filled the dishwasher, ran two loads of laundry, took out the trash -- and I'm pretty done."
Yet asking patients to call in when their weight spikes hasn't worked.
"Denial is a big deal," Duman says. "People say, 'I'll be better tomorrow, I ate a big Thanksgiving dinner, whatever.' "
Without the home monitor, Martin agrees, he would be less likely to call in and report his sudden weight gain.
"Partly embarrassment," he says. "With the machine, the accountability is there, but it's not me having to call Susan and tell her I'm in trouble.
"I just step on my scale, and the info goes in."
Much more here:
http://www.oregonlive.com/health/oregonian/index.ssf?/base/news/1229988315262550.xml&coll=7
This is a great discussion of the practicalities and usefulness of home monitoring – well worth a browse.
Fourth we have:
COACH, HIMSS establish new professional credential
By AuntMinnie.com staff writers
December 25, 200The Canadian Organization for Advancement of Computers in Health (COACH), Canada's not-for-profit health informatics association headquartered in Toronto, has collaborated with the Healthcare Information and Management Systems Society (HIMSS) of Chicago, to establish a new professional credential for healthcare informatics professionals.
The Certified Professional in Healthcare Information and Management Systems (CPHIMS) credential will be awarded to individuals who pass an examination develop by COACH and HIMSS, as well as a Canadian supplemental examination. The first examination will be offered at the e-Health 2009 conference, starting May 31, 2009, in Quebec City.
Candidates must meet the requirements of having a bachelor's degree and five years of associated IT experience, three of which must be healthcare-specific, or a graduate degree with three years of associated IT experience, two years of which must be healthcare-specific.
More here:
http://www.auntminnie.com/index.asp?Sec=sup&Sub=pac&Pag=dis&ItemId=84098
It really is about time we had something like this in Australia. We need to see the Australian College of Health Informatics and the Health Informatics Society of Australia get together and create something useful which would be valuable to all. This is at least one model to consider.
Fifth we have:
Medical devices lag in iPod age
Patients' safety is at risk, experts say
By Carolyn Y. Johnson, Globe Staff | December 29, 2008
A 32-year-old woman was on the operating table for routine gall bladder surgery, and doctors needed a quick X-ray. To keep her chest still while the image was shot, her ventilator was switched off. But the anesthesiologist, distracted by another problem, forgot to turn the breathing machine back on. The woman died.
The case is an extreme example of the kind of error that could be prevented if medical devices were designed to talk to each other, says Dr. Julian Goldman, a Massachusetts General Hospital anesthesiologist who has compiled such instances from across the United States to highlight the need for medical device "connectivity." In this case, he says, synchronizing the X-ray machine with the ventilator, so the image was automatically timed to a natural pause in breathing, would have made it unnecessary to turn it off.
As technology moves forward, people expect the electronic devices of everyday life to work together, from cellphones that can call or text-message other phones, to computers that interconnect with a slew of gadgets. But in the medical world, where the stakes are higher, such flexible interconnection is rare. Each device operates in its own silo.
"It is really unacceptable, and it's one of the reasons we're unable to make dramatic improvements in patient safety," said Goldman, a leader in calling for a new generation of medical devices that talk to each other.
Now the push for greater connectedness in hospital electronics is gaining momentum. The goal is devices that can not only plug into one another, but can also "understand" each other and automatically identify potential life-threatening problems sooner than they would have been caught by busy nurses and doctors.
More here
http://www.boston.com/news/science/articles/2008/12/29/medical_devices_lag_in_ipod_age/
Certainly an objective for the next few years – to make the idea a reality!
Sixth we have:
Kalorama: EMR market to grow by 14 percent annually through 2012
By Bernie Monegain, Editor 12/31/08
Kalorama Information forecasts the EMR market to grow by 14.1 percent annually through 2012, from $9.5 billion in 2007.
The emerging personal health record trend will have a vast impact on the electronic medical records market and on healthcare in the upcoming year, according to the New York-based marketing research firm.
The report, "U.S. Markets for EMR Technology," examines how the focus of ownership of medical records is shifting from one that is distributed among various healthcare providers to one that is shared and controlled by both the patient and the provider.
Patients' and physicians' interest in viewing records online has increased, since giving patients online access to their own charts is expected to enhance the doctor-patient relationship and reduce healthcare costs.
"The driver for EMR sales has always been hospital-side, as in 'this can reduce your costs,'" said Bruce Carlson, publisher of Kalorama Information."That's still true, but with PHRs, the driver is also on the consumer side, as in 'this can make your organization seem friendly and modern to healthcare consumers.' "
UnitedHealth Group, in an effort to compete with Google Health and Microsoft's HealthVault, announced its new www.myoptumhealth.com on Dec. 1, allowing patients to create and manage their own digital health records. If patients need to refill a prescription or view the latest test result, they can access it from their computers, instead of making a phone call.
More here:
http://www.healthcareitnews.com/story.cms?id=10658
Good to see there are some sectors of the economy actually growing!
Seventh we have from the New York Times
Health Care That Puts a Computer on the Team
By STEVE LOHR
MARSHFIELD, Wis. — Joseph Calderaro, 67, is one of health care’s quiet success stories. Over the last four years, he has carefully managed his diabetes by lowering his blood sugar, blood pressure and cholesterol with diet, exercise and medication.
To keep on track, Mr. Calderaro visits his doctor, attends meetings for diabetes patients and gets frequent calls from a health counselor. It is a team effort, orchestrated by the Marshfield Clinic here. And it is animated by technology, starting with Mr. Calderaro’s computerized patient record — a continuously updated document that includes his health history, medications, lab tests, treatment guidelines and doctors’ and nurses’ notes.
To visit the Marshfield Clinic, a longtime innovator in health information technology, is to glimpse medicine’s digital future. Across the national spectrum of health care politics there is broad agreement that moving patient records into the computer age, the way Marshfield and some other health systems have already done, is essential to improving care and curbing costs.
A paper record is a passive, historical document. An electronic health record can be a vibrant tool that reminds and advises doctors. It can hold information on a patient’s visits, treatments and conditions, going back years, even decades. It can be summoned with a mouse click, not hidden in a file drawer in a remote location and thus useless in medical emergencies.
Modern computerized systems have links to online information on best practices, treatment recommendations and harmful drug interactions. The potential benefits include fewer unnecessary tests, reduced medical errors and better care so patients are less likely to require costly treatment in hospitals.
The widespread adoption of electronic health records might also greatly increase evidence-based medicine. Each patient’s records add to a real-time, ever-growing database of evidence showing what works and what does not. The goal is to harness health information from individuals and populations, share it across networks, sift it and analyze it to make the practice of medicine more of a science and less an art.
The Bush administration has left it mainly to advocacy and the private sector to introduce digital medicine. But President-elect Barack Obama apparently plans to make a sizable government commitment. During the campaign, Mr. Obama vowed to spend $50 billion over five years to spur the adoption of electronic health records and said recently that a program to accelerate their use would be part of his stimulus package.
The Marshfield Clinic, a large doctors’ group in Wisconsin, shows that computerized records can indeed improve the quality and efficiency of medicine. Yet the Marshfield experience suggests that the digital record becomes truly useful only when patient information is mined to find patterns and answer questions: What treatments work best for particular categories of patients? What practices or procedures yield the best outcome?
The Marshfield Clinic “understands that it’s a system of improvement that technology makes possible that really matters, and the electronic health record itself is no silver bullet,” said Dr. Carolyn M. Clancy, director of the federal Agency for Healthcare Research and Quality.
More here
This is a great article and it is well worth registering at the Times to read this sort of material!
Last we have:
A look back at health IT in 2008
By: Jean DerGurahian
Posted: December 29, 2008 - 5:59 am EDT
This is part one of a three-part series.
Health information technology became a central issue this year as the federal government pushed a number of initiatives to increase IT adoption among providers at all levels. In doing so, several key issues were raised, from transparency and interoperability to the privacy of data being exchanged and the cost of implementing that exchange. In all, 2008 might be known as the year of the electronic health record, which is seen by some to be the defining technology that is expected to bring together all facets of the health-delivery system, though many still question its effectiveness and expense.
Over the past year, Health IT Strategist has chronicled the key issues affecting the industry. Take a look at what readers found to be the most important, based on a review of page views for stories.
More here:
http://modernhealthcare.com/article/20081229/REG/312299996/1134/FREE
This is a useful and well worth reading series – worth registering for access to be able to read it.
More when too much Health IT News is just not enough!
David.
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