International News Extras For the Week (04/02/2009).

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

First we have:

Course Interprets Rx Marketing Messages

A new, free online course is designed to help clinicians assess the confusing drug information they receive from pharmaceutical companies.

The goal is to help clinicians make better prescribing decisions. Wake Forest University School of Medicine in Winston-Salem, N.C., developed the course with a regional unit of the North Carolina Area Health Education Centers Program.

The five-lesson course, called SmartPrescribe, targets physicians, physician assistants, nurse practitioners and medical students. Covered topics include:

* distinguishing between good studies and mediocre studies,

* understanding problems and recent improvements in FDA regulation of new drugs,

* learning about pharmaceutical marketing strategies,

* assessing how much course participants are influenced by marketing, and

* determining if course participants are prescribing dangerous drug combinations.

More here:

http://www.healthdatamanagement.com/news/education27600-1.html?ET=healthdatamanagement:e745:100325a:&st=email&channel=medication_management

What an excellent idea – this is certainly something the TGA should look at replicating in Australia!

Second we have:

Worthing may dump Cerner Millennium

26 Jan 2009

Worthing and Southlands Hospitals NHS Trust may ditch its brand new Cerner Millennium system in favour of a 20-year old legacy patient administration system.

This April, the trust will merge with neighbour The Royal West Sussex Hospital NHS Trust. Following the merger, E-Health Insider understands the intention is to run the long established Sema-Helix PAS, currently in use at The Royal Wessex, across the whole of the new trust.

E-Health Insider understands the decision to move to Sema-Helix was taken in principal by the Worthing and Southlands board in December.

It is believed to be based on the problems experienced since go-live in September 2007, and lack of ongoing development following Fujitsu’s removal as local service provider in the South.

The trust declined to confirm or deny any decision had been taken. NHS South East instead responded to questions directed to the trust, saying no “final” decision had been taken; a message repeated by NHS Connecting for Health.

More here:

http://www.e-health-insider.com/news/4511/worthing_may_dump_cerner_millennium

Sounds like “trouble at mill” with this installation!

Third we have:

Technology Gets a Piece of Stimulus

STEVE LOHR

Published: Monday, January 26, 2009 at 5:12 a.m.

Last Modified: Monday, January 26, 2009 at 5:12 a.m.

The time-tested way for governments to create jobs in a hurry is to pour money into old-fashioned public works projects like roads and bridges. President Obama’s economic recovery plan will do that, but it also has some ambitious 21st century twists.

The $825 billion stimulus plan presented this month by House Democrats called for $37 billion in spending in three high-tech areas: $20 billion to computerize medical records, $11 billion to create smarter electrical grids and $6 billion to expand high-speed Internet access in rural and underserved communities.

A study published this month, which was prepared for the Obama transition team, concluded that putting $30 billion into those three fields could produce more than 900,000 jobs in the first year. The mix of proposed spending is different in the House plan, but the results would be similar, said Robert D. Atkinson, president of the Information Technology and Innovation Foundation, which did the study.

Beyond creating jobs, advocates say, government investment in these technology fields holds the promise of laying a lasting foundation for more business innovation and efficiency, while helping to create new digital industries.

Much more here:

http://www.nytimes.com/2009/01/26/technology/26techjobs.html?_r=1&partner=rss

This NY Times article explains the broader technology investment plans of the Obama administration. An extra investment in country broadband sounds a little familiar!

Fourth we have:

Selecting the correct healthcare software solution

January 23, 2009 | Chad A. Eckes, CIO, Cancer Treatment Centers of America and Edgar D. Staren, MD, Senior Vice President for Clinical Affairs and Chief Medical Officer, Cancer Treatment Centers of America

Most healthcare information technology vendors want you to believe that their software can meet any organization's needs. As a matter of fact, healthcare IT vendors and their software are quite unique. The single most important process for a successful software implementation is the selection of the correct solution.

There are several guiding principles that should be taken into consideration when selecting your healthcare software. First, your IT department should never be the primary entity selecting the software. The operational users of the software need to be the principal participants in the selection process. The IT department's role should primarily be to facilitate the solution selection process.

Appropriate representation takes into account the various disciplines, interest, and expertise in the organization. Second, optimal selection necessitates that a multi-disciplinary team representing the organization's stakeholders be prepared to invest a significant amount of time; typical solution selections require 4 to 6 months and up to 20,000 hours. The third principle is to not select software based upon previous relationships nor having used the technology in another organization. The fit of software is highly influenced by the culture and business processes of an organization. Finally, the best way to find the software with the closest functional fit is to follow a structured selection methodology. In that regard, we have designed a three phase and 12 task selection methodology, which follows a standard selection funnel.

Heaps more here:

http://www.healthcareitnews.com/blog/selecting-correct-healthcare-software-solution

This is an excellent article – that is worth reading in full for ideas on how to conduct a quality system selection process. Certainly one for Health IT project managers to save and a series to follow.

Fifth we have:

MDs using social networks prescribe more

By Anne

Created Jan 25 2009 - 6:44pm

The following may seem like more of a marketing than an IT issue--but I'd argue that it has implications for IT execs too, largely in what applications you'll need to slate for development in the future. As you'll see, it's a data point that suggests that physicians who engage online are physicians you want in your corner.

A new study has concluded that physicians who are currently participating in online physician communities and social networks write a mean of 24 more prescriptions per week than those who aren't interested in such communities. The study goes on to suggest that such physicians are more pharma-friendly too.

Lots more (with links) here:

http://www.fiercehealthit.com/story/mds-using-social-networks-prescribe-more/2009-01-25

The press release for the study is here:

http://www.fiercehealthcare.com/press-releases/physician-social-networkers-are-high-prescribers-and-more-likely-engage-pharma?utm_medium=nl&utm_source=internal&cmp-id=EMC-NL-FHI&dest=FH

I am not sure I know exactly what this result means – but I am not totally convinced it is a good thing!

Western NY launches patient record exchange

BUFFALO, N.Y. (AP) — Doctors in western New York have a new, electronic way to access patient records with the hope of reducing medical errors and avoiding costly duplicative tests.

The HEALTHeLINK Western New York Clinical Information Exchange is a step toward Gov. David Paterson's goal of creating a unified statewide system where doctors can access records that are now scattered among different clinics and offices.

"The emergency room doctor who's never seen that patient before ever will have access to their information, their medication history, any lab work, any radiology reports," HEALTHeLINK Executive Director Dan Porreca said.

On a national level, President Barack Obama, during his campaign, promised a $50 billion investment to store patient records electronically. Earlier this month, Obama said he wants all of the country's medical records computerized within five years.

"We believe that New York is setting the standard in fulfilling the president's goal of digitizing patient health records and HEALTHeLINK is an integral component of our statewide initiative," said Lori Evans, the state Health Department's deputy commissioner of health information and technology.

Addressing privacy concerns, Porreca said the electronic files are more secure than paper, since only authorized people will have access to the Web-based system and to a patient's records.

"If it's a paper chart, you never know who's looked at that," he said. "In electronic form, we can track who's looking at what."

More here:

http://www.google.com/hostednews/ap/article/ALeqM5hp8nUD2UaCNd1aE9cf9KaFAqMq4AD95SS7UG2

Great name for a Health Information Exchange – seems it is a bit familiar however..think NSW Health! Nevertheless a serious investment and effort is being made.

Seventh we have:

CCHIT Proposes Expansion, Leaving Some Vendors Crying Foul

Kathryn Mackenzie, for HealthLeaders Media, January 27, 2009

Since launching in 2004, the Certification Commission for Health Information Technology has become the de facto stamp of approval for EHRs, helping providers judge EHR product suitability, quality, interoperability, and security. For about $28,000, a vendor who meets the Commission's criteria can be certified, automatically proving to providers that their EHR is worth the money, say CCHIT proponents. Now, CCHIT is expanding its scope of certification, and not everyone is happy about CCHIT's increasing influence in the market.

The expansion includes two areas already named in previous years—behavioral health and long-term care—that will be developed as planned. In addition, four new program areas are proposed, all of which are optional add-on certifications for ambulatory EHRs: clinical research, dermatology, advanced interoperability, and advanced quality.

One of the main components being added to CCHIT's lineup will be increased flexibility and opening up the option of certifying advanced levels of technology for products that go "beyond the basics" in any domain, says Mark Leavitt, MD, chair of CCHIT.

"There is now a degree of sophistication with the technology and a readiness on the part of the end users that we need to have different levels of certification. You will still have the certification for ambulatory EHR, but those with advanced decision support, for example, would get additional certification that says this product also offers advanced decision support so if that's something you are ready for and looking for, this has it," says Leavitt.

He says the group chose the expansion areas based on a model that quantified the benefit of certification by looking at how many patients are affected by the specialty, how many dollars are spent in the specialty, the readiness of the specialty (for example, have providers gotten together and formed committees to define what they need or would CCHIT have to start from scratch) and then, "we balanced those out. We ultimately came out with a prioritization, and published that January 14 open for comment. We are accepting comment through February 5," says Leavitt. CCHIT also is considering eventual certification programs for software to support eye care, oncology, obstetrics/gynecology, advanced security, and advanced clinical decision support.

More here:

http://www.healthleadersmedia.com/content/227160/topic/WS_HLM2_TEC/CCHIT-Proposes-Expansion-Leaving-Some-Vendors-Crying-Foul.html

This is a useful article describing the pressures Health IT Certification functions can come under. NEHTA should have a close read! – along with the comments that have been posted.

See here for example.

http://www.smartbrief.com/news/chime/storyDetails.jsp?issueid=2ED668E3-6F37-47A2-92FE-0943072C024E&copyid=A27B4E34-6C32-4642-9639-D0A980ED90F8

and here:

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090127/REG/301279962/1031/FREE

Eighth we have:

Database Helps Assess Your Breast Cancer Risk

By Serena Gordon

HealthDay Reporter

Sunday, January 25, 2009; 12:00 AM

SUNDAY, Jan. 25 (HealthDay News) -- If you want to learn more about the key risk factors for breast cancer, such as obesity, pollutants or smoking, a database can guide you to the available evidence that confirms or quells an association.

"Breast cancer is multifactorial. It would be rare for there to be a single environmental chemical that alone would be sufficient to cause an increase in breast cancer," said Dr. Robert Schneider, co-director of breast cancer research at New York University School of Medicine in New York City.

"In many cases, an increased risk of breast cancer is quite small, and we don't yet know how each factor affects the risk of breast cancer," he said, explaining that it's similar to a puzzle. "We need to know how all of the pieces fit together, and this database begins to help us start assessing some of that."

The database, a joint project of Susan G. Komen for the Cure and the Environmental Factors and Breast Cancer Science Review project led by the Silent Spring Institute, includes information on 216 chemicals, diet, smoking, physical activity and weight that may play a role in the development of breast cancer.

More here:

http://www.washingtonpost.com/wp-dyn/content/article/2009/01/25/AR2009012500665.html

The database is found here:

http://sciencereview.silentspring.org/index.cfm

Ninth we have:

Detailed Care Records for 3.5m patients

27 Jan 2009

More than 3.5m patients in Yorkshire and the Humber now have a Detailed Care Record for primary and community care, in one of the lesser-known success stories of the National Programme for IT in the NHS.

The records form part of a fully operational DCR, with information being shared between general practice, community and child health systems.

According to figures supplied to EHI Primary Care, Yorkshire and the Humber has 100% of primary care trust community teams, 40% of GP practices and approaching 100% of child health teams using TPP’s SystmOne, supplied by its local service provider, Computer Sciences Corporation.

NHS East of England is close behind, with 3.4m patients on the system, followed by NHS East Midlands (2m) and the NHS North East (1.2m).

In an exclusive interview with EHI Primary Care, Tony Megaw, head of primary care IT for NHS Yorkshire and the Humber , estimated that the DCR created by SystmOne was now being used by as many as 50% of primary care NHS staff in the strategic health authority's area.

He said: “The NPfIT vision of integrated, detailed care records improving patient care is a reality in Yorkshire and the Humber.”

Full article here:

http://www.ehiprimarycare.com/news/4508/detailed_care_records_for_3.5m_patients

With all the bad news – it is important to realise good things are also happening in the UK!

Much more detail here:

http://www.ehiprimarycare.com/comment_and_analysis/383/making_a_detailed_care_record_a_reality

See also here for more good news.

http://www.ehiprimarycare.com/news/4520/gp2gp_milestone_reached

GP2GP milestone reached

28 Jan 2009

Tenth we have:

Electronic records to support $2.5M diabetes study at Palo Alto

January 28, 2009 | Bernie Monegain, Editor

PALO ALTO, CA – Electronic health records in use at the Palo Alto Medical Foundation for nearly a decade will support a new $2.5 million diabetes research project focused on California's Asian population.

PAMF announced earlier this week it had received a $2.5 million grant from the National Institutes of Health to conduct a five-year study on diabetes and its risk factors among the six largest Asian ethnic groups in California - Asian Indians, Chinese, Filipino, Japanese, Korean and Vietnamese.

PAMF's EHR system gives researchers a unique resource to better understand variations in treatment for diabetes, identify best practices and recommend ways to improve care both inside and outside of the organization, PAMF officials say. In addition to reviewing existing medical records as part of the study, researchers will use the EHR system to select and follow a group of patients over more than a decade to study diabetes risk factors that may be unique to Asian Americans.

"By the end of the study, we hope to gain a much better understanding of what puts certain Asian ethnic minorities at greater risk for diabetes, one of the most costly and prevalent chronic health conditions," said Latha Palaniappan, MD, principal investigator for the study. "The study also holds substantial promise for clinicians and policymakers, as we will offer information and recommendations on how to identify and target high-risk Asian populations for diabetes prevention, treatment and management."

More here:

http://www.healthcareitnews.com/news/electronic-records-support-25m-diabetes-study-palo-alto

This is the extra value add we get from EHRs that – while not getting on with it – we are missing out on!

Eleventh we have:

Groups push for health IT privacy safeguards

By GRANT GROSS, IDG News Service\Washington Bureau, IDG

U.S. lawmakers need to make sure privacy safeguards are in place before pushing electronic health records on the public, senators and witnesses at a hearing said.

Health IT improvements are needed to improve the quality and efficiency of health care in the U.S., but patients might be wary of electronic health records without strong privacy safeguards built in, Senator Patrick Leahy, a Vermont Democrat, said during a Senate Judiciary Committee hearing Tuesday.

"If you don't have adequate safeguards to protect privacy, many Americans aren't going to seek medical treatment," Leahy said. "Health-care providers who think there's a privacy risk ... are going to see that as inconsistent with their professional obligations, and they won't want to participate."

A US$825 billion economic stimulus package, called the American Recovery and Reinvestment Act, includes $20 billion targeted toward health IT efforts. The bill, which could come before the full House this week, establishes an Office of the National Coordinator for Health Information Technology, with the duty of driving health IT standards.

More here:

http://www.nytimes.com/external/idg/2009/01/27/27idg-Groups-push-for.html

Again a lesson about how important it is the get the approach to privacy right – and to communicate it clearly to re-assure people.

Last for this week we have:

Health Central acquires Wellsphere

Silicon Valley / San Jose Business Journal

HealthCentral Inc., a collection of online condition-specific consumer health and wellness information, said Wednesday it acquired health technology company Wellsphere Inc.

Arlington, Va.-based HealthCentral did not disclose terms of the deal with Wellsphere, which is based in San Mateo.

"The acquisition combines HealthCentral's high-quality, condition-specific interactive experiences, content and audience with Wellsphere's aggregation of over 1,500 health and wellness bloggers and unique Health Knowledge Engine technology that deciphers highly specific health information," the company said.

More here:

http://www.bizjournals.com/sanjose/stories/2009/01/26/daily53.html?

From the growth figures quoted it seems there is a place for detailed consumer health information out there!

There is an amazing amount happening (lots of stuff left out) – and - as Peter Cundall would say ‘ that is your bloomin lot for the week’!

David.

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