Report Watch – Week of 6 April, 2009

Just an occasional post when I come upon a few interesting reports that are worth a download. This week we have a few.

First we have:

Province unveils electronic health data plan

March 30, 2009

Joseph Hall

Health Reporter

Ontario has unveiled a $2.1 billion strategy that promises to give every diabetic patient in the province an electronic health record by 2012.

The "eHealth Ontario" initiative will also connect doctors, patients and pharmacists electronically to better manage the flow, safety and effectiveness of prescription drugs and cut wait times at Ontario hospitals, the head of the group developing the program says.

"There is a very clear line between investing in information and information technology in these three areas and seeing improvements from a patient perspective," says Sarah Kramer, president of eHealth Ontario.

The 53-page strategy aims to have 65 per cent of the province's primary physicians and two-thirds of their patients hooked up to the electronic medical data by April 2012.

The eHealth agency was formed last September after a previous costly and controversial program failed to produce viable health record plans.

More here:

http://www.thestar.com/News/Ontario/article/610773

The report and consultations are discussed here:

http://www.ehealthontario.on.ca/about/strategy.asp

The report can be downloaded here:

http://www.ehealthontario.on.ca/pdfs/About/eHealthStrategy.pdf

It is a pity the first pass went so badly!

Opposition parties claim Ontario wasted $647 million on e-health records

TORONTO — Five years and $647 million were wasted by the Ontario government's attempt to develop electronic health records before the project was shut down and started all over again, the opposition parties charged Thursday.

The government quietly shuttered the Smart Systems for Health Agency last fall and replaced it with e-Health Ontario, another body charged with the same task of creating a system that would allow people's medical records to be shared electronically among health professionals.

The Progressive Conservatives and New Democrats say it was no accident the Liberals closed the old agency the same day the government released its first report on outbreaks of a deadly bacteria in Ontario hospitals.

"They finally recognized the agency was a failure ... and quietly pulled the plug on the same day that C. difficile results were announced, on a Friday ... and set up the other agency hoping that nobody would notice," said Opposition critic Elizabeth Witmer.

"For five years this government allowed the agency to move forward without any accountability whatsoever."

Witmer said "it's unbelievable" that a government agency could spend hundreds of millions of taxpayer dollars and have practically nothing of value at the end - a sentiment echoed by NDP critic France Gelinas.

"Ontarians should be worried that $647 million was spent with very, very little to show for it," Gelinas said.

More here:

http://www.google.com/hostednews/canadianpress/article/ALeqM5gRqu858PX4BNI-1WK9rz9PBDU8oQ

This sort of failure to proceed successfully reminds me of somewhere rather closer to home. Version 2 of the Ontario strategy deserves close reading as they have the battle scars!

Second we have:

College highlights poor PACS image sharing

30 Mar 2009

Picture Archiving and Communication Systems installed in the NHS in England are largely successful in individual hospitals but communication between systems in different hospitals is poor, according to a new position paper from the Royal College of Radiologists.

The paper, prepared by the college’s IT sub-committee, is critical of the National Programme for IT in the NHS’ record on image and report sharing in PACS and radiological information systems.

It says: “When local service providers were appointed to deliver the NPfIT in 2001-02, the contract was for one year of local PACS storage with additional archiving to Central Data Stores at a cost of £35m.

“NHS trusts were led to believe that these CDS would be pivotal to automatic image and report sharing. It subsequently came to light that radiology image and report sharing was not in fact a contractual requirement for LSPs.”

Lots more here:

http://www.e-health-insider.com/news/4700/college_highlights_poor_pacs_image_sharing

The link to the report is in the text.

Another example of not getting the initial planning right. It just seems to keep happening!

More useful analysis here:

http://www.e-health-insider.com/Features/item.cfm?docID=197

Data sharing: the next move for PACS

Third we have:

Patient’s Guide to HIPAA: How to Use the Law to Guard your Health Privacy

Prepared by Robert Gellman for the World Privacy Forum

With assistance from Pam Dixon, executive director World Privacy Forum, John Fanning, former privacy advocate, U.S. Department of Health and Human Services, and Dr. Lewis Lorton, health technology and privacy expert. Robert Gellman and the World Privacy Forum take responsibility for the judgments and accuracy of information in this guide. Nothing in this guide constitutes legal advice.

How to Use This Guide

You can access the Guide here, or you can use the drop-down menu containing all the parts of the Guide at the top of each page.

The Guide offers a roadmap through the thicket of dense health privacy laws and rules that many patients have questions about. The purpose of this guide is to help patients cut through the red tape and understand how to make health privacy laws work to protect their privacy.

The Guide is written for patients, and uses a Frequently Asked Questions and Answers format. The Guide focuses mostly on the federal health privacy rule known as HIPAA. This federal privacy rule establishes a baseline of protection that applies to health care providers and health care insurers throughout the United States. The guide also discusses other federal laws that cover some medical records. This guide does not offer detailed, technical explanations for every provision and every nuance of HIPAA. Instead, this guide concentrates on those parts of HIPAA that will be most helpful to real people. This guide does not offer a review of state law, and you need to know that a stronger state law can provide additional privacy protections.

You can use the Index to Frequently Asked Questions (FAQs) to jump to the part of the Guide that covers your particular question or problem, or you can navigate through the Guide using the drop down menus at the top of each page.

More here:

http://www.worldprivacyforum.org/hipaa/index.html

The link to access the guide and a lot of others are in the text. A useful service of some interest as we refine out Health Privacy Laws.

Fourth we have:

Physician acceptance of information technologies: Role of perceived threat to professional autonomy Source

Decision Support Systems

Volume 46 , Issue 1 (December 2008)

Pages 206-215

Year of Publication: 2008

ISSN:0167-9236

Authors

Zhiping Walter The Business School, University of Colorado Denver, Denver, CO 80202, United States

Melissa Succi Lopez School of Policy Planning and Development, University of Southern California, Los Angeles, CA 90089, United States

Publisher

Elsevier Science Publishers B. V. Amsterdam, The Netherlands, The Netherlands

The Abstract and References are found here:

http://portal.acm.org/citation.cfm?id=1464575

This is an interesting report. I wonder how the issued can best be managed?

Last we have:

Smart Card Advocates Back Standards

The Smart Card Alliance Healthcare Council has issued a report outlining the need to use existing standards for patient identity management.

The report, “Effective Healthcare Identity Management: A Necessary First Step for Improving U.S. Healthcare Information Systems,” calls for using such ID standards as the FIPS 201 Personal Identity Verification of Federal Employees and Contractors in health care.

More here:

http://www.healthdatamanagement.com/news/smart_cards-27996-1.html?ET=healthdatamanagement:e822:100325a:&st=email&channel=electronic_health_records

Sounds like a useful report!

It can be found here:

http://www.smartcardalliance.org/pages/publications-effective-healthcare-identity-management/

Again, all these are well worth a download / browse.

There is way too much of all this – have fun!

David.

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