Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.
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Regular weekly updates that supplement the regular monthly homepage edition of i2P.
Access and click on the title links that are illustrated
It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title “Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.
Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.
I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.
It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.
Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).
Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.
This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.
Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.
Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning
Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach.
A vacation just means taking a break from your everyday activities.
A change of pace.
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically.
But did you also know that you can help boost our economy by taking some days off?
Call it your personal stimulus package.
This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.
While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?
We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations
Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.
Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language. In the business lexicon their use can be, and often is evocative and stimulate creative images. But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment. The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.
Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.
The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.
Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD
(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).
Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.
Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.
The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.
Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:
Dr David More
From a Medical IT Perspective: I am vitally interested in making a difference to the quality and safety of Health Care in Australia through the use of information technology. There is no choice.. it has to be made to work! That is why I keep typing. Disclaimer - Please note all the commentary are personal views based on the best evidence available to me - If I have it wrong let me know!
This blog has only three major objectives.
Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment. General Comment Otherwise some good blogs on e-Health matters are noted.
Quite an interesting week last week and we have Senate Estimates to report this week so I am sure some interesting things will emerge.The impacts of the Budget are still reverberating and clarity is missing on just what will actually get through and what will die in the Senate.
Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
Otherwise some good blogs on e-Health matters are noted.
THE Abbott government has handed down an unpopular budget but there is joy for the tech sector with a 40 per cent increase for technology investments.
The Abbott government approved about $1.26 billion in ICT investments across 67 ICT-enabled measures in the 2014-15 budget, according to data from the Australian Government Information Management Office provided to The Australian.
It represented an increase of roughly 40 per cent from the $906 million in ICT investments approved in the 2013-14 budget.
The government will look to Rosemary Deininger, now the de facto government chief information officer, for guidance on technology strategy. Three key areas to see funding in the recent budget are “smaller government”, weather and e-health.
“There is a tremendous opportunity at the intersection of health and technology,” said Young Sohn, president and chief strategy officer for Samsung Electronics’ Device Solutions. “This is the single greatest opportunity of our generation.”
Sohn said that Samsung plans to build out wearable sensors that can monitor our bodies continuously and less invasively.
As Samsung sees it, it won’t be pushing its take on the future of health tech on its own. “We want to bring the best talent from outside,” Sohn said. “This is a big enough challenge — we cannot do it alone, we have to do it with partners.”
Still, Samsung wants to be in the driver’s seat, proposing others join its platform for sensor and wearable development. Samsung has created two platforms — the Samsung Simband device and the Samsung Architecture Multimodal Interactions (SAMI) cloud service.
Posted on May 31, 2014 by Grahame Grieve
This post is a follow up to a previous post about the PCEHR review, where I promised to talk about medications coding. The PCEHR review quotes Deloittes on this:
The existing Australian Medications Terminologies (AMT) should be expanded to include a set of over the counter (OTC), medicines and the Systematised Nomenclature of Medicine for Australia (SNOMED-CT -AU) should become universal to promote the use of a nationally consistent language when recording and exchanging health information.
Then it says:
Currently there are multiple sources of medication lists available to the PCEHR with varying levels of clinical utility and functionality. From some sources there is an image of the current medication list, from some sources the current medication list is available as text, from some sources the information is coded and if the functionality existed would allow for import and export into and out of clinical systems as well as transmission by secure messaging from health care provider to health care provider.
30 May, 2014 Amanda Davey
Doctors have long been aware that patients often struggle with their hospital discharge instructions but that’s set to change thanks to the humble USB stick and starry-eyed doctors.
Dubbed CareTV, the Alfred Hospital is piloting a ‘video discharge’ program for patients who are given a USB stick or DVD containing a 3-5 minute video, starring their medical team.
Designed to improve patient understanding of their diagnosis and treatment plan, the USB details post-discharge recommendations with the aim of improving clinical outcomes.
The Alfred’s director of general medicine, Associate Professor Harvey Newnham told the Herald Sun that it was hoped the trial would assist caregivers, help to prevent readmissions and reduce medical mixups.
27 May 2014
A revolutionary online tool to support young people living with depression or a mental health issue is being developed by University of Sydney software engineers.
The team is adapting online tracking techniques used by marketing analysts in their internet-based tool dubbed, CyberMate.
The researchers aim to design algorithms that will give CyberMate the ability to screen a young person’s social networking pages such as Facebook or Twitter for comments that may indicate potential for self-harm. CyberMate would then act as a quasi-psychotherapist and engage with the young online user suggesting options for help or support via email or SMS.
23 May, 2014 Paul Smith
The number of Practice Incentives Program payments will be cut from 10 to six under a Federal Government overhaul flagged for 2016.
Federal Health Minister Peter Dutton (pictured), speaking at the AMA conference in Canberra on Friday, said five incentives would be rolled into one “streamlined” incentive.
There was no detail about which incentives he wanted to target or whether the changes would become a mechanism to cut PIP funds.
Mr Dutton said the move was part of “continuous quality improvement” in the specialty.
The minister also announced another review of the authority script system in a pledge to cut red tape for GPs.
By Isaac Leung 31 May 2014
BRISBANE-based medical devices company Analytica has started producing its PeriCoach sensor devices, with first sales expected in the next few weeks.
The PeriCoach is an e-health treatment system for female Stress Urinary Incontinence, a condition that affects 1 in 3 women worldwide. It consists of a device, a web portal and a smartphone app.
The device evaluates activity in pelvic floor muscles, then transmits the information to a smartphone app, which uploads the information to the web portal where physicians can monitor patient progress.
This allows doctors to remotely determine if a woman is correctly performing pelvic floor exercises and if these are improving her condition.
Date May 30, 2014
Microsoft is planning to launch a new smart watch that will be compatible with iOS, Android and Windows Phone devices, according to a new report.
The watch will reportedly have heart rate monitoring capabilities and a two-day battery life.
Citing "multiple sources with knowledge of the company's plans," Forbes reports the watch will rely on technology used by Xbox Kinect engineers to enable the watch to track its wearer's heart rate at all times.
A spokesperson for Microsoft declined Mashable's request to comment but a recently granted patent indicates Microsoft could indeed be working on such a device. That patent, first filed in 2012, depicts a smart watch with heart-rate and fitness tracking capabilities.
Although doctors are in the top three of most trusted professions, they also have a conservative image. There is the perception that doctors are resistant to change, such as the introduction of eHealth in their practices.
Nothing could be further from the truth.
Doctors are used to change. Medicine and healthcare are areas where new developments happen on an almost daily basis.
The start of Doctor Amir Hannan’s career was a rocky one. In 2000 he took over the surgery from convicted murderer Doctor Harold Shipman. On their first day, Amir and his colleague found that Shipman’s children had removed all furniture, phones and computers from the practice. Equipment had to be borrowed from other surgeries.
The practice has long since been turned around into a thriving GP clinic with a strong focus on eHealth; for the past 7 years patients have had online access to their electronic health records.
Around the world there are several projects going that allow patients to get access to their records, and Amir Hannan is one of the trail blazers.
Posted Wed, 28/05/2014 - 06:24 by Fran Molloy
Professor Nick Talley, the new President of the Royal Australasian College of Physicians (RACP), says that preventative health care is high on his agenda.
“If we are going to work till we're 70 or older, the system has to support the health of everybody effectively – which requires changing our health system,” he says, adding that he is concerned about the potential loss of focus on preventative health care following the Federal Budget.
“We look forward to working with government on enhancing preventative programs and ways of improving health. It is much easier to prevent disease than to treat it.”
The RACP, with over 20,000 members, is the largest specialist medical college in the country, and trains and represents specialist physicians and paediatricians throughout Australia and New Zealand.
Date May 31, 2014
The Prime Minister is planning sweeping changes to the highest ranks of the public service to make it more responsive to the Coalition government.
With his first budget behind him, Prime Minister Tony Abbott is determined to turn around what he believes has been a significant brain drain of the best and brightest from Canberra in the past decade.
The retirement of Finance Department Secretary David Tune on Friday is just the first step in what will be a one- to two-year reform of the service.
Health Department secretary Jane Halton is the strong favourite to replace Mr Tune.
Professor Halton has served as the head of health since 2002.
28th May 2014
IT IS among the most popular sources of healthcare information for both patients and doctors, but now a US study has found what proportion of Wikipedia articles covering common health conditions contain factual errors.
For the study, 10 internal medicine residents or medical interns were recruited from hospitals across America to compare the most closely corresponding Wikipedia entries with peer-reviewed literature for the 10 most costly health conditions in the US as defined by both public and private expenditure. Conditions included heart disease, lung cancer, diabetes, osteoarthritis, depression and asthma.
In a double-blinded process, each reviewer examined two Wikipedia articles each to identify assertions of fact and then cross-referenced the assertions against a peer-reviewed source, published or updated within the last five years.
Alzheimer’s Australia Vic has proudly launched its first online learning resource today at the fourth biannual Victorian Parliamentary Friends of Dementia meeting at Parliament House.
The launch of Dementia Learning Online, focusing on carer education, was co-convened by Georgie Crozier MP, Parliamentary Secretary for Health and Jenny Mikakos MP, Shadow Minister for Seniors & Ageing.
An innovative and interactive learning environment, Dementia Learning Online aims to achieve practice improvement in the workplace among residential and community carers who play a key role in the lives of people living with dementia.
Created on Friday, 30 May 2014
The AMT v2.56 release can be downloaded from the NEHTA website.
Published - May 26, 2014
SAI Global has revealed that private equity giant Pacific Equity Partners has approached it with a $1.1 billion takeover offer, and dumped its chief executive on a dramatic morning for the standards and risk management group.
SAI told the market on Monday morning that it has received the “unsolicited, indicative, conditional and non-binding” proposal from PEP, valuing the company at $5.10 to $5.25.
SAI shares last traded at $4.28.
The company said that the board is yet to form a view about the takeover but says it is “open to engagement with PEP to determine whether a binding proposal” can be developed.
Date May 26, 2014
Yelp helps people find a place to eat.
After a particularly bad restaurant meal, you may be moved to post a review on the website Yelp, warning other diners. But now someone else is listening in: New York City health officials, who may try to track you down if you complain that the meal made you sick.
The federal Centres for Disease Control and Prevention released a report on Thursday saying that the city's Department of Health and Mental Hygiene had completed a pilot project that used Yelp reviews to help identify unreported outbreaks of food-borne illness.
Using a software program developed by Columbia University, city researchers combed through 294,000 Yelp reviews for restaurants in the city over a period of nine months in 2012 and 2013, searching for words like "sick","vomit" and "diarrhea", along with other details. After investigating those reports, the researchers substantiated three instances when 16 people had been sickened. Those people had eaten the house salad, shrimp and lobster cannelloni, and macaroni and cheese spring rolls at three restaurants that the agencies are not identifying.
Thursday, 22 May 2014 (0 Comments)
Posted by: Communications Manager Heather Hunt
While the full implications of the Federal health budget are yet to unfold, and many of us are still pouring over the details of the PCEHR Review released this week, some messages from the Government are coming through loud and clear.
There is a strong focus on workforce productivity, which HISA welcomes. Health Workforce Australia will be replaced by a Health Productivity Commission. Workforce productivity requires expert digital health, technology development and innovation all of which are abundant in our HISA member organisations.
We need to significantly improve the productivity of our healthcare system so that no one misses out. E-health can deliver those productivity gains by making sure healthcare professionals have access to the information they need, when they need it and reduce waste in the system.
Date May 26, 2014 - 9:17AM
This isn't a post telling you that you should use a different password for every site, that you should use multi-factor authentication for your email, or that you should use a password manager to store strong passwords. You should do those. (And you should eat less dessert, exercise more and call your mother.)
This is a post to share two stupid password tricks that will make your online life a little more secure without the (perceived) hassle of those other measures.
The first stupid password trick is a way to improve the "security questions" that sites have you set up in case you need to recover your password. What's your mother's maiden name? What street did you grow up on? Who was your first-grade teacher?
Here is the link:
Session said to start at 9.15pm
We have Senate Estimates Community Affairs Committee Meeting tomorrow (June 2, 2014).
Here are the details.
The draft schedule runs from 9:15pm – 11:00pm (105 mins) with e-Health up first.
Here is the link to video to watch the session.
Now, I need to say up front that, like the two comments on the alert blog last week, I have very low expectations of getting straight and useful answers from the bureaucrats who have a very good track record of highly effective obfuscation and simply not answering the question.
That said my questions would be:
1. Could you please provide a detailed breakdown of the planned expenditure on the PCEHR?
From the Budget we were told:
"The Government will provide $140.6 million in 2014-15 for the continued operation of the Personally Controlled Electronic Health Record (PCEHR) system while the Government finalises its response to the review of the PCEHR.
How much is to be spent on Accenture, spent with the Department of Human Services and so on?
2. Does this funding cover funding of the National E-Health Infrastructure (NASH, IHI, SMD, etc.)?
3. Does this funding cover NEHTA or is this and the activities in Question 2 funded elsewhere and where is that covered in the Budget?
4. When will the Government release a detailed response and forward plan for e-Health responding to the PCEHR review having now had the Review for over 5 months?
5. Does the $140.6 million cited in the Budget cover the intended changes to the PCEHR as recommended in the Review or will additional funds be allocated once a plan is developed?
6. When will the Government release the full updated 2013 version of the National E-Health Strategy as cited in the PCEHR Review but with no link provided?
7. Does the Department of Health agree with the Review recommendations regarding the dissolution of NEHTA and the changed governance for e-Health in Australia?
If we were able to get answers to these it would help those involved in e-Health get a much clearer idea of what is planned in the future and what part they may be able to play in that future.
What would you like to ask?
Here are the results of the poll.
Do You Think It Is A Good Idea To 'Dissolve' NEHTA And Replace Its Functions With A Better Governed, More User-Friendly and More Consultative Organisation?
You Bet 61% (53)
Probably 9% (8)
Neutral 6% (5)
Probably Not 15% (13)
No Way 5% (4)
I Have No Idea 5% (4)
Total votes: 87
Very interesting. Good participation with a clear majority (70%) of those who responded have the view that NEHTA is no longer worth pressing on with. Also very few fence sitters this time as well.
Again, many thanks to all those that voted!
Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
Posted on May 23, 2014
By Kaiser Health News
By Sandra G. Boodman
This KHN story was produced in collaboration with The Washington Post.
Doctors at a Northern California hospital, concerned that a 40-year-old woman with sky-high blood pressure and confusion might have a blood clot, order a CT scan of her lungs. To their surprise, the scan reveals not a clot but large cancers in both breasts that have spread throughout her body.
Had they done a simple physical exam of the woman's chest, they would have been able to feel the tumors. So would the doctors who saw her during several hospitalizations over the previous two years, when the cancer might have been more easily treated.
A middle-aged man admitted to a Seattle emergency room for the third time in six weeks displays the classic signs of liver cirrhosis for which he has been repeatedly treated, including swollen legs and a distended abdomen.
But a veteran doctor spots a telltale indicator of a different disease: rapid inward pulsations just beneath the man's right ear. The patient's problem is not his liver but his heart: he has constrictive pericarditis, a serious condition that requires surgery.
MAY 23, 2014 9:57am ET
When Dean Sittig moved to Houston, he, like most drivers, was very comfortable merging to the left to get on the highway. But Houston's seven-lane freeways often require merging to the right. "I wasn't good at merging to the right, and I knew I had to be careful, especially if I was crossing multiple lanes," he says. Even after several years, he still exercises extra caution.
Sittig, professor of biomedical informatics at the University of Texas Health Science Center and a leading researcher on hazards in clinical information systems, says that with the rapid adoption of electronic health records, clinicians nationwide are having to learn to "merge to the right." They have to record and use information in unfamiliar ways that create new opportunities to make mistakes, and Sittig says extra training will go only so far.
"Most wrecks aren't caused by lack of driving skill," he says. "We don't re-train drivers after they have a wreck-we just tell them to be more careful." Most clinicians have the basic computing skills they need, but the "be more careful" part will take longer to internalize, and will need a team effort by vendors, provider I.T. staff and users.
While experts generally agree that electronic health records are better for patient safety than paper ones, there's growing recognition that they present their own challenges. In its annual round-up of top 10 medical technology hazards, ECRI Institute, Plymouth Meeting, Pa., ranked "data integrity failures in EHRs and other health IT systems" No. 4, with several other IT-related hazards also on the list.
Physicians are most interested in using their mobile devices to access electronic health records, according to a survey from MedData Group.
Almost 60 percent of physicians surveyed were interested in mobile EHR access. Other areas of mobile interest include secure texting (42 percent), researching drug information (40 percent) and patient portals for scheduling communication (35 percent).
Currently, just 18 percent of physicians access EHRs on their mobile device.
By: Jonah Comstock | May 21, 2014
There are now more than 100,000 apps on the iOS and Android app stores, according to a new report by research firm Research2Guidance, double the market size of two and a half years ago. They project the mobile health app market will have produced $26 billion in revenue by the end of 2017, up from $2.4 billion so far.
Research2Guidance also found that the average app publisher has seven apps and between three and 100 employees. Thirty-six percent of publishers entered the market in the last two years.
The market has just a few winners at the top and a vast number of companies struggling on the bottom. For instance, 82 percent of publishers generated less than 50,000 downloads across all of their apps last year, but the top 5 percent reached more than 500,000 downloads. Additionally, 68 percent of publishers make less than $10,000 a year, including those that make no revenue. Seventeen percent make between $50,000 and $1 million, but the top 5 percent makes more than $1 million.
5/22/2014 09:06 AM
Munson Medical Center IT department's implementation of a single sign-on system did more than increase efficiency for the hospital's healthcare workers -- it changed IT's approach to solving problems.
Single sign-on wasn't the highest item on Munson Medical Center IT department's to-do list. Clinicians, however, were fed up with the long time it took them to log on to computers and access applications -- and these excruciatingly complex processes were having an impact on the healthcare staff's work and on patients' satisfaction.
Over the years, IT had considered various alternative approaches to its multi-faceted but very secure log-on approach, said Dale Atkins, technical architect at the Traverse City, Mich.-based hospital, in an interview. But the technologists had never found anything that met its requirements. That turned out to be the problem.
Posted on May 22, 2014
By Neil Versel, Contributing Writer
Not only is data getting bigger, it's getting smarter.
For example, health insurer WellPoint is branching out from simply looking for gaps in coding, thanks to a combination of better data and more advanced algorithms. Now, the company can look for gaps in care as well, Patrick McIntyre, the company's senior vice president for healthcare economics, explained last week at SAS Institute's 11th annual executive conference on health analytics.
About 2.5 million of WellPoint's 37 million enrollees have insurance tied to some sort of value-based reimbursement model, McIntyre said, and the Indianapolis-based payer shares reports with providers whenever there is risk-sharing. "We use analytics and reporting to create economies of scale for all of the provider communities we work with," he said.
Posted on May 22, 2014
By Eric Wicklund, Editor, mHealthNews
Making telemedicine work is often no easy process, but officials from Boston-based Partners HealthCare, a longtime leader in connected health, believe they've done it. So what's their secret?
Its Center for Connected Health is a think tank for digital and mHealth concepts, and hospitals like Massachusetts General Hospital are engaged in a number of projects that improve mobility and communications for both clinicians and consumers.
At the American Telemedicine Association conference and exhibition this week in Baltimore, Partners executives shared advice on how to link technical, clinical and business stakeholders in a new telehealth venture.
21 May 2014 Sam Sachdeva
Trusts looking for electronic patient record systems should consider open source alternatives, as they offer “the biggest bang for buck”, an NHS England representative has said.
Speaking at EHI’s CCIO open source conference, held as part of the Digital Health Festival, NHS England’s head of business systems Richard Jefferson, said the organisation’s immediate focus is on encouraging a move to open source EPRs due to the greater value for money they offer trusts.
“We are prioritising the EPR space because that’s where we see [open source] as having the biggest bang for buck, but there is a wide spectrum of possibilities.”
The NHS needs to change the way it thinks about new technology – and the way it buys it, the HANDI spring symposium was told. Lis Evenstad reports.
19 May 2014
The Royal College of General Practitioners was invaded by ‘appy people’ last week as it played host to the HANDI spring symposium.
On a gorgeous spring day, while the sun was shining down on London, 100 or so app developers, NHS professionals and enthusiasts sat down inside to discuss everything app related.
Participants included chief clinical information officers, NHS IT directors, owners of small and medium sized enterprises and officials from NHS England.
As the temperature built outside, it also rose a few degrees in the air-conditioned building as they argued that the NHS is still behind the times when it comes to embracing mobile technology; and debated what can be done about that.
Posted on Wednesday, May 21 at 2:50pm | By Stephanie M. Lee
Practice Fusion, a San Francisco web-based electronic health record company, is opening up a huge swath of patient information to the scientific community.
The company, which more than 112,000 physicians use to store patient records, said Wednesday that it has scrubbed the identities of a subset of more than 81 million patient records. It is now allowing physicians, researchers and analysts to study that health information.
The database, called Insight, is free to access and lets users explore medical trends like diagnoses of seasonal infections like the flu, and of chronic conditions like diabetes, both in real-time and in the past. There’s information about the popularity of prescription medications. And researchers can check out which patients are being diagnosed with which diseases based on their body-mass index, age group or sex.
MAY 20, 2014 8:30am ET
Information governance programs are not as prevalent or mature in healthcare compared to other industries, according to preliminary results of a benchmarking survey by the American Health Information Management Association.
In the survey, only 11 percent of respondents characterized their information governance as "mature" programs. Also, a mere 17 percent of healthcare organizations had mature policy and procedure practices in place. In addition, 35 percent of survey respondents either didn't know whether their healthcare organizations had information governance efforts underway or indicated that their organization did not recognize the need for information governance, while 22 percent acknowledged the need but didn't yet initiate a program.
Wed, May 21 2014
By Andrew M. Seaman
NEW YORK (Reuters Health) - Electronic medical records will let patients access their health information over the Internet, but a new study suggests some of the most vulnerable older Americans may be left behind.
While Internet use doubled among seniors in general over the past decade, researchers found, there was little growth among people with physical impairments - suggesting a new digital divide could be forming.
Functional impairments, including physical disabilities such as the loss of a sense or the ability to walk, make it difficult for people to live in their community, take care of personal finances and coordinate transportation.
Posted on May 21, 2014
By Anthony Vecchione, Contributing Writer
There is ample evidence that barcode technology for medication has had a significant impact on patient safety. But while most U.S. hospitals have adopted barcode medication administration, experts say there's big room for improvement.
According to a recent study conducted at Boston's Brigham and Women's Hospital and published in the New England Journal of Medicine, the use of the bar-code electronic medication administration significantly reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events.
The study, "Effect of Bar-Code Technology on the Safety of Medication Administration," concluded that while barcoding did not eliminate errors altogether, it remains "an important intervention to improve medication safety."
May 21, 2014 | By Susan D. Hall
More than 1 billion prescriptions were routed electronically in 2013, up from 788 million the previous year, according to Surescripts' annual National Progress Report and Safe-Rx Rankings, published this week.
The nationwide health information network routed 58 percent of the eligible prescriptions, including 73 percent of those written by office-based physicians, according to an announcement.
In addition, last year Surescripts delivered nearly 700 million electronic medication history records, covering two-thirds of the U.S. population, a 19 percent increase over the 2012 total.
HealthDay May 20, 2014
TUESDAY, May 20, 2014 (HealthDay News) -- Almost 80 percent of doctors in the United States have switched from paper to electronic health records, new government statistics show.
By 2012, almost 72 percent of physicians had made the change, compared to just under 35 percent in 2007, according to the report from the U.S. Centers for Disease Control and Prevention. Since then, the number of doctors using electronic health records has increased even more, added lead researcher Esther Hing, a statistician at CDC's U.S. National Center for Health Statistics.
"In 2013, 78 percent of physicians were using electronic health record systems," Hing said. "We are reaching nearly all the doctors."
By Tom Sullivan, Editor
Healthcare providers and the IT vendors who serve them just got a dose of welcome relief from the increasingly controversial certification pieces of meaningful use.
That came in the form of a proposed rule the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT jointly circulated on Tuesday to “change the meaningful use timeline and the definition of certified electronic health record technology (CEHRT),” the agencies wrote in the rule. “It would also change the requirements for reporting clinical quality measures for 2014.”
And it appears to be arriving none too soon.
“Vendors aren’t ready, no subject matter experts are available to implement upgrades,” said Mandi Bishop, president of FloriDATA Foundation, and a self-described hardcore data geek and patient engagement advocate. “Products aren't fully-baked. Providers are frustrated.”
by Lisa Zamosky, iHealthBeat Contributing Reporter Wednesday, May 21, 2014
Historically, health care prices negotiated between providers and insurers have lived in a black box, making it nearly impossible for consumers to figure out how much a particular service or procedure will cost. There are two primary reasons for this, according Suzanne Delbanco, executive director of Catalyst for Payment Reform.
The first and primary reason has been political, she said. "Providers and plans don't want us to have it. Plans feel just as proprietary about what they're paying to providers as providers feel about what they're getting paid."
Second, our health care benefit designs historically have not supported the need for price transparency. Employers have shouldered a large portion of health care costs for the majority of Americans, creating little incentive for consumers/patients to question the cost of their care.
Analytics can help healthcare providers reduce costs and save lives, say attendees of Crimson Clinical Advantage Summit 2014 -- but they must be implemented thoughtfully.
When healthcare organizations provide clinicians with data previously hidden within disparate databases and paper files, they can improve treatment and reduce costs, according to a recent gathering of high-level medical professionals.
More than 600 CEOs, CIOS, health system executives, chief medical officers, physicians, and informatics professionals attended The Advisory Board Company's Crimson Clinical Advantage Summit 2014 in Orlando last week, where they shared best-practices, case studies, and partnerships surrounding their use of Crimson Continuum of Care, Crimson Population Risk Management, and Crimson Care Management and related services.
5/20/2014 11:30 AM
As systematic changes in US healthcare convert patients into consumers, hospitals must meet each generation's measures of quality.
The Hospital Consumer Assessment of Healthcare Providers and Systems, better known as HCAHPS (pronounced H-caps), is the national, standardized, publicly reported survey of patients' perspectives of hospital care -- an increasingly important metric as hospitals learn to treat patients more like consumers and pay more attention to consumer choice.
The HCAHPS survey, its methodology, and its results were first publicly reported in March 2008. This reporting creates incentives for hospitals to improve healthcare quality and also increases accountability by increasing transparency into hospitals' quality of care.
Posted on May 20, 2014
By Diana Manos, Senior Editor
What the U.S. government really needs now is a federal safety center for health IT.
That was the consistent drumbeat during a three-day workshop, May 13-15, on the FDA’s Safety and Innovation Act efforts. The workshow drew a wide variety of industry stakeholders and the involvement of other agencies that work with the FDA, among those the Federal Communications Commission and Office of the National Coordinator for Health IT.
“This safety center needs to be in place as soon as possible,” said Michael Hodgkins, MD, chief medical information officer at the American Medical Association, adding that it will be “where the rubber meets the road.”
15 May 2014 Sam Sachdeva
Patients should be allowed to “own” and interact with their medical records if they are to be fully involved in their own care, a new parliamentary report argues.
The report on patient empowerment, released today by a coalition of six health-based All-Party Parliamentary Groups, says NHS England should be aiming further than its goal of providing online access to GP records by 2015.
Successive UK governments have promised patients greater access to their healthcare records, with Labour promising to give patients 'records on a stick' a decade ago.
The present government promised that patients would have access to all their records as it came into power, but the pledge has steadily been scaled back, to cover GP records and then the information in the Summary Care Record.
May 18, 2014 | By Judy Mottl
People, places, payment and purpose are the four critical dimensions necessary for mobile healthcare to attain its full potential, according to a new Deloitte report.
"The key to the four dimensions is to be sure all are considered, which is associated with greater success and return on investment," Henry Greenspun (pictured), senior advisor for Deloitte, told FierceMobileHealthcare. "Typically, when mHealth programs fail, it is often the result of one of the dimensions being overlooked."
Greenspun also recently discussed mHealth strategies in a radio broadcast and the challenges ahead, including the need for more investment in data security and new privacy regulations. A recent Compass study revealed regulatory and privacy issues are also looming hurdles.
May 19, 2014
Well-designed and rigorously tested EHR systems can improve care by making it easier to collect, share and interpret patient data, according to a paper from the Centers for Disease Control and Prevention (CDC). Laboratory data-related interoperability and usability issues, however, can result in preventable patient safety risks.
Display discrepancies in EHR systems, such as variations in EHR system design, functionality and ability to exchange data accurately, serve as challenges but lab professionals are critical to ensuring the safety and effectiveness of laboratory data in EHR systems, according to the paper.
By Sumathi Reddy
May 19, 2014 7:13 p.m. ET
It's one of the most important services we pick, yet more people are turning to online reviews to pick doctors. Sumathi Reddy reports on Lunch Break with Tanya Rivero. Photo: Getty.
To find a good restaurant, we can check any number of online reviews.
To select a doctor, however, many of us rely on a single recommendation, or even a random search through the Yellow Pages. A growing number of doctor-review websites are aiming to change that by allowing people to rate physicians in much the same way they would a sushi dinner or haircut.
5/19/2014 09:06 AM
Regulatory requirements have gone from high priority to the only priority for healthcare IT.
Healthcare has always been a highly regulated industry, but in the last few years requirements for implementing and documenting digital healthcare systems have been piling up so fast that IT organizations have little time for anything else -- including making sure the systems they already have in place are being used effectively. The InformationWeek Healthcare IT Priorities Survey of 322 technology pros at healthcare providers shows "meeting regulatory requirements" is the No. 1 initiative on participants' minds. Most of the other items at the top of the list, such as implementing or upgrading electronic health records (EHR) systems, are also largely driven by federal government requirements.
"The priorities we're trying to deal with right now are those being mandated," says Randy McCleese, CIO of St. Claire Regional Medical Center. "We can't do anything else. We have put everything else on the back burner except for those things that absolutely have to be done."
"My fondest wish, my highest hope, is to inspire a small clan of crazy ones in every substrata of the healthcare system. A small strata of crazy medical school deans, a small strata of crazy health system CEOs, a small strata of community hospital CEOs, a small strata of crazy primary care docs. Each one of them says, I am going to be the guy who marches the wrong way. I am going to be the guy who stops protecting my flank and starts attacking her flank. And the great news is, I don't need many of them, because the point is, we've got about 50% excess capacity in our system, so frankly, if everyone did it, it wouldn't work."
So says Jonathan Bush, CEO and co-founder of the prominent ambulatory EHR software maker athenahealth. In my Q&A with him last week, Bush took aim at complacent large healthcare organizations who expose their flank to disruptors, but fail to use technology effectively to expose others' flanks, instead relying on an older generation of technology to lock in physicians and patients.
MAY 16, 2014 12:45pm ET
Hospitals are leading the movement to improve the quality of care delivered to U.S. patients, outpacing improvements in other settings, according to two national reports issued by the Agency for Healthcare Research and Quality (AHRQ). Three-quarters of hospital quality measures showed significant improvement, compared with 60 percent for home health and nursing home care, and about half for ambulatory settings.
The 2013 National Healthcare Quality Report and National Healthcare Disparities Report shows that Americans are receiving recommended medical services 70 percent of the time. The reports include data based on hundreds of healthcare measures categorized in several areas of quality. These are effectiveness, patient safety, timeliness, patient-centeredness, care coordination, efficiency, health system infrastructure and access. This marks the 11th year AHRQ has reported on the state of national healthcare quality and disparities.
May 19, 2014 | By Jane Antonio
While the country moves toward fully automated healthcare documentation, electronic healthcare technology may make fraud and abuse schemes easier through cut and paste shortcuts, according to an Office of Inspector General report.
As many as 90 percent of doctors copy and paste electronic health record (EHR) encounter data, a Health IT Exchange blog post noted. And up to 78 percent of physicians' notes are copied text, according to a Sedgwick Connection blog post.
This raises the question of whether providers hear the concerns of each patient and record them in unique notes, or if providers try to save time by using copy and paste commands to document typical complaints and treatment plans. "Risk managers shudder when they think about the potential fallout from this practice," Sedgwick Connection noted.
Another program integrity hazard, physicians can make macros that autopopulate certain parts of the chart and document all aspects of a physical exam whether doctors performed them or not. Concerns such as this led one hospital executive to conclude that too many EHR features are tied to billing as opposed to patient care.
By Josh Wolford · May 15, 2014 ·
While there are plenty of settings where wearable tech like Google Glass is rather inappropriate and can make you, well, look like a tool, it’s becoming more clear that one place it could find a home is in the medical community. Doctors with Glass? Makes sense. Last June, Google Glass was used during surgery for the first time ever, and since then more and more hospitals and medical schools and hospitals have been experimenting with the technology.
Now, one school is looking to make Google Glass an integral part of its curriculum.
UC Irvine School of Medicine has announced intentions to become the first med school in the country to fully integrate Google Glass into its four-year program–from anatomy course to rotations, UC Irvine wants to equip its students with the wearable tech.
by Anantachai (Tony) Panjamapirom and Robin Raiford Monday, May 19, 2014
Through the newly released 2015 Inpatient Prospective Payment System Proposed Rule, CMS lays out the clinical quality measure (CQM) reporting options that Medicare hospitals may use to submit CQM data to meet the meaningful use requirements. The proposed options are similar to those available in 2014; hospitals may select to submit CQM data via attestation or electronically.
The attestation option may relieve some resource needs for now, but the electronic submission option would help hospitals validate the accuracy of their electronic health record-collected CQM data and prepare for the alignment advantage between the Medicare Electronic Health Record Incentive Program and the Hospital Inpatient Quality Reporting Program in the near future. CMS has reiterated its intent to align clinical quality reporting across various programs, so it is only a matter of time before electronic CQM reporting becomes mandatory.
5/16/2014 12:50 PM
Karen DeSalvo, new National Coordinator for Health IT, says improving interoperability standards is the next big challenge.
The US Department of Health and Human Services will work with the public and private sectors to improve interoperability standards in healthcare, said Dr. Karen DeSalvo, National Coordinator for Health Information Technology, during a keynote question-and-answer session at the Crimson Clinical Advantage Summit 2014 in Orlando, Fla., on Thursday.
The Office of the National Coordinator for Health Information Technology (ONC) "has authority for governance of an interoperable exchange," said DeSalvo, who is four months into her new role at ONC. "It matters so much to me that systems have a way to speak to each other. Incentive or no, this is one of these situations where everyone's asking for it."
The adoption and use of electronic health records in federally qualified health centers has grown by 133% in the past five years, thanks in large part to targeted federal funding and incentives, a survey from The Commonwealth Fund shows.
The survey of 679 senior executives and clinicians at FQHCs found that 85% reported advanced HIT capabilities in 2013, which meant that they could perform at least nine of 13 functions, such as ordering pharmacy prescriptions electronically. The rate was 30% in 2009, when The Commonwealth Fund conducted its last survey.
The pace of HIT implementation at many FQHCs has accelerated to the point where it is outstripping that of many larger physicians groups or integrated health systems. In 2013, 78% percent of office-based physicians used electronic health records, up from 48% in 2009.
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