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 last week.
Saturday, October 01, 2011
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.
Here are a few I have come across last week.
While England waits for an information revolution the NHS in Scotland is pushing on with its second e-health strategy. Shanna Crispin reports from Edinburgh 15 September 2011 Scotland’s e-health strategy for 2011-17, released on Monday, describes itself as “ambitious” and to have “the citizen at its centre.” It commits to joining up health and social care IT, increasing patient access to services, and improving support for people with long term conditions. But a key concern of those making early responses to the strategy is how another commitment - to give clinicians more access to adequate information, when they need it - is going to be managed. ----- http://www.modernhealthcare.com/article/20110919/NEWS/309199986
By Joseph Conn Posted: September 19, 2011 - 12:45 pm ET Technology-induced medical errors—a problem that health IT stakeholders once were loathe to admit existed—now are part of mainstream discussions about the implications of health information technology. So, what to do about them? The Agency for Healthcare Research and Quality funded a study by the not-for-profit RAND Corp. to come up with some answers, which have been posted to AHRQ's website as a "Guide to Reducing Unintended Consequences of Electronic Health Records." ----- http://govhealthit.com/news/ahrq-tests-tool-identify-and-report-health-it-hazards
September 20, 2011 | Mary Mosquera BETHESDA, MD – The Agency for Healthcare Research and Quality (AHRQ) is testing a tool among physicians to identify and report patient safety risks and near misses that may arise from the interaction of health IT with other systems or as a result of software design. The health IT hazard manager will ultimately be scalable for use as a national clearinghouse of health IT-related risks, near misses and safety incidents so they can be compared and analyzed and systems corrected. The hazard manager enables providers to classify and communicate the unintended consequences of establishing electronic health records (EHRs) and other health IT system so the problems can be fixed or controlled before they reach the patient, said Dr. James Walker, CIO of the Geisinger Health System, which is one of seven providers testing the usefulness and usability of the software. Four health IT vendors also participate in the pilot. ----- http://www.technologyreview.com/business/38487/ Tuesday, September 20, 2011
How speech recognition software is changing so doctors don't have to. By Erica Naone Doctors don't like technology to get in their way, especially when they are dictating notes about patients. When the typewriter was invented, doctors found someone else to type their observations. When the tape recorder arrived, they mailed off tapes to transcription services. With computers, speech recognition software has automated the work of turning a doctor's spoken words into text. The match has been good for doctors and also for Nuance Communications, based in Burlington, Mass., the market leader in medical dictation software, which last year generated about $450 million in sales of its Dragon speech software to the medical profession. But now both Nuance and doctors are facing a threat to the way they do business: the spread of electronic medical records. Record-keeping software, heavily promoted by the government, is meant to improve patient care by getting doctors to record data in digital forms with computer-readable fields. The problem: doctors can't talk into the forms. ----- http://www.healthdatamanagement.com/news/edi-ehr-records-locator-analytics-43211-1.html
Joseph Goedert HDM Breaking News, September 20, 2011 Medicare/Medicaid transactions processor ABILITY Network Inc., formerly VisionShare, has introduced software to locate fragmented patient medical records or partial medical records on a real-time basis. In addition to handling claims submission, eligibility, claim status and other transactions, the vendor offers a master patient index assessment service to identify duplicate records. It also resells records cleanup and verification services from consulting firm Just Associates. -----
Disease prevalence, aging, and cost pressures seen as major factors in soaring demand for remote monitoring devices. By Ken Terry, InformationWeek September 20, 2011 URL: http://www.informationweek.com/news/healthcare/mobile-wireless/231601670 The global telehealth market is headed for explosive growth over the next decade, according to a new report from InMedica, a division of IMS Research. The main reasons are increasing disease prevalence, an aging population, and governmental pressure to hold down healthcare costs. "Many public healthcare systems now have targets to reduce both the number of hospital visits and the length of stay in hospital," said Diane Wilkinson, research manager at InMedica, in a press release. "This has led to a growing trend for healthcare to be managed outside the traditional hospital environment, and as a result, there is a growing trend for patients to be monitored in their home environment using telehealth technologies once their treatment is complete." ----- http://www.boston.com/Boston/whitecoatnotes/2011/09/blumenthal-electronic-health-records-despite-flaws-make-doctors-better/kdvuYnvMjntRqtt6zF0G2O/index.html
By Chelsea Conaboy, Globe Staff When Dr. David Blumenthal was appointed in 2009 by the Obama administration to coordinate national efforts to promote electronic health records, his wife thought it was “a huge failure of vetting,” he told an audience at a Schwartz Center for Compassionate Healthcare event last night. She manages their home computers. And he had not grown up as someone naturally interested in information technology. Blumenthal, who left his federal role earlier this year and is a Harvard Medical School professor of health care policy, said that as he learned to use the electronic systems as a primary care physician at Massachusetts General Hospital in the early 2000s, he became a believer. Quite simply, he said, the electronic records made him a better doctor. ----- http://www.modernhealthcare.com/article/20110922/NEWS/309229954/
By Joseph Conn Posted: September 22, 2011 - 12:30 pm ET HHS has posted online a model privacy-policy form (PDF) that providers can use with patients whose individually identifiable medical information is posted to a personal health record. The three-page document is available on the newly launched HealthIT.gov site for healthcare professionals and organizations as well as consumers. ----- http://newsroom.accenture.com/news/accenture-completes-assessment-for-texas-health-services-authority.htm
September 07, 2011 Accenture Completes Assessment for Texas Health Services Authority Project to Support Health Information Exchange and Interoperability AUSTIN, TX; September 07, 2011 – Accenture (NYSE: ACN) has completed an assessment and plan to support implementation and interoperability standards for a state-wide health information exchange (HIE) for the Texas Health Services Authority (THSA). Accenture identified the technology standards, architecture, and strategy to ensure consistency with state and federal requirements. The strategy will support interoperable health information management and exchange among unaffiliated organizations. Accenture also developed an enterprise architecture blueprint (EAB) for state-level HIE services and a plan to manage the EAB lifecycle to help ensure compatibility as standards evolve. ----- http://yourlife.usatoday.com/health/healthcare/prevention/story/2011-09-20/Tracking-diseases-before-they-become-outbreaks/50475608/1
WASHINGTON – The doctor doesn't think your sore throat is bad enough yet to order a strep test — unaware that a dozen people across town were diagnosed with strep throat just last week. Doctors rarely know what bugs are brewing in the neighborhood until their own waiting rooms start to fill. Harvard University researchers reported Monday that getting them real-time information on nearby infections could improve patient care — for strep throat alone, potentially helping tens of thousands avoid either a delayed diagnosis or getting antibiotics they didn't need. ----- http://www.lvrj.com/health/internet-personal-health-record-services-slow-to-catch-on-130098668.html
By John Przybys LAS VEGAS REVIEW-JOURNAL Posted: Sep. 18, 2011 | 9:39 p.m. When did you have that appendectomy? What's the dosage of your blood pressure medication? What was your blood glucose level last Wednesday at noon? Admit it: If the specifics of our own health history formed the basis of questions on "Who Wants to be a Millionaire?" most of us would be lucky to leave with the change in our pockets. Keeping our health records -- and keeping them current -- always has been a challenge for busy consumers. But, as it has for so many other aspects of 21st century life, the Internet offers help, in the form of personal health record services. ----- http://www.healthcareitnews.com/blog/day-emr-died
September 23, 2011 | Jeff Rowe, HITECH Watch We end the week on a note that is semi-whimsical, and thus also at least half-serious. This doctor writes of his reaction recently when, gasp, his computer froze when he was with a patient, and nothing he did managed to unlock it. “It's never supposed to happen of course,” he begins. “But it happened today: the computer froze and could not be resurrected - a brief interlude to the daily clinic routine.” What ensues is a comedy of bumblings as he – and his colleagues, as well, as it appears the entire practice is similarly locked up – tries to remember the steps he used to take pre-EMR. ----- http://healthcareitnews.com/news/5-technologies-every-hospital-should-be-using
September 20, 2011 | Michelle McNickle, Web Content Producer With new health IT products springing up left and right, you may find yourself swimming in a sea of apps, updates, frameworks and systems. Shahid Shah, enterprise software analyst and owner of the blog The Healthcare IT Guy, breaks it down to the five technologies every hospital should be using. 1. Single Sign-On (SSO) and common identity management with CCOW integration. "Start to phase out all applications that cannot meet common identity or SSO requirements," said Shah. The benefits of SSO are many, and include end-to-end user audit sessions to improve security reporting and auditing as well as significant password help desk cost savings. Likewise, Clinical Context Object Workgroup (CCOW) was designed to allow information sharing between clinical and health IT applications, Shah wrote on his blog, adding that "if a hospital can get their labs, EMR, and CPOE vendors to become CCOW compliant, they can share patient context instead of the user having to log in and out of each application separately." ----- http://www.healthcareitnews.com/news/electronic-tool-being-piloted-give-babies-healthier-start-life
September 22, 2011 | Molly Merrill, Associate Editor WHITE PLAINS, NY – A new computerized family history tool aimed at allowing providers to take a detailed family history during the first prenatal visit, helping screen for inherited conditions and preterm birth, is being piloted by the March of Dimes and its partner organizations. The March of Dimes, along with the National Coalition for Health Professional Education in Genetics, the Genetic Alliance and Massachusetts General Hospital will begin piloting their new family history electronic tool in several clinical settings, including a federally funded health center, putting family medical history at doctors' fingertips. ----- http://www.modernhealthcare.com/article/20110921/NEWS/110929994/chime-dont-tie-metadata-to-meaningful-use
By Joseph Conn Posted: September 21, 2011 - 6:00 pm ET The College of Healthcare Information Management Executives is counseling federal health information technology policy makers to go slowly and not tie the use of metadata tagging to future meaningful-use criteria for electronic health-record incentive payments. The Ann Arbor, Mich.-based association for chief information officers and other healthcare IT leaders, presented its opinion in a two-page response (PDF) to a formal advance notice of proposed rulemaking issued by the Office of the National Coordinator for Health Information Technology last month. ----- http://www.businessweek.com/magazine/electronic-medical-records-a-silicon-valley-gold-rush-09222011.html
By Carol Eisenberg and Douglas MacMillan Patients at Dr. Surinder Saini’s Newport Beach (Calif.) office are no longer given a clipboard upon arrival. Instead, they’re handed an iPad, where they tick off symptoms and allergies with the touch of a finger. A nurse uses her own iPad to plug in vital signs. In the exam room, Saini summons the data by tapping on his tablet and is aided by a list of likely diagnoses for, say, abdominal pain. “Most patients are amazed,” says the gastroenterologist. After the visit, Saini dictates his notes about the patient straight into the iPad, where they’re instantly transcribed and stored with other records. Lured by new technologies and financial incentives from the U.S. government, doctors are throwing out stacks of paper and replacing them with handheld computers. The programs, made by heavyweights such as Allscripts (MDRX) and Cerner (CERN) as well as a raft of scrappy Silicon Valley startups, promise to save physicians time and help them make smarter decisions based on reliable data that are accessible online. An extra nudge comes from the 2009 economic stimulus, which set aside $27.4 billion to jump-start the switch to electronic records. The law offers doctors up to $63,750 over five years to help pay for the change if they can prove they’re making “meaningful use” of the systems by, say, submitting prescriptions electronically. ----- http://www.ehi.co.uk/news/acute-care/7187/dh-and-intellect-to-stimulate-market
22 September 2011 Lyn Whitfield The Department of Health is to work with Intellect to stimulate the market for NHS IT, following this morning’s announcement that the national programme is to be “dismantled.” A press release issued by the DH this morning says that a new partnership will “explore ways to stimulate a market place that will no longer exclude small and medium sized companies from participating in significant government healthcare IT projects.” In response, Intellect issued a statement saying that it wanted the DH to focus on helping the market to deliver interoperable systems and to develop a "central focus on clinical information sharing in the NHS Information Strategy." ----- http://www.fierceemr.com/story/80-americans-concerned-about-ehr-privacy/2011-09-22
September 22, 2011 — 8:13am ET | By Marla Durben Hirsch - Contributing Editor A majority of Americans believe that electronic health records don't keep their medical records confidential, according to a new survey released by security firm SailPoint. The survey, released September 20, found that 80 percent of Americans were concerned about moving their personal medical information to EHRs because of the risks of identity theft, exposure of their information on the Internet and the viewing of their records by those not directly related to their care. There also was concern that patients' private health conditions could be revealed to current or potential employers. ----- http://www.fierceemr.com/story/life-saving-potential-ehrs-already-being-realized/2011-09-22
September 22, 2011 — 11:42am ET | By Marla Durben Hirsch - Contributing Editor With all of the hoopla regarding how electronic heath records enable providers to earn incentive payments, it's heartening to read Health Affairs' new study that indicates meeting the computerized physician order entry (CPOE) standards for meaningful use may reduce the number of inpatient deaths due to heart attack or failure. It's even better, however, to learn about real examples of EHRs improving the quality of care for patients. For instance, the Peter Christensen Health Center, a small family practice located on the Lac du Flambeau reservation in Northern Wisconsin, found that implementing an EHR system enabled the clinic to track patient health data and provide more preventive care to its medically underserved community. It also improved patient care to such an extent that the life expectancy of its patients increased overall by 3.5 years, according to Tony Ryzinski, senior vice president of product management and marketing for Sage Healthcare, whose EHR system the clinic uses. ----- http://www.businessweek.com/news/2011-09-20/health-insurers-pool-1-trillion-in-claims-data-to-spot-trends.html
September 20, 2011, 3:43 PM EDT By Pat Wechsler Sept. 20 (Bloomberg) -- Major health insurers are pooling more than $1 trillion in claims data and creating an institute to cull the statistics and identify the drivers of higher health spending. More than 5 billion medical claims from Aetna Inc., Humana Inc., Kaiser Permanente and UnitedHealth Group Inc. will be collected and combined with government health claims data by the newly formed Health Care Cost Institute. The nonprofit group, which will likely be housed in Washington, will begin publishing semi-annual scorecards beginning next year on spending and consumption of health-care services and products. ----- http://www.healthcareitnews.com/news/revenue-growth-expected-image-management-systems-europe
September 19, 2011 | Jamie Thompson, Web Editor Medical imaging vendors in Europe are developing cardiology information systems (CIS) with advanced functionality and integration capabilities. New analysis from Frost & Sullivan suggests that this trend will spur revenue growth in the image management systems market. The report, titled Clinical Information Systems in Europe – Cardiology, finds that in 2010 the market earned $54.5 million – a number that's estimated to reach $104.8 million by 2017. -----
Bipartisan legislation would issue digital ID cards to 48 million Medicare enrollees, save $30 billion a year, say sponsors. By Neil Versel, InformationWeek September 20, 2011 URL: http://www.informationweek.com/news/healthcare/security-privacy/231601605 A small but notably bipartisan group of lawmakers has introduced antifraud legislation that would create smartcards for Medicare enrollees and providers, a move that sponsors say could save $30 billion a year. The proposed Medicare Common Access Card Act of 2011, introduced in the Senate (S. 1551) Sept. 13 by Sens. Mark Kirk (R-Ill.), Ron Wyden (D-Ore.), and Marco Rubio (R-Fla.), and in the House (H.R. 2925) Sept. 14 by Reps. Jim Gerlach (R-Pa.), Earl Blumenauer (D-Ore.), and John Shimkus (R-Ill.), would create a series of pilot programs to embed secure chips on Medicare identification cards. If the pilots were to prove successful after a year, the legislation would authorize distribution of smartcards to all beneficiaries of Medicare, currently about 48 million people and counting. ----- http://healthcareitnews.com/news/hhs-text4health-mhealth-initiatives-focus-smoking-cessation
September 19, 2011 | Molly Merrill, Associate Editor WASHINGTON – The U.S. Department of Health and Human Services announced new recommendations and initiatives on Monday to support health text messaging and mobile health (mHealth) programs. In November 2010, HHS established the Text4Health Task Force as part of the agency’s commitment to promoting innovation at HHS. The task force, comprised of public health experts across HHS, was charged with providing recommendations for HHS’ role in encouraging and developing health text messaging initiatives, which would deliver health information and resources to individuals via their mobile phones. ----- http://www.technologyreview.com/business/38486/ Wednesday, September 21, 2011
As medicine grows more complex, doctors are about to get an ambitious new assistant: the IBM computing system that defeated humans on Jeopardy!. By Brian Bergstein On the TV show House, Dr. Gregory House spends most of each hourlong episode wrestling with how to diagnose a patient who presents a bewildering set of symptoms. IBM research engineer Steve Daniels jokes that he and his colleagues could turn House into a "five-second show." The doctors would simply ask, "Hey, Watson, what does this guy have?" Watson is the supercomputing engine that beat the top two human competitors on the quiz show Jeopardy! this year, and Daniels is on the IBM team developing the software's first commercial application as what could be a stunningly useful diagnostic assistant for doctors. If it works as envisioned, Watson could help doctors identify what is afflicting any patient and suggest a course of treatment. ----- http://blogs.wsj.com/venturecapital/2011/09/19/david-brailer-in-health-care-its-not-all-about-the-big-ideas/
Health-care venture capitalists are often drawn to the bold promise of recent medical advances, but those hunting for their next fund should emphasize solutions within close reach when pitching David Brailer, America’s first digital-health czar and the chairman of investment firm Health Evolution Partners. A physician and entrepreneur, Brailer is all for innovation. Before launching Health Evolution in 2007, he practiced medicine, formed a company, CareScience Inc., and in 2004 under President Bush began helping craft a 10-year plan for widespread deployment of health IT. With Health Evolution he backs funds and companies. In either case, he favors those pursuing technologies or services that solve medical-industry problems in the near term. ----- http://www.govhealthit.com/news/building-mammoth-federal-ehr-tech-easy-part-julyaugust-2011?topic=32
September 18, 2011 | Tom Sullivan, Editor The joint electronic health record (EHR) that the Department of Defense and VA are creating is not the first open source project a federal health agency has undertaken -- but it is the largest and arguably most important. Consider the scope. According to VA CIO Roger Baker, "The key phrase is single common electronic health system. It's two large systems, and... the intention is to get to a point where there is a single repository for all the data related to an individual' s medical record whether generated in DoD or VA, and I might add through the nationwide health information network." That admirably ambitious initiative will be composed of proprietary and open source code, many APIs and ATIs, myriad modules, perhaps hundreds of GUIs, beginning with the Tripler GUI currently being piloted in Hawaii, with North Chicago up next. ----- http://www.govhealthit.com/news/va-dod-details-joint-ehr-interface-unified-view
September 21, 2011 | Mary Mosquera The Veterans Affairs and Defense Departments have provided details on how they will rely on a graphical user interface to knit together current aging and proprietary systems into their planned integrated electronic health record (iEHR), providing a common look and feel. The shared interface will unify what the providers, employees and patients see even as functions and systems change on the backend throughout the iEHR’s phases of development. ----- http://www.ehi.co.uk/news/ehi/7175/dh-outlines-plans-for-post-gpsoc-world
19 September 2011 Fiona Barr Less choice of system and mandated interoperability are likely to be the future of general practice IT, according to the Department of Health’s programme director for GP IT. Kemi Adenubi told last week’s EMIS National User Group conference that no decisions had been made about future funding for GP IT when GP Systems of Choice ends in 2013. “Nobody knows what’s going to happen in the new world and whether GPs are going to hold the money for GP systems and where choice is going to sit and that’s actually very empowering," she told conference goers. ----- http://www.fiercehealthit.com/story/himss-urges-congress-create-national-patient-identifier/2011-09-16
September 16, 2011 — 3:52pm ET | By Ken Terry HIMSS has asked Congress to support the development of a "nationwide patient identity solution" to promote interoperability and reduce errors related to mismatches between health data and patients. The association of health IT professionals also requested that Congress continue to support the adoption of health IT and not cut off funding for the government's electronic health record incentive program. While there has been no overt effort to repeal the HITECH Act, which authorized up to $27 billion in incentives for Meaningful Use of EHRs, anything is considered possible as Congress moves to reduce the size of the federal budget deficit. So HIMSS' appeal is more than just pro forma. ----- http://www.modernhealthcare.com/article/20110919/NEWS/309199988/onc-announces-metadata-initiative
By Joseph Conn Posted: September 19, 2011 - 12:45 pm ET The Office of the National Coordinator for Health Information Technology has announced the "soft launch" of an initiative to use metadata tagging to create patient consent-management controls over the movement of sensitive elements of patients' electronic records. The controls, the ONC noted in an e-mailed statement, are in keeping with recommendations of a December 2010 report by the President's Council of Advisors on Science and Technology. The ONC's Office of the Chief Privacy Officer and the Office of Standards and Interoperability are leading the initiative, which aims to "address standards for the ability to exchange parts of a medical record (often called data segmentation)," according to the statement. The initiative is part of the ONC's Standards & Interoperability Framework. Johnathan Coleman was named as initiative coordinator and Jamie Parker as program manager. ----- http://www.ehi.co.uk/news/mobile/7144/skype-service-expands-in-south-devon
6 September 2011 Fiona Barr Clinicians in south Devon are using Skype to hold consultations with patients from their own homes using patient-controlled record system supplier Patients Know Best. Dr Mohammad Al-Ubaydli, founder of Patients Know Best, told EHI Primary Care that the project had been running for a couple of months in response to demand from clinicians working for South Devon Healthcare NHS Foundation Trust. He added: “It started with speech and language therapy and now lots of other specialists are asking for it and clinicians are using it for pre-operative assessment and also for follow-up appointments.” Use of the Skype software application for doctor-patient consultations was the subject of debate recently, after NHS medical director Sir Bruce Keogh said he wanted to give doctors’ incentives to carry out online consultations. ----- http://govhealthit.com/news/himss-members-rally-capitol-hill-one-voice-one-vision-hit
September 16, 2011 | Diana Manos, Healthcare IT News Against the backdrop of National Health IT Week, HIMSS members stormed Capitol Hill Sept. 15 with the intent to raise federal lawmakers' awareness of the importance of healthcare IT. HIMSS representatives from all over the country rallied at the tenth annual HIMSS Policy Summit in preparation for meeting with their senators and representatives. The meeting was held at the Hyatt Regency Capitol Hill as part of National Health IT Week. HIMSS’ mantra is “one voice, one vision.” “With adequate knowledge and the right resources, we can work together to verbalize one voice with one vision, bettering our healthcare system through the use of health information technology,” said HIMSS leaders. ----- http://www.ihealthbeat.org/features/2011/health-it-key-to-patient-engagement-better-care-experts-say.aspx Monday, September 19, 2011
by Kate Ackerman, iHealthBeat Managing Editor WASHINGTON -- The Robert Wood Johnson Foundation, the Office of the National Coordinator for Health IT and the Agency for Healthcare Research and Quality have teamed up on a new initiative aimed at boosting patient engagement in an effort to improve the quality of health care in the U.S. Health care experts argue that patient empowerment is key to driving health care improvements. Risa Lavizzo-Mourey, president and CEO of RWJF, said in a news release, "Patients need to understand that the quality of health care varies widely across the nation -- even within communities -- and there are things they can do to ensure they and their loved ones get the best care possible." She added that "it is critical that we all do our part as patients to take responsibility for our own health and care, like learning more about our illness, taking care of ourselves and following recommendations from our doctors and nurses." At an event on Thursday marking the midpoint of the monthlong project, called Care About Your Care, health care leaders discussed how patients can play an important role in helping to address health care cost and quality issues. ----- http://www.technologyreview.com/business/38484/?nlid=nldly&nld=2011-09-19 Monday, September 19, 2011
The health battles of millions, recorded digitally, open a world of virtual research. By Neil Savage The antidepressant Paxil was approved for sale in 1992, the cholesterol-lowering drug Pravachol in 1996. Company studies proved that each drug, on its own, works and is safe. But what about when they are taken together? By mining tens of thousands of electronic patient records, researchers at Stanford University quickly discovered an unexpected answer: people who take both drugs have higher blood glucose levels. The effect was even greater in diabetics, for whom excess blood sugar is a health danger.
----- Enjoy! David. Posted by Dr David More MB PhD FACHI at Saturday, October 01, 2011 0 comments
The American Medical Information Association seems to have achieved something of a coup! This was announced a few days ago
By Joseph Conn Posted: September 23, 2011 - 11:45 am ET For the first time, physicians will have the opportunity to become board-certified in the subspecialty of clinical informatics, the American Medical Informatics Association announced. The American Board of Preventive Medicine will administer a clinical informatics examination for physicians seeking certification in the subspecialty, which the American Board of Medical Specialties recently voted to recognize. Physicians who have primary specialty certification through the ABMS will have the opportunity to sit for the exam.
The target timeline is to have the exam available by fall 2012 and the first certificates awarded in early 2013, according to an AMIA news release. The association will develop materials for online and in-person courses for physicians wanting to prep for the exam, the release noted, adding that materials should be available next spring.
"Establishment of the clinical informatics medical subspecialty is consistent with the current emphasis on broadening and professionalizing the health information technology workforce," AMIA President and CEO Dr. Edward Shortliffe said in the release. "With the need over the next decade for 50,000 informatics professionals in the health sector with various levels of expertise, this focus on physician expertise in clinical informatics is clearly a step in the right direction."
More here: http://www.modernhealthcare.com/article/20110923/NEWS/309239957/clinical-informatics-to-be-certified-subspecialty There is also a blog on the same topic from the same author here: By Joseph Conn
The big news in healthcare information technology last week was the announcement by the American Medical Informatics Association that "official medicine" is finally climbing aboard the IT train. By late 2012, for the first time, physician informaticists will be able to sit for an exam and gain board certification in the subspecialty of clinical informatics. The American Board of Preventive Medicine will administer the exam, which the American Board of Medical Specialties has voted to recognize. Certificates should be issued by early 2013—matching a timeline published in March 2010 by former AMIA President and CEO Dr. Don Detmer. AMIA has been working toward certification in clinical informatics since 2005. The AMIA board received a 2007 grant from the Robert Wood Johnson Foundation to develop the content and requirements. Under the plan, practicing physician informaticists who have been university-trained in medical informatics or informally educated can take the board exam for the first five years. More here: http://www.modernhealthcare.com/article/20110927/BLOGS02/309279999/professional-medicine-officially-embraces-it Additionally there is coverage here:
September 23, 2011 | Diana Manos, Senior Editor WASHINGTON – The American Board of Medical Specialties (ABMS) has now recognized clinical informatics as a subspecialty, according to the American Medical Informatics Association (AMIA). AMIA officials announced the news Thursday following what they called “a multi-year initiative” to elevate clinical informatics to an ABMS subspecialty. According to AMIA, the certification will be available to physicians who have primary specialty certification through ABMS. Clinical informatics (CI) certification will be based on “a rigorous set of core competencies,” developed by AMIA and its members. AMIA said many of its members have pioneered the field and supported CI’s new status as an ABMS-recognized area of clinical expertise. AMIA anticipates the first CI board exam to be available next fall, with the first certificates awarded early in 2013. To prepare physicians who wish to sit for this examination, AMIA is developing preparatory materials both as online and in-person courses starting in spring 2012. “It is entirely appropriate and timely to certify clinical informatics as a specialized area of training and expertise in an era when more and more clinicians are turning to data-driven, computer-assisted clinical decision support to provide care for their patients,” said AMIA’s Board of Directors Chair Nancy M. Lorenzi, of Vanderbilt University Medical Center. “Clinical informatics blends medical and informatics knowledge to support and optimize healthcare delivery.” More here: http://www.healthcareitnews.com/news/clinical-informatics-becomes-board-certified-medical-subspecialty AMIA provides a link to a page which explains just what is covered, what the speciality is and what those in the profession add to clinical care. See here: http://www.amia.org/clinical-informatics-medical-subspecialty At present it seems that informatics is to be seen as a sub-speciality for someone who already holds specialist certification but the president of AMIA has also said that other paths to certification are being considered actively. This quote shows the forward plans: “A press release on the subject (of certification) was distributed last week (see “AMIA in the News” on AMIA.org) and the feedback and interest have been remarkably positive. Meanwhile, recognizing that many individuals who wish to obtain clinical informatics certification will not be eligible for the ABMS examination, AMIA’s Academic Forum is working with the association’s leadership to develop additional certification options. A special task force is considering various ways in which AMIA can work to assure that clinical informatics certification is available to everyone, regardless of whether the person is a board-certified physician. AMIA has also started development of board review courses that will assist members and other physicians who wish to take the ABMS/ABPM exam. The boards will not be offered until at least the autumn of 2012, but there is much to do in the meantime to develop the review courses while the ABPM is developing the examination itself.” Given the diverse skill sets and origins of people who wish to be involved professionally in Health Informatics (computing, engineering, medicine, nursing and others) this seem very sensible and pragmatic. To me the most important thing is to have both professional recognition and real career paths for people interested in the area. Both are needed to encourage people with the right skill mixes to join in! This is a step the Australasian College of Health Informatics should be working towards over time. David. Posted by Dr David More MB PhD FACHI at Friday, September 30, 2011 0 comments
The following press release came out today: http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr11-nr-nr195.htm
Minister for Health and Ageing, Nicola Roxon, released the draft eHealth records legislation for public consultation. Printable version of Release of draft eHealth Legislation (PDF 23 KB) 30 September 2011 Today the Minister for Health and Ageing, Nicola Roxon, released the draft eHealth records legislation for public consultation. “Electronic health records have the potential to save lives, time and money and make the health system more efficient,” Minister Roxon said. “The draft legislation outlines the process by which consumers, health care organisations and data repositories will register to be part of the eHealth system. “It also will establish a new independent advisory council to advise the Government on the operation of the system.” This legislation will underpin the strict security regime being established to protect the privacy of patients using the eHealth system. A benefit of eHealth is making medical information much more secure and private than paper based records. “Using a combination of legislation, security and technology, backed by strict penalties for infringements, we will give patients peace of mind that their sensitive medical information is safe and secure,” Minister Roxon said. “For the first time patients will have control over who accesses their information – and further they will know who has accessed their medical records, and the exact time that record was accessed. “This system will be a first for Australia. Patients will not only be able to access their own eHealth record but, will also be able to view who has accessed their record. The legislation includes strong penalties of up to $66,000 for a record being inappropriately accessed. If more than one record is accessed without authorisation then the penalty multiplies by the number of records. There will also be proactive monitoring of the system to detect suspicious or inappropriate behaviour, ensuring that records are only accessed when there is a need to do so. “Patients can upgrade their privacy settings to suit their needs, for example, giving their GP access to their entire records, but more limited access to their dentist,” Minister Roxon said. “Doctors, or other health professionals, will be the only people allowed to create medical notes on the file. Patients can add their own notes about their general health but cannot make medical notes. eHealth system is a critical part of national health reform. All Australians will be able to register for a personally controlled eHealth record from July 2012. Comments on the legislation will be open until Friday 28 October. The release of this draft legislation follows a previous round of consultation on a Legislative Issues Paper. Final legislation will be introduced into Parliament later this year. To read the draft legislation and make a comment visit: www.yourhealth.gov.au ----- End Release. Something to download and read for the weekend - between the football! David. Posted by Dr David More MB PhD FACHI at Friday, September 30, 2011 1 comments
The following reports of a PwC Report appeared a few days ago. There is coverage here:
September 22, 2011, 12:16 AM EDT By Carol Eisenberg Sept. 22 (Bloomberg) -- Electronic health data breaches are increasingly carried out by “knowledgeable insiders” bent on identity theft or access to prescription drugs, according to a report from PricewaterhouseCoopers LLP. More than 11 million consumers have had medical data stolen or inappropriately disclosed since September 2009, and the privacy breaches are expected to rise as more health information is put online, according to the report released today by the New York-based accounting firm’s health research institute. The most frequently reported issue was the improper use of protected information by an “internal party,” the study found. The report underscores the need to strengthen privacy and security controls as health records are more frequently stored online and accessed by portable devices, said James Koenig, co- lead of PwC’s Health Information Privacy and Security Practice. Consumer concerns that personal medical information may be vulnerable to disclosure are likely to increase as the Obama administration spurs the adoption of digital records. “Going forward, there needs to be the vigilant focus not just on improvements to health care, but also making sure privacy and security keep pace so that confidence in these new uses can be enabled,” Koenig said in an interview. Survey of Executives The report analyzed data from a survey of 600 executives from U.S. hospitals and physician groups, insurers and pharmaceutical and life sciences companies. More than half of the organizations reported a privacy or security-related issue related to health data over the last two years, Koenig said. Theft accounted for 66 percent of publicly reported breaches, including stolen laptops, smart phones and other electronic devices, misuse of patient data to submit fraudulent claims and people seeking care in someone else’s name. More details are here: http://www.businessweek.com/news/2011-09-22/theft-of-digital-health-data-more-often-inside-job-report-finds.html There is also some coverage here:
Thu, Sep 22 2011 By Alina Selyukh (Reuters) - New technologies are flooding into the healthcare world, but the industry is not adequately prepared to protect patients from data breaches, according to a report published on Thursday. A vast majority of hospitals, doctors, pharmacies and insurers are eager to adapt to increasingly digital patient data. However, less than half are addressing implications for privacy and security, a survey of healthcare industry executives by PricewaterhouseCoopers LLP found. PwC's Health Research Institute interviewed 600 executives in the spring of this year and also found that less than half of their companies have addressed issues related to the use of mobile devices. Less than a quarter have addressed implications of social media. "The health IT and new uses of health information are changing quickly and the privacy and security sometimes may not be moving in step," said Jim Koenig, a PwC director who is among the contributors to the report. More here: http://in.reuters.com/article/2011/09/22/us-privacy-poll-idINTRE78L0ZD20110922 There is very comprehensive coverage here with a link to the actual report.
September 22, 2011 | Mike Miliard, Managing Editor NEW YORK – Most health organizations are under-prepared to protect patient privacy and secure personal health information as new uses for digital health data emerge and access to confidential patient information expands, according to a new report from PwC's Health Research Institute. Old privacy and security controls no longer suffice to comply with existing privacy laws and patient consent agreements, say to PwC officials – who emphasize that health organizations need to update practices and adopt a more integrated approach to ensure that patient information doesn't fall into the wrong hands. The report, titled "Old data learns new tricks: Managing patient privacy and security on a new data-sharing playground," shows how existing privacy and security controls have not kept pace with new realities in healthcare: increased access to information in electronic health records; greater data collaboration with external partners and business associations; the emergence of new uses for digital health information to improve the quality and cost of care; and the rise of social media and mobile technology to better and more efficiently manage patient health. A recent nationwide PwC Health Research Institute survey of 600 executives from US hospitals and physician organizations, health insurers, and pharmaceutical and life sciences companies found:
"Although paper-based health information breaches must now be disclosed under the breach notification provision under the HITECH Act, electronic data breaches occur three times more frequently and affect 25 times more people when they occur," said James Koenig, director and co-leader, Health Information Privacy and Security Practice, PwC. "Most breaches are not the result of IT hackers, but rather reflect the increase in the risks of the knowledgeable insider related to identity theft and simple human error - loss of a computer or device, lack of knowledge or unintended unauthorized disclosure." ..... A full copy of PwC's report can be found here .(After registration) Much more here: http://www.healthcareitnews.com/news/pwc-health-industry-under-prepared-protect-privacy The full report - or at least the summaries linked here are important reading. Just as you though it was all easy we have a slightly contrarian view put here:
Jay Cline September 20, 2011 (Computerworld) The Eli Lilly employee whose programming glitch exposed the e-mail addresses of almost 700 Prozac users to each other didn't know he was making history. Since that day in June 2001, hundreds more US healthcare organizations have reported medical-data breaches. As a result of those reports, federal and state health agencies have dealt out millions of dollars in fines, and the U.S. Department of Health and Human Services has launched a round of 150 audits. Meanwhile, a cottage industry of breach-notification service providers has arisen, and healthcare organizations can't find enough privacy talent to batten down the hatches. But is this obsessiveness over health-data privacy warranted? Do medical-data breaches harm people, and does notifying them of the incidents help them? The answer to these questions might seem like a resounding yes. The thought of our medical records ending up on websites or in criminals' hands makes us nervous. We want to know about these incidents if they happen, even though few of us take any action as a result of being notified. This large and growing allocation of healthcare resources in an era of cost containment, however, deserves a closer look. The phenomenon of data-breach notification started in California the same year as the Eli Lilly incident. State legislators Steve Peace and Jim Simitian drafted what became SB 1386, the first data-breach notification act in the world. Passed in 2002, this law remained an outlier until the infamous ChoicePoint breach of 2005. Nearly every U.S. state passed a breach-notification law in its aftermath, and many other countries are following suit. Most of these laws notably did not include personal medical records in their scope of concern. That all changed in 2009. In April of that year, Congress passed the HITECH Act as part of the economic-stimulus package. Included in that act were instructions for the U.S. Department of Health and Human Services (HHS) to issue a series of new rules about improving the protection of personal health information. In August 2009, HHS released its first installment -- an "interim final rule" on notification of health-data breaches. By the end of 2011, HHS is expected to divulge its "final final rule" on medical-data breach notification. The landmark feature of the interim final rule is a mandate to immediately notify HHS of any data breaches affecting 500 or more people. The rule also requires an annual notification to the department of incidents affecting fewer people. The department posts the notices for the large breaches on its infamous "wall of shame." Lots more here: http://www.computerworld.com/s/article/9220132/Jay_Cline_Are_medical_data_breaches_overreported_?taxonomyId=84 Jay Cline does go on to propose a sensible framework for assessment of health information breaches but I have to say that I do think at the very least those whose identifiable information leaks out or is exposed are entitled to know about it. After that Jay is right that a ‘horses for courses’ approach makes sense looking at the risk, possible damage and so on. Better still might be to look hard at the PwC report and see where improvements can be made. You can be sure once the national PCEHR is commenced the pressure for breach notification will skyrocket! David.Return to home