s Weekly Overseas Health IT Links - 31st March, 2012. | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

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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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

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.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

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.

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The sure way to drive business away

Gerald Quigley

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.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

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.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

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).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

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.

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Academics on the payroll: the advertising you don't see

Staff Writer

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.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

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.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

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

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Take a vacation from your vocation

Harvey Mackay

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.

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Explainer: what is peer review?

Staff Writer

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.

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Dentists from the dark side?

Loretta Marron OAM BSc

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?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

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

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

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.

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Attracting and Retaining Great People

Barry Urquhart

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.

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Updating Your Values - Extending Your Culture

Neil Johnston

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.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

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.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

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).

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Culture Drive & Pharmacy Renewal

Neil Johnston

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.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

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.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

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.

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Generation and Application of Community Pharmacy Research

Neil Johnston

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:

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Weekly Overseas Health IT Links - 31st March, 2012.

Dr David More

articles by this author...

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!

Visit my blog http://aushealthit.blogspot.com/

This blog has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on how things are progressing in e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Weekly Overseas Health IT Links - 31st March, 2012.

Here are a few I have come across last week.

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.

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March 20, 2012

The Clinical Alerts that Cried Wolf


Across the U.S., as healthcare providers implement computerized physician order entry (CPOE) systems, they find themselves dealing with the growing issue of clinical alert fatigue. With patient care alerts proliferating within clinical decision support (CDS) systems, physicians have often come to ignore all alerts. Healthcare IT leaders are working to resolve this important issue to everyone’s benefit, increasingly implementing systems that put out only effective alerts or apply asynchronous alerting strategies.

What happens when something designed for patient safety ends up having the exact opposite effect? In what can best be described as a “boy who cried wolf”-type scenario, this is exactly what is happening in some healthcare communities with CPOE systems.


Kalorama expects the pending penalties to continue to drive up sales and predicts the EMR market growth rate to be 20 percent in 2012-2013. 


$4 billion price tag for VA, Defense EHRs

By Joseph Conn

Posted: March 23, 2012 - 1:00 pm ET

Tags: Electronic Health Records (EHR), Information Technology, U.S. Department of Veterans Affairs

The proposed new, best-of-breed, joint electronic health-record system to be created for the Veterans Affairs and Defense Departments will cost $4 billion just to develop and probably a lot more to license and install, said Roger Baker, the assistant secretary for information and technology at the VA.



EMR sales up 14 percent in 2011

By Rene Letourneau, Editor, Healthcare Finance News

Created 03/23/2012

NEW YORK – Propelled by government incentives, a desire to improve patient outcomes and the bottom line, sales of electronic medical records reached $17.9 billion in 2011, up 14.2 percent from the previous year, according to market research publisher Kalorama Information.

In its recent report, “EMR 2012: the Market for Electronic Medical Records,” Kalorama found the uptick in sales is being aided by increasing physician and hospital acceptance, robust competition and growth in EMR budgets.



Can Health Care Orgs Maintain Trust With Electronic Records?

Eric Savitz, Forbes Staff

Guest post written by S. Joe Bhatia and Rick Kam

S. Joe Bhatia is CEO of the American National Standards Institute, ANSI. Rick Kam is president and co-founder of ID Experts.

You don’t want your personal health information to spread virally around the Internet. Save that for the talking baby videos on YouTube.

The truth is, the electronic health information of millions of patients can be breached in a matter of seconds. As the industry moves from paper records to electronic health records (EHR), protected health information (PHI) is now more susceptible to exposure than ever.


iPad Features May Accelerate Healthcare Productivity

Retina display, cameras, and voice recognition will help doctors, but Bluetooth 4.0's ability to connect the iPad directly to patients' medical monitoring devices could be the real game-changer.

By Nicole Lewis,  InformationWeek

March 19, 2012

URL: http://www.informationweek.com/news/healthcare/mobile-wireless/232602825

Healthcare providers who lined up with the masses this weekend to purchase the new iPad will soon discover that the world's first Bluetooth Smart-Ready tablet may improve their clinical workflow. That is because the iPad will enable healthcare providers to directly access data from Bluetooth-enabled medical home monitoring devices that collect patient data.

The latest version of the iPad, which incorporates Bluetooth 4.0, opens up a world of possibilities for healthcare providers as they seek to manage information in a healthcare industry that is becoming increasingly data-driven and patient-centric.

For instance, the Henry County Health Center, based in Mt. Pleasant, Iowa, is getting ready to roll out 30 iPads this year to doctors who work at the 74-bed hospital. "The doctors are strongly requesting iPads, which is an idea whose time has come," Stephen M. Stewart, Henry County Health Center's CIO told InformationWeek Healthcare. "The reality of life today is that consumer-driven items are infiltrating the workplace, and we need to embrace it rather than fight it."



Online counseling tool a boon to recovering cancer patients

By danb

Created Mar 23 2012 - 1:40pm

An online tool to provide counseling to cancer survivors experiencing fatigue was shown to be more effective than traditional, in-person sessions, according to a study [1] published this month in the Journal of Clinical Oncology. The study's authors believe the tool could blaze a trail for other programs aimed at easing what is often a costly and time-consuming process.



Good EHR Bets for Multispecialty Groups Surface in Survey

Robert Lowes

March 22, 2012 — Electronic health record (EHR) systems from Epic Systems and Cerner are the safest bets for large groups and hospitals that want to please primary care physicians plus the widest range of specialists with a single program, according to a new report by the research firm KLAS.

Designing an EHR program for specialists as well as primary care physicians has challenged software makers, as KLAS found out when it interviewed more than 700 medical professionals. Internists and family physicians are the happiest with their software, posting scores of 7.6 and 7.5 on a 9-point satisfaction scale, respectively. At the low end of the ratings are oncologists and ophthalmologists, at 5.8.

KLAS zeroed in on Epic, Cerner, and 4 other vendors in an analysis of EHRs that can provide broad specialty coverage in a large group or hospital. Epic and Cerner stand out from the rest because their inpatient and ambulatory EHRs are built on the same software platform, and thus do not need special interface software for exchanging data.



Supreme Court's blood monitoring ruling could impact decision support

By mdhirsch

Created Mar 21 2012 - 10:06pm

Earlier this week, the United States Supreme Court ruled [1] that a diagnostic testing company could not patent and exclusively control the use of a method for determining the right dosage level of a class of drugs; measuring metabolite levels and telling providers to make applicable adjustments, they said, is not a patentable invention.

The company at the heart of the case, Prometheus Laboratories, had patented a diagnostic testing kit which determined the dosage level of the drugs and issued a warning when the metabolite level was above or below a certain number. It sued the Mayo Clinic, which had purchased the kits, for patent infringement when the hospital refined the process and began using the newer one.

The Court said that the company couldn't restrict providers that way. "They tell a treating doctor to measure metabolite levels and to consider the resulting measurements in light of the statistical relationships they describe. In doing so, they tie up the doctor's subsequent treatment decision ... and threaten to inhibit the development of more refined treatment recommendations," Justice Stephen Breyer said, writing for the Court.



Memorial Sloan Onboard to Enhance Watson Supercomputer Technology

Joseph Goedert

MAR 22, 2012 12:10pm ET

Memorial Sloan-Kettering Cancer Center is the latest health care organization to collaborate with IBM Corp. on the data analytics, natural language processing and retrieval technologies of the Watson supercomputer for research and treatment purposes.

The hospital and vendor will develop an oncology clinical decision support system taking advantage of Memorial Sloan-Kettering’s molecular and genomic databases, and its repository of cancer case histories. The first applications, with piloting scheduled for late 2012 and wider distribution by late 2013, will include lung, breast and prostate cancers.



ONC pilot uses tablets for HIE meaningful consent

By: Brian Dolan | Mar 20, 2012  

The Department of Health and Human Services (HHS) plans to launch a pilot in September to determine whether patients can “meaningfully consent” to their data being shared with other health care providers using an application on a tablet in the waiting room. The pilot will take place at a hospital and three clinics in western New York that are all a part of the HEALTHeLINK health information exchange. If the pilot works, HHS and ONC plan to make the patient consent education app open source so that other facilities can use it, too.



Despite EHRs, healthcare still 'buried in paperwork,' says survey

By Mike Miliard, Managing Editor

Created 03/21/2012

WESTBOROUGH, MA – Even as more and more healthcare organizations are implementing EHR systems, many of them are not decreasing their reliance on paper-based processes, according to a new survey from Anoto, which develops digital pen and paper technology.

More than half of the respondents say paper is still a primary source for tracking information within their organizations’ daily activities, the study found, with respondents saying that paper is still too embedded in the culture, that technology adoption is too expensive and that switching to an electronic system requires too much training and disrupts care delivery.



5 things CFOs need to communicate to CIOs to prevent overspending

By Michelle McNickle, Web Content Producer

Created 03/21/2012

The current healthcare landscape is calling for more collaboration, and possibly the most important partnership is that of the CIO and CFO. With new IT becoming a pressing necessity, it's crucial both professionals understand the ins and outs of IT spending. 

"In terms of working with hospitals on their IT spend, it's a new thing," said Jeff Muscarella, EVP of IT at spend management consultancy company NPI. "When we started the company 10 years ago, many folks didn't know you could go out and look for a Kelley Blue Book of IT products and service and pricing. Nowadays, it's become more common." 



March 21, 2012

Ramping Up to Leadership: CMIOs’ Profile Keeps Growing


As physician informaticists rise into CMIO titles, the CMIO role itself is gradually being transformed, particularly in more advanced patient care organizations, from its early “tech-head doc” function to a management role focused on implementation, to increasingly, a transformational leadership role. CMIOs and industry experts agree that the skills needed to help lead change on a broad scale are pushing medical informaticists to new levels of professional development.

The evolution of the CMIO role has been a fascinating one. CMIOs have emerged out of the ranks of physicians as “lone-wolf” information technology advocates; over time many have evolved into part-time implementation facilitators, full-time managers, and senior lieutenants over squadrons of clinician informaticists. Now, those in the most advanced patient care organizations nationwide have taken on the role of senior leaders helping to move their organizations forward on the quality journey.



Informaticists make case for ICD-10 delay

By Joseph Conn

Posted: March 22, 2012 - 1:00 pm ET

Last month's announced delay in the rollout of the ICD-10 diagnostic and procedural codes has received the written endorsement of five noted medical informaticists in an article published online by the journal Health Affairs.



ICD-10 delay may have been a good call: survey

By Joseph Conn

Posted: March 20, 2012 - 12:30 pm ET

The CMS appears to have made the prudent call when it announced last month its rollback of the compliance date for the nationwide conversion to the ICD-10 codes, according to the results of a survey by the Workgroup for Electronic Data Interchange.

Significant numbers of healthcare provider organizations, health insurance plans and even vendors of information technology systems all lagged badly in their preparations for the complex code upgrade, WEDI survey data indicated. The Reston, Va.,-based WEDI is a coalition of health information technology users and developers.



JAMA: Physicians behave badly online

By sjackson

Created Mar 22 2012 - 1:32pm

Hospitals need to implement strong ethical rules for physicians' online behavior--and now. That's the upshot of a study [1] published recently in Journal of the American Medical Association.

The study found that out of 48 participating state medical boards, nearly all of them had a story to tell, and they weren't pretty. The most common alleged misbehavior: Asking patients out on dates, according to a report [2] in the Sacramento Bee.



Cost of data breaches drops in U.S., but not for healthcare

By kterry

Created Mar 22 2012 - 1:00pm

The average organizational cost of a data security breach in the U.S. dropped 24 percent to $5.5 million in 2011 from $7.2 million in 2010, according to the latest report from the Ponemon Institute [1].

Based on the data breach experiences of 49 companies from 14 industries, including healthcare, the average cost per record also dropped from $214 to $194. This was the first time in the seven years for which the Ponemon Institute has done this survey that this cost declined.



Nightingale on Demand Achieves Canada Health Infoway Certification

First electronic medical record system to receive national mark for privacy, security and interoperability

March 22, 2012 (Toronto, ON) - Canada Health Infoway (Infoway) announced today that Nightingale on Demand, a software product developed by Nightingale Informatix Corporation (TSX-V: NGH), (Nightingale), is the first product in Canada to successfully achieve electronic medical record (EMR) certification.

Infoway has developed EMR certification in concert with its jurisdictional partners, to ensure that EMR solutions conform to national and international standards for privacy, security and interoperability.

"We salute this achievement by Nightingale because it is fundamental to Infoway's mandate that authorized health care providers, such as physicians and nurse practitioners, have ready access to accurate and comprehensive information about their patients through secure connections to electronic health record systems," says Richard Alvarez, President & CEO, Canada Health Infoway.



Cerner roll out causes clinical incidents at North Bristol trust

Electronic patient records system led to problems including wrong patient notes being supplied and incorrect clinic lists

Jo Best

Guardian Professional, Wednesday 21 March 2012 11.38 GMT

The roll out of the Cerner Millenium electronic patient records system has led to a series of clinical incidents at North Bristol NHS trust.

The trust began deploying Cerner in December 2011 as a replacement for two older patient records systems.

Between the launch of the system and 17 January 2012, 16 clinical incidents were reported as a direct result of the Cerner implementation, the trust revealed in a response to a freedom of information (FoI) request made by a BBC journalist.



10 simple ways to secure and optimize your iPad

By Michelle McNickle, Web Content Producer

Created 03/20/2012

The iPad has become a mainstay in the industry, but with its increased use comes the increased risk of breaches. And although preventing them seems basic, Christina Thielst, vice president at Tower Strategies and author of the blog Christina's Considerations, believes there are benefits to be had from discussing simple ways to not only protect, but also optimize your iPad.   

"This is important because of the rise in data breaches, the rise in the risks, and the rapid increase in malicious attacks," she said. "It's why we have to talk about it rather than not worry." 



By Joseph Conn

Can healthcare IT be like the railroads?

To be most effective, standards should be used by everyone; but must everyone pay for those standards?

For most U.S. railroads, variability in rail gauge—the distance between the rails—is no longer a barrier it once was to the interoperability of rolling stock. With passage of the Pacific Railway Act in 1863, the federal government adopted 4 feet 8 1/2 inches as the U.S. standard gauge for the transcontinental railroad, thus promoting its widespread adoption and facilitating the movement of goods and passengers from one rail line to another.



Electronic clinical summaries worth providing to docs

By mdhirsch

Created Mar 21 2012 - 12:03pm

Here's yet more proof that electronic clinical decision support can help providers treat patients. Doctors who had electronic access to summaries of clinical information found them very useful, according to a recent study [1] published this month by BMC Pediatrics.

In the study, researchers from Canada and Australia used one-page summaries of up-to-date evidence, which they called "clinical answers" to help 83 pediatricians treating children with respiratory issues keep abreast of the latest research. The study's authors theorized that since physicians increasingly are turning to electronic clinical decision support tools for help in delivering care, the summaries would be important because they enabled the physicians to quickly digest the information without having to read voluminous clinical literature.



IBM Unveils New Analysis Packages

IBM introduces new analysis packages for financial fraud, consumer behavior and risk management

By Joab Jackson
Tue, March 20, 2012

IDG News Service (New York Bureau) — IBM has unveiled three packages of services and software to help organizations analyze their data for profit and improved efficiency.

The signature solutions, as IBM calls these offerings, go beyond generic analysis software to address three different specific tasks: detecting financial fraud, predicting consumer behavior and estimating financial risk.

"Having software is important but having industry expertise and domain knowledge is also pretty essential," said Deepak Advani, IBM vice president of predictive analytics. IBM's intent behind these packages is to combine its analytic software with the lessons it has learned installing such software for clients, Advani said.



FDA: Should people self-screen for disease?

Written by

Gary Robbins

4:26 p.m., March 18, 2012

The public’s huge and growing use of the Internet and other technologies to get health information has the U.S. Food and Drug Administration asking a provocative question:

Should the agency stop requiring prescriptions for certain drugs that are used to treat diseases and conditions that people can diagnose by themselves, or with a bit of help?

The FDA says the idea represents a possible “new paradigm” in health care, and that it will hold public hearings on the matter Thursday and Friday in Washington, D.C. The testimony will focus on drugs commonly prescribed for high cholesterol, high blood pressure, migraine headaches and asthma. The agency also may explore easier access to diabetes treatments.



NIST Releases Technical Guidance for Evaluating Electronic Health Records

From NIST Tech Beat: March 20, 2012

An important aspect of any product is how easily someone can use it for its intended purpose, also known as usability. Electronic health records (EHR) that are usable have the potential to improve patient care, which is why the National Institute of Standards and Technology (NIST) has outlined formal procedures for evaluating the usability of EHR systems.

The proposed usability protocol encourages a user-centered approach to the development of EHR systems. It provides methods to measure and address critical errors in user performance before those systems are deployed in a medical setting.

“This guidance can be a useful tool for EHR developers to demonstrate that their systems don’t lead to use errors or user errors,” said NIST researcher Matt Quinn. “It will provide a way for developers and evaluators to objectively assess how easy their EHR systems are to learn and operate, while maximizing efficiency.”



How Much of Your Personal Health Information Should Be Online?

By Brian S. McGowan

It's time to move beyond the isolated patient experience, but the social outlets we're using aren't made for sharing high-stakes information.

"Has anyone else gone through this before?" That's one of the first things a person asks himself after being anointed a "patient." In illness, as in any other life events, we are social creatures looking for shared experiences and in need of support. But the reality is that our health care system is not designed to serve this purpose. Instead, our system evolved to promote isolation. And, in many ways, this isolation is very much at the heart of the patient experience.

There are two solutions to the isolation experience. The first is to build layers upon the patient-clinician relationship -- to build stronger ties, more connections, and a culture of shared decision-making between patient and physician. There are many advocating for this idea, but it requires cultural shifts across a medical profession that typically evolves at a snail's pace and would require systemic changes in both policy and reimbursement. The second is to build communities of patients with shared experiences, shared fears, and shared data -- and it is this second solution that deserves much more public discourse, lest we get ourselves in an unexpected and unfortunate jam.



Connectathon’s Role in Achieving Interoperability

Elizabeth Gardner

MAR 20, 2012 11:43am ET

As you stroll the exhibit floor at the annual Healthcare Information and Management Systems Society conference, it's hard to miss the Interoperability Showcase, where dozens of information systems and medical devices from different vendors send data hither and yon, simulating a health care environment with (ideally) a seamless, glitch-free flow of information.

Its presenting organization is Integrating the Healthcare Enterprise (IHE), a consortium of professional associations, providers, government agencies, research institutions and vendors whose goal is to turn the plethora of HIT data communication standards into something that's usable in the real world. IHE was founded in 1997 by HIMSS and the Radiological Society of North America.


Telepharmacy Startup Targets California's Rural Hospitals

California Healthcare Foundation's investment in Pipeline Healthcare Solutions could help rural and safety-net hospitals gain round-the-clock access to pharmacists' expertise.

By Ken Terry,  InformationWeek

March 20, 2012

URL: http://www.informationweek.com/news/healthcare/CPOE/232602881

The California Healthcare Foundation (CHCF) has invested in a startup firm called Pipeline Healthcare Solutions to bring the benefits of telepharmacy to California's rural and safety-net hospitals. Pipeline, which has worked with rural facilities in Washington State and Illinois, is now meeting with administrators of critical access hospitals across California, according to Margaret Laws, director of CHCF's Innovation for the Underserved Program.

Telepharmacy uses Internet and teleconferencing tools to deliver the expertise of pharmacists remotely to hospitals that do not have around-the-clock pharmacist coverage. Rural hospitals might not be able to afford this kind of coverage, or they might not be able to find enough pharmacists to staff their pharmacies on evenings and weekends.



5 reasons EHR functionality hasn't changed since 1982

By Timathie Leslie and Megan Doscher and Brynnan Toner, Booz Allen Hamilton

Created 2012-03-19 11:53

Electronic health records (EHRs) have traveled on quite a journey since their inception in the 1960s. Powered by the advancement of modern technology, they no longer exist simply on stand-alone terminals – EHRs are now mobile, enabled by mobile broadband, smart phones, and tablets. In recent years, EHR adoption has increased quickly, spurred in part by the federal Meaningful Use Incentive program, bringing promise of vast improvements in healthcare quality, patient safety, workplace efficiencies, and patient empowerment.

Despite this progress, basic EHR functionality remains largely unchanged since 1982, slowing the evolution and integration of new technologies and capabilities, which remain paramount to transforming the healthcare system.



EMIS to take foot off EMIS Web brake

19 March 2012   Rebecca Todd

EMIS has been “throttling” the install rate for EMIS Web, but is now preparing to hit the accelerator pedal, according to chief executive Sean Riddell.

In its preliminary results for 2011, released on Friday, the company said it was speeding up the roll-out rate of its next generation system to hit 200 practices a month in the final quarter of this year.

This would see the majority of the 1,400 practices on its order book completed in 2012.

Riddell told eHealth Insider the company had adopted a controlled roll-out approach towards the end of 2011, which meant “you have your foot on the brake."



EMR 2.0: Harnessing data to give new life to a legacy system

By gshaw

Created Mar 20 2012 - 12:24pm

NorthShore University HealthSystem in Chicago implemented its electronic medical record system in 2003. It included lots of bells and whistles, such as computerized physician order entry, and was deployed big-bang style at the system's four hospitals and at physician offices and ambulatory care centers.

"Is there life after that event?" President and CEO Mark Neaman, speaking at a "Masters Series" session at the annual congress of the American College of Healthcare Executives [1] (ACHE) in Chicago yesterday, asked the audience.



4 Tech Success Strategies for Hospitals

Joe Cantlupe, for HealthLeaders Media , March 16, 2012

This article appears in the February 2012 issue of HealthLeaders magazine.

Changes wrought by technology are making an indelible mark in service lines for health systems big and small. This is being reflected in a hospital when a patient is given an iPod with a Pandora app to listen to any music she wants to hear as she waits for an oncological exam (You want Motown, you've got it!) and in the surgical suite where physicians use da Vinci robotic systems for minimally invasive procedures, as well as new cloud-based data systems that allow clinicians instantaneous access to a patient's heart rhythms.

Health systems are moving ahead quickly in pursuing technology improvements, using robotics, apps, telemedicine, clouds, electronic medical records, device journals, or other innovations to provide value and add volume to their service lines. Leaders of healthcare systems say they are working to improve patient experience and patient flow in highly personalized programs while using smartphones and tablets to monitor health conditions and evaluate symptoms. Part of the rush is based on federal incentives under meaningful use requirements.



Warwick to use iPads for patient records

14 March 2012   Chris Thorne

South Warwickshire NHS Foundation Trust has signed a five-year contract with Kainos to digitise all of its patient records and make them available to staff on iPads.

The trust hopes to give staff mobile access to its systems by the end of the year, using Apple iPad devices. The iPads will give staff the ability to access and update a patient’s record at the point of care during a clinic, or a visit to a patient’s home.

The trust published an ICT strategy for 2011-14 in June last year, which said it wants to create a paper-light environment and improve mobile working, especially among its community staff.



ONC advances HIE tools with Connect 3.3

By Mary Mosquera

Created 2012-03-16 13:04

ARLINGTON, VA – The Office of the National Coordinator for Health IT has made available the next version of the Connect gateway software that incorporates the most up-to date technical standards and descriptions for the nationwide health information network (NwHIN) Exchange to support functions like patient discovery and query for and retrieve documents.

Connect gateway and adapter software uses NwHIN standards and services to enable healthcare organizations and federal agencies to share patient information securely through the Internet.

In addition to the specifications, the Connect version 3.3 released March 16 is designed to improve performance, usability and prepare it for higher volumes, said Lauren Thompson, director of ONC’s Federal Health Architecture.



Meaningful Use impact on data encryption could be positive

By kterry

Created Mar 17 2012 - 6:12pm

I recently had a conversation with a computer security consultant who has worked in both banking and healthcare. He rated data security as very poor in most healthcare organizations, and said that banks do a far better job of protecting their sensitive information. What he said jibed with the long list of security breaches--major and minor--that have been reported over the past year.

One of the simplest methods to safeguard data is simply to encrypt all information stored on end-user devices. Not only does that make it harder for hackers to steal the data, but it also lessens the chance that the loss or theft of laptops and other mobile devices will compromise personal health information (PHI).



Monday, March 19, 2012

Employers Embrace Telehealth, but Roadblocks Remain

by Rebecca Vesely, iHealthBeat Contributing Reporter

Janel Woods woke up one recent morning, looked at herself in the mirror and saw a bad case of pink eye.

The manager of talent strategy and development at Blue Cross and Blue Shield of Minnesota had to get her kids ready for school and herself ready for work.

"My mindset was, 'How do I solve this in the quickest way possible?'" Woods said.

So she logged onto her work laptop, which she had fortunately brought home the night before, and got onto her employer's telehealth video service, called Online Care Anywhere. She was already registered for the service -- she had used it once before to consult with a doctor when her son was experiencing migraines. Within 15 minutes she had completed a video chat with a nearby physician licensed to practice in Minnesota, who called in a prescription to Woods' local pharmacy.



'Pocket Heath' app allows UK patients to access health info

By Jamie Thompson, Web Editor

Created 02/28/2012

CSC has announced its ‘Pocket Health’ mobile app, developed in collaboration with the NHS. Pocket Health allows UK residents with an iPhone, iTouch or iPad to access a wide range of healthcare information from the NHS Choices website.

Officials say the app is designed to make it easier for people to make healthcare and lifestyle decisions, as well as to find NHS services they need anywhere in England.





Posted by Dr David More MB PhD FACHI at Saturday, March 31, 2012 0 comments



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Friday, March 30, 2012

IT In The UK NHS Has Got A Lot Further Than You Might Imagine. Look Closely At What Is Continuing.

The following press release appeared a few day ago from the UK Department of Health

Shifting power to the local NHS – a new way for NHS IT

March 8, 2012

A profound shift of decision-making to the local NHS means that clinicians lead change in information technology, ensuring its freedom to innovate, the Health Secretary said today at the launch of the Chief Clinical Information Officers network.

Confirming that the government has secured agreement to over a billion pounds reduction in its contract with Computer Sciences Corporation, the largest supplier to the now-dismantled National Programme for IT, the Health Secretary made clear that this money will be released back into the NHS.

Following years of waste and delay in introducing electronic care records to hospitals, he emphasised that this agreement signals an enormous breakthrough that will free up clinicians in the NHS to exercise control and flexibility.

He also made clear that it was intolerable that clinicians who regularly use a smartphone to video chat with colleagues across the world, have to spend weeks waiting for patient information to be sent by post.  The gap in utilising modern technology was to be closed by the leadership of those with their patients in mind, not by central decree from government.

Alongside focusing on clinical involvement to drive change, the Health Secretary reiterated the need for clinical systems across the country to talk to each other, exchanging information safely in the interests of patients.  The NHS Commissioning Board will lead on championing the national standards that are required to underpin local innovation and choice.

Key to future success will be the NHS as a more intelligent customer and small and medium-sized suppliers no longer excluded from introducing their products.  The local NHS is no longer being told what to do when it chooses its IT systems.  Alliances with Intellect, the NHS Confederation and the British Computer Society are helping stimulate a varied, vibrant market of suppliers.  And sharing data about NHS IT implementations with the local NHS via E Health Insider’s website, is ensuring any local investment decision is informed by the experiences of others.

Connecting for Health will no longer exist in April 2013.  A new, leaner delivery organisation will manage existing national applications and services such as the Spine, Choose and Book, digital X-rays, the Electronic Prescription Service, the Summary Care Record and a secure broadband network.  All of these are necessary to how the NHS runs on a daily basis and will continue, but any new national initiatives will only happen when there is a clear need across the NHS.

Health Secretary Andrew Lansley, said:

“In the past doctors and nurses have had to bend over backwards to fit in with the needs of the systems introduced to their workplaces.  They were shackled with rigid, expensive IT contracts that failed to deliver as intended.  We are now putting local clinicians in the driving seat, able to reap the benefits of the explosion in information and technology which is re-shaping the world beyond the NHS.”


The release is found here:


The key quote is here:

“A new, leaner delivery organisation will manage existing national applications and services such as the Spine, Choose and Book, digital X-rays, the Electronic Prescription Service, the Summary Care Record and a secure broadband network.  All of these are necessary to how the NHS runs on a daily basis and will continue, but any new national initiatives will only happen when there is a clear need across the NHS.”

The only major part that is not being maintained and pushed on with is essentially the Hospital Computing Program which is now happening at a more local level driven by local need.

The National Program has already meant there are a few well-resourced GP System providers who are continuing to innovate and thrive.

Looking at a strategic level it is really hard to say this has all been a disaster - things have actually moved forward with a range of useful applications and more will come. My guess, five years from now we will look around and see the UK is in pretty good e-Health shape.

I hope we will be able to say the same about OZ!


Posted by Dr David More MB PhD FACHI at Friday, March 30, 2012 0 comments



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Thursday, March 29, 2012

It Looks Like One Of the Key PCEHR Targets Will Be Hard To Hit. The PCEHR Is Just A Very Poorly Conceived Idea.

It has been a long standing claim that the PCEHR was to initially be an initiative to focus on those in most need which was said to be those with chronic disease, the elderly, aboriginal populations and mothers and babies.

It must be rather annoying then for the designers of the PCEHR to realise they have seriously missed the mark. For the PCEHR to be valuable and widely used it needs clients who will value what it has to offer. If you don’t know how to sensibly use a computer and you don’t know the risks associated with incorrect use then much of that benefit might be lost.

In this context we see this report of NEHTA’s attendance at a recent hearing.

NEHTA to front Senate cyber safety hearing

Posted Fri, 23/03/2012 - 12:21 by Mark Jones

NEHTA is taking steps to reassure government and health industry stakeholders that it is comprehensively addressing a range of ehealth privacy and security concerns.

Industry groups including AusCERT have questioned the efficacy of the ehealth agency’s standards and technologies for protecting the Personally Controlled Electronic Health Record (PCEHR).

Two senior NEHTA executives will today front a Senate Committee hearing into cyber safety, which chief executive Peter Fleming described as part of the organisation’s ongoing engagement with government on the issue. Dr Mukesh Haikerwal, NEHTA clinical lead, and David Bunker NEHTA’s head of architecture, will make presentations at the inquiry.

Mr Fleming said NEHTA was working hard to meet the July 1 deadline when consumers will be able to register for the PCEHR. “We’ve been working flat out with DoHA, the jurisdictions and the states to deliver on the 1st of July promise and deliver a good quality system,” he said.

More here:


There is coverage also found here

Concerns raised over e-health records for elderly

NEHTA conceded that the system may not be "senior friendly"

Chloe Herrick (Computerworld)

23 March, 2012 15:02

The suitability and accessibility of the Federal Government’s Personally Controlled Electronic Health Record (PCEHR) system for the elderly has been brought into question by a Senate committee investigating cyber safety for senior Australians.

The committee voiced concerns to the National E-Health Transition Authority (NEHTA) — the body charged with the rollout of the PCEHR — around just how “senior-friendly” and easy to use the system would be for the demographic.

“We are working with the relevant stakeholders to ensure it is a system that will meet their needs and provide them with a level of confidence that their personal information is safe and secure,” NEHTA head of architecture, David Bunker, said.

 “I wouldn’t single it out as being elderly friendly. I think we need to accept that there is a range of sophistication, maturity and literacy around the use of technology and the system, to be safe, secure and easy to use, has to allow for that.

“I think the best way to address that is to say in terms on developing education materials, there is support for those things and the nature of that material has to be directed to a varying level of computer literacy.

More here:


There is also recognition that ‘senior citizens’ need help they presently are not getting.

ACMA calls for improved senior citizen cyber safety education

Face-to-face programs preferred over online sessions, according to ACMA research

Hamish Barwick (Computerworld)

23 March, 2012 16:56

Improving cyber safety education of senior citizens through more targeted programs would greatly improve their confidence and get more elderly Australians online, according to an Australian Communications and Media Authority (ACMA) submission to a Senate committee investigating cyber safety for senior Australians.

Speaking at the Senate hearing in Sydney, ACMA digital economy division general manager, Andrea Wright, said that most cyber safety programs are aimed at young people and the Authority is trying to change this.

During Safer Internet Day in 2012, for example, ACMA targeted grandparents with face-to-face presentations across Australia.

 “We provided a list of questions to seniors that they might ask their grandchildren so they could get online and learn how to use social networking sites,” Wright said.

More here:


The bottom line here is that for the PCEHR to be a success it needs to be fully usable and properly understood by its target demographic. Sadly that little detail just seems to have gone through to the keeper as they say.

The simple fact is that the PCEHR is a wrongly directed and ill-conceived investment in a bad idea. Investment in providers systems and provider messaging was what was needed first and only with this really working do you move to access to live systems for those who want to and can use such access.

This is just another reason we will see such limited penetration in the target demographic along with a lack of useful functionality and so on!



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