s I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

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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Recent Comments

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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
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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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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Australian Health Information Technology -Links from 1-30 January 2014

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.

Relevant Links 1 January 2014 to 30 January 2014

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Thursday, January 30, 2014

An Important Learning Experience On Health Care Application Safety Is Planned For The Middle Of Next Month.

I was alerted to this a day or so ago.

Follow up workshops: Clinical Safety for Healthcare Applications

Posted on January 28, 2014 by Grahame Grieve

Back in November I ran a clinical safety workshop for the MSIA in Sydney. I had several requests for follow ups in Melbourne and Brisbane, so I will be holding follow up workshops on March 11 (Melbourne) and Mar 13 (Brisbane). I’ll do more if there’s sufficient interest.

Here’s some quotes from the announcement:

This workshop provides a set of tools and knowledge that will help healthcare application designers create safer software. Attendees will work through real, practical examples that demonstrate clinical safety issues in application design, and also cover general clinical safety thinking, coding, presentation, data management issues, and the looming regulatory process.

The workshop is for people who make decisions about software design, or manage the software design process – whether their background is clinical, programming, or otherwise.

Testimonials

“The Clinical Safety Workshop was not what I expected, but so much more. Grahame did not condescend to dictate specific software tricks to write safe software. Rather, he engaged with participants to help them understand for themselves a philosophy and approach to developing safe and effective health software using skills we already know. Suited to senior technical management, architects and code cutters alike.”  Mat Hudson, CEO RadLogix Pty Ltd

Grahame brings together his years of experience in medical software and standards development to address one of the most important issues related to using information and associated machines in the provision of health care and that issue is safety.  The workshop I attended was both academically rigorous and practical. I would not hesitate to recommend it for anyone wanting to work with information and knowledge in health and in my view there is no-one that doesn’t! Michael Legg, Conjoint Associate Professor, School of Medical Sciences, University of New South Wales

The workshop will cost $700, or $500 for employees of companies that are MSIA members (the program was prepared in association with the eHealth Industry Clinical Safety and Security Committee auspiced by the MSIA)

Hopefully, I’ll see you there.

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Here is the link:

http://www.healthintersections.com.au/?p=1847

By the time you read this a registration facility will be available at the following link I am assured:

http://www.healthintersections.com.au/?page_id=1841

This post is a public service for my readers and I stand to make not a cent, but have had to spend a moment of two of my time creating the blog.

Regular readers of this blog will fully understand how interested I am in all aspects of this area of endeavour if only because of a concern that if software development in the Health IT space is not cognizant of the possible risks issues around safety could come back to bite us and erode public confidence.

Note that the coverage provided is both on mobile as well as traditional applications.

For those that can benefit this is a must not miss event.

David.

Posted by Dr David More MB PhD FACHI at Thursday, January 30, 2014 0 comments

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Wednesday, January 29, 2014

Just Why This Is Going On With The Future Of The PCEHR Being Under Review?

This appeared in a major journal of record a few days ago.

Wealth of health on site

Jan. 23, 2014, 6:25 a.m.

The Western NSW Medicare Local (WML) and Blayney Family Medical Practice are encouraging residents and surrounding communities to register for a Personally Controlled Electronic eHealth record (PCEHR) by holding a registration day on Friday, February 7.

WML will be helping and registering community members for a free eHealth record and then doctors will be able to upload a summary of their health information to the system.

Any visitors can attend the registration day and get an eHealth record and have their own GP upload their health summary later.

An eHealth record is an electronic summary of a patient's key health information drawn from their existing patient records.

Information can be uploaded by an authorised healthcare professional which is typically a person's regular GP.

Information that can be uploaded includes medications, test results, discharge summaries, allergies and details of any immunisations.

The doctors are in favour of everyone registering for an eHealth record, according to Suba Vijayakumar, Practice Manager at the Blayney Family Medical Practice.

"It's in our patients's best interests to have all their health information accessible in one online location, no matter where they are or whoever they go to," she said.

"We are very excited about the potential for the eHealth record and how it can help patients control and take ownership of their own medical history."

Stephen Jackson, Deputy CEO at WML, said the team has been promoting meaningful use of the eHealth record system across the region.

More information on the activities is found here:

http://www.blayneychronicle.com.au/story/2039648/wealth-of-health-on-site/?cs=521

As you will be aware Blayney NSW is a major metropolis in Western NSW  on the Mid-Western Highway with a population of a little over 3000 souls.

You can see some great pictures of the very neat town here:

http://en.wikipedia.org/wiki/Blayney,_New_South_Wales

There are three questions that spring to mind here:

1. Why are none of the doctors in the practice quoted rather than the lay staff?

2. Why is it that this activity is being funded when the PCEHR is under-review?

3. I wonder what the WML staff imagine ‘meaningful use’ means in the context of the PCEHR?  I note they make it clear that registration is the goal and that filling in and use of the record is to come at some time later.

Surely there other things that might make a larger difference to the health of those living in Blayney that registering them for a PCEHR which they may or may not use later?

David.

Posted by Dr David More MB PhD FACHI at Wednesday, January 29, 2014 3 comments

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Tuesday, January 28, 2014

I Wonder Do These Provide A Hint As To What The PCEHR Enquiry Might Say?

These appeared last week.

First we had.

Govt mulls PCEHR overhaul

21/01/2014

The Federal Government is considering its response to a review of the controversial Personally Controlled Electronic Health Records system.

The three-member review panel, which was chaired by UnitingCare Health Group Director Richard Royle and included AMA President Dr Steve Hambleton, delivered its report to Health Minister Peter Dutton on 20 December.

Though details of the report and its recommendations have not been disclosed, it is believed to suggest wide-ranging changes to the PCEHR to improve its clinical usefulness and encourage its adoption by patients and doctors.

Mr Dutton said the review looked into significant concerns about the progress and implementation of the PCEHR, and its report “provides a comprehensive plan for the future of electronic health records in Australia”.

In its submission to the review, the AMA called for a fundamental change to the system to reduce patient control.

The AMA said the ability of patients to remove or restrict access to information in the PCEHR undermined its usefulness, because doctors could not be confident that it provided the comprehensive medical information needed to make an accurate diagnosis or properly assess the safety of proposed avenues of treatment.

AMA Vice President Professor Geoffrey Dobb said the capacity of patients to remove information from the record without trace was a fundamental flaw of the system.

“To encourage use of the PCEHR, GPs, community specialists and emergency department specialists must be confident that it contains accurate, up-to-date information,” Professor Dobb said. “Without a fundamental change to increase clinical confidence, the PCEHR does not serve the best interests of patients. As a result, it would be rejected by many doctors, and would fail.”

The full article is found here:

https://ama.com.au/ausmed/govt-mulls-pcehr-overhaul

Then we had.

The five most pressing health priorities in 2014

 

21/01/2014

Trying to identify just five top priorities in an area as complex and ethically fraught as health care is a tough challenge, but that was the task Australian Medicine set for seven of the nation’s leading health advocates and thinkers, including AMA President Dr Steve Hambleton, the nation’s Chief Medical Officer Professor Chris Baggoley, health policy expert Dr Lesley Russell and World Medical Association Council chair Dr Mukesh Haikerwal. Here they provide their thought-provoking and insightful responses.

AMA President Dr Steve Hambleton

1.  Make population health a cross-portfolio priority for all levels of government
Population health is not just about treating illness. It’s also about keeping people well, and all portfolios (Agriculture, Defence, Education, Employment, Environment, Finance, Foreign Affairs and Trade, Health, Immigration and Border Protection, Industry, Infrastructure and Regional Development, Social Services, Treasury etc) need to do their part to fight the threat of non-communicable diseases which stem from tobacco, alcohol, over-nutrition and under- exercise. 

2. Continue the investment in closing the life expectancy gap between Aboriginal and Torres Strait Islander peoples and all Australians
All governments need to keep up the investment, but not just in the health portfolio. There is stark evidence that investing in the social determinants of health and a good education, starting at birth, are major predictors of health outcomes.

3. Fix e-health and the PCEHR
We must be able to talk to each other in the same language -general practice, hospitals (public and private), public outpatients, private specialists, aged and community care. Too often the right message just does not get through. Let's get the (e) rail gauge right and use it. 

4. Reduce unwarranted clinical variation
The fastest way to save health dollars and achieve better outcomes is to (as Professor Lord Ari Darzi advised at the 2012 AMA National Conference) “close the gap between what we know and what we do”.  We know we are doing a good job and are very cost effective. If we embrace the move of learned colleges toward clinical audit and self-reflection we can make best practice even better.

5. Invest in research
The human papillomavirus vaccine will save millions of lives. Research delivered and refined the place of statins, also saving millions of lives. We need new ways of treating infections, perhaps more antibiotics or better ways to use the ones we already have.

Heaps of other views here:

https://ama.com.au/ausmed/five-most-pressing-health-priorities-2014

To me these article suggest there are priorities for the AMA in:

1. Standards and interoperability.

2. Governance and control of clinical information

3. Data quality

4. Clinician Trust and Use.

Given both these articles have come out from the AMA after Dr Hambleton finished the PCEHR review for the Health Minister we can conclude these issues may have been canvassed in the comprehensive plan given to the Minister.

What is your take on these clues?

David.

Posted by Dr David More MB PhD FACHI at Tuesday, January 28, 2014 16 comments

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Monday, January 27, 2014

Weekly Australian Health IT Links – 27th January, 2014.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Well, we are through the silly season and the year actually begins this week after the December / January hiatus.

For those just coming back to work all you really missed was the Government going around floating all sorts of ways of saving money including some ideas around the health sector. There have been no decisions announced on e-Health or the Medicare Locals.

All is can say is Happy Real New Year!

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http://www.medicalobserver.com.au/news/older-aussies-happiest-to-share-erecords-with-gps

Older Aussies happiest to share e-records with GPs

21st Jan 2014

Andrew Bracey

LESS than half of older Australians are willing to share the full contents of their personally controlled electronic health record (PCEHR) with allied health and other non-GP health professionals involved in their care, a survey has revealed.

While 95% of 80 regional Australians over-65 surveyed by researchers from Monash University said they were happy to share their full record with their GP, just 44% said they would allow allied health professionals the same access.

Respondents from Victoria’s Bendigo region were also reluctant to grant full access to others involved in their care. Some 48% said they would share their records with diagnostic laboratories, 46% would allow pathology staff access and 44% were happy for their pharmacist to see their record in full. 

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http://www.blayneychronicle.com.au/story/2039648/wealth-of-health-on-site/?cs=521

Wealth of health on site

Jan. 23, 2014, 6:25 a.m.

The Western NSW Medicare Local (WML) and Blayney Family Medical Practice are encouraging residents and surrounding communities to register for a Personally Controlled Electronic eHealth record (PCEHR) by holding a registration day on Friday, February 7.

WML will be helping and registering community members for a free eHealth record and then doctors will be able to upload a summary of their health information to the system.

Any visitors can attend the registration day and get an eHealth record and have their own GP upload their health summary later.

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http://www.theaustralian.com.au/technology/industry-in-dark-on-privacy-law/story-e6frgakx-1226806170574

Industry in dark on privacy law

HALF of all organisations are not even aware of amendments to the Privacy Act that could see fines of about $1.7 million imposed when it comes into effect next month.

IT vendors and privacy advocates hope the startling low awareness figure will shock corporate Australia and smaller players into action.

"Fifty per cent of organisations in Australia don't even know about the legislative changes," Capgemini Australia testing services director Shane Lonergan said. "It's across the board from tier-one to tier-two organisations ... they're major players (in the dark)."

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http://www.smh.com.au/nsw/google-search-doesnt-reveal-doctors-bad-behaviour-listed-on-ahpra-site-20140122-3194s.html

Google search doesn't reveal doctors' bad behaviour listed on AHPRA site

Date January 23, 2014

Amy Corderoy

Health Editor, Sydney Morning Herald

People are being put at risk because there is no way of telling from internet searches if their doctor has broken the rules or is working under sanctions from medical regulators, experts warn.

More than 680,000 health practitioners, including doctors, nurses, and dentists, have their registration status published by the Australian Health Practitioner Regulation Agency (AHPRA), including information about whether special conditions have been placed on their practice because of past bad behaviour.

But lawyers and patient advocates say patients are being left in the dark because the results do not show up in search results. One barrister told Fairfax Media she had clients who had been harmed by a doctor they had researched online, only discovering when they sought legal advice the doctor had conditions placed on them.

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http://www.lexology.com/library/detail.aspx?g=72d9a3c0-92e6-4980-bb89-a567587b9499

Australian privacy laws and health information

Australia privacy rights are regulated by Commonwealth and Australia privacy rights are regulated by Commonwealth and State legislation and the laws protecting confidential information under the common law.

Australian privacy laws govern the collection, use and disclosure of “personal information”. Further, individuals are provided with a right of access and correction of their own personal information. There are also data security, data quality and cross-border transborder data flow requirements.

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https://ama.com.au/ausmed/govt-mulls-pcehr-overhaul

Govt mulls PCEHR overhaul

21/01/2014

The Federal Government is considering its response to a review of the controversial Personally Controlled Electronic Health Records system.

The three-member review panel, which was chaired by UnitingCare Health Group Director Richard Royle and included AMA President Dr Steve Hambleton, delivered its report to Health Minister Peter Dutton on 20 December.

Though details of the report and its recommendations have not been disclosed, it is believed to suggest wide-ranging changes to the PCEHR to improve its clinical usefulness and encourage its adoption by patients and doctors.

Mr Dutton said the review looked into significant concerns about the progress and implementation of the PCEHR, and its report “provides a comprehensive plan for the future of electronic health records in Australia”.

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https://ama.com.au/ausmed/five-most-pressing-health-priorities-2014

The five most pressing health priorities in 2014

21/01/2014

Trying to identify just five top priorities in an area as complex and ethically fraught as health care is a tough challenge, but that was the task Australian Medicine set for seven of the nation’s leading health advocates and thinkers, including AMA President Dr Steve Hambleton, the nation’s Chief Medical Officer Professor Chris Baggoley, health policy expert Dr Lesley Russell and World Medical Association Council chair Dr Mukesh Haikerwal. Here they provide their thought-provoking and insightful responses.

AMA President Dr Steve Hambleton

1.  Make population health a cross-portfolio priority for all levels of government
Population health is not just about treating illness. It’s also about keeping people well, and all portfolios (Agriculture, Defence, Education, Employment, Environment, Finance, Foreign Affairs and Trade, Health, Immigration and Border Protection, Industry, Infrastructure and Regional Development, Social Services, Treasury etc) need to do their part to fight the threat of non-communicable diseases which stem from tobacco, alcohol, over-nutrition and under- exercise. 

2. Continue the investment in closing the life expectancy gap between Aboriginal and Torres Strait Islander peoples and all Australians
All governments need to keep up the investment, but not just in the health portfolio. There is stark evidence that investing in the social determinants of health and a good education, starting at birth, are major predictors of health outcomes.

3. Fix e-health and the PCEHR
We must be able to talk to each other in the same language -general practice, hospitals (public and private), public outpatients, private specialists, aged and community care. Too often the right message just does not get through. Let's get the (e) rail gauge right and use it. 

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http://www.nehta.gov.au/for-providers/usability-support/public-hospitals-conencted-to-the-pcehr

Public Hospitals Connected to the PCEHR

By the end of 2013, over 4,700 General Practices and 600 Community Pharmacies will be using the eHealth record system.  There are also around 200 public hospitals across Australia submitting discharge summaries for patients with an eHealth record, and more connecting every month.

Check whether your local hospital is able to submit discharge summaries to the eHealth record system in the table below.

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www.fiercehealthcare.com/story/email-overload-costs-hospitals-millions/2014-01-23

Email overload costs hospitals millions

January 23, 2014 | By Katie Sullivan

Medical centers pay a high price for the convenience of email--millions of dollars each year as well as a loss in doctor productivity, according to a research letter published in the Journal of the American Medical Association Pediatrics.

Ian Paul, M.D., and Benjamin Levi, M.D., Ph.D., both of the Penn State College of Medicine, examined how long it would take to go through more than 2,000 mass emails Paul received during the 2009-2010 academic year, and what that equated to in dollars.

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http://www.computerworld.com.au/article/536338/qld_health_aftermath_govt_still_seeking_redress_overpayments/

Qld Health aftermath: Govt still seeking to redress overpayments

So far staff have pledged to repay $3.5 million out of some $120 million worth of overpayments

Queensland Health staff have committed to handing back overpayments worth $3.5 million, the state government announced this morning.

The overpayments are a product of the Queensland Health payroll system debacle. In total 2500 Queensland Health staff members have signed up to repay money, according to Queensland's health minister, Lawrence Springborg.

"I hope to see the number of Queensland Health staff using the new online repayment system continue to rise so we can all put Labor’s payroll debacle behind us," Springborg said.

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http://www.smh.com.au/it-pro/business-it/data-armageddon-preserving-data-can-be-tricky-business-20140123-hv9j9.html

Data Armageddon: preserving data can be tricky business

Date January 24, 2014

Drew Turney

There's a crisis looming in scientific data, with a leading scientific journal estimating 80 per cent of current scientific research will be lost in 20 years.

The study, published in Nature, included all data – even paper stored in garages or mouldy basements – but digital-only information may be under even greater threat. Digital conservation and what's called "digital archaeology" (picking up the pieces of data loss) is going to be an increasingly important strategy.

Rackspace chief technology officer Alan Perkins had to restore data from files written by discontinued and unsupported software. "I had to reverse-engineer the encrypted data," he says. "And I noticed several repeating characters every 673 characters, which let me decipher it."

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http://www.computerworld.com.au/article/536295/vic_govt_updates_ict_strategy/

Vic govt updates ICT strategy

Plans to implement whole-of-government infrastructure as a service roadmap

The Victorian government is preparing to move to the next stage of its ICT strategy.

The Victorian government on Monday sought comment on an update to the plan that was launched in February 2013. The government strategy has a rolling two-year plan with an annual update that is designed to keep it up to date.

“The strategy is driving the delivery of better services, reducing duplication, encouraging innovation and improving ICT procurement and project management across government and, as we move towards the second stage, we need to ensure that the Victorian Government takes advantage of the opportunities arising from the ever-evolving ICT industry,” said Victorian technology minister, Gordon Rich-Phillips.

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http://www.theaustralian.com.au/executive-living/who-goes-there/story-e6frg9zo-1226807742484

Who goes there?

IF Roman armies of ancient times had perpetually used the Latin for "watchword" to verify their identities, friend may have been indistinguishable from foe in battle. Military security would have been breached and Rome's glorious battle history and, ultimately, human civilisation may have panned out differently.

Yet fast forward to 2013 and "password" was the second most commonly used password online, pipped only by "123456". In 2012, "password" was actually No 1.

Splashdata's annual "worst passwords" list illustrates that many take warnings about hacking, identity theft, malware, ransomware and online fraud lightly. Put bluntly, the fastidiousness of the Roman tesserarii, who managed the distribution of watchwords, puts many of us to shame in terms of password security.

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http://www.itnews.com.au/News/370147,nsw-health-begins-hunt-for-new-it-leader.aspx

NSW Health begins hunt for new IT leader

By Paris Cowan on Jan 24, 2014 10:23 AM

Super-CIO wanted for new eHealth body.

NSW Health has begun advertising for its new IT chief, who will take over the soon-to-be-established entity eHealth NSW in an expanded CIO role.

The agency plans to appoint an inaugural chief executive of eHealth NSW by April. The successful candidate will "have a thorough understanding of healthcare delivery within a complex health system, as well as current trends, issues and policy directions in e-health," according to the NSW government's jobs website.

The role encompasses responsibilities once held by departed NSW Health CIO Greg Wells, but will operate at a more senior level, answering directly to director-general Mary Foley.

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http://www.lexology.com/library/detail.aspx?g=a951d7ea-bda5-41ce-a506-c45a5cf3ca32

Update on Personally Controlled Electronic Health Records - legal and privacy issues

As part of the 2010/11 Federal budget, the Government announced a $466.7 million investment over two years for a national Personally Controlled Electronic Health Record (PCEHR) system for all Australians who choose to register on-line, from 2012-2013. This initiative has the potential to be a revolutionary step for Australian health care, in terms of both consumer's access to their own health information and improvement in information which will be available to health professionals when they treat a patient.

To date, the uptake has been slow. NeHTA scorecard as at 29 October 2013:

  • The total number of people who registered for an eHealth record as at 29 October 2013 was 1,042,966.
  • More than 5,681 healthcare provider organisations have signed onto the eHealth Record system.
  • 8,105 individual doctors, nurses and other healthcare providers throughout Australia has been authorized by their organisations to access the PCEHR system;
  • More than 15.25 million documents have been uploaded into the PCEHR system.

With respect to the number of providers with HPI-Is that have been linked to access the system, it is NeHTA’s understanding that these numbers are linkages via the provider portal and exclude any linkages through local clinical information systems, so the total number of authorized users can be significantly greater.

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http://www.itnews.com.au/News/369972,wa-health-replaces-cio.aspx

WA Health replaces CIO

By Paris Cowan on Jan 20, 2014 12:12 PM

Western Australia’s Department of Health has installed another acting executive to head its extensive IT operations.

Bill Leonard has taken over the role of acting CIO at the 40,000-strong organisation.

He replaces Dr Andy Roberson, who had filled in for the past 12 months but has now stepped down to return to his “substantive role” as deputy chief health officer and director of disaster management, regulation and planning.

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http://www.itnews.com.au/News/363802,wa-health-boss-denies-covering-up-hospital-it-problems.aspx

WA Health boss denies covering up hospital IT problems

By Paris Cowan on Nov 12, 2013 7:03 AM

'I was not gilding the lily'.

Former WA Health director-general Kim Snowball has defended himself against accusations he intentionally downplayed IT problems plaguing the construction of the state’s flagship Fiona Stanley Hospital.

The $2 billion facility will open to patients in October 2014, six months later than originally planned. Delays in the opening of the "paperless" hospital have been attributed to complex and unfinished IT.

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http://www.smh.com.au/world/is-the-stethoscope-on-its-way-out-20140124-hv9pt.html

Is the stethoscope on its way out?

Date January 24, 2014

Jasper Copping

London: The cold sensation of the doctor's stethoscope has been familiar to patients for decades.

But the device could soon be replaced by new technology, a leading scientific journal has predicted.

It claims that a new generation of hand-held ultrasound devices, modelled on smartphones, are able to diagnose heart, lung and other conditions quicker and with more accuracy than the 200-year-old stethoscope.

The editorial article, in Global Heart, the journal of the World Heart Federation, says: "Many experts have argued that ultrasound has become the stethoscope of the 21st century."

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http://www.theaustralian.com.au/higher-education/aussies-invent-gizmo-for-parkinsons-falls/story-e6frgcjx-1226809877305

Aussies invent gizmo for Parkinson's falls

  • AAP
  • January 25, 2014 12:00AM

AUSTRALIAN scientists have invented a device that warns people with Parkinson's disease when they are in danger of a bone-breaking fall.

Although backed by serious science, it's a simple headband that gives people time to stabilise themselves before they suffer an unexpected freeze in their walking, which is common in Parkinson's disease.

Most Parkinson's patients are older than 60, and broken bones are one of their biggest dangers.

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http://www.theaustralian.com.au/news/features/brisbane-technology-could-help-71000-blind-people-use-computers/story-e6frg8h6-1226809457967

Brisbane technology could help 71,000 blind people use computers

HE has his own way of seeing my hand, which he shakes, taking "feedback" from its touch. "Michael Curran," he says, folding a collapsible white blind cane in three places. His right hand touches the corner of his kitchen bench upon which he knows, subconsciously, sits a cane fruit bowl with two oranges and two red apples. He knows the colours of orange and red because he saw them long before his vision turned black.

He walks to his lounge room and points to a sofa with a pile of laundry on it, ready to be folded. "Would you like to sit here?" he asks, and then points to a hardwood table to his left. "Or at this stupidly large dining table?"

In this modest lowset brick home in the quiet, suburban Ferny Grove, in Brisbane's west, Michael Curran, a 30-year-old computer software designer, fully blind since he was 15, and his wife, Amy, not fully blind but vision-impaired, raise their two daughters, Gabrielle, five, and Hannah, three. Michael and Amy fell for each other when they were vice-president and treasurer, respectively, of the Young Blind Citizens Victoria advocacy group, where they ran sessions for blind youths about moving out of home as a blind citizen, forming relationships, finding work, becoming a parent. They moved to Queensland in 2010.

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http://www.healthtechzone.com/topics/healthcare/articles/2014/01/23/367687-mmrglobal-granted-patent-personal-health-record-mobile-app.htm

January 23, 2014

MMRGlobal Granted Patent for Personal Health Record Mobile App

MMRGlobal, Inc., also known as MyMedicalRecords, announced this week that it has received a U.S. patent for an app that allows users to store personal health records in the form of voice mail, faxes, email, file upload and other forms of media on their personal devices, according to a statement released by the company. The app will also include an interface that collects and displays prescriptions for submission to pharmacies, allows users to annotate health records and set up appointment rem­­­inders.

"This 10th health IT patent comes at a unique time when awareness of the importance of online access to medical information is at the forefront of everybody's mind,” CEO Robert H. Lorsch said in the statement. “The eHealth market, and specifically the use of Personal Health Records and other products and services including PHRs, EMRs, telemedicine and wireless services that utilize portions of MMR's intellectual property, continues to grow. Additionally, MMR has 18 pending patent applications in the U.S. plus additional applications issued or in various stages of examination globally."

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http://www.medicalobserver.com.au/news/mls-need-to-go-gp-survey-reveals

MLs need to go: GP survey reveals

22nd Jan 2014

Byron Kaye

THE AMA has reignited its opposition to Medicare Locals, saying a survey of GPs found almost three quarters believed the organisations were failing to make healthcare delivery easier and should be shut down.

The AMA survey was released as 1700 primary healthcare workers and GPs await the outcome of a review of MLs ordered by Health Minister Peter Dutton. Mr Dutton, who had previously said MLs were an unnecessary bureaucratic layer that should be scrapped, has refused to speculate on how he will respond to the review until it is completed.

By contrast, the AMA, which had initially called for the ML rollout to be frozen on grounds that their corporate structure diluted GP leadership, has more recently softened its stance. In an editorial for MO last year, AMA president Dr Steve Hambleton wrote that it would be too expensive to unwind the organisations and they should instead be “shaped” to improve support for GPs.

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http://blogs.wsj.com/cio/2014/01/17/health-exchange-woes-illustrate-need-for-escape-clauses/?mod=djemCIO_h&cb=logged0.5140116707044313

Health Exchange Woes Illustrate Need for Escape Clauses

·         By Clint Boulton - Reporter

CIOs should include detailed project requirement rules in their vendor contracts to indemnify themselves against poor-performing vendors, said Jeff Muscarella, an IT sourcing consultant for NPI Financial LLC. He said adding certain escape clauses will better prepare CIOs when vendor disputes end up in court.

Such vendor management is one of the key problems with health exchanges created under the Affordable Care Act. Despite technical difficulties afflicting state exchanges in Minnesota, Oregon and Massachusetts, contractors responsible for the website-crippling glitches are still on the job. Mr. Muscarella said the complex nature of the health exchanges make it difficult to let contractors go. Difficult, but not impossible, provided CIOs define the rules.

Project Governance. CIOs must include a set of clauses that define how IT problems will be tracked, managed and resolved. This process should cover problem resolution, typically starting with project managers for the customer and the vendor, and then escalating to the vice presidents of IT, if necessary. Failure to resolve these problems usually spurs the CEOs of each party to meet. If the vendor doesn’t observe this clause to the letter, the client can void the contract. “If they don’t manage the project accordingly, that’s grounds for termination,” Mr. Muscarella said.

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http://www.smh.com.au/digital-life/digital-life-news/the-rise-of-artificial-intelligence-20140122-317g3.html

The rise of artificial intelligence

Date January 23, 2014

Iain Gillespie

Recent advances in making computers work like the human brain have pointed the way to a new era in artificial intelligence, and chances are you have already used some of the software improvements involved.

Breakthroughs in deep learning, a process that imitates the brain with digital ''neural networks'' that gather information and react to it independently, have prompted the world's technology giants to invest billions of dollars in a fierce competition to lead the field.

Google co-founder Sergey Brin has been quoted as saying he wants to build the equivalent of the sentient computer HAL from the film 2001: A Space Odyssey, except that it wouldn't kill people. Deep learning might bring that objective a step closer.

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http://www.theaustralian.com.au/higher-education/astronomers-glimpse-cosmic-web/story-e6frgcjx-1226804418825

Astronomers glimpse 'cosmic web'

  • John Ross
  • The Australian
  • January 20, 2014 5:00AM

SCIENTISTS say they have recorded the first glimpse of the "cosmic web", a colossal network of giant intersecting threads which holds the universe together.

Astronomers have speculated for years that gigantic voids in the universe are crisscrossed by “filaments” of dark matter. These filaments siphon together gases and other material, forming galaxies along their length and tightly packed clusters of galaxies at their junctions.

However, dark matter emits little if any radiation, including light. Consequently, the threads of the cosmic web have only been observed in computer simulations.

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http://www.computerworld.com.au/article/536708/after_10_years_mars_rover_opportunity_makes_big_water_find/

After 10 years on Mars, rover Opportunity makes big water find

Robotic rover finds evidence of an older, milder water environment on Martian surface

After 10 years on Mars, NASA's rover Opportunity has discovered evidence of an ancient wet and mild environment that is much older than previously thought.

The discover is giving scientists further indication that the Red Planet might have been able to sustain life.

"These rocks are older than any we examined earlier in the mission, and they reveal more favorable conditions for microbial life than any evidence previously examined by investigations with Opportunity," said Ray Arvidson, Opportunity's deputy principal investigator and a professor at Washington University in St. Louis.

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Enjoy!

David.

Posted by Dr David More MB PhD FACHI at Monday, January 27, 2014 3 comments

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Sunday, January 26, 2014

Australia Day Holiday

As most will be off having fun seems little point in publishing a blog for Monday. So enjoy the poll results, respond to the new one and have a great holiday.

Normal service resumes, of course, tomorrow!

David.

Posted by Dr David More MB PhD FACHI at Sunday, January 26, 2014 0 comments

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AusHealthIT Poll Number 202 – Results – 26th January, 2014.

Is Promoting The Concept Of e-Health And The PCEHR As A Panacea For Much That Ails The Health Sector Deceptive and Misleading Advertising?

For Sure 78% (32)

Probably 10% (4)

Possibly 5% (2)

No Way 7% (3)

I Have No Idea 0% (0)

Total votes: 41

It seems 88% of readers are pretty sure that promotion of e-Health and the PCEHR has been less that open, truthful and honest.

Again, many thanks to those that voted!

David.

Posted by Dr David More MB PhD FACHI at Sunday, January 26, 2014 0 comments

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Saturday, January 25, 2014

Weekly Overseas Health IT Links - 26th January, 2014.

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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http://www.healthcareitnews.com/news/health-it-experts-brainstorm-onc-clinical-quality-measures

Health IT experts brainstorm with ONC on clinical quality measures

Posted on Jan 17, 2014

By Anthony Brino, Editor, HIEWatch

Informaticists joined clinical quality experts in a brain storming session this week with new ONC chief Karen DeSalvo, exchanging ideas on developing the "next generation" of quality measures. 

Charged with developing new e-clinical quality measures that can work in tandem with accountable care measures, the HIT Policy Committee’s Quality Measures Workgroup offered recommendations to Karen DeSalvo at her first policy meeting.

The Workgroup’s co-chairs, National Quality Forum VP Helen Burstin, MD, and Veterans Health Administration informatics director Terry Cullen, MD, developed recommendations for measure domains, criteria and implementation, some of which seems to have drawn resistance from a few health IT companies.

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http://www.healthcareitnews.com/news/cios-gauge-decade-health-it-headway

CIOs gauge decade of health IT headway

Posted on Jan 17, 2014

By Bernie Monegain, Editor

The healthcare IT industry just marked  the 10-year anniversary of then President George W. Bush’s call to action – in his 2004 State of the Union address – to finally transform a paper-mired healthcare system into a digital-age industry that operates more like other sectors of the economy.

As we look back on 10 years, we spoke to some leaders on the frontline of health information technology, asking them to take measure of how far the industry has moved towards a truly high-tech, data-driven system of care.

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http://www.fiercehealthit.com/story/patients-using-telehealth-services-hit-7-million-2018/2014-01-17

Patients using telehealth services to hit 7 million by 2018

January 17, 2014 | By Dan Bowman

The number of patients worldwide using telehealth services will rise from less than 350,000 in 2013 to roughly seven million in 2018, according to a new report published by IHS Technology.

Additionally, the report estimates that revenue for telehealth services will balloon tenfold, from $440.6 million in 2013 to $4.5 billion in 2018. The report's authors point to the introduction of mobile health hubs and projected growth in wearable technology as catalysts for such growth.

"Amid rising expenses, an aging population and the increasing prevalence of chronic diseases, the healthcare industry must change the way it operates," Roeen Roashan, a medical devices and digital health analyst at IHS, said in an announcement. "Telehealth represents an attractive solution to these challenges, increasing the quality of care while reducing overall healthcare expenditures."

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http://www.informationweek.com/healthcare/leadership/3-trends-are-reshaping-healthcare-it/d/d-id/1113460?

3 Trends Are Reshaping Healthcare IT

Skepticism of innovative health technology is nothing new. But trends such as social technology will redefine healthcare's future.

1/16/2014 00:10 AM

Kaveh Safavi
Commentary

The history of healthcare is one of constant discovery, progress, and invention -- and often skepticism from both practitioners and patients.

Take this prediction from The Times of London in 1834: "That it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble." The innovation in question: the newly invented stethoscope.

The same is true with the development of healthcare information technology (HIT) today. Its transformational power has yet to be fully recognized. While tools like electronic health records (EHR) are now accepted and mainstream, there are more wide-ranging, IT-driven opportunities still to be grasped. Above all, Internet access, mobile technologies, and social networks collectively offer a future where it is possible to deliver highly personalized care without necessarily having to do it in-person, or even with a doctor.

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http://www.healthdatamanagement.com/news/wedi-to-sebelius-you-need-more-icd10-testing-47102-1.html

WEDI to Sebelius: You Need More ICD-10 Testing

Joseph Goedert

JAN 15, 2014 3:40pm ET

The Workgroup for Electronic Data Interchange has sent a letter to Health and Human Services Secretary Kathleen Sebelius giving a variety of compelling reasons for the department to expand its ICD-10 testing before the Oct. 1, 2014, compliance date. Here is the letter, dated Jan. 13:

“In its advisory role under the Health Insurance Portability and Accountability Act of 1996, the Workgroup for Electronic Data Interchange periodically brings to your attention issues related to healthcare information exchange and related areas that it believes merit review and consideration by the Secretary of Health and Human Services. We take this opportunity to ask you to consider additional Medicare testing prior to ICD-10-CM and ICD-10-PCS (ICD-10) implementation.

“In the January 16, 2009 Federal Register (74 FR 3328), HHS published a final rule adopting the ICD-10-CM and ICD-10-PCS medical code sets as the HIPAA standards to replace the previously adopted ICD-9-CM medical code set for diagnosis and inpatient procedure coding. The compliance date established by the final rule was October 1, 2013. In the September 5, 2012 Federal Register the compliance date for this requirement was extended to October 1, 2014.

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www.fierceemr.com/story/researchers-ehr-outcome-mu-studies-need-shift-focus/2014-01-13

Researchers: EHR outcome, MU studies need to shift focus

January 13, 2014 | By Marla Durben Hirsch

Clinical decision support tools and computerized physician order entry--both Meaningful Use program requirements--are proven to have positive effects on quality outcomes, but reporting of contextual and implementation details have been "poor," making it impossible to determine why some electronic health record implementations were successful and some not, according to a new study funded by the Office of the National Coordinator for Health IT published in the Annals of Internal Medicine.

"Healthcare providers should be encouraged to adopt CDS and CPOE, and future studies of CDS and CPOE should concentrate on how to make them work better rather than testing the hypothesis of whether they work at all," the researchers said.

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http://www.fierceemr.com/story/ehr-research-needs-be-more-meaningful/2014-01-16

EHR research needs to be more meaningful

January 16, 2014 | By Marla Durben Hirsch

I usually take electronic health record research at face value. These are generally scientific endeavors, often conducted by esteemed institutions or academicians who are testing the effectiveness of such tools, assessing their impact on satisfaction and productivity, or determining their role in research.

So it's disconcerting to read not one, but two studies this week that question the quality of some of the EHR research being conducted.

First there's the RAND Corporation's study on Meaningful Use, funded by the Office of the National Coordinator for Health IT. If you read ONC's blog post about the study, Meaningful Use is fabulous. It "improves quality, safety and efficiency outcomes." The blog post provides all sorts of statistics to support its claim. It glosses over the fact, however, that most of the studies being cited pertain only to clinical decision support and computerized physician order entry; the other components of Meaningful Use "are not as well studied."

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http://www.healthcareitnews.com/news/onc-chiefs-early-years-inform-her-work

ONC chief's early years inform her work

Posted on Jan 16, 2014

By Anthony Brino, Editor, HIEWatch

Karen DeSalvo, MD, has stepped into the role of national coordinator for healthcare information technology at a time when American healthcare is in a state of unprecedented change.

Her resume shows that DeSalvo has the right mix of skills to advance the healthcare system while helping the IT industry create better tools for providers and patients alike.

A practicing internist, she recently led a purchasing committee select a new EHR system. DeSalvo served as the New Orleans public health commissioner until recently, after working at Charity Hospital and Tulane University’s medical school.

DeSalvo’s experience in New Orleans -- such as patients suffering end-stage diseases that could have been prevented or mitigated and the disaster of Hurricane Katrina -- combined with her upbringing, left her with concerns about inequality in access to healthcare and an insufficient medical communications infrastructure.

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http://www.hiewatch.com/perspective/patient-generated-data-which-road-travel

Patient-generated data: Which road to travel?

Source: Joseph Kvedar, MD, Center for Connected Health Date: Jan 15, 2014

Patients who could most benefit from personal health tracking are not currently the ones doing so. But the convergence of BYOD, connected sensors and evolving EHRs presents a number of paths providers should consider travelling, keeping in mind Robert Frost's famous poem, argues Joseph Kvedar.

Two roads diverged in a wood, and I—I took the one less traveled by, And that has made all the difference.”  Robert Frost

I received two emails from organizational leadership in the past week that represent milestones to me. One was about our efforts to better manage populations in the context of risk-bearing (pay-for-value) contracts with our payers: “[Partners] is undergoing a planning process to determine what we can do over the next 3 years (2015 to 2017) to better prepare for increased risk in payer contracts….there is a segment of our Hypertension and Diabetes population (and CHF) that would benefit from telemonitoring.” The language here is not dramatic, but the recognition that patient-generated data can be a critical tool for population health management and improved efficiency of care delivery is something we have strived to demonstrate over the last 10 years or more. It feels good to hear it come from others.

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http://www.ehi.co.uk/insight/analysis/1240/insider-view

Insider view

On the first anniversary of health secretary Jeremy Hunt’s groundbreaking speech on NHS IT, EHI editor Jon Hoeksma asks whether the ‘paperless’ NHS needs to start a new chapter.

16 January 2014

A year ago, health secretary Jeremy Hunt announced that he wanted to see a ‘paperless’ NHS by 2018.

Twelve months on, the idea remains an important clarion call to action, without a huge amount of clarity on what paperless means, why it should be achieved, or how it will be taken forward.

Literally paperless a pipe dream

Almost nobody working in NHS IT believes in the objective in a literal sense. There is not a chance the NHS will have ceased to use paper within four years.  Stationers and printers across the land can sleep a little easier.

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http://www.ehi.co.uk/news/EHI/9143/welsh-boards-share-info-via-portal

Welsh boards share info via portal

14 January 2014   Lis Evenstad

Two health boards in Wales are sharing patient information across hospitals using the Welsh Clinical Portal.

In a four-month pilot, eight clinicians at Abertawe Bro Morgannwg Health Board have used the portal to view information about patients referred from Hywel Dda Health Board.

Dr Stephen Dorman, consultant cardiologist at Morriston Cardiac Centre, said the project has improved the speed with which they are able to view a patient’s details.

“The Welsh Clinical Portal cross border pilot has enabled us as clinicians to access vital test results on our patients in a much more timely fashion,” he said.

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http://www.fierceemr.com/story/onc-suite-guides-aims-boost-ehr-safety/2014-01-16

ONC suite of guides aims to boost EHR safety

January 16, 2014 | By Susan D. Hall

The Office of the National Coordinator for Health IT announced this week that it has issued nine guides to help healthcare organizations assess the safety of electronic health records and to use them effectively. Known as the Safety Assurance Factors for EHR Resilience (SAFER) Guides, they offer a suite of tools that include checklists and recommended practices to boost EHR safety.

The nine guides are:

  • High Priority Practices
  • Organizational Responsibilities
  • Patient Identification
  • CPOE with Decision Support
  • Test Results Review and Follow-up
  • Clinician Communication
  • Contingency Planning
  • System Interfaces
  • System Configuration

The guides have been in the works since the U.S. Department of Health & Human Services released a final health IT safety plan last July, Jacob Reider, ONC Chief Medical Officer, said in a post yesterday to the Health IT Buzz blog.

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http://www.healthcareitnews.com/news/onc-aims-safer-use-ehrs

ONC aims for SAFER use of EHRs

Posted on Jan 16, 2014

By Mike Miliard, Managing Editor

The Office of the National Coordinator for Health IT has released what it calls Safety Assurance Factors for EHR Resilience guides: nine toolkits to help providers make safer use of electronic health records and other technology.

The SAFER suite include checklists and recommended practices designed to help care providers and affiliated organizations optimize EHR safety. ONC officials say it's an important component of the Health IT Patient Safety Action and Surveillance Plan issued by the Department of Health and Human Services this past July.

"A basic premise of the Health IT Safety Plan is that all stakeholders have a shared responsibility to make sure that health IT is safely implemented and that it is used to improve patient safety and care," said Jacob Reider, MD, chief medical officer at ONC, in a press statement. "The SAFER Guides combine the latest applied knowledge of health IT safety with practical tools that will help providers – working closely with EHR developers, diagnostic service providers and others – effectively assess and optimize the safety and safe use of EHR technology within their organizations."

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http://www.fierceemr.com/story/himss-analytics-expect-rapid-growth-portal-data-mining-radiology-barcoding/2014-01-16

HIMSS Analytics: Expect rapid growth for portal, data mining, radiology barcoding apps

January 16, 2014 | By Susan D. Hall

Patient portals, clinical data warehousing/mining and radiology barcoding applications are poised for rapid growth among hospitals, according to the HIMSS Analytics report "Essentials of the U.S. Hospital IT Market, Winter 2013 Edition."

Though more than half the health systems, hospitals and clinics in a recent KLAS survey reported offering a portal, the HIMSS report says of the three application types, "first-time purchases of these advanced [electronic medical record] applications are expected to increase greatly among hospitals across the country."

It also predicts a high volume of replacement sales for several foundational applications that have already saturated the market, including laboratory barcoding, pharmacy management systems and information systems for radiology and laboratory departments.

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http://www.healthleadersmedia.com/content/PHY-300035/Telemedicine-a-Win-for-StressedOut-Doctors

Telemedicine a Win for Stressed-Out Doctors

Jacqueline Fellows, for HealthLeaders Media , January 16, 2014

A provider of urgent and primary care is shining a spotlight on telemedicine's reach. This is more than just a way to reach patients in rural areas and cut healthcare costs. Early data shows that patients and physicians are finding other reasons to like virtual provider visits.

As a young medical student, Ben Green, MD, was a family physician in training at a typical primary care office. Rushing around to fit in as many as 20-30 patients per day, he realized quickly that this wasn't what he envisioned medicine to be, and became disillusioned.

"Ten minutes was the average face-to-face time with a patient," says Lee who is now one of the medical directors at Carena, a Seattle-based virtual telemedicine provider of urgent and primary care. "I don't feel like that's the right thing for patients in a primary care setting. I have a lot of respect for providers who do that, but for me, it didn't fit with my comfort level."

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http://www.healthcareitnews.com/news/ehr-payments-soar-near-20b

EHR payments soar to near $20B

Posted on Jan 15, 2014

By Anthony Brino, Editor, HIEWatch

Electronic health record incentive payments to eligible docs and hospitals continue to climb into the new year. The "inexorable progress" of the federal EHR incentive program continues, with payments to providers moving ever closer to $20 billion.

As of the end of November, more than 436,000 hospitals and health professionals have registered for the Medicaid and Medicare EHR incentive program, and the federal government has made more than $17.7 billion in payments, the Centers for Medicare and Medicaid Services told the Health IT Policy Committee in an update.

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http://www.fiercehealthit.com/story/tiger-team-focus-privacy-issues-arising-authorized-access-patient-records/2014-01-15

Tiger team to focus on privacy issues arising from authorized access to patient records

January 15, 2014 | By Dan Bowman

The Privacy and Security Tiger Team--which makes recommendations to the Health IT Policy Committee--laid out its 2014 agenda and named a new co-chair at its first meeting of the new year on Monday. The team's agenda will focus on, among other issues, the privacy of patients who grant other individuals access to their electronic health data, Healthcare Info Security reported.

In particular, the team will discuss such issues as they relate to the records of adult patients in Q1 of 2014. That focus won't shift to issues as they relate to minors until Q3 due to complexities involved in such situations, including parental consent.

Potential second-quarter discussions will center on the data practices of business associates, in particular, data intermediaries, according to Healthcare Info Security. Business associates, of course, now are liable for the protection of private patient information under the Health Insurance Portability and Accountability Act.

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http://www.fiercehealthit.com/story/next-chapter-oncs-work-focus-population-health-management-desalvo-says/2014-01-15

'Next chapter' of ONC's work to focus on population health management, DeSalvo says

January 15, 2014 | By Dan Bowman

National Coordinator for Health IT Karen DeSalvo has wasted no time sharing her thoughts on the direction of ONC's work under her tenure. At Tuesday's Health IT Policy Committee meeting, DeSalvo, one day after taking office, said she believes ONC's next phase will focus on harnessing health IT for, among other things, population health.

"That is the major next chapter that we must undertake as part of the President's major domestic policy initiative," DeSalvo said. "[T]o see the promise of health information technology in the clinical interface for the health systems and the population and community at large to come to fruition."

The new ONC head added that she would like to see "real improvements" in health over time that could help with things like preparedness in the face of disasters. DeSalvo, of course, served as health commissioner for the City of New Orleans, where she helped to establish health IT infrastructure in the wake of Hurricane Katrina. She also previously served as president of the Louisiana Health Care Quality Forum, taking the lead on efforts to secure health information exchange and regional extension center grant funding.

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http://www.healthcareitnews.com/news/health-it-banks-record-vc-cash-2013

Health IT banks record VC cash in 2013

Posted on Jan 14, 2014

By Erin McCann, Associate Editor

Health IT is where the money's at -- at least in 2013, which saw venture capital funding nearly double from the previous year, according to a new industry report released Monday.  

The Mercom Capital Group report highlighted VC and merger and acquisition activity for the healthcare IT market over the past year, and the numbers did not disappoint. 

Venture capital funding in the healthcare IT sector almost doubled, reaching $2.2 billion in 2013 across 571 deals, compared to $1.2 billion across 163 deals in 2012. The biggest recipient of VC dollars was the mobile health sector, which raised some $564 million. 

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http://www.fierceemr.com/story/resolutions-ehr-usability-roi-welcome-relief-or-just-lip-service/2014-01-09

Resolutions on EHR usability, ROI: A welcome relief, or just lip service?

January 9, 2014 | By Marla Durben Hirsch

I read with great interest this week's proposals to improve electronic health records in the new year. First we have Jacob Reider, Acting National Coordinator for Health IT, who published a blog post on Jan. 6 acknowledging that EHR usability continues to be an unresolved issue that remains a priority for ONC. He also notes that the agency is working to understand the issues and determine what the government's role should be regarding EHR usability.

Then we have the Institute of Medicine on the same day issuing a proposed standard model for hospitals and others to evaluate the financial benefits and costs of purchasing an EHR and its potential return on investment (ROI). The proposed model helps provide inter-organizational comparisons, identify "best-in-class" implementation approaches and prioritize process redesign endeavors.

These are welcome developments. It's about time that there's an emphasis on EHR usability and a real tool to help providers determine their ROI when purchasing an EHR. Plus, these initiatives are coming from the government and the Institute of Medicine, no less, so they're backed with notable credibility.

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http://www.healthleadersmedia.com/content/TEC-299958/The-Hospital-Room-PC-Reimagined

The Hospital Room PC, Reimagined

Scott Mace, for HealthLeaders Media , January 14, 2014

A new PC being tested in hospital rooms isn't like any PC you know. Sure, it delivers streaming video and gaming, but it can also provide patient monitoring and reporting.

Virtual desktops may be on a trajectory to erase the traditional work PC in hospitals, but at the International CES show last week, Intermountain proved that PCs have a new, somewhat surprising starring role in healthcare.

Last September, I wrote about how Memorial Healthcare in Owosso, Michigan had decided to replace traditional PCs with so-called "zero client" hardware that provided maximum mobility for clinicians and minimum maintenance headaches for IT staff. That trend continues, although some readers noted that antiquated software licensing policies at Microsoft and the PC-based EHR companies are slowing the move to zero-client PCs.

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http://www.healthleadersmedia.com/content/TEC-299934/The-Trouble-with-EHRs

The Trouble with EHRs

Scott Mace, for HealthLeaders Media , January 14, 2014

Although electronic health records are known to reduce healthcare costs, concerns about accuracy and usability—and the risk of EHR-caused medical errors—are growing.

This article appears in the December issue of HealthLeaders magazine.

The move away from paper medical records to EHRs has many benefits, but the flip side is that providers need to carefully manage the usability, accuracy, and audit trails of EHRs across the entire care team.

Providers say the day of the doctor carefully controlling and supervising every aspect of a medical record is giving way to an age where the entire medical team and even patients will scrutinize and update a record's accuracy, all while legal and regulatory requirements for maintaining those records are met. At the same time, the complexity of EHR software itself increases the risk of EHR-caused medical errors.

While EHRs have been around for years, the requirements of meaningful use stage 2 for patients to be able to view, download, and transmit their medical records to providers across the care continuum as well as health information exchanges mean it is time for providers to pay special attention to proper record maintenance.

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http://www.healthdatamanagement.com/news/standard-framework-offered-to-assess-hit-return-on-investment-47088-1.html

Standard Framework Offered to Assess HIT Return on Investment

Joseph Goedert

JAN 10, 2014 3:37pm ET

A team of researchers from across the industry have developed a framework for assessing the return on investment of health information systems.

The Institute of Medicine has published the framework as a discussion paper, available here. “Although it may seem obvious that both the demands for higher reliability and higher-value health care require robust electronic health records, information exchange and deep analytic capabilities, it remains difficult to measure the return on investment in information systems,” the authors note. “The lack of a standard model for ascribing the costs of implementing or the benefits of using EHRs and related technology makes comparisons across different institutional experiences, different implementation approaches, and different technologies difficult. Moreover, the absence of a format for a standard business case for information investment may add to the hesitation for investment in information systems and thwart progress in creating the reliable digital foundation needed for a continuously learning health system.”

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http://www.fiercehealthit.com/story/onc-seeks-more-input-tech-support-patient-involvement/2014-01-13

ONC seeks more input on tech to support patient involvement

January 13, 2014 | By Susan D. Hall

The Office of the National Coordinator for Health IT has been working to change focus from technology to support physicians to technology that centers on patients. Publishing an issue brief summing up the work done so far and what remains, the office is also asking for public input.

"A little over a year ago, we embarked on an effort to look to a long term future, where health IT and communications technology could support people in managing their own health and partnering in their health care. We engaged visionaries and subject matter experts to help us develop a policy framework for putting the person more at the center of their own health and health care, enabled by health IT," writes Jodi G. Daniel, Director of the Office of Policy and Planning, in a post at Health IT Buzz.

It points to efforts such as Blue Button Plus, Patient Centered Outcomes Research (PCOR) and expansion of the Investing in Innovation ("i2") Program that have focused on using technology to improve care and give patients more access to their own information.

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http://www.ihealthbeat.org/insight/2014/a-review-of-the-federal-health-it-activity-in-q4-2013

A Review of the Federal Health IT Activity in Q4 2013

by Helen R. Pfister, Susan R. Ingargiola and Erica L. Cali, Manatt Health Solutions Monday, January 13, 2014

The federal government continued to implement the Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act, during the fourth quarter of 2013. Below is a summary of key developments and milestones achieved between October 1, 2013, and December 31, 2013.

Highlights

The fourth quarter of 2013 saw a number of important developments:

  • HHS Announces New National Coordinator. On Dec. 19, 2013, HHS Secretary Kathleen Sebelius announced that Karen DeSalvo will be the next national coordinator for health IT. DeSalvo last served as the New Orleans Health Commissioner and a senior health policy adviser to Mayor Mitch Landrieu (D). She takes over the national coordinator post on Jan. 13.
  • CMS Proposes To Extend the Meaningful Use Timeline. On Dec. 6, 2013, CMS proposed a new timeline for the implementation of meaningful use under the Medicare and Medicaid Electronic Health Record Incentive Programs. Under the revised timeline, Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for those providers that have completed at least two years in Stage 2. On the same day, ONC proposed to allow for certification criteria to be updated more frequently under the ONC Health IT Certification Program. 

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http://www.ft.com/intl/cms/s/0/1959b026-7a2a-11e3-a3e6-00144feabdc0.html?ftcamp=crm/email/2014113/nbe/DrugsHealthcare/product&siteedition=intl#axzz2qG5eT7wX

Charities launch campaign on sharing medical data

By Clive Cookson

Britain’s largest medical charities are launching a campaign on Monday to encourage National Health Service patients to share their records for research and other purposes beyond their own clinical care.

The charities want to convince people that the benefits of medical data sharing – with safeguards to protect confidentiality – “far outweigh inflated privacy concerns”.

Their campaign coincides with an expansion of patient data-sharing across NHS England.

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Enjoy!

David.

 

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