Publication Date 01/04/2014         Volume. 6 No. 3   
Information to Pharmacists

Editorial

From the desk of the editor

Business is tight!
Cash flow has evaporated!
The PGA calls for unity while simultaneously dismembering the business of consultant pharmacists.
The federal government continues to strip massive funds from the PBS to the extent that it is gasping for air.
Oh, and I forgot, the Revive Clinic thinks that pharmacists cannot vaccinate patients in community pharmacies ( It is actually a warehouse pharmacy group trying to destabilise the market here to push fellow-pharmacists off balance by supporting the Revive group).
Even wage-earning pharmacists have discovered that they have not had a rise in their pay over the past five years

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Health IT Update - May 2011

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 - 28 May, 2011.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. 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.

Healthcare IT Spending To Reach $40 Billion

The U.S market for healthcare IT hardware, software, and services is expected to grow 24% annually for several years, driven in part by mandatory use of EHRs.

By Nicole Lewis, InformationWeek

May 16, 2011

URL: http://www.informationweek.com/news/healthcare/EMR/229500682

The U.S. health IT market is forecast to grow at a compound annual growth rate (CAGR) of around 24% during 2012 to 2014, according to a study from RNCOS, a global market research and information analysis company.

The report, U.S. Healthcare IT Market Analysis, which was published earlier this month, said the health IT industry is expected to surge to $40 billion by the end of 2011. The growth will be driven not only by healthcare reform and the implementation of e-health systems, but also by a population that will demand and increasingly be able to afford quality services.

Segmenting the market into IT hardware, IT software, and IT services, the report notes that IT hardware accounted for 65% of the total market at the end of 2010. It also said the mandatory use of electronic health records (EHRs) has boosted the market for software. As a result, the healthcare IT software market will increase in revenues from $6.8 billion in 2010 to $8.2 billion in 2011.

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http://www.fiercehealthit.com/story/growth-e-prescribing-intriguing-far-finished/2011-05-16

Growth of e-prescribing intriguing, but far from finished

May 16, 2011 — 10:49am ET | By Ken Terry

Surescripts, a company that connects physician offices to pharmacies online, has released electronic prescribing data for 2010 that show a rapid expansion of this key health IT capability. The number of office-based providers who prescribed electronically jumped 50 percent from 156,000 at the end of 2009 to 234,000 at the end of last year. During that same period, the number of electronically routed prescriptions leaped 72 percent, from 191 million to 326 million.

That's impressive growth, and it shows that the government incentive programs for e-prescribing and electronic health records are having an impact. But before we assume that e-prescribing has taken over the world, let's remember that 3.99 billion medications were dispensed in the U.S. last year.

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http://www.ehi.co.uk/news/primary-care/6877/gutteridge-calls-for-50m-scrs

Gutteridge calls for 50m SCRs

13 May 2011 Fiona Barr

The NHS must deliver Summary Care Records for all its patients and encourage widespread use of HealthSpace or an equivalent, the Department of Health’s clinical director for informatics has said.

Dr Charles Gutteridge gave unequivocal endorsement to the SCR programme at this week’s Primary Health Info conference, while setting out how he hoped informatics would develop in future.

Gutteridge is a former medical director of Barts and the London NHS Trust and has played a key role in the implementation of Cerner Millennium at the hospital.

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Medical Data Mining Strengthens Drug Safety

By applying analytics to medical journal articles, Rand researchers were able to uncover dangerous side effects before regulators' existing systems could.

By Neil Versel, InformationWeek

May 16, 2011

URL: http://www.informationweek.com/news/healthcare/patient/229500635

Data mining of the medical literature could help uncover drug side effects before they cause serious harm to patients, a new study suggests.

Researchers from Santa Monica, Calif., think tank Rand surmised that a review of published studies could help regulators, like the U.S. Food and Drug Administration, spot dangerous uses of drugs earlier and prevent situations like the 2004 recall of rofecoxib--sold under the brand name Vioxx--following revelations that the arthritis drug could increase the risk of heart attack and stroke.

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http://www.ehi.co.uk/news/acute-care/6886/npfit-contracts-face-further-scrutiny

NPfIT contracts face further scrutiny

18 May 2011 Lyn Whitfield

Two inquiries will start next week into the future of the care records element of the National Programme for IT in the NHS, following today's damning report by the National Audit Office.

The Common’s public accounts committee will hold hearings on the report into the non-delivery of detailed care records systems, while the Cabinet Office’s Major Projects Authority will take a “cold hard look” at the programme from a wider government perspective.

Both will ask fundamental questions about the future of the attempt to deliver integrated care records to the NHS, even though this element of the programme was originally slated for completion by 2010.

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http://www.ehi.co.uk/insight/insider-view/742/insider-view:-jon-hoeksma

Insider view: Jon Hoeksma

The NAO’s third report on NPfIT provides the government with plenty of ammunition to kill off the integrated care records service and its contracts. But will it load and fire, EHI’s editor asks.

18 May 2011

This week’s National Audit Office report on the National Programme for IT in the NHS can only be described as damning.

With its narrow focus on detailed care records systems, it leaves the Department of Health and the programme’s main contractors little space to hide.

It bluntly says NPfIT has failed to deliver, and will now never deliver, on its key objective; getting integrated records into health communities.

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https://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/732

Education of next generation of nurses to include effective clinical use of information and communications technologies

May 19, 2011 (Toronto, ON) - A new initiative announced today by the Canadian Association of Schools of Nursing (CASN) and Canada Health Infoway (Infoway) aims to prepare nursing students for practice in modern, technology-enabled clinical environments. Canada's nursing faculties and students will be involved in a three-year effort to strengthen learning on effective uses of information and communications technologies (ICT), now essential tools in clinical practice.

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http://news.nurse.com/article/20110518/NATIONAL02/105230024/

Expanded Emr Use Could Make Big Difference In Infant Mortality

Expanded use of electronic medical records would substantially reduce infant mortality in the U.S., according to an upcoming study in the Journal of Political Economy.

A 10% increase in hospital use of basic electronic records would save 16 babies for every 100,000 live births, the study found. A complete national transition to electronic records would save an estimated 6,400 infants each year in the U.S.

Many health professionals have advocated for electronic records as a way to improve care and curb costs. For obstetricians, electronic records might make it easier to identify high-risk pregnancies and coordinate care.

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http://drugtopics.modernmedicine.com/drugtopics/Modern+Medicine+Now/Automated-pharmacy-launched-by-UCSF/ArticleStandard/Article/detail/721906?contextCategoryId=47558

May 15, 2011

UCSF launches automated pharmacy

By Fred Gebhart, Contributing Editor

Pharmacists at the University of California San Francisco (UCSF) are in the process of bringing online one of the world's largest and most advanced robotic pharmacies. An automated picking system opened in October, 2010, and a sterile preparation and fill operation comes online this fall.

The automated pharmacy is not expected to reduce pharmacy staffing needs, said Lynn Paulsen, PharmD, director of pharmaceutical services, UCSF Medical Center, but it is already creating a safer working environment for both patients and pharmacy personnel.

"We have already filled more than 400,000 oral-solid and sterile-injectable doses with zero order-fill errors," Paulsen told Drug Topics. "Technician picking would generate between 0.1% and 1% errors."

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http://www.bbc.co.uk/news/health-13373535

13 May 2011 Last updated at 07:13 GMT

Twitter 'vital' link to patients, say doctors in Japan

In the aftermath of the earthquake in Japan, Twitter is proving "an excellent system" for communicating with chronically-ill patients, say doctors.

In letters written to The Lancet, Japanese doctors say social networking sites have been vital in notifying patients where to get medication.

Although telephone networks were disrupted after the earthquake, internet access remained reliable.

But Japan must now strengthen its primary care system, they said.

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http://healthcareitnews.com/news/first-physicians-nation-get-mu-check

First physicians in the nation get MU check

May 19, 2011 | Healthcare IT News Staf

NORTH KANSAS CITY, MO – Four physicians have become the first in the country to receive their Medicaid EHR incentive payments for demonstrating meaningful use.

Juan Salazar, MD, an internal medicine physician from McAllen, Tex., and three physicians from multi-specialty West Broadway Clinic of Council Bluffs, IA, announced receipt of government incentive funding for successful use of electronic health records (EHR), with the support of Kansas City, Mo. based health company, Cerner Corporation. West Broadway Clinic and Salazar achieved the first stage of rigorous requirements certifying them 'meaningful users' of health information technology and are excited to announce that the meaningful use dollars have been received via electronic bank deposits.

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http://searchhealthit.techtarget.com/news/2240035845/Blumenthal-Building-national-health-network-could-take-decades

Blumenthal: Building national health network could take decades

WORCESTER, Mass. -- When Dr. David Blumenthal was national health IT coordinator, he focused on 2015, the HITECH Act's original target date for meeting meaningful use criteria. Now that he's back in civilian life, he's taking a longer view of the initiative to create a national health network triggered by the HITECH Act's cash incentives to physicians and hospitals using electronic health record (EHR) systems.

Blumenthal, who keynoted the Massachusetts annual health IT conference last week, quoted President Barack Obama's line that the HITECH Act was a "down payment" on health reform. He likened the fusion of health IT and payment reform processes -- in the spirit of reducing health care costs while making quality gains -- to a series of mountains to climb, one peak after another.

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http://articles.boston.com/2011-05-17/lifestyle/29552737_1_intensive-care-eicu-telemedicine

Worcester hospital finds success with remote ICU

May 17, 2011|By Liz Kowalczyk, Globe Staff

Seriously ill patients at UMass Memorial Medical Center suffered fewer complications and were less likely to die when they were monitored by doctors working in a remote “eICU,’’ some of the first evidence that telemedicine can improve on care provided at the bedside.

Intensive care specialists who oversaw the hospital’s intensive care units from a low-rise office building 3 miles away improved care by essentially acting as a second set of eyes for the on-site doctors and nurses, according to a study published online yesterday by the Journal of the American Medical Association.

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http://www.healthdatamanagement.com/news/hipaa-security-ocr-rule-encryption-mandate-42489-1.html

Final PHI Protection Rule Won't Mandate Encryption

HDM Breaking News, May 17, 2011

The omnibus federal final rule that will cover changes to the HIPAA privacy, security, breach notification and enforcement rules will not include a mandate for encryption of protected health information, confirms Susan McAndrew, deputy director for health information privacy in the Department of Health and Human Services' Office for Civil Rights.

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http://www.healthleadersmedia.com/content/TEC-266240/Looking-for-Imagings-Missing-Link.html

Looking for Imaging's Missing Link

Gienna Shaw, for HealthLeaders Media , May 17, 2011

Research proves it: Patients and caregivers alike "universally hate" CDs as a method of transferring image files. That's according to Jeffrey Carr, MD, part of a research team at Wake Forest University in Winston-Salem, NC, that's investigating alternative image-sharing technologies.

To be fair, those are just initial survey results, Carr says. But it sure makes sense.

Usually patients themselves have to schlep CDs from one provider to another—often carrying them to their primary care provider after a trip to the ED. And when the discs arrive, there's no guarantee the receiving organization will be able to open or read them.

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http://www.latimes.com/health/boostershots/la-heb-end-of-life-program-20110516,0,296718.story

Computers can help patients make decisions about end-of-life care

By Karen Kaplan, Los Angeles Times / For the Booster Shots blog

3:37 PM PDT, May 16, 2011

End-of-life planning isn't exactly fun -- especially when you are very sick and your days are probably numbered.

But researchers at Pennsylvania State College of Medicine and Pennsylvania State University are trying to make it easier with a computer program that helps patients think through difficult questions, such as whether they want aggressive treatment to prolong their lives or whether they'd rather maximize their quality of life, even if it means they'd probably die sooner.

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http://www.modernhealthcare.com/article/20110517/NEWS/305179988

Info exchanges not reaching potential: Harvard researchers

By Joseph Conn

Posted: May 17, 2011 - 12:15 pm ET

A team of Harvard researchers took a comprehensive look at the state of regional health information exchanges across the country and found the numbers—from a health information technology policy perspective—to be disturbing.

Their findings "call into question whether RHIOs in their current form can be self-sustaining and effective in helping U.S. physicians and hospitals engage in robust HIE to improve the quality and efficiency of care," the researchers wrote in an article, "A survey of health information exchange organizations in the United States: Implications for meaningful use," appearing online in the Annals of Internal Medicine.

The federal government has promoted regional information exchanges as a tool to enable interoperability among electronic health-record systems since the early days of Dr. David Brailer's regime as the first head of the Office of the National Coordinator for Health Information Technology in 2004.

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http://www.healthleadersmedia.com/print/TEC-266231/Only-13-RHIOs-Meet-Meaningful-Use-Criteria

Only 13 RHIOs Meet Meaningful Use Criteria

Margaret Dick Tocknell, for HealthLeaders Media , May 17, 2011

There are 75 operational RHIOs (regional health information organizations) across the U.S. but only 13 of them meet the most basic criteria for meaningful use of health information technology, according to a 2009 study by a group of Harvard University researchers.

With grant support from the federal government, RHIOs provide hospitals and physicians with a single connection to swap clinical data with other participating providers such as labs and public health departments.

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http://www.modernhealthcare.com/article/20110517/NEWS/305179953/

Advanced IT linked with hospital profitability, Fitch finds

By Melanie Evans

Posted: May 17, 2011 - 11:00 am ET

Profits and profit growth rates were higher among not-for-profit hospitals that had implemented advanced information technology, received quality awards or both as compared with other hospitals, according to a report (registration required) released today by Fitch Ratings.

An analysis of 291 tax-exempt hospitals and health systems with Fitch credit ratings found that those with advanced IT or quality awards were more likely to be rated A- or above. Slightly more than 80% of those considered high quality or high technology were rated at least A-. That's compared with 67% of the organizations in the overall portfolio that received an A- or higher ratings, according to the report.

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http://www.modernhealthcare.com/article/20110517/NEWS/305179961/

Audit reports hit HHS on digital security

By Joseph Conn

Posted: May 17, 2011 - 12:01 am ET

Two new audit reports question HHS' commitment to digital security in health information technology.

The reports, issued today by HHS' inspector general's office, target both the Office of the National Coordinator for Health Information Technology and the Office for Civil Rights for failing to adequately protect patients' electronic information.

In a 36-page “rollup” report citing audits at seven unnamed hospitals, the inspector general's office assails the Office for Civil Rights for a lack of rigor in enforcing the security provisions of the Health Insurance Portability and Accountability Act of 1996. The report also calls out the CMS, which previously oversaw digital security.

In a separate 23-page report, auditors criticize the ONC for lack of leadership in promoting electronic health information security.

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http://www.modernhealthcare.com/article/20110517/NEWS/305179987/

Tele-ICU interventions reduce mortality rates: study

By Joseph Conn

Posted: May 17, 2011 - 11:00 am ET

Massachusetts researchers have found an association between using telecommunication technology in a hospital's intensive-care units with improved patient outcomes and better adherence to clinical best practices, according to a report on their study published in the Journal of the American Medical Association.

The study, conducted under the auspices of the University of Massachusetts Medical School, covered the period from late April 2005 to September 2007 and looked at the experiences of 6,290 adult patients admitted to seven intensive-care units at an unnamed 834-bed academic medical center. The tele-ICU system was rolled out at the seven ICU care sites with staggered implementation dates over the period of a year, letting the researchers compare results for a "preintervention group" of patients admitted to intensive care before tele-ICU was provided to that unit and a group of patients admitted after telehealth services were being used.

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http://www.fiercehealthit.com/story/how-far-has-google-health-really-fallen/2011-05-11

How far has Google Health really fallen?

May 11, 2011 — 9:12am ET | By Ken Terry

John Moore of Chilmark Research, a respected health IT industry blogger, suggested this week that Google Health is "cryogenically" frozen in place after the disbanding of most of its development team. The most recent departure is that of Missy Krasner, who tells FierceHealthIT that she left Google Health after "five wonderful years."

Google officials did not respond to requests for comment on Moore's assertion, but there's little doubt that Google Health has fallen behind Microsoft HealthVault, its main rival as a web-based personal health record platform. Google has signed up far fewer industry partners than HealthVault; and, unlike HealthVault, it has not announced it will allow providers to upload clinical data using the new Direct Project messaging protocol.

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http://consumer.healthday.com/Article.asp?AID=652847

Telemonitoring Success May Depend on Patients' Age, Literacy Level

Findings from study of heart failure patients might help improve monitoring systems

THURSDAY, May 12 (HealthDay News) -- Heart failure patients who are older than 65 and have a high level of health literacy are more likely to continue using telemonitoring technology that tracks their condition than younger people with low health literacy, a new study finds.

Health literacy refers to the ability to read, understand and use health care information. Telemonitoring systems, which help doctors monitor patients outside of office visits, are seen as a way to improve care for heart failure patients, but results so far have been mixed.

The new study shows that individual characteristics play a major role in patients' interest and success in using telemonitoring systems -- knowledge that could help improve the design of such systems and increase patient participation, the researchers said.

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http://robotics.tmcnet.com//channels/healthcare-robotics/articles/174019-doctors-now-diagnose-treat-remotely-even-vacation.htm

May 12, 2011

Doctors Can Now Diagnose and Treat Remotely, Even On Vacation

By Deborah Hirsch

TMCnet Contributor

Imagine you’re in San Francisco and your psoriasis is kicking up, but your doctor’s traveling through Europe. A new breed of robots deployed at hospitals around the country now allows physicians to virtually consult with patients, even if they are miles away.

Called robotic telepresence, a study by Johns Hopkins Hospital shows that 80 percent of patients surveyed feel that the use of it increases physician accessibility.

Telepresence requires that the users’ senses be provided with information giving them the feeling of being in another location. Users get access to the physician at his remote location through the use of a robot. The doctor gets to see the user’s position, movements, actions, and hear his voice, all of which are transmitted and duplicated to the remote location. The real value is that information can now travel in both directions.

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http://www.healthdatamanagement.com/news/ehr-electronic-health-record-certification-comment-42473-1.html

Comment Sought on EHR Certification

HDM Breaking News, May 13, 2011

The HIT Standards Committee's implementation workgroup is seeking public comment on the temporary electronic health records certification program being used to support Stage 1 of the meaningful use program.

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http://www.cmio.net/index.php?option=com_articles&article=27715&publication=68&view=portals

Kvedar: Telemedicine may be 'EHR v2.0'

WORCESTER, Mass.—Currently, the world of HIT is enshrouded in meaningful use, said Jospeh Kvedar, MD, from the Partners HealthCare System and director of the Center for Connected Health. “However, there are some challenges beyond the ‘simple’ implementation of an electronic medical record,” Kvedar told an audience at the Health IT: Improving Healthcare and the Economy” conference on May 10.

“It’s almost like EHR v 2.0, or moving care out of the EHR and into the patient environment, making it more continuous, more just-in-time,” and telemedicine makes this possible, he said.

“I’ve been at this since 1995, when it really was a crazy thing,” Kvedar said. “I was inspired by the idea that we might be able to extract value out of healthcare interaction if we were able to separate the provider and the patient.”

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http://www.modernphysician.com/article/20110513/MODERNPHYSICIAN/305139996/

VA hospital will test 'point-of-care' clinical trial

By Andis Robeznieks

Posted: May 13, 2011 - 1:45 pm ET

A new method for medical research, the "point-of-care clinical trial," will be tested in a study looking to find a better way to control hypoglycemia in 3,000 diabetic, nonintensive-care patients at an undisclosed Veterans Affairs Healthcare System hospital.

In a report published in the journal Clinical Trials describing the study, researchers from Stanford University, Palo Alto, Calif., and the VA Boston Healthcare System describe how the VA's VistA electronic health-record system will be used to conduct a clinical trial in which the "apparatus" of the study—involving recruitment, randomization and attaining consent—is embedded into routine care.

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http://www.ehi.co.uk/news/mobile/6879/telecoms-firms-looking-to-mhealth

Telecoms firms looking to mHealth

13 May 2011 Shanna Crispin

Almost half of all global telecoms firms are actively working to break into the mHealth market, according to a London analyst.

The results of the Informa Telecoms and Media’s Vertical Markets survey has shown that 45% of telecoms companies are looking to mHealth to increase revenue.

Senior analyst Sheridan Nye said healthcare is extremely attractive for companies that already provide mobile services, smart devices, and cloud-computing.

Nye told eHealth Insider she expects to see a rapid increase in companies tapping into the ‘self-care’ area of mobile health.

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http://www.ehi.co.uk/resources/industry-view/57/

EHI Interview: Keith Nurcombe

O2 Health’s managing director doesn’t like the term mHealth. He just believes it could transform the NHS. Shanna Crispin talks to him.

13 May, 2011

He wants to focus on how mobile technologies can transform the NHS, and passionately believes this can happen. It’s just a pity the service is having trouble realising it.

Now we are two

A specialist business unit run within O2 UK, O2 Health is just two months shy of its first birthday. It’s just one of a number of telecoms companies that have decided to try and apply their expertise to the health sector.

It seems that business is booming for Nurcombe and his team of healthcare experts come telecoms professionals, as he says demand for “mobile solutions” is far in excess of what they can actually supply.

But despite the demand from individual NHS organisations, he believes the NHS as a whole is standing in the way of allowing mHealth to improve healthcare.

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http://www.insurancenewsandmarkets.com/inm/NEWS/INM_NEWS1305563454.aspx?NewsID=33836

Canadian E-Health Records System Still Lacking, According to New Study

(Montreal, Canada - Insurance News and Markets) - According to a new study released on February 23 in the Canadian Medical Association Journal, by researchers at the McGill University Health Centre Research Institute, an electronic, virtual health records system should be the mainframe of Canadian healthcare reforms. Additionally, the implementation of such a system must be accelerated across Canada; in the study's opinion, the best way for this to be done effectively is for doctors, medical administrators, and front-line healthcare employees, such as nurses, to take more active positions in the creation and maintenance of this electronic system.

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http://www.neurope.eu/articles/5-keys-to-making-eHealth-a-reality-/106379.php

5 keys to making e-Health a reality

Author: John Bowis

15 May 2011 - Issue : 935

Today when we speak about healthcare in Europe, much of the discussion centres on the financial burdens currently faced by Member States. Regardless of the need to focus on providing better healthcare to the patient, the underlying considerations will always be at the behest of the Health Ministry’s budget. And so, for years now, discussions throughout the EU have focused on the potential for e-Health to reduce costs for healthcare systems while providing improved care for patients.

Often, e-Health is seen as the panacea to the problems that remain in healthcare systems throughout the EU. Yet, policymakers and stakeholders continue to struggle with how to implement and utilise current technologies to make e-Health solutions a reality for patients and healthcare professionals. Issues of patient awareness and access, compatibility, interoperability, reimbursement and investment continue to hinder the uptake of e-Health solutions preventing e-Health from becoming the cure to the budgetary ills of Member States.

In light of these difficulties, stakeholders throughout the EU have engaged with policymakers to shed light on the issues preventing patients and health Ministers from realising the benefits e-Health has to offer.

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Enjoy!

David.

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