Archive for November, 2008

20 November 2008

Hip-pocket appeal could drive PHRs

It’s a fact of life: no organisation, not even governments, likes to spend money on something unless they can see that it will make or save money. Well, here’s some evidence about the money-saving aspects of personal health records (PHRs) that should make governments, even in Australia, sit up and take notice. The AusHealthIT blog has uncovered a story about a US study that claims the implementation of PHRs across the American healthcare system will save more than US$21 billion a year, through things such as more efficient monitoring and sharing medication lists.

As AusHealthIT blogger David More writes, “If PHRs can deliver even half of these benefits I will take two, thanks!”

One important caveat – the study was funded by ‘unrestricted grants’ from companies including Microsoft and Google, which of course have a vested interest in the success of electronic PHRs…

19 November 2008

Specialist push for online claims

From today’s Australian IT: “Medicare Australia wants medical specialists who have largely resisted online connectivity to come on board with Eclipse, its e-claiming system for hospitals.

“The Electronic Claims Lodgement Information Processing Service Environment allows privately insured hospital patients to pay their doctors bill by lodging a single claim to both Medicare and their insurer. It also gives the patient warning of any out-of-pocket expenses.

“Only 40 per cent of medical specialists have computers and IT infrastructure to support online claiming, compared with over 90 per cent of GPs who use computers in their practices, and almost 100 per cent of pharmacists.

“As an incentive, medical specialists in metropolitan areas will receive a one-off $750 payment to cover start-up costs and $1000 for those in rural and remote areas. In addition, practices will receive an incentive payment of 18 cents every time a claim is sent electronically.”

Read the rest here.

17 November 2008

That’d be right – blame the parents

I remember my mother bemoaning the fact that my sister took a psychology course at college and announced that all her problems were due to the dysfunctional way she was brought up. “Sure, blame everything on me, don’t take any responsiblity for your own actions,” she grizzled. I thought to myself, “Hmmm, it’s all someone else’s fault – I’ve got to check out this caper!” When I went to university I minored in psychology so I could examine this theory in more detail. Sure enough, everyone from Freud on down had been blaming adult issues on mothers. It was a great way of excusing everything from relationship breakdowns to career frustrations over the next several years. Finally, while co-writing a book with a psychologist about men’s issues, we were talking about mothers and childhood and I had this great epiphany as the psychologist turned to me and said, “Ray, your mother is who she is, and she did the best she knew how to do. At your age, you need to start taking responsbility for your own actions!”

I’d like to say I completely changed my life that day, became a perfect husband, father and son and my career blossomed as I released my mother from her role as child-thwarter. Yeah, pull the other one… let’s just say I became more self-aware and have led a life with a bit more balance since then.

Anyway, to pull this huge digression from the topic of this blog back to the business at hand, I was reminded of my early studies in psychology by a new book about the Net Generation by futurist Don Tapscott, Grown Up Digital. A sequel to Growing Up Digital: The Rise of the Net Generation, Tapscott studies the generation of children who have grown up not knowing anything other than the Internet. While media reports decry the kids of today, accusing them of being unfit (well, that one is probably true) and brain dead through playing video games and Facebooking instead of dealing face to face with real people, Tapscott says that, in fact, “Net Geners” are, as he told a reporter for The Economist, the “smartest generation ever”. He says the experience of parents who grew up watching television is misleading when it comes to judging the 20,000 hours on the internet and 10,000 hours playing video games already spent by a typical 20-year-old today. “The Net Generation is in many ways the antithesis of the TV generation,” he argues. One-way broadcasting via television created passive couch potatoes, whereas the net is interactive, and, he says, stimulates and improves the brain.

The book sounds fascinating and I think I’ll buy a copy, if for no other reason than to get some insight into how my kids’ brains work. But I can’t believe how things have come around; now, any misunderstanding of my children and their contemporaries is being blamed on that generation of people who grew up frying their brains through too much television. So again, it is the parents’ fault. Wait a minute, who was it that let me watch too much “Gilligan’s Island”, “Get Smart” and “Lost in Space” when I was a lad?…

14 November 2008

Sorry to tell you, but the market doesn’t care

Like a Molotov cocktail hurled into a crowd, Publishing 2.0 blogger Scott Karp has ignited the already heated debate about the future of journalism and publishing with his most recent post, entitled “The market and the internet don’t care if you make money”.

He’s pinched the title from Seth Godin, the marketing pundit who is peddling his latest book Tribes, but Karp takes the idea and runs with it in a long screed about how the Internet has broken the newspaper industry’s business model, a topic about which plenty of people including myself have written about ad nauseum. But Karp offers a detailed and particularly articulate discussion of this issue, writing that “Nobody has the right to a business model – Ask not what the market can do for you, but what you can do for the market.”

As usual with this sort of thing, the comments are as entertaining and thought-provoking as the blog post, and as a former journalist I can relate to the responses from people in the traditional media. The words of Thomas Jefferson, author of the American Declaration of Independence, still echo in my ears as one of the main reasons I got into the media business: “Given a choice between a government without newspapers and newspapers without government, I would not hesitate to choose the latter.” The media have an important role in informing society and keeping governments honest. But while Jefferson specifically mentioned newspapers, if he was here today I think he would understand and approve of the Internet and blogging. It is the same principle he was talking about back in the 18th century – free speech. Whether it’s Rupert Murdoch or Ariana Huffington or Joe Bloggs exercising that right doesn’t matter.

At the end of the day, say what we will, the market doesn’t care about ‘quality’ journalism and comprehensive local news coverage. We collectively need to find a model that works in this new and changing environment. I agree with Karp that a future business model lies in the power of networks, not the power of monopolies.

[Reproduced from Zazoo blog]

13 November 2008

NEHTA and the budget, part II

In a follow-up to my earlier post about NEHTA’s budget spend, they’ve gone from being criticised for underspending their budget to criticised for over-spending on the wrong things. Australian IT reports that the authority has more than doubled its spend on administration – staff, consultants, etc. – over last year, 169 people costing nearly $30 million. My calculator tells me that works out at nearly $178,000 per head, so either they have the best-paid staff in the public service, or the consultants, who account for $13 million of the total, are raking it in. Hey, how do I get on the gravy train?

12 November 2008

Australians want e-health records

Australians support the introduction of an Individual Electronic Health Record (IEHR) and would agree to their medical records being included in the service.

This is according to a poll conducted on behalf of the National E-Health Transition Authority (NEHTA), which showed that 82% of respondents believe an IEHR would save lives and improve health services by having important medical information immediately assessable. 77% of the 2,700 people surveyed across Australia indicated they would want their records added to the service.

“This research confirms Australians endorse the use of electronic health records if they are introduced with all the necessary levels of privacy and security,” said NEHTA chief executive Peter Fleming.

The news was welcomed by AMA president Rosanna Capolingua, who reiterated the organisation’s long-time support of electronic health records, but also highlighted issues such as patient confidentiality and system access, as the issues delaying implementation. “Maybe not next year, but hopefully soon after we may see some movement,” she suggested.

Security and safety around the electronic storage of medical information was a key consideration, with 79% of those polled indicating it was important any future IEHR offers patients the ability to quarantine sensitive or very personal medical information. The poll also showed that Australians feel strongly about choice in relation to the IEHR. 78% of respondents said the IEHR service should be voluntary.

- From 6 minutes

5 November 2008

Patients embracing Web 2.0 / Health 2.0

The number of consumers in the US using Web 2.0 technologies in relation to health matters (dubbed ‘Health 2.0′) has doubled in the past year to 60 million people, according to a study just released by Manhattan Research.

Manhattan defines Health 2.0 consumers as people who have: 

  • read health-related blogs, message boards or participated in health-related chatrooms;
  • contributed or posted health content online such as: writing or commenting on a health-related blog, adding or responding to a topic in a forum or group, or creating health related web pages, videos or audio content; or
  • used online patient support groups, message boards, chatrooms, or blogs.

The report says, “Pharmaceutical marketers are catching on to the trends, but there’s a long way to go before brand media closes the gap between where consumers are and where budgets are going – only a small fraction of overall pharmaceutical advertising spend is currently allocated to online campaigns. But as we’re seeing with our clients, consumer trends are prompting marketers to put more weight behind digital strategies.”

“…. Social media is a powerful force impacting the pharmaceutical industry – whether or not brands choose to participate. Taking too conservative of an approach to a channel which thrives on two-way dialogue and open communication will undoubtedly distance brands from consumers – especially for those looking to reach the groups most engaged in Health 2.0. And even if brands aren’t yet ready participate in conversations, some sites sell aggregated data to pharmaceutical companies looking to understand the experiences and challenges that patients face.”

3 November 2008

Don’t they want this to work?

I know governments are usually taken to task for overspending their budgets, but the Federal Department of Health is getting a reputation for underspending when it comes to e-health. The Australian reports that the DoH spent only $42.5 million out of the $53.8 million allocated for e-health implementation in 2007-08. This follows on from the previous year, when the Department spent only $37.5 million from a budget of $79 million allocated to national products, including the failed HealthConnect.

Exactly what did it spend money on? According to the report, the department saw success in the development with the National E-health Transition Authority (NEHTA) of individual and provider identifiers, standardised clinical terminologies and secure messaging standards.

“In addition, the department worked closely with NEHTA on the development of targeted packages to support the implementation of electronic discharge, specialist referral and pathology clinical services,” it says.

“The department also contributed to the development of the National E-Health Strategy through the national e-Health Information Principal committee. When the strategy is implemented, it will allow significantly greater inter-jurisdictional and national co-ordination of e-health policy direction.” 

Hunh??

The report says a major achievement was an e-prescribing trial in the Northern Territory, in a community pharmacy and aged care setting, resulting in fewer misplaced prescriptions and delays in mailing or faxing scripts.

However, as The Australian points out, “industry observers have noted that the trial involved a limited, point-to-point transmission service, rather than a scalable interchange system needed for a robust national e-prescribing system.”

What we really need to know is, what was that $11 million supposed to be spent on? What is being unnecessarily delayed because of government disorganisation and apathy? How much longer has the promised e-health nirvana been pushed back?

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