Archive for ‘e-health’

9 February 2009

EHRs and investment deficit disorder

Just read a comprehensive, well-researched, thought-provoking article in the New York Times about the global economic crisis and the tasks facing Barack Obama as he tries to turn the US around. Smack dab in the middle of it was, of all things, a reference to electronic health records:

“One good way to understand the current growth slowdown is to think of the debt-fueled consumer-spending spree of the past 20 years as a symbol of an even larger problem. As a country we have been spending too much on the present and not enough on the future. We have been consuming rather than investing. We’re suffering from investment-deficit disorder.

“You can find examples of this disorder in just about any realm of American life. Walk into a doctor’s office and you will be asked to fill out a long form with the most basic kinds of information that you have provided dozens of times before. Walk into a doctor’s office in many other rich countries and that information — as well as your medical history — will be stored in computers. These electronic records not only reduce hassle; they also reduce medical errors. Americans cannot avail themselves of this innovation despite the fact that the United States spends far more on health care, per person, than any other country. We are spending our money to consume medical treatments, many of which have only marginal health benefits, rather than to invest it in ways that would eventually have far broader benefits.”

Sadly, Australia is not one of those “rich countries” referred to in the article; our progess toward implementing electronic health initiatives is far behind even the US…

There is also a discussion on how the US spends too much on medical treatments that don’t work particularly well (trouble ahead for the pharma industry). The whole article is well worth reading: http://www.nytimes.com/2009/02/01/magazine/01Economy-t.html?_r=1&pagewanted=all

9 February 2009

Your heart rate, now on Google

Google and IBM have announced a partnership that will enable Google Health to connect to and stream from medical devices.

According to Forbes, “In demonstrations, IBM and Google fitted Wi-Fi radios to gadgets like heart rate monitors, blood pressure cuffs, scales and blood-sugar measurement meters, allowing the devices to communicate with a PC and feed real-time medical information directly into Google’s online records.

“Hooking up those devices to the Web, IBM argues, will offer a new immediacy and granularity of health monitoring. A user can remotely track the blood pressure readings or glucose levels of a diabetic parent living alone, or stream his or her medical information like weight or heart rate directly to a doctor or physical trainer.”

“….For IBM, the new Google Health functions are also a dress rehearsal for “smart” health care nationwide. The computing giant has been coaxing the health care industry for years to create a digitized and centrally stored database of patients’ records. That idea may finally be coming to fruition, as President Obama’s infrastructure stimulus package works its way through Congress, with $20 billion of the $819 billion fiscal injection aimed at building a new digitized health record system.”

Privacy concerns abound. As Forbes reports: “‘They give consumers the appearance of an effective way to keep their health information, but it’s also a digital gold mine for health marketing,’ says Jeff Chester, director of the Center for Digital Democracy, who points to Google’s sponsorship of the ePharma drug marketing conference taking place in Philadelphia next week. ‘It’s one thing to turn your search queries over to Google. This is like making them your next of kin,’ Chester says. ‘Why would you give an advertising company access to your moment-by-moment expression of health concerns and risks?’”

4 February 2009

Australia Card redux – now patients want it

Twenty years after a huge public outcry stopped the introduction of the Australia Card, it appears that Australians are now ready for smart cards – at least when it comes to their health - according to a study published in this months’ Australian Health Review.

The survey, conducted with 270 emergency department patients and 92 staff at three hospital emergency departments in Victoria, compared the perceptions of patients and staff regarding the use of health smart cards containing patient medical records.

The study recorded data on a range of health smart card issues including awareness, privacy, confidentiality, security, advantages and disadvantages, and willingness to use. While a significantly higher proportion of staff had heard of the card, more of the patients said they were willing to use it.

The perceived disadvantages reported by patients and staff were, overall, significantly different, with the staff reporting more disadvantages. A significantly higher proportion of patients believed that they should choose what information is on the card and who should have access to the information.

Patients were more conservative regarding what information should be included, but staff were more conservative regarding who should have access to the information. Significantly fewer staff believed that patients could reliably handle the cards.

Overall, however, the cards were considered acceptable and useful, and their introduction would be supported.

Study author Dr David Taylor, director of emergency medicine at Melbourne’s Austin Health, said a major benefit of smart cards would be to save time. He told 6 minutes, “It’s quicker for a doctor to put a card into a machine and push a few buttons on a computer than it is to request a medical chart to come from medical records … or call up the patient’s GP or their pharmacist … it would save an enormous amount of work.”

Dr Taylor said that situations such as a patient  forgetting to bring along their card or the accuracy of information could pose problems for the system, but said it had worked “reasonably well” in a Tasmanian trial.

3 February 2009

Australian government won’t be drawn on e-health implementation

From Australian Doctor:

The Federal Government is refusing to set a deadline for national e-health records, despite admitting the system is fundamental to its ambitious reform program.

Recently, a further $216 million was handed over to fund the body responsible for making e-health a reality: the National E-Health Transition Authority.

An additional $1 billion is expected to be committed for infrastructure development via the Council of Australian Governments.

Federal Health Minister Ms Nicola Roxon said: “Workforce and e-health are the chief enablers of all the health reforms. Without them the reforms will not be able to work.”

But she would not be drawn on a timetable for when the system will be in place, only stressing that it would be after 2010.

“The steps are going ahead but I can’t give you a date. It takes a lot of time,” she told Australian Doctor.

She also said no decision had been made on the government’s role in delivering national e-health records.

The e-health system in the NHS cost the UK government about $15 billion. The first of some 50 million e-health records were rolled out in 2007, but the project’s implementation was dogged by delays and rising costs.

Ms Roxon said: “I don’t think it is necessary for us to go down the NHS route of us owning and running the entire storage system. It did seem to be very expensive in the UK. I’ve met with some of the people involved in the delivery of the NHS system. They are not convinced that it’s the model you would use if you started again.”

“I’m agnostic about it. We will go with what will work.”

- By Paul Smith

6 January 2009

On the HIT parade

Hurrah for us – the Welling Digital blog has now been certified as a top health technology blog by gaining a listing on HITSphere, “a network of premium weblogs that write content about the healthcare, medical, and clinical informatics and information technology (IT) industry.” Check out HITSphere for a wide listing of blogs in the health tech area.

5 January 2009

MJA online – who are they kidding?

The Medical Journal of Australia announced today that it was going to lock down content on its website to subscribers-only. David More from the AusHealth IT blog points out the many fallacies in the rationale for this decision. He writes that: “If the MJA thinks it is of similar prestige to the Annals, JAMA, the BMJ or Lancet it is smoking a very strong brew of something which I suspect is not legal…. we now find Australia lacks an open professional platform for discussion of Health Policy….  (C)losing a professional health publications is a retrograde step in an era when we are working to improve information flows in health.”

I agree – the MJA needs to take a dose of reality pills and embrace the fact that the searchability and easy access of the journal over the past 10 years has added value to the MJA, and it will become a lot less useful and used.

31 December 2008

Digital marketing push for pharma in 2009

From iMedia:

“The pharmaceutical industry is preparing to make a big push in the digital marketing space in 2009, according to a new survey from MarketBridge. Although the industry is largely behind the curve when it comes to digital marketing, nearly 45 percent of pharmaceutical executives made it clear that they need to better understand the opportunity, and more than a third said they’re not adequately organized to take advantage, ClickZ reports.

“Half of all those who responded to the ‘Digital Marketing in Pharma’ survey said less than 10 percent of their company’s marketing budget is allocated to digital. Moreover, there’s still a great deal of uncertainty among pharmaceutical companies about whether they can prove a substantial return on investment if they put more efforts into digital marketing.

“At least 72 percent of all respondents said they would be investing more in 2009, although that may be tempered somewhat by the recession. Partha Krishnamurthy, director of the University of Houston’s Institute for Health Care Marketing, suggests that large pharmaceutical companies face significant risk if they embrace Web 2.0. By its very nature, digital marketing will give consumers a louder voice in shaping a brand’s message, and those with the most negative experiences can easily rise to the top.”

30 December 2008

Social network for health

Here’s a great example of social media used by the healthcare industry, from MediaPost: Health insurance company Humana has developed some social media tools, including a Facebook application, to help customers keep their New Year fitness resolutions.

“One game, the ‘Freewheelin’ Cycle Challenge,’ is inspired by the company’s bike-sharing program. In the online game, users race against virtual opponents–such as a cheerleader or Marine drill sergeant–in a bicycle race. Energy and speed are gained by capturing nutritious snacks while running over junk food.

“The game is available at www.humanagames.com, a Web site set up in May by the health insurance company as a way to explore how to use games and technology to further messages of health. The game is being promoted through information and blogs on popular casual gaming sites, and can be emailed for maximum viral effect….

“The other application, available via Facebook, is called ‘The Battle of the Bulge.’ Through the social networking site, users answer a few questions and are assigned a virtual waistline. Through the Facebook network, other users can ‘fling fat’ at you, which would expand your waistline and lead to a possible online heart attack. Answering health-related questions correctly can shrink the size of the virtual waistline and enable you to throw fat at your friends.”

A Humana spokesperson said the application leveraged the competitive aspect of Facebook.

16 December 2008

EMR penetration not as good as it looks

Ken Terry writes on BNET Healthcare: “The latest news on electronic medical record (EMR) penetration in physician practices can be interpreted in two different ways, depending on whether you see the glass as half empty or half full. According to a 2008 survey by the Centers for Disease Control and Prevention, 38.4 percent of doctors reported they were using full or partial EMR systems, and 20.4 percent said they were using minimally functional EMRs, including e-prescribing, the ability to order tests and view lab results, and electronic notes. In a 2006 CDC survey, the corresponding figures were 29.2 percent and 12.4 percent, respectively. Optimists might cite these figures as showing that physicians are really starting to embrace EMRs.

“But not so fast. When the CDC asked about EMR systems that conform to interoperability standards and are known as electronic health records (EHRs), just 17 percent of physicians reported having basic EHRs (which do all that basic EMRs do, and can also connect with other systems in a standardized way), up from 11.2 percent in 2006. Only 4 percent of respondents said they had fully functional EHRs, compared with 3.1 percent two years earlier.

“Here’s why the answers to the EHR questions are significant: According to the Department of Health and Human Services, to which CDC belongs, an EHR is considered interoperable if it is certified by the private, nonprofit Certification Commission for Healthcare Information Technology (CCHIT). Vendors of most full-featured EHRs have had their products certified by CCHIT for competitive reasons. So physicians who report they have a “basic” EMR are probably using a low-cost or older, non-certified EMR that can’t exchange data with other systems. Even practices with “basic” EHRs may not have the tools they need to use their systems for quality improvement or care coordination.

“So if someone tells you that nearly 40 percent of doctors have EMRs, remember that only 4 percent have fully functional EHRs that can do all the good things that health reform advocates want them to do.”

11 December 2008

E-health waste a billion-dollar Australian industry

Released this week was a Booz and Co consultancy report commissioned by the Government’s health reform adviser, the National Health and Hospital Reform Commission, that has warned Australia was wasting money and falling behind in the digital health revolution.

The Australian called it “a new study [that] slammed scattergun spending of almost $1.3 billion on state-based e-health schemes.” It also reported on the same day that State health ministers have finally agreed on a national plan to share patients’ electronic records.

It reported, “they gave the tick to the strategy commissioned in April amid controversy over delays, cost blowouts and resignations in e-health projects and bodies across the country.

“Electronic records for patients are currently held separately, if at all, across GP surgeries, hospitals, government agencies and other health centres, allowing only patchy sharing of information.

“The gaps have resulted in duplicate consultations, tests and treatments and prescribing mistakes, with past studies calculating the net benefits of better electronic record-keeping at up to $8.7 billion over the first 10 years.

“The lack of common IT systems and fast broadband has also stalled moves towards more sophisticated innovations, such as remote robotic surgery and electronic monitoring of patients.”

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