View Article  eHealth Reports of note – April 2009

Canada's e-health journey and HIMSS Analytics' Canada Information and Communications Technology Study (2009 - Healthc Q.) NoFull Text
In spring 2007, HIMSS Analytics began developing its first Canada Information and Communications Technology (ICT) Study. Less than one year later, 38 RHAs, DHAs and HAs are already on board, with some 20 more scheduled to participate by year's end. Why are so many Canadian provincial healthcare delivery organizations now participating in HIMSS Analytics' Canada ICT Study? The answer is tied to the character of the HIMSS study, the value offered to all participants and specific Canadian healthcare issues that are addressed by the study.


US: Interoperable electronic prescribing in the United States: a progress report. (April 2009 - Health Affaires)
Although the vast majority of U.S. physicians still handwrite prescriptions, adoption of electronic prescribing is slowly growing. Major barriers to adoption remain, including the inability to electronically submit prescriptions for controlled substances and confusion about standards for data exchange. Federal and state governments and private insurers are using payment and policy incentives to boost e-prescribing because they still believe in its promise for improving the quality and efficiency of health care. However, additional efforts and further investments are needed to reap the benefits of e-prescribing on a national scale.

Health information technology: dispatches from the revolution. (April 2009 - Health Affairs)
Countries around the world are increasingly employing health information technology (IT). These tools hold the promise of powerful health system breakthroughs from Johannesburg to Jakarta. While implementers multiply, a global e-health consensus framework is beginning to take shape among donors, governments, industries, researchers, and policymakers. As plans are formulated in the United States for substantial new federal investments in health IT, this paper details common threads in national and global health IT discourse. Among them are the need for strong stakeholder engagement, workable policy solutions, funding and donor coordination, and the imperative for adequately addressing standards and interoperability.

Exploring antecedents of consumer satisfaction and repeated search behavior on e-health information (2009 - J Health Commun.)::
E-health information has become an important resource for people seeking health information. Even though many studies have been conducted to examine the quality of e-health information, only a few studies have explored the effects of the information seekers' motivations on the perceived quality of e-health information

User information seeking behaviour: Perceptions and reality. An evaluation of the WHO Labresources Internet portal (2009 - Inform Health Soc Care.)
This article discusses the evaluation of a WHO Internet portal: the Labresources website. The evaluation investigates user satisfaction with the resource, usability, demographic information about users and how well they could complete specific tasks using the website and compared this with the actual online behaviour revealing a number of discrepancies


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View Article  Ireland uses patent wristbands with barcodes

IT is a significant driver for a safer and more efficient healthcare system in Ireland, funded to the tune of €17bn per year.  In a move to make the system more efficient and to better track patients through the system, the system is beginning to use patient wristbands with barcodes that provide full access to the patients key information (see Taking the pulse, reported on the SiliconRepublic.com).

"In times of financial prudence, the budget for infrastructure such as IT is often cut to the quick in an attempt to rein in costs. Conversely, industry observers say now is the time to spend because IT has been proven to save money and drive efficiencies. Despite past technology projects going very publicly awry, the HSE is proceeding with smaller projects that it hopes will improve patient care and increase efficiencies.

ID technology integrator Zetes is involved in a project for patient wristbands with two-dimensional (data matrix) barcodes. The wristband contains key demographic information that includes the patient’s name, surname, date of birth, sex and hospital number. The information is now electronically transferable for use by a PDA-type device, mobile computer or any electronic interface.

“We did this for a hospital in Roscommon that wanted to improve its phlebotomy practices. It previously had to print labels and it now uses electronic wristbands,” explains Barry Long, sales manager with Zetes. “This has two advantages: electronic transfer of information and the details on the wristband is consistent and the same as on the hospital’s system.” Barcoding is a fundamental building block in the installation of wireless networks in hospitals and many hospitals throughout the country are either putting in or piloting the technology, according to Long."

 

Read the full article Taking the pulse.

View Article  U.S. Health IT Lags

According to statistics from the Centers for Disease Control and Prevention, only 1 in 10 U.S. physicians in 2005 were using systems that included prescription and diagnostic test orders, test results and physician notes, which are vital to a complete health information network. That number may be in the rise, but it still lags behind demand and the pace of technology.

 

“As a result, the United States—which had a key role in the creation of personal computers, the rise of the consumer Internet, the mapping of the human genome and using technology to cut costs—lags Denmark, the Netherlands and some other industrialized nations when it comes to moving medical records into the digital age, according to the Commonwealth Fund, a healthcare-focused private foundation in New York,” writes Lisa Baertlein with Reuters in U.S. Health IT Lags on eWeek.com

Insurance companies, which have come under fire for cherry picking the healthiest patients or limiting payments to members, make up another sector that stands to benefit from digital information to find the most effective treatments.

 

The United States plans to develop a national network of health information by 2014, and the European Union has called for every member state to create a system of electronic medical records, according to PricewaterhouseCoopers' recent Pharma 2020 report.

 

AND THE WINNER IS ... DENMARK

 

Denmark leads the pack among European and English-speaking countries when it comes to using digital information to deliver health care, according to the Commonwealth Fund.

 

The Danish government provides health care for its citizens and most of their health information is kept in a single system that can be accessed and updated by an individual's primary care doctor and other medical professionals.

 

Anyone who has personally—or through an acquaintance or family member—grappled with a complex or terminal medical condition knows just how difficult it can be to keep track of specialist visits, hospital stays and prescription drugs—and how valuable it is for doctors, patients and family members to have immediate access to complete records during a health crisis.

None of this of course is a surprise. In a June 2006 article, Health IT struggles echo 19th century challenges (Government Health IT), John Pulley writes, “Up to 100,000 Americans die each year from preventable medical errors, according to estimates released by the Institute of Medicine in 2000. Subsequent studies have estimated twice as many such deaths, with medical errors killing more people every year than breast cancer, AIDS or wrecks involving motor vehicles.”

“One in every five of those fatal errors results from a lack of immediate access to patient health care information, said Jodi Daniel, the director of policy and research for the Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology.”

While the “war on terror” continues to dominate the U.S. administration’s policy, priorities such as Health IT will continue lag and fall further behind European counterparts.

View Article  One step closer to Canadian EHRs

A recent agreement between Canada Health Infoway (Infoway) and the Canadian Institute for Health Information (CIHI) has given the green light to establishing a new Canada-wide coordination body.  Housed by Infoway, the Infoway Standards Collaborative will manage, deliver and maintain health information standards, including those standards related to pan-Canadian electronic health records (EHR).

 

Currently, Canada’s health information standards are managed by several different organizations and initiatives, including CIHI. Having one body responsible for these standards being upheld ensures that the data collected about Canadas health system meet quality criteria and can be easily compared.

 

The Infoway Standards Collaborative will take on several of CIHIs initiatives already underway that support health information standards, including the Partnership for Health Information Standards, HL7 Canada and liaison activities with Digital Imaging and Communications in Medicine (DICOM). While CIHI will no longer be managing the same slate of standardization activities, it will continue to provide leadership in the development and maintenance of the key content standards (such as ICD-10-CA, CCI, MIS Standards) underpinning its information products and services.

 

Based on extensive consultations and collaboration, the Blueprint is focused on interoperability – the capability of computer systems to seamlessly communicate with one another. It provides guidance for integrating the approximately 40,000 existing health information systems in use across the country, while remaining flexible to allow for incorporating new and better information systems and capabilities.

 

This announcement follows on the heels of the release of a revised version of the Electronic Health Record Solution Blueprint developed by Infoway. The revised blueprint provides stakeholders developing Electronic Health Record Solutions with a technology framework for sharing health information securely and appropriately across Canada. It also takes a closer look at privacy and security issues.

 

For more information on Canada Health Infoway, please go to www.infoway-inforoute.ca .

 

Portion of this article originally published in CIHI’s Directions newsletter, June 2006 issue.

View Article  US spends $31 billion on healthcare IT

The American Hospital Association (AHA) claims that advances in technology have transformed patient care, particularly in the shift from inpatient to outpatient settings and in the development of less invasive diagnostic and therapeutic techniques.  Perhaps this explains why annual IT spending in the healthcare industry has jumped $12 billion since 2000.

 

According to industry analysts Sheldon I Dorenfest & Associates, $31 billion dollars was spent on picture archiving and communications systems, and computerized provider order entry systems, among other IT gadgets and software this year.  And it doesn’t look that this spending splurge will end anytime soon.

 

This detail clearly challenges the view that healthcare organizations spend much less on IT than other industries. According to reports on spending in 2001, banking and financial services spent about 5% to 6% of revenues on IT, compared with 3% to 4% for healthcare organizations.


Data from a Modern Healthcare/PricewaterhouseCoopers annual survey of hospital executives indicate that the typical healthcare organization allocates 2.5% of the operating budget to IT. Senior hospital executives responding to the Modern Healthcare 2005 survey indicated their primary near-term IT priority to be the electronic health record (EHR).

 

Implementing a national EHR system would be in the realm of $276 billion to $320 billion over 10 years.  Broken down this translates to an estimated initial cost of $2.7 million for a medium-sized hospital and then $250,000 per year, with an expected annual savings of $1.3 million once the system is fully operational.  If accurate, that could mean a $77.8 billion annual savings nationally.

 

Originally reported in Canadian Healthcare Technology.

View Article  New electronic tools to benefit mental health and addiction patients
The Vancouver Island Health Authority(VIHA) will be the first health care organization in Canada to use technology to support mental health and addictions clinicians and clients to make the most informed decisions about their care.

With the help of a $1.8 million investment from Canada Health Infoway’s Innovation and Adoption program, VIHA will implement electronic tools to match clients with mental health and addictions challenges with the most appropriate care in the community.

“Electronic health initiatives are improving and modernizing the delivery of better, faster and safer health care,” said Health Minister George Abbott. “B.C. is leveraging investment and partnership opportunities from Canada Health Infoway to lead the country in developing electronic health information systems and we may see achievements in B.C. replicated in other jurisdictions."

“We are very grateful for Canada Health Infoway’s investment in this innovative project,” Waldner said. “By leveraging VIHA’s electronic health record system and introducing new web-based decision support technology, we can provide our clinicians with comprehensive information at the point of care, allowing them to make the best possible treatment decisions based on their clients’ needs.”

As in many other Canadian jurisdictions, VIHA clinicians do not currently have a standardized method for identifying and recording clients’ needs and risks, nor do they have access to an inventory of services available in the community. With paper-based processes still being used to document clinical information and refer clients to community-based services, transfer of critical health information and treatment can be delayed.

“This is a remarkable example of electronic tools supporting the needs of patients with acute or chronic conditions,” said Richard Alvarez, Infoway’s President and CEO. “This innovative solution will help reduce wait times and lead to more appropriate care and could serve as a model for other jurisdictions across the country,” he added.

With Infoway’s investment, VIHA’s Mental Health and Addictions Services team and Information Management/Information Technology staff will work closely with two of their existing technology providers, Cerner and Strata Health Solutions, to develop standardized electronic assessments forms and decision support tools specific to mental health and addictions needs. Clinicians will document a client’s assessments in Cerner’s PowerChart tool. Using that information, Strata Health’s web-based Strata PathWays’ ™ tool will provide access to a real-time inventory of mental health and addictions services available in the community that meet the needs of the specific client. VIHA expects it will take approximately 24 months to develop, test and implement the new electronic tools and train staff to use the new technology.

Strata PathWays™ is part of the B.C. eHealth initiative to build an integrated, electronic system that improves outcomes for patients by making their specific information available in hospitals, doctor's offices – wherever and whenever they need to seek health care services.

Read more at Canada Health Infoway invests in mental health apps