ICMCC

Phones against infections

“Advanced imaging technology has been installed in a mobile telephone that can be used in blood tests for infectious diseases.”
Article
Paul Chinnock, TropIKA, 6 January 2009

Who owns electronic health records? (Part II)

“Town Hall panelists continue the conversation about the ownership of health information.”
Video
Healthcare Town Hall, 6 January 2009

Personal Health Records in Primary Care

“Personal health records are important in improving the quality and patient-centeredness of care and, are an essential step to create an effective medical home. However, the informatics need of the primary care setting creates challenges to integrate a PHR into daily practice and also generate new opportunities.”
Article
Stephen J. Morgan, EMR Services of Canada Blog, 6 january 2009

Wipro Launches Pay-Per-Use “EMR Lite” Software

“I have posted a number of blog notes about Software-as-a-Service (SaaS). My own belief is that “renting” software and the necessary associated data storage on the web eliminates many of the problems associated with PC-based applications such as PC failure, data backup, and the necessary periodic software upgrades. I interact with web-based applications for more than 80% of my daily computing activities including the writing and publishing of this blog as well as my email and business-related applications using Gmail and Google Apps.”
Article
Bruce Friedman, Lab Soft News, 6 January 2009

Let’s Reboot America’s Health IT Conversation Part 2: Beyond EHRs

“Yesterday we tried to put EHRs into perspective. They’re important, and we can’t effectively move health care forward without them. But they’re only one of many important health IT functions. EHRs and health IT alone won’t fix health care. So developing a comprehensive but effective national health IT plan is a huge undertaking that requires broad, non-ideological thinking.”
Article
David Kibbe, Brian Klepper The Health Care Blog, 6 January 2009

New York Times Examines How EHRs Could Improve Evidence-Based Medicine

“The New York Times last week examined how “widespread adoption of electronic health records might … greatly increase evidence-based medicine,” among other benefits. The article is part of an occasional Times series called “The Evidence Gap.” According to the Times, “Each patient’s records adds to a real-time, ever-growing database of evidence showing what works and what does not” that could allow physicians to “harness health information from individuals and populations, share it across networks, sift it and analyze it to make the practice of medicine more of a science and less an art”.”
Article
Medical News Today, 6 January 2009

Colorado to expand health data network

“Over the past month, Colorado has successfully demonstrated its ability to share patient data securely among four health and hospital systems across the state.
Within two years, the Colorado Regional Health Information Organization, or CORHIO, plans to connect additional regional and enterprise systems by expanding its clinical messaging capability to those systems, said executive director Phyllis Albritton.”
Article
Patty Enrado, Healthcare IT News, 6 January 2009

Federal healthcare spending report shows e-Rx can save money

“National health spending in 2007 was at its lowest rate of overall growth since 1998, according to a new report from the Centers for Medicare & Medicaid Services.
CMS researchers said slower prescription drug spending contributed to the slowed healthcare spending.”
Article
Diana Manos, Healtcare IT News, 6 January 2009

Procurement blocks innovation: report

“The Policy Exchange has attacked the government for not doing enough to drive innovation in the NHS and called for a shake-up of financial incentives and procurement processes to drive new technologies and working practices into the service.
The right-leaning think-tank says that as things stand, new drugs, devices and other technologies “inch” their way into the health service and “this is one of the reasons our standards often fall below those of comparable countries”.”
Article
Lyn Whitfield, e-Health Insider, 6 January 2009

Hospitals advised to end mobile phone bans

“Hospitals in England have been told to consider allowing “more liberal use of mobile phones”, following new guidance issued today by the Department of Health.
Under the new guidelines areas of hospitals where mobile phone use is banned could become the exception rather than the norm. Bans will remain in place in areas where critical care equipment is susceptible to electro magnetic interference.”
Article
Jon Hoeksma, e-Health Insider, 6 January 2009

NYC pays primary care doctors to get EMRs, meet quality targets

“New York City has begun a $60 million project under which it is heavily subsidizing EMRs for 1,000 primary care physicians in an effort to improve care and collect public health data. New York is trying to connect the majority of practices with 10 or fewer doctors, largely those in poorer neighborhoods.”
Article
Anne Ziegler, FierceHealthIT, 5 January 2009

Does CCHIT Really Matter?

“The Certification Commission for Healthcare Information Technology is an independent, non-profit organization that examines and certifies Electronic Medical Records (EMR) software based on a standard set of criteria. Their goal is to “accelerate the adoption of robust, interoperable healthcare information technology…” The idea is to take the uncertainty out of selecting an EMR. They want physicians to think that any CCHIT-certified EMR will provide quality and functionality.”
Article
Ryan Ricks, EMR Blog, 6 January 2009

Who owns electronic health information? (Part 1)

“Who owns electronic health records? Gail Graham of Veterans Affairs, Washington State Insurance Commissioner Mike Kreidler, and King County Executive Ron Sims discuss the question of ownership and how electronic health information can and should be used.”
Video
Healthcare Town Hall, 5 January 2009

EMR 2.0 Video by AllScripts

“If a picture is worth a thousand words, a video should be worth ten thousand.”
Article
Ben Quirk, Implementing EMRs, 5 January 2009

Insurers move to provide PHRs for members

“It seems these insurers and their offerings will provide not only access to patient records, but also provide information on evidence-based health and wellness information (e.g. smoking cessation). One of the points made about these offerings is that these EHR portals can provide information to customers about the available network of physicians, as well as providing physicians with the ability to send reminders to their patients. One of the downsides mentioned in the article includes advertising from pharmaceutical companies. Another issue mentioned is that physicians are wary of PHRs because they don’t really understand how it ads value or fits within their healthcare delivery practice.”
Article
Healthcare & Technology, 5 January 2009

All Change Please

“Even when backed by clear evidence, new technologies and practices inch their way too slowly through the vast web of structures that make up the National Health Service. This is one of the reasons our standards often fall below those of comparable countries. Data collected by the World Health Organisation shows that premature deaths from causes that are preventable with prompt and effective healthcare are higher in the UK than Germany, Canada, Australia and France. A lack of MRI and CT scanners can lead to long waits for diagnostic tests, while shortages in radiotherapy equipment are a factor in our comparatively poor cancer treatment. Among European countries, the UK is consistently below average in the adoption of new drugs for the treatment of certain common cancers. And within Britain, too, there is an unjustifiably wide variation in outcomes of care.
To understand why it is so difficult to spread new technologies and practices within the NHS, the authors of All Change Please interviewed more than 80 senior healthcare professionals here and in North America. Professor Barlow and Jamie Burn discuss challenges the NHS faces spreading the best ideas through the health system. They provide new analysis of how much is currently spent on innovation and diffusion, and make seven recommendations on how to improve the system.”
Report
James Barlow and Jamie Burn, Policy Exchange, january 2009

Is the PHR Just a Tool for the Wealthy and Healthy?

“Is the PHR like the “executive physical”? Some have suggested that personal health records (PHRs) - a system whereby patients enjoy custodial rights to their secure health data anytime, anywhere - is a privilege that appeals just to the wealthy, healthy or “worried well”.”
Article
Neil Seeman, Longwoods Essays, 5 January 2009

Tensions associated with the use of electronic knowledge resources within clinical decision-making processes: A multiple case study

“Content and objective
Health professionals now routinely use electronic knowledge resources (EKRs). Few studies have considered EKR-related tensions which may arise in a clinical decision-making context. The present study aims to explore three types of tension: (1) user–computer tension, (2) social tensions, and (3) organizational tensions (constraints associated with organizational routines and health policies).
Design, participants, intervention, setting
We conducted a multiple case study, examining Family Medicine residents’ searches for information in everyday life. Cases were defined as critical searches for information among 17 first year family medicine residents using InfoRetriever® 2003/2004 on a PDA over 1.5 months at McGill University. InfoRetriever®-derived information was used within a resident-patient decision-making context in 84 of 156 cases. For each case, residents were interviewed, and extracts of interview transcripts were assigned to themes using specialized software (presence of tension; type of tension). Further computer-assisted lexical-semantic analysis was performed on transcripts. Authors reached consensus on assignments.
Results
Twenty-five cases with tension were identified (one case had two types of tension), and illustrate the above mentioned types of tensions: (T1) tension between the resident and InfoRetriever® (N = 16); (T2) InfoRetriever®-related tension between the resident and other social actors, specifically supervisors, other health care professionals and patients (N = 7); (T3) InfoRetriever®-related tension between the resident and the health organization/system (N = 3).
Conclusions
Results suggest EKR usage in a clinical decision-making context may have negative consequences when three types of tension arise in a clinical decision-making context. Illustrated types of tension are interrelated and not mutually exclusive. Awareness of EKR-related tensions may help clinicians to integrate EKRs in practice.”
Abstract
N. Mysore, P. Pluye, R.M. Grad, J. Johnson-Lafleur, International Journal of Medical Informatics, In Press, Corrected Proof, Available online 30 December 2008, doi:10.1016/j.ijmedinf.2008.09.004

Bahrain should Adopt Open Source Electronic Medical Records

“As Bahrain begins the switch to electronic medical records the use of open source software becomes increasingly important. Without it, the country’s public health data is at the mercy of private companies, local young innovators are unable to contribute solutions, and the citizens’ fears about how data is used will lead to patients withholding information from their doctors.”
Article
Mohammad Al-Ubaydli, Bahrain Medical Bulletin, Vol. 30, No. 4, December 2008

Is Mobile Teleconsulting Equivalent to Hospital-Based Telestroke Services?

“Background and Purpose Telemedicine is increasingly used to provide acute stroke expertise for hospitals without full-time neurological services. Teleconsulting through mobile laptop computers may offer more flexibility compared with hospital-based services, but concerns about quality and technical reliability remain.
Methods We conducted a controlled trial, allocating hospital-based or mobile teleconsulting in a shift-by-shift sequence and evaluating technical parameters, acceptability, and impact on immediate clinical decisions. Both types of telemedicine workstations were equipped with DICOM (Digital-Imaging-and-Communications-in-Medicine) viewer and videoconference software. The laptop connected by asymmetrical broadband UMTS (Universal-Mobile-Telecommunication-Systems) technology with a one-way spoke-to-hub video transmission, whereas the hospital-based device used landline symmetrical telecommunication, including a 2-way videoconference.
Results One hundred twenty-seven hospital-based and 96 mobile teleconsultations were conducted within 2 months without any technical breakdown. The rates per allocated time were similar with 3.8 and 4.0 per day. No significant differences were found for durations of videoconference (mean: 11±3 versus 10±3 minutes, P=0.07), DICOM download (3±3 versus 4±3 minutes, P=0.19), and total duration of teleconsultations (44±19 versus 45±21 minutes, P=0.98). Technical quality of mobile teleconsultations was rated worse on both sides, but this did not affect the ability to make remote clinical decisions like initiating thrombolysis (17% versus 13% of all, P=0.32).
Conclusions Teleconsultation using a laptop workstation and broadband mobile telecommunication was technically stable and allowed remote clinical decision-making. There remain disadvantages regarding videoconference quality on the hub side and lack of video transmission to the spoke side.”
Abstract
Heinrich J. Audebert; Sandra Boy; Ralf Jankovits; Philipp Pilz; Jochen Klucken; Nando P. Fehm; Johannes Schenkel, Stroke. 2008;39:3427-3430

WHIT08 - EC Workshop Procuring for health benefits: Critical Factors for Beneficial Deployment of Innovative eHealth and Telemedicine Services

“The main procurement models presented were:

• Formal large-scale procurement for telemedicine equipment and services – NHS CfH England
• Regional procurement of a large-scale application of a remote telemonitoring service supported by a range of self-standing pilots to expand patient and client experience of the new approaches as the procurement exercise is taken forward – Northern Ireland
• Local development of telemedicine and services equipment, with a plan to scale-up – Catalan
• Procure for emarketplace with local call-off – Odense, Denmark.”

Report
European Commission WHIT 08- Procurement Workshop, DG Information Society and Media November 6, 2008, Copenhagen, ICT for Health Unit, December 2008

Robotics for Healthcare Final Report

“For the last two decades the European Commission (EC), and in particular the Directorate General Information Society and Media, has been strongly supporting the application of Information and Communication Technologies (ICT) in healthcare. ICT is an enabling technology which can provide various solutions in the healthcare sector, ranging from electronic patient records and health information networks to intelligent prosthetics and robotised surgery. The EC funded the present study with the aim to investigate the potential of robotics in healthcare.”
Report
Maurits Butter, Arjan Rensma, Joey van Boxsel, Sandy Kalisingh, Marian Schoone, Miriam Leis, Gert Jan Gelderblom, Ger Cremers, Monique de Wilt, Willem Kortekaas, Axel Thielmann, Kerstin Cuhls, Anna Sachinopoulou, Ilkka Korhonen, European Commission, DG Information Society, October 2008

The experiential health information processing model: supporting collaborative web-based patient education

“Background
First generation Internet technologies such as mailing lists or newsgroups afforded unprecedented levels of information exchange within a variety of interest groups, including those who seek health information. With emergence of the World Wide Web many communication applications were ported to web browsers. One of the driving factors in this phenomenon has been the exchange of experiential or anecdotal knowledge that patients share online, and there is emerging evidence that participation in these forums may be having an impact on people’s health decision making. Theoretical frameworks supporting this form of information seeking and learning have yet to be proposed.
Results
In this article, we propose an adaptation of Kolb’s experiential learning theory to begin to formulate an experiential health information processing model that may contribute to our understanding of online health information seeking behaviour in this context.
Conclusions
An experiential health information processing model is proposed that can be used as a research framework. Future research directions include investigating the utility of this model in the online health information seeking context, studying the impact of collaborating in these online environments on patient decision making and on health outcomes are provided.”
Article
Laura A O’Grady, Holly Witteman and C NADINE Wathen, BMC Medical Informatics and Decision Making 2008, 8:58doi:10.1186/1472-6947-8-58

An Evaluation of the Healthelink Electronic Health Record Pilot (Summary Report)

“This report presents the results of an evaluation of the Healthelink electronic health record (EHR) pilot. This report was prepared by KPMG. It focuses on the implementation, functioning and performance of the Healthelink EHR pilot from the time of its commencement in March 2006 to September 2008.”
Report
KPMG for NSW Healthelink, September 2008
(Thanks to David More)

Nationwide Privacy and Security Framework For Electronic Exchange of Individually Identifiable Health Information

“Electronic health information exchange promises an array of potential benefits for individuals and the U.S. health care system through improved clinical care and reduced cost. At the same time, this environment also poses new challenges and opportunities for protecting individually identifiable health information. In health care, accurate and complete information about individuals is critical to providing high quality, coordinated care. If individuals and other participants in a network lack trust in electronic exchange of information due to perceived or actual risks to individually identifiable health information or the accuracy and completeness of such information, it may affect their willingness to disclose necessary health information and could have life-threatening consequences. A key factor to achieving a high-level of trust among individuals, health care providers, and other health care organizations participating in electronic health information exchange is the development of, and adherence to, a consistent and coordinated approach to privacy and security. Clear, understandable, uniform principles are a first step in developing a consistent and coordinated approach to privacy and security and a key component to building the trust required to realize the potential benefits of electronic health information exchange.”
Report
Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services, 15 December 2008

The Chaos Continues
Posted 7 Nov 2008

Dutch EHR - Chaos Behind the Dikes
Posted 4 Nov 2008

Health2.0, definition, vision, opportunities and a goal
Posted 3 Nov 2008