Health-e Information Technology Act of 2008

“To promote the adoption and meaningful use of health information technology, and for other purposes.”
Preliminary bill text
US House of representatives

Breaking News: Congress Wants to Create National eHealth Network, Legislate Who “Owns” Health Data

“Clue - it ain’t patients. Google. Microsoft. I hope someone in your healthcare organizations reads this brief. Look especially to the latter 1/3rd.
Browsing Twitter this afternoon, I learned about a House bill draft (HR ____) nicknamed “Health e-Information Technology Act of 2008″ from @jesran.
It has not yet been assigned a number, but the draft copy is available here. It looks to be in pre-committee.
Sponsors: Mr. STARK (for himself, Ms. SCHWARTZ, Mr. MCDERMOTT, Mr. MCNULTY, Mr. LEVIN, Mr. EMANUEL, Mr. NEAL of Massachusetts, Mr. PASCRELL, and Mr. LEWIS of Georgia).
IF YOU ARE IN HEALTHCARE, THIS BILL IS THE MOST IMPORTANT THING YOU MAY READ THIS YEAR.”
Article
Jen McCabe Gorman, Health Management Rx, 8 October 2008

Welkom en Dutch Grand Rounds, Grote Visit - 4th Edition!

“Health Management Rx has the unique privilege to host the first US-based Dutch Grand Rounds today!
Due to the language barrier (ours, not theirs!), the format of this Grand Rounds will be text heavy - some posts are in English, some in Dutch.
Our Dutch colleagues have kindly translated many Dutch links to English text for us, so content of those posts is included below en total.
Since we have so much great ‘imported’ material to cover, I’ll keep the intro short and sweet.
It’s a privilege to provide inside perspectives from my adopted homeland. This is a rare chance for the American health and medical blogosphere to hear what’s really going on over there in the Netherlands, and how Dutch bloggers view international healthcare fumblings.”
Article
Jen McCabe Gorman, Health Management Rx, 7 October 2008

E-health is a key facilitator for reform

“The future of healthcare in Europe is being shaped by e-Health and Sweden has had huge successes in this area. It is this excellence in e-health that has led to Sweden being given the responsibility, along with 11 other member states, of developing e-health within the European Union. Public Service Review asked the Head of e-Health at the Swedish Ministry of Health and Social Affairs to describe his country’s technologically advanced healthcare systems.”
Article
Public Service Review: European Union Issue 16, 7 October 2008

Vic rethinks e-health

“VICTORIA is ruling a line under its patchy HealthSmart IT rollout, and has returned to the drawing board with plans for a new whole-of-health ICT strategy for the period 2009-2013.
When the now-$427 million program began in 2003, it was hoped that the ICT refresh and rebuild across the state’s public hospitals, rural alliances and community health providers would be complete within four years.
But in April this year, Victoria’s auditor-general Des Pearson said HealthSmart had been overly ambitious in its targets, and was at least two years behind schedule.”
Article
Karen Dearne, Australian IT, 6 October 2008

With someone in charge change can be fast

“SCM Microsystems writes to say its eHealth terminal has now been certified by German authorities and will start showing up in doctors’ offices and pharmacies nationwide next month.”
Article
Dana Blankenhorn, ZDNet Healthcare, 26 September 2008

State Alliance calls for state action on healthcare IT

“The State Alliance for e-Health, made up of governors and state officials from across the country, is calling on states to support e-prescribing and address medical privacy and security issues in order to boost healthcare IT.”
Article
Bernie Monegain, Healthcare IT News, 23 September 2008

Canadian territory receives boost for EHR

“Nunavut, the largest territory in Canada, has received a boost to its electronic health record project.
Canada Health Infoway, a federally funded, independent, not-for-profit organization and catalyst for EHR adoption across Canada, has made a $7.4 million investment in Phase 2 of the department’s E-health program.”
Article
Molly Merrill, Healthcare IT News, 12 September 2008

E-health logjam frustrates providers

“As a new national e-health strategy comes down the pipe, health services providers are bubbling with frustration and hope.
Deloitte is set to deliver its e-health review to the National E-Health Transition Authority board and the Council of Australian Governments (COAG) in October.
Many of the health services providers waiting on the review were in attendance at CHIK Service’s annual Health-e-Nation conference in Melbourne last week and expressed frustration with the lack of progress on standards.”
Article
Karen Dearne, Australian IT, 9 September 2008

Foundation of National Telemedicine and eHealth Council of Pakistan (NTmeHCP)

The Federal Ministry of Health, under the leadership of its Director General-Prof. Dr. Rasheed Jooma took this initiative in collaboration with WHO and organized a National eHealth policy Workshop. I on behalf of the Ministry of Health (MOH) coordinated & organized the workshop and gathered all the current & potential stake holders in Telemedicine and eHealth in Islamabad for 2 days ( August 21 & 22, 2008) where we deliberated extensively on formation of this group with its aims and objectives and a road map for the MOH to initiate a master plan for Telemedicine / eHealth in Pakistan. The group has an official status and will be formally notified by the MOH soon. Read the rest of this entry »

German hospitals count benefits of SAP

“Hospitals in Germany say they expect regional e-health networks to deliver substantial cost savings of up to €2 million a year.
The figures are extrapolated from a new survey, conducted by German software giant SAP. In its survey of hospital managers at ten major hospitals using SAP, respondents said they anticipated average savings of €100 for every patient.”
Article
e-Health Europe, 3 September 2008

e-health portal launched for Lithuania

“A new Lithuanian ehealth information website has been launched to keep health professionals and members of the public informed about the development of Lithuania’s National Electronic Health System (NESS).”
Article
e-Health Europe, 1 September 2008

Schweizer: „Ja“ zum elektronischen Patientendossier

“Ein elektronisches Patientendossier zur Identifikation der Patientinnen und Patienten mit allen aktuellen und bisherigen Daten über unsere Gesundheit: Wie nimmt die Schweizer Bevölkerung die vom Bundesrat beschlossene Einführung des elektronischen Patientendossiers auf?”
Article (German)
Krankenhaus IT Journal, 27 August 2008

ICW selected for US telehealth programme

“German e-health specialist InterComponentWare (ICW) has been selected by US health network Coventry Health Care to provide the infrastructure for a home monitoring programme.
ICW will provide the interoperability platform and infrastructure technology for Coventry Health’s telemonitoring pilot program.”
Article
e-Health Europe, 27 August 2008

Estonia takes steps to e-health

“The Estonian Government this week approved of the package of regulations which paves the way to the introduction of digital health records.
In a press release issued today Estonia’s Minister of Social Affairs Maret Maripuu said that the regulations adopted on Thursday will create preconditions for the gradual transition to e-health.”
Article
e-Health Europe, 22 August 2008.

Estonia to test the e-health system

“Yesterday’s government session approved the regulation packet which takes Estonia one step closer to switching over to e-health system, aripaev.ee writes.”
Article
Sandra Taimre, Baltic Business News, 15 August 2008

The failure of e-health/telehealth today

“Because I recently had rotator cuff surgery, my output has declined and maybe it allowed me to sit back and think of the state e-health/telehealth today in the US.
Sadly with some exceptions, I am not impressed, but in parts of the world we don’t even compare.
Why perhaps its lack of leadership or our e-health/telehealth leaders are risk adverse?
What may be lacking, in my opinion is we don’t have any e-health/telehealth statesmen.”
Article
The Bob Blog, 10 August 2008

Health 2.0 and Medicine 2.0: Tensions and Controversies in the Field

“Background: The term Web 2.0 became popular following the O’Reilly Media Web 2.0 conference in 2004; however, there are difficulties in its application to health and medicine. Principally, the definition published by O’Reilly is criticized for being too amorphous, where other authors claim that Web 2.0 does not really exist. Despite this skepticism, the online community using Web 2.0 tools for health continues to grow, and the term Medicine 2.0 has entered popular nomenclature.
Objective: This paper aims to establish a clear definition for Medicine 2.0 and delineate literature that is specific to the field. In addition, we propose a framework for categorizing the existing Medicine 2.0 literature and identify key research themes, underdeveloped research areas, as well as the underlying tensions or controversies in Medicine 2.0’s diverse interest groups.
Methods: In the first phase, we employ a thematic analysis of online definitions, that is, the most important linked papers, websites, or blogs in the Medicine 2.0 community itself. In a second phase, this definition is then applied across a series of academic papers to review Medicine 2.0’s core literature base, delineating it from a wider concept of eHealth.
Results: The terms Medicine 2.0 and Health 2.0 were found to be very similar and subsume five major salient themes: (1) the participants involved (doctors, patients, etc); (2) its impact on both traditional and collaborative practices in medicine; (3) its ability to provide personalized health care; (4) its ability to promote ongoing medical education; and (5) its associated method- and tool-related issues, such as potential inaccuracy in enduser-generated content. In comparing definitions of Medicine 2.0 to eHealth, key distinctions are made by the collaborative nature of Medicine 2.0 and its emphasis on personalized health care. However, other elements such as health or medical education remain common for both categories. In addition, this emphasis on personalized health care is not a salient theme within the academic literature. Of 2405 papers originally identified as potentially relevant, we found 56 articles that were exclusively focused on Medicine 2.0 as opposed to wider eHealth discussions. Four major tensions or debates between stakeholders were found in this literature, including (1) the lack of clear Medicine 2.0 definitions, (2) tension due to the loss of control over information as perceived by doctors, (3) the safety issues of inaccurate information, and (4) ownership and privacy issues with the growing body of information created by Medicine 2.0.
Conclusion: This paper is distinguished from previous reviews in that earlier studies mainly introduced specific Medicine 2.0 tools. In addressing the field’s definition via empirical online data, it establishes a literature base and delineates key topics for future research into Medicine 2.0, distinct to that of eHealth.”
Article
Hughes B, Joshi I, Wareham J, J Med Internet Res 2008;10(3):e23, doi:10.2196/jmir.1056

A Second Life for eHealth: Prospects for the Use of 3-D Virtual Worlds in Clinical Psychology

“The aim of the present paper is to describe the role played by three-dimensional (3-D) virtual worlds in eHealth applications, addressing some potential advantages and issues related to the use of this emerging medium in clinical practice. Due to the enormous diffusion of the World Wide Web (WWW), telepsychology, and telehealth in general, have become accepted and validated methods for the treatment of many different health care concerns. The introduction of the Web 2.0 has facilitated the development of new forms of collaborative interaction between multiple users based on 3-D virtual worlds. This paper describes the development and implementation of a form of tailored immersive e-therapy called p-health whose key factor is interreality, that is, the creation of a hybrid augmented experience merging physical and virtual worlds. We suggest that compared with conventional telehealth applications such as emails, chat, and videoconferences, the interaction between real and 3-D virtual worlds may convey greater feelings of presence, facilitate the clinical communication process, positively influence group processes and cohesiveness in group-based therapies, and foster higher levels of interpersonal trust between therapists and patients. However, challenges related to the potentially addictive nature of such virtual worlds and questions related to privacy and personal safety will also be discussed.”
Article
Gorini A, Gaggioli A, Vigna C, Riva G, J Med Internet Res 2008;10(3):e21, doi:10.2196/jmir.1029

When ehealth is not ehealth

“Now that I’ve had a few weeks under my belt in my ‘industry role’, I’ve been able to do some more thinking about my previous post.  Here are some of my thoughts.”
Article
Hans Oh’s eHealth Blog, 5 August 2008

Deloittes Discussion Points for the National E-Health Strategy – Initial Comments.

“As reported late last week, on Wednesday July 30 2008, NEHIPC convened a forum to review their latest draft of the National E-Health Strategy being developed by Deloittes.
I have now had a chance to browse the slides and form some preliminary views as to where this is up to.”
Article
David More, Australian Health Information Technology, 3 August 2008

ICT, Self-care, PHR’s, and EHR’s: Healthcare and Web 2.0

“Healthcare systems are undergoing a series of complex transformations. Consumers are demanding better services and information that enables provider transparency and a more personalized service delivery model. This shift in healthcare has already begun, whether or not healthcare delivery organizations are ready to respond or not. We are quickly moving away from the traditional models of medicine and towards a patient-centric model with the intent to deliver more efficient care, whilst simultaneously improving patient outcomes.”
Article
Panteleon, Acumeme, 1 August 2008

Important Australian National E-Health Strategy Document to Review

“The following was posted on the HISA Site today. (August 1, 2008)
National E-Health Strategy Draft Review
On Wednesday July 30, NEHIPC convened a forum to review their latest draft of the National E-Health Strategy being developed by Deloittes. Michael Legg (HISA President) represented HISA at this event.”
Article
David More, Australian Health Information Technology, 1 August 2008

Open eHealth Foundation sets out priorities

“The Open eHealth Foundation (OeHF), an open source initiative for improving the exchange of medical information using existing standards, has been incorporated as a non-profit organisation in Delaware enabling it to begin operations.”
Article
e-Health Europe, 29 July 2008

House committee approves major health IT bill

“The House Energy and Commerce Committee unanimously approved a major health IT bill today and sent it to the full House for action.>
The committee leaders who sponsored the Protecting Records, Optimizing Treatment and Easing Communication Through Healthcare Technology Act of 2008 (H.R. 6357) made significant concessions to privacy advocates and to those who use health information as they modified the bill approved in June.”
Article
Nancy Ferris, Government Health IT, 23 July 2008

Taking e-Health to the Next Level

“Chief executive officers, chief information officers and other senior managers from healthcare provider organizations across Canada, along with representatives of sponsoring supplier firms, shared a diverse set of views and some fascinating insights into healthcare IT implementation challenges at the eighth eHealth Summit, held June 11-13 in Mont Tremblant, Que.”
Article
Panteleon, Acumeme, 23 July 2008

Patients’ Engagement With “Sweet Talk” – A Text Messaging Support System for Young People With Diabetes

“Background: Guidelines for optimizing type 1 diabetes in young people advocate intensive insulin therapy coupled with personal support from the health care team. “Sweet Talk” is a novel intervention designed to support patients between clinic visits using text messages sent to a mobile phone. Scheduled messages are tailored to patient profiles and diabetes self-management goals, and generic messages include topical “newsletters” and anonymized tips from other participants. The system also allows patients to submit data and questions to the diabetes care team.
Objectives: The aim was to explore how patients with type 1 diabetes interact with the Sweet Talk system in order to understand its utility to this user group.
Methods: Subjects were 64 young people with diabetes who were participating in the intervention arms of a randomized controlled trial. All text messages submitted to Sweet Talk during a 12-month period were recorded. Messaging patterns and content were analyzed using mixed quantitative and qualitative methods.
Results: Patients submitted 1180 messages during the observation period (mean 18.4, median 6). Messaging frequency ranged widely between participants (0-240) with a subset of 5 high users contributing 52% of the total. Patients’ clinical and sociodemographic characteristics were not associated with total messaging frequency, although girls sent significantly more messages unrelated to diabetes than did boys (P = .002). The content of patients’ messages fell into 8 main categories: blood glucose readings, diabetes questions, diabetes information, personal health administration, social messages, technical messages, message errors, and message responses. Unprompted submission of blood glucose values was the most frequent incoming message type (35% of total). Responses to requests for personal experiences and tips generated 40% of all the incoming messages, while topical news items also generated good responses. Patients also used the service to ask questions, submit information about their self-management, and order supplies. No patients nominated supporters to receive text messages about their self-management goals. Another option that was not used was the birthday reminder service.
Conclusions: Automated, scheduled text messaging successfully engaged young people with diabetes. While the system was primarily designed to provide “push” support to patients, submission of clinical data and queries illustrates that it was seen as a trusted medium for communicating with care providers. Responses to the newsletters and submission of personal experiences and tips for circulation to other participants also illustrate the potential value of such interventions for establishing a sense of community. Although participants submitted relatively few messages, positive responses to the system suggest that most derived passive support from reading the messages. The Sweet Talk system could be readily adapted to suit other chronic disease models and age groups, and the results of this study may help to inform the design of future text message support interventions.”
Article
Franklin VL, Greene A, Waller A, Greene SA, Pagliari C, J Med Internet Res 2008;10(2):e20, doi:10.2196/jmir.962

A development framework for semantically interoperable health information systems

“Background
Semantic interoperability is a basic challenge to be met for new generations of distributed, communicating and co-operating health information systems (HIS) enabling shared care and e-Health. Analysis, design, implementation and maintenance of such systems and intrinsic architectures have to follow a unified development methodology.
Methods
The Generic Component Model (GCM) is used as a framework for modeling any system to evaluate and harmonize state of the art architecture development approaches and standards for health information systems as well as to derive a coherent architecture development framework for sustainable, semantically interoperable HIS and their components. The proposed methodology is based on the Rational Unified Process (RUP), taking advantage of its flexibility to be configured for integrating other architectural approaches such as Service-Oriented Architecture (SOA), Model-Driven Architecture (MDA), ISO 10746, and HL7 Development Framework (HDF).
Results
Existing architectural approaches have been analyzed, compared and finally harmonized towards an architecture development framework for advanced health information systems.
Conclusion
Starting with the requirements for semantic interoperability derived from paradigm changes for health information systems, and supported in formal software process engineering methods, an appropriate development framework for semantically interoperable HIS has been provided. The usability of the framework has been exemplified in a public health scenario.”
Abstract
Diego M. Lopez and Bernd G.M.E. Blobel, International Journal of Medical Informatics, In Press, Corrected Proof, Available online 14 July 2008, doi:10.1016/j.ijmedinf.2008.05.009

Three standard types needed for e-health

“A sub-group of the European Standardisation Organisations alliance has published a paper warning of gaps and overlaps in existing e-health standards.
The group, known as eHealth-INTEROP, says three types of standard need to be focused on to enable the achievement of interoperability in e-health – base standards, profiles and interoperability specifications.”
Article
e-Health Europe, 16 July 2008

Communiqué des associations médicales belges sur le projet de loi relatif à l’institution et à l’organisation de la plate-forme eHealth.

“Sur son site, l’asbym met en ligne un communiqué commun des associations médicales belges à la veille du vote à la chambre. Depuis, la chambre a approuvé eHealth avec certains amendements du MR et l’OpenVLD. L’ABSyM souhaite que la nouvelle loi soit évoquée au Sénat. Si le Sénat modifie le texte, il devra être revoté par la Chambre.”
Article
Soins Infirmiers & Informatique, 14 July 2008

See also:
Wetsontwerp e-health gestemd, Maggie de Block, 14 July 2008