Informaticopia

Friday, March 31, 2006

Blogposium is a Go: April 18-19 editing Clininfowiki

HealthNex: Blogposium is a Go: April 18-19

Jack Mason on his blog HealthNex has announced that April 18-19 is the date for the first collaborative work for the health IT blogsphere.

He suggestes that:

Blogposium will be a two-day, virtual collaboration among our circle of bloggers to show the world that together, we can do real and practical work. To make this cross-blog cooperative experiment a success, we'll keep the work and the objective relatively simple:

The Objective: to help flesh out The Clinical Informatics Wiki started by Dean Sittig with a dozen or more new entries, so that this wikipedia-like resource will become more useful for all.

The Work: In the next few weeks, each participating blogger will choose a topic related to healthcare IT research it, and prepare a first draft for an entry in the ClinfoWiki. Entries should include basic definitions, links to supporting material, etc.

April 18: Bloggers will post their first drafts on and all of us, as well as all our readers, will provide comments, suggests and edits on each other's work. Everyone should include links at the bottom of their draft to the preliminary drafts of fellow Blogposium participants, so that we will pass traffic and editorial eyeballs around.

April 19: Based on community input, bloggers will post their second draft, for ultimately inclusion in the wiki.

The beauty of this approach, we hope, is that each participant can draw on their particular interests or expertise, and contribute something of practical value with only a short commitment of time and effort.

I am going to be somewhere in the North Atlantic on the dates concerned & out of contact on the dates concerned but will find a way to contribute - If you are interested in getting involved contact Jack via his blog

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electronic Journal of Health Informatics

electronic Journal of Health Informatics

The Health Informatics Research Group at Central Queensland University (CQU) has launched a new refereed eJournal of Health Informatics, fully endorsed by the Health Informatics Society of Australia and the Australian College of Health Informatics. This first publication is a special issue on Health Data Mining.

The electronic Journal of Health Informatics is an international journal committed to scholarly excellence and dedicated to the advancement of Health Informatics and information technology in healthcare. It is a journal for all health professions and informaticians of all levels.

eJHI aims to publish original, high quality papers related to Health Informatics and health informatics technology in a timely fashion.

It aims to provide health care workers with a readily accessible, electronic vehicle for sharing information about research, knowledge, experiences, perceptions and wisdom with colleagues involved in all facets of health informatics and health information technology.

Readers must register for full-text access to the journal.

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Wednesday, March 29, 2006

UK Health Informatics Today - Spring 2006

UK Health Informatics Today - Spring 2006

The latest edition of UK Health Informatics Today - The Newsleter of the UK Health informatics Society has just been published on the Web.

It provides some current news and events as usual but this edition is a special issue which has been edited by Dr Mohammad Al-Ubaydli and deals with Open Source Software

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NHS Connecting for Health Nursing & Midwifery Conference 28th March 2006

The first Nursing and Midwifery conference organised by NHS Connecting for Health was held in London on the 28th March 2006. The conference was aimed at all nurses and midwives but seemed to attract a large number of nurse managers, civil servants and educationalists, rather than front line staff, with about 300 people attending. Perhaps this was appropriate as it was a general awareness raising event aimed at getting people on board people who could influence future developments and implementation.

The conference was opened by Barbara Stuttle (Director of Primary Care and Development at Thurrock Primary Care Trust) who took up her part time secondment as National Clinical Lead for Nursing with NHS Connecting for Health in April 2005. Barbara emphasised the importance of nurses as the ones who hold the NHS together and made some very general comments about the importance of Connecting for Health programmes for all practitioners.

Beki Ruban (Head of Nursing Development Programme, NHS Connecting for Health
) gave an overview of the various programmes contained within Connecting for Health including; the spine, care records, choose and book, N3, PACS, Contact and eprescribing. She emphasised the complexity of the organisation and the size of the challenge describing it as the biggest civil IT project – a frequently used phrase which seems to have been adopted from the title of Sean Brennan’s book. Beki concluded by urging everyone to get involved to tell the programme what they wanted and needed, trying to get everyone, but particularly clinicians, to have ownership of the changes and realise the potential benefits.

A keynote address entitled “Connecting for Health: Breakthrough or Barrier” was next on the agenda by Professor Christine Beasley (Chief Nursing Officer, England). She opened with some personal memories and related these to issues around demographic changes, changing patient expectations and the recent White Paper. She emphasised “Nursing Constants” suggesting Caring For + Caring About = Confidence. Discussing whether technology would prove a help or hindrance she mentioned usability and some of the “difficulties on the journey”, which were to be expected. She used several examples to suggest that IT, and particularly a national approach, can aid in informing practice, improving patient safety, catalysing research and supporting new roles. She closed by urging everyone to get involved in the design, implementation and evaluation of new systems and suggested that the RCN was helping by managing enrolling all its members onto the NHS Contact messaging and scheduling service. She also seemed to give an advert for her Balckberry! During the question and answer session she managed to avoid answering questions about “Caring” getting lost in patient care, liaison with social services and other agencies (e.g. Nursing Homes) and the confidentiality issues around the electronic transmission of patient records without their consent.


The next session was an enjoyable and humorous presentation by Carol Steltenkamp and Victoria Bradley from the University of Kentucky (UK), College of Medicine. They provided a snapshot of work they have undertaken to reduce adverse drug events due to organisational, technical and human factors, at a US medical centre (while including adverts for horse racing in Kentucky). They described the process of putting in Computerised Prescriber Order Entry and Clinical Decision Support systems and some of the lessons they had learnt. While accepting that the scale of the implementation in England is much more ambitious they did provide some useful insights into the pitfalls and benefits along the way.

After the lunch break which provided a good opportunity to catch up with friends old and new and visit the stands laid on by Connecting for Health, we reassembled for a presentation by Jonathon Ashbridge (President of the Nursing and Midwifery Council). He set out many of the systems and processes of the NMC relating to standards, particularly in relation to pre-registration education entry and qualifications and CPD. He emphasised the important of communication and continuity amongst all stakeholders and mentioned improved quality assurance processes to come.

Delegates were then invited to attend two of the five workshops on offer:
• Education, Training and Development (Felim McCarthy, Frontline Connect Delivery and Content Manager)
• How Nurses are Helping to Shape Clinical Information Systems (Helen Hood, Senior Project Manager, Do Once and Share programme and Cath Mercer, Project Manager Maternity of the Do Once and Share Action Team)
• How Benefits will be delivered to patients and Staff (David Lane, Head of Clinical Benefits Advisors)
• Using Knowledge Tools to Support Clinical Practice (Dee Hackett, Process and Design Lead and Cathy Gritzner, Programme Manager)
• Overcoming Implementation Hurdles – Question and Answer Session (Carol Steltenkamp and Victoria Bradley, University of Kentucky)

The first one I attended was on knowledge tools and was a description of the Evidence Based Conents Service which is working to validate care pathways and then incorporate them into the software being provided across England. There was lots of discussion of the governance process (and the forthcoming name change for which we were invited to make suggestions) but little on how this will advantage patients.

My second workshop was on Education Training and Development who looked at some of the barriers to change and work currently underway in both IT training (e.g. ECDL) and for the National Care Records Service and touched on the relationship with Higher and Further Education.

The conference was closed by Susan Osborne (NHS Connecting for Health, Clinical Lead for Nursing) which centred around the treatment of her cat “Mr Tigger” and his electronic record at the Vet, with some mention of the governance and engagement of nurses within Connecting for Health. She used some examples including Sister Mary a Robot at her own hospital and the use of barcodes on name badges to point the way forward to a safer service for patients.

Several speakers said that they didn’t know anything about technology, almost as a boast, and suggested didn’t need to know how it worked or understand the science behind the programmes, which this could potentially give out a very negative message to nurses in the audience, however if it succeeded in getting senior nurses and midwives informed about and involved in the forthcoming changes then it will have served it’s purpose.

Summaries of the keynote presentations are available from Connecting for Health

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Monday, March 27, 2006

Evidence in Practice = Clinical Effectiveness at UBHT

Evidence in Practice = Clinical Effectiveness at UBHT

I am acting as part of the extended reference group for the development of elearning materials by this project & feel they have some useful materials which will help junior doctors understand some of the aspects of Evidence Based Medicine, and have the potential to be used more widely under the "Do Once and Share" programme.

They have just started to load some of the materials into an elearning environment/Learning Management system provided by e2train which has been purchased by the Avon Gloucestershire & Wiltshire Strategic Health Authority, and I was having a look at the deployment of these materials & found I couldn't access them in my Firefox Browser - having to use Internet Explorer instead.

When I queried this as an interoperability issue I was told "we have designed the materials primarily for Internet Explorer, reasonably so because of its overall market domination, and it being the absolute standard web browser for all NHS PCs"

Perhaps this brings a new definition of EBM - as well as meaning Evidence Based Medicine, it could be taken as meaning Especially Bl**dy Microsoft.

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Saturday, March 25, 2006

Physicians’ Use of Email With Patients

Journal of Medical Internet Research - Physicians’ Use of Email With Patients: Factors Influencing Electronic Communication and Adherence to Best Practices

This paper by Robert G Brooks & Nir Menachemi in the Journal of Medical Internet Research reports a US study which aimed to examine the factors associated with physician-patient email, and report on the physicians’ adherence to recognized guidelines for email communication.

They concluded that "physicians, practicing in ambulatory settings, show only modest advances in the adoption of email communication, and little adherence to recognized guidelines for email correspondence. Further efforts are required to educate both patients and physicians on the advantages and limitations of email communication, and to remove fiscal and legal barriers to its adoption."

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Sunday, March 19, 2006

HC2006 conference and blog

For the next few days I will be attending the HC2006 conference in Harrogate - therefore any posts will appear on the conference blog.

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Friday, March 17, 2006

Med-e-Tel's latest newsletter

I've just signed up for the Med-e-Tel Newsletter in preaparation for their nconference in April (more details) and with their permission share this below.

If you are interested in recieving this by email please sign up using the form at: http://www.medetel.lu/index.php?rub=news&page=newsletter_subscription

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March 8, 2006
newsletter - newsletter - newsletter

In this newsletter:
- Cardiocom Multi-Disease Management is your single source for vital sign remote biometric monitoring of CHF, diabetes, COPD, asthma, CAD and obesity
- Wireless technologies to improve operational efficiencies and reduce costs in care outside of dedicated care facilities
- IT at the service of the client/patient: new solutions and strategies for hospitals, mutualities and the industry
- Healthcare anywhere/anytime, using broadband and wireless mobile technologies
- Patient follow-up and tracking using RFID and wireless technologies
- Automating a patient's complete health care course from first consultation till end of treatment
- eHealth for coagulation self-monitoring
- Congestive heart failure and the virtual hypertension clinic
- IBM for healthcare and life sciences
- Home telehealth applications and disease management extensively covered at Med-e-Tel 2006
- News from ISfTeH
- Med-e-Tel Matchmaker
- News from the Med-e-Tel media partners
- Newsbriefs

Cardiocom Multi-Disease Management is your single source for vital sign remote biometric monitoring of CHF, diabetes, COPD, asthma, CAD and obesity
Cardiocom is the leader in telemedicine solutions for daily remote patient monitoring and disease management. Cardiocom provides health professionals with home telemonitoring equipment and telehealth services to identify symptomatic patients and intervene early to prevent unnecessary hospitalizations. Cardiocom addresses CHF, COPD, Asthma, Diabetes, CAD and Obesity. Cardiocom received the "Best Enabling Tool for Disease Management" from the DMAA in 2004 and 2002. Cardiocom was awarded the "Most Innovative Technology to Improve Patient Outcomes" at The Emerging Technologies and Healthcare Innovations Congress.
For more information about Cardiocom, please visit www.cardiocom.com. Cardiocom's complete disease management products and services will be on display at Med-e-Tel 2006 in Luxembourg. Meet Cardiocom at stand 1C-08.

Wireless technologies to improve operational efficiencies and reduce costs in care outside of dedicated care facilities
Representatives of UK based Wireless Matters will be at Med-e-Tel to discuss CareTeamTM, a suite of wireless enabled medical devices, rich internet applications and services that enable multi-disciplinary teams and family members to collaborate across a virtual environment to deliver individualised care to patients outside of dedicated care facilities.
The range of functionality within CareTeamTM includes patient self-management, case management and disease management and is delivered as outsourced services to care providers. Wireless Matters is based at the Innovation Centre in Hatfield, Hertfordshire home of the new Bedfordshire and Hertfordshire Postgraduate Medical School.
More information can be obtained from Wireless Matters on their stand at Med-e-Tel, or visit www.wireless-matters.com.

IT at the service of the client/patient: new solutions and strategies for hospitals, mutualities and the industry
The Luxembourg CRP-Santé (Institute for Research in Healthcare, Public Health & Biotechnology) will conduct a regional symposium at Med-e-Tel, focusing on how IT services at the patient's disposal will lead to new solutions and new strategies for hospitals, mutualities (healthcare insurance providers) and the industry. The symposium will see Luxembourg Minister of Health, Mars Di Bartolomeo, provide an overview of current realizations and future projects in this field. Several business cases, presented by industry leaders like IBM, Telindus and Selligent, will illustrate successful applications in automated appointment booking, online consultation of electronic patient records, CRM, telemonitoring, RFID, mobile applications, electronic signatures, and health portals. The symposium will show how IT services change the way hospital departments and mutualities are run and how they interact with the outside world.
This regional symposium will be held in French (all other Med-e-Tel conference sessions are in English). For a detailed overview of this symposium as well as other Med-e-Tel conference sessions, go to www.medetel.lu/index.php?rub=educational_program&page=program.

Healthcare anywhere/anytime, using broadband and wireless mobile technologies
The International Initiative for Ubiquitous Healthcare (u-Health), will present its views at Med-e-Tel 2006 on how collaboration between countries and the use of broadband and wireless mobile technologies can help to provide healthcare to people anywhere at anytime.
The initiative was conceived as part of the future activities of IEEE Healthcom, which brings together academia, industry, healthcare and information technology professionals to facilitate collaborations for the development of humanity's future good.
According to the u-Health Initiative, the world's increasing ageing population necessitates concentrated research and action on healthcare paradigms beyond the current hospital-based healthcare regime because the hospitals (which are already stretched to limits) will not be able to handle the increase in ageing population. Current partner countries in the initiative include Australia, France, Greece, Korea, Taiwan and USA, with more to join soon.
The u-Health session is scheduled for April 6th as part of the Med-e-Tel conference program (see www.medetel.lu/index.php?rub=educational_program&page=program). Join u-Health representatives after the session for the Med-e-Tel Exhibitor & Attendee Reception, offered by u-Health and Med-e-Tel.

Patient follow-up and tracking using RFID and wireless technologies
Belgian company HICT (Health Information Communication Technology) offers industry specific solutions and services to the extended healthcare market place (care providers, patients, suppliers, public sector related services, 3rd payers, etc.).
HICT's vision is that healthcare-specific information, communication and technology solutions can bring measurable added value to this industry. HICT's mission is offering the healthcare market place consulting, software development and integration services based on healthcare specific value propositions, with the objective to raise the service level and quality of care for the patients and their relations and to optimize the resources for the healthcare providers.
HICT will present its solutions at the Med-e-Tel 2006 exhibition and will also discuss a successful business case during the CRP-Santé symposium (see above) on the subject of "patient follow-up and tracking using RFID and wireless technologies".
For more information, visit www.hict.be and meet the HICT team at Med-e-Tel.

Automating a patient's complete health care course from first consultation till end of treatment
YUSE, an innovating health care company, is the developper of the Matrix Box, a practically-oriented solution, able to automate a patient's complete health care course, from the first consultation till the end of the treatment. YUSE also defines and implements - with the help of hospital staff - the change management that is necessary to improve the quality of patient care, of its effectiveness and working conditions.
According to YUSE, hospital computerization is mostly done based on individual initiative and departmental initiative. The most effective approach to computerize hospital processes is nevertheless taking the patient's course as a red thread. From the first hospitalization, or first line healthcare until release from the hospital and the follow-up after release.
YUSE proposes a total and multidisciplinary solution to the hospital world, that integrates all internal and external care processes. A modular system that can possibly also be linked to existing applications. This YUSE Matrix Box assures optimization and improvement of health care quality, a more effective organization, planning and administration, and a real and proven profitability.
YUSE (www.yuse.be) will be one of the companies to present a successful business case during the CRP-Santé symposium at Med-e-Tel (see above). Meet them also on the Med-e-Tel exhibition floor.

eHealth for coagulation self-monitoring
Timely review of patient data with close to real-time feedback is a critical success factor in today's disease management. Finland based eHIT provides the Health Gateway, an effective and secure tool that transfers patient data from different measurements devices to the health care provider via mobile platform wirelessly. It provides patient and nursing solutions ensuring that measurement results are available, accurate and both cost and time effective, and allowing for remote analysis of blood glucose, blood pressure, body temperature, coagulation, body weight, heart rate, EMG, ECG, oxygen saturation, peak expiratory flow.
A bidirectional connection between patient and health care provider presents several advantages in comparison with traditional methods: measurement results are accurate, available in real-time and in correct form; faster patient treatment process - patient can receive feedback almost immediately; motivating treatment progress information directly available to the patient; evidence based process traceability information: remote measurement and monitoring regardless of patient location; easy to use for both patient and nursing staff.
Join eHIT at the Med-e-Tel exhibition and attend their presentation scheduled in the Med-e-Tel conference program. More info is also available at www.ehit.fi.

Congestive heart failure and the virtual hypertension clinic
Optimal management of patients with congestive heart failure (CHF) has to detect a beginning haemodynamic imbalance in time through daily weight monitoring in order to avoid decompensation and hospital admission. The "Virtual CHF Clinic" has been designed to serve as an easy to use automatic wireless telemonitoring system used by CHF patients for daily transmission of physiological and clinical parameters to a remote general practitioner or healthcare provider. By means of a simple, interactive communication between the healthcare professional and the patient, based on client-server interactivity, the CHF disease can be timely monitored online.
By using the Virtual CHF Clinic, continuously optimizing the therapy and strengthening the relationship between patient and healthcare professional, costly re-admissions can be avoided, patient's quality of life improved, and mortality reduced.
German company I.E.M. will present more details on the topic of CHF management in the Med-e-Tel 2006 conference program and exhibition. More information can also be found at www.iem.de.

IBM for healthcare and life sciences
Today's healthcare industry is under pressure to reduce clinical and administrative costs and meet tighter compliance and security mandates. IBM provides the technology, services, consulting and e-business experience needed to meet those demands and realise new opportunities in the ever-changing healthcare environment.
A pioneer in healthcare information technology, IBM remains at the forefront of improving how healthcare organisations deliver efficient, high quality care. IBM, in combination with its global network of business partners and strategic alliances, delivers powerful business technology and comprehensive services that help healthcare organisations achieve success.
IBM is helping clients manage an explosion of data. Accelerate discovery and development. Reduce costs. Respond to compliance and security mandates. Improve diagnoses and patient care.
Meet IBM's Belgium and Luxembourg team at Med-e-Tel 2006 and join their presentation on the topic of "telemonitoring" during the CRP-Santé symposium (see above). For more information visit www.ibm.com/industries/healthcare.

Home telehealth applications and disease management extensively covered at Med-e-Tel 2006
Throughout the Med-e-Tel 2006 conference and exhibition, an extensive focus will be placed on homecare and disease management applications and programs. Home telehealth offers affordable and sometimes even necessary solutions to face the challenges of early hospital discharge, an increased ageing population and the associated rise in chronic conditions, and a predicted nursing shortage. Keeping patients-at-risk at home, or keeping the elderly living longer independently in their own home, will considerably relieve the current healthcare systems and healthcare budgets.
Topics covered in the conference include: telecardiology, teleconsultation, video communication in homecare, fall detection and activity monitoring for elderly, medication compliance and reminders, homecare system for post-operative patient management, telemedicine aid for Parkinson's disease, telemedicine in palliative care, and more.
Companies, organizations and projects that are dealing with these types of services or products and that will be represented in the Med-e-Tel conference programs and/or on the exhibition floor include a.o.: Aerotel, Cardiocom, eHIT, EHTEL, Healthware, Honeywell HomMed, IBM, IEM, Interlife, Medixine, Pharmionic, u-Health, Viterion TeleHealthcare, Wireless Matters.
For more information about the Med-e-Tel exhibitors, go to www.medetel.lu/index.php?rub=exhibitor&page=exhibitors_sponsors. Conference program details can be found at www.medetel.lu/index.php?rub=educational_program&page=program.
For conference registration, submit your online registration form at www.medetel.lu/index.php?rub=visitor&page=registration.

News from ISfTeH
In this section of the Med-e-Tel newsletter, we report news from the ISfTeH (International Society for Telemedicine & eHealth), supporting partner of the Med-e-Tel event.
- ISfTeH will be present at the Med-e-Tel 2006 exhibition together with several of its national member associations. The ISfTeH stand will feature information from various national projects and information about the national and regional activities from its members. Also information about the IITEC Course (www.iitec.org), which is now scheduled for January 2007, will be available on the ISfTeH stand. ISfTeH will also host a conference session at Med-e-Tel on Friday April 7th, featuring presentations on the state of current telemedicine and ehealth use and implementation in the member countries. An ISfTeH Board Meeting is scheduled at Med-e-Tel on Friday afternoon April 7th. All this makes of Med-e-Tel the ideal opportunity to meet with ISfTeH representatives and members and to learn more about ISfTeH activities and cooperation possibilities.
- An ISfTeH breakfast meeting is also scheduled at Med-e-Tel on Friday morning April 7th. All ISfTeH members are invited, as well as people or organizations interested in getting to know more about ISfTeH or interested in becoming a member. For information and to register for this breakfast meeting, please contact us at contact@isft.net.
- The website for the upcoming 11th ISfTeH International Conference, scheduled for 26-29 November 2006 in Cape Town, South Africa is now available at www.mrc.ac.za/conference/satelemedicine/index.htm. More information about this conference will also be available on the ISfTeH stand at Med-e-Tel 2006.
- For more information or to contact ISfTeH, see www.isft.net or send an e-mail to contact@isft.net.

Med-e-Tel matchmaker
The Med-e-Tel matchmaker aims to facilitate contacts and links between various telemedicine and ehealth professionals and providers around the world. To obtain more details about the request(s) below or to provide your services, contact us at info@medetel.lu and we will put you in touch with the source of these requests. If you would like to submit a request of your own, e-mail us and we will publish it in a next newsletter.
- Moldova: telemedicine and ehealth professionals are looking to get in touch with people or organizations that are specialized in IT development in mother and child care, primary care and distance education

News from the Med-e-Tel media partners
For information on publications, journals, magazines, reports and on-line information services that will help you to stay abreast of what is going on in the field of ehealth and to make better informed decisions in your daily business or healthcare practice, check out the list of Media Partners on www.medetel.lu. To follow is a review of just some of the publications that will be featured in the Med-e-Tel 2006 Media Corner:

- IHE (International Hospital Equipment & Solutions) is Med-e-Tel's main international media partner. To learn more about IHE as well as about the markets and areas served by IHE with its regular 27,000+ high quality BPA audited circulation, check out the new IHE website at www.ihe-online.com.

- The VerveMed Global Network is an innovative forum for the international medical device industry. Complete a free member profile at www.vervemed.com to receive the VerveMed Global Business update, a bi-monthly newsletter with valuable industry information, international business opportunities, new product information and resources. Enter the site to locate qualified staff, identify qualified partners and get the resources, specialized information, and network to grow your medical device business into key global markets.

- Healthcare IT Management is the official voice of the European Association of Healthcare IT Managers (EAHITM). Management and best-practices driven, the publication is devoted to supporting the goals of EAHITM and providing a central communications platform for key stakeholders in the healthcare IT sector. Published bi-monthly, it focuses on: technology innovations and trends, best practices, better returns on IT investments, research & development, and the use of technology to achieve optimal patient & staff satisfaction and improve workflow efficiency. For more information, please contact Karmin Ruocco, Managing Editor, at k.ruocco.me@eahitm.org.

- IOS Press is an international STM publishing house of books and journals in a wide range of fields, including medical science, artificial intelligence, rehabilitation, physics and computer science. Information about Technology and Health Care (Official Journal of the European Society for Engineering and Medicine) and other relevant IOS Press publications, and books will be provided in the Med-e-Tel Media Corner. More info at www.iospress.nl.

Newsbriefs
To follow are links to some interesting and recently published articles and studies (if you would like to suggest an article for inclusion into a following newsletter, feel free to send details to info@medetel.lu):
- RFID ensures safety in Thailand hospitals (i4d)
- Telemedicine remote health care monitors patients in their homes (TMCnet)
- IT’s Elder Care Intervention---Passive in-home monitoring systems can reduce the cost of care while improving elders' quality of life (hospitalconnectt.com)
- Telemedicine Is Crucial to Implementing Acute Stroke Therapy (Medscape - free registration required)
- Space-System-Based Disaster Management, Telemedicine and Near-Earth Objects to be Discussed at UN Conference (SpaceRef.com)
- International Teleradiology (The New England Journal of Medicine)
- Coming soon - vital health care by computer (icWales)
- Wireless To Organize--And Maybe Save--Lives (Diagnostic Imaging)
- U.S. Health Care Costs Could be Slashed through Accelerated Broadband Deployment for Seniors, Disabled (New Millenium Research Council)
- The CONTENT project: a problem-oriented, episode-based electronic patient record in primary care (Informatics in Primary Care)
- Evaluation of teleconsultation systems (International Journal of Medical Informatics)
- I.T. Modernizes House Calls: Home-monitoring systems enable agencies to check in on patients without daily visits (Health Data Management)

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Free Our Data: Make taxpayers' data available to them


Free Our Data: Make taxpayers' data available to them

Following a couple of articles in the Guardian about requiring payments for data which UK government agencies have collected (first one reported here) there is now a campaign website and blog for others to get involved in the debates.

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Wednesday, March 15, 2006

OU to make learning material free on the internet

The Open University : Open Content Initiative : OCI Press Release

This press release from the Open University outlines plans to make some of their educational content available for free on the Internet, suggesting "There will be one site that is primarily for learners, where material with suggested learning pathways will be offered. A second site will be primarily for other course creators; it will foster the concept of sharing and re-use of materials."

The initiative is funded with over £5 million from the The William and Flora Hewlett Foundation.

This sort of initiative moves forward dreams of making quality educational materials available to all through the medium of the internet (which is currently mired in copyright and intellectual property rights and ownership issues), however it will be interesting to what materials are selected for inclusion and how they are presented packaged.

Potentially this has great potential - I hope it lives up to it.

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Tuesday, March 14, 2006

Making a Difference: Safe and Secure Data Sharing

Making a Difference: Safe and Secure Data Sharing Between Health and Adult Social Care Staff - Cabinet Office

The Cabinet Office Better Regulation Executive has produced this report because "persistent confusion exists amongst practitioners and professionals over the interpretation of data sharing legislation. This confusion stems from the perception that the Data Protection Act is vague and lacks sufficient detail required at grass-roots."

Key issues identified during fieldwork and included in this report are:

* Increased numbers of patient record requests as a result of personal injury claims;
*• Confusion about the legal position on data sharing and existing guidance from central government departments and professional bodies, particularly around the common law duty of confidentiality and Data Protection Act; and
* A lack of clarity around gaining patient consent to share information for medical research.

The report outlines agreed actions that will yield the following benefits:

*• a reduction of patient record requests;
*• a single protocol which details when information can be shared between health and adult social care staff; and
*• the clarification of the use of patient information for medical research.

The report uses a series of case studies to explore some of the issues which can arise and potential solutions and outcomes with implementation dates. It will be interesting to see whether these are met and whether greater clarity does result.

Further comment on this is available from E Health Insider Primary Care

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Nurses and new technologies in the NHS

Opportunities to develop and improve nursing practice thanks to new technologies in the NHS | eGov monitor

eGovMonitor carries an interview with Susan Osborne CBE, the recently-appointed joint national clinical lead for nurses at NHS Connecting for Health.

In it she explains the importance of CfH initiatives to nursing practice and argues that they will act as a support to, rather than fundamentally changing the art and science of nursing.

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NAO urged to investigate 1st "go live" of electronic records at Nuffield Orthopaedic Centre (NOC)

BBC NEWS | Health | Fears over patient record system

The BBC is today running a story about calls for the National Audit Office to investigate the implementation of the NHS National Programme for IT (NPfIT) electronic care records system at Nuffield Orthopaedic Centre (NOC) based on a story in Computer Weekly.

It suggests that patients were put at risk when the hospital, the first in the Southern Cluster and the first to implement the Cerner Millenium system from the Fujitsu Alliance, finally went live on 20 December 2005.

This is a small hospital with only one specialty - lets hope that some of the lessons from this implementation have been learnt before it is implemented in more complex settings over the next few months.

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Thursday, March 09, 2006

Paying for data your taxes paid for

Guardian Unlimited Technology | Technology | Give us back our crown jewels

Interesting piece in today's Technlogy Guardian, in which Charles Arthur and Michael Cross examine the anomaly of UK public sector data, which tax payers have paid for, being unavailable to individuals, public or private sector without further payment, unlike the US situation where this information is put into the public domain

However they do not include the data collected by the NHS and Department of Health, through the Health and Social Care Information Centre which is then contracted out to a private company Dr Foster, as previously mentioned on this blog.

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Informing healthier choices: Information and intelligence for healthy populations - DoH consultation

Informing healthier choices: Information and intelligence for healthy populations - A consultation : The Department of Health - Consultations

The Department of Health issued this consultation document a couple of days ago, inviting comments from anyone interested (closing date 5th May 2006).

The public health information and intelligence strategy, aims to improve the availability and quality of health information and intelligence across England and to increase its use to support population health improvement, health protection and work on care standards and quality.

It specifically considers the six key areas which were highlighted for action in the White Paper
Choosing Health: Making Healthy Choices Easier.
* Tackling health inequalities;
* Reducing the numbers of people who smoke;
* Tackling obesity, including promoting exercise;
* Improving sexual health;
* Improving mental health and wellbeing;
* Reducing harm from alcohol and encouraging sensible drinking.

It seems, to me, to be an admission that we don't know enough about the factors which affect the health of the population, and a recognition that the information needs to be collected in a systematic fashion and made widely available, as described in the second "Wanless Report - Securing Good Health for the Whole Population", in which he concluded that good information is needed to identify health problems early, and that adequate information is essential when making the case for change and for investment in health. If the public are to engage in a dialogue on health, people need access to meaningful information about local health issues. This basic knowledge allows them to express their preferences from an informed position.

Wanless concluded that "little comprehensive information is collected on the health status of the population or on the prevalence of important behavioural factors such as smoking, drinking, diet and exercise". He also found that “there is no regular mechanism by which a Primary Care Trust (PCT) or Local Authority (LA) can gather reliable information on its own population”, and that “given the multi-sectored nature of public health, the current lack of
effective mechanisms for data-sharing between organisations at local and national levels, is a major potential impediment to more targeted and responsive public health actions”.

The issues raised in the Wanless report with regards to information use in public health can be summarised as follows:
* Gaps in existing information data flows and systems inhibit data capture, sharing and dissemination.
* Links are not sufficiently well made between numerical data on population health, research evidence and information on the cost-effectiveness of interventions.
* Public health capabilities and capacities need to be developed to make other resources more effective and to promote health literacy.
* More evidence is needed on cost-effective interventions and that evidence needs to be rapidly disseminated to drive local action.

Useful background information on the issues can be seen in this report: The Intelligent Board

It will be interesting to see whether the indicators chosen will be appropriate and whether the collection and publication of the data will influence behavior or how services are provided.

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Health Wonk Review up over at THCB

Health Wonk Review the almost-new round up of the good and the great in blogging about health care policy, business and technology is up over at The Health Care Blog


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Saturday, March 04, 2006

Healthcare Informatics - book review

Healthcare Informatics - book review

I've just reviewed the new book "Healthcare Informatics"
by C. William Hanson which aims to cover a wide range of topics related to Healthcare Informatics from direct patient care technologies to medical records and supportive technologies.

I think it has something to offer - as you can see from the review - but may be limited for a UK audience.



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Thursday, March 02, 2006

NSG meeting with C4H Nursing Leads

Yesterday evening I attended a meeting organised by the British Computer Society Nursing Specialist Group (NSG) with Barbara Stuttle and Susan Osborne the two newly appointed nursing clinical leads for NHS Connecting for Health.

Apart from terrible train journeys it was an interesting meeting - if a little short on detail for me. Barbara and Susan were welcomed by Richard Hayward NSG Chair at the Bloomsbury Holiday Inn Hotel, London



Barbara opened her presentation by making light of the fact that the projector and laptop were not working properly by suggesting "it's normally Connecting for Health (C4H) that gets accused of not delivering".

She set out how she sees her role as the "voice of nursing" on C4H, & perhaps it's conscience. The international perspective included not just the relationship between England and the other four countries in the UK but also a recent trip she had made to the HIMSS conference in the USA. This highlighted global issues for nursing which are vital for the quality of care.

Cost and investment in C4H inevitably was considered along with current political buzz topics such as choice and an overview of the complexity of the largest civil IT programme in the world.

Barbara used examples from her own time as a patient to describe the advantages to be gained from the programme, with improvements in patient records and cultural changes. Each of the components of C4H was briefly described and placed in context within a changing world of multidisciplinary and multiagency working of health and social care, with "outside" providers increasingly providing care for patients, and how they need to be enabled to access records to provide optimum care.

Telemonitoring, particularly for elderly patients featured prominently, and linked to discussions of social interaction and the need to make the technology user-friendly and understandable for all. Barabara described her obvious delight at using a tablet PC - likening it to an "EtchaSketch" !

Further highlights included improvements in confidentiality and raising standards - reducing variances, meauring who's good & who isn't and making nursing evidence enabled.

The importantce of education and training with projects for curriculum development was highlighted - however perennial issues of "backfill" to replace staff on courses continue to prove a barrier. Barbara argued that even when money is made available for backfill, appropriate staff were not available to cover the shifts.

She concluded with positive comments about nurses as the "glue of the NHS" and a vital conduit for communication who will be supported by appropriate and accessible IT - and hinted at a new programme for 2006.


Susan Osborne then spoke briefly from her perspective within acute care, mentioning the wireless capabilities for ECG monitoring & the pilot of a bedside robot at St Mary's Hospital, and ID bands with bar codes and the capability to monitor vital signs.

She consluded with positive comments about the exciting times which develop nurses analytical skills and encourgaing clinical staff to "say what they want".

The presentations were followed by a wide ranging set of questions and answers, with some discussion, from the speakers and those who attended. These included;

* Mechanising processes with system add ons rather than supporting nursing practice
* Education & training - not just IT skills but deeper understanding and analysis
* Quantifying nurses "gut feeling"
* ECDL & the propsoed additional "health specific" module
* Numeracy skills & patient saftey/reduction in medication errors
* GP domination & nurses involvemenet in software development and implementation
* Care pathways & multidisciplinary care
* Analytical skills eg Watrelow scores rather than assessment principles & practice
* Examples of the Scottish approach
* The need to clearly define nursing art & science
* A telling question asked whether it is now too late in the process for nursing involvement.


The final comments were about mecahnisms for involving nurses from a variety of backgrounds in C4H projects were discussed including a suggestion from Stuart Glendinning Hall of running a blog - but it was suggested many nurses would not be able to access this. Information will also be collected from pilot sites/early implementers about nursing involvement & the effect on nursing practice. The possibility of story lines in Holby City & other soaps was also raised and is being followed up.

Barbara & Susan are willing to act as conduits and will make their email addresses available, on the NHS Connecting for Health Connecting with Nurses page.

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