Medical Technology Ontario

e-Health Ontario agency review scrapped

medicaltechnologyontario — Wed, 31 Mar 2010 14:07:23 +0000

The Liberal government has quietly scrapped a mandatory review of a new health bureaucracy.

Premier Dalton McGuinty says the legislative review, which was to have taken place by the end of March, was dropped because Ontario’s 14 Local Health Integration Networks (or LHINs) are not yet fully operational. The LHINs took effect on April 1, 2007.

“As it turns out, all of the responsibilities that we wanted the LHINs to take on, they have yet to take on,” he told the legislature.

“In particular, a big part of their new responsibilities would be long-term care (and they) have not yet done that.”

Progressive Conservative leader Tim Hudak said the review was much needed in light of a recent spending scandal at eHealth Ontario. Millions in untendered contracts were handed out at that agency, which was criticized as the worst-managed agency Auditor General Jim McCarter had ever seen.

Hudak contends health bureaucrats at various LHINs have handed out at least $7 million in untendered contracts. “I suspect Dalton McGuinty’s motivation is clear,” he said. “He does not want to have any more scrutiny of the growing rot at his LHINs, which resembles very much the kind of scandalous spending we saw at eHealth.”

The province designed LHINs to enable better local health planning and more local freedom in distributing health dollars to the neediest recipients. Ottawa is part of the Champlain LHIN, which co-ordinates and funds hospitals, community care access centres, addictions and mental health agencies, community support services, community health centres and long-term care homes across eastern Ontario. It is headed by Dr. Robert Cushman.

Cancer advocacy group calls for e-health records for patients, more drug funding

medicaltechnologyontario — Thu, 25 Mar 2010 14:11:21 +0000

By Anne-Marie Tobin (CP) – Mar 24, 2010

TORONTO — As Donna Hammill-Chalk undergoes treatment for breast cancer, she can log onto the website at Sunnybrook Health Sciences Centre in Toronto, type in a username and secure password, and gain access to her medical records.

In Prince Edward Island, her mother, who was diagnosed with breast cancer in December, doesn’t have electronic records – but if they existed, it would be easier for her to share updates on her condition and treatment with her four grown children living in different parts of the world.

“Cancer – you lose all control and you can get some control back by having access to your information,” Hammill-Chalk said in an interview Wednesday from her home in Markham, Ont., where she is recovering from a mastectomy.

“I think in this day and age, patients need to take ownership and accountability for managing their own care. And you can’t do that if you don’t have the information.”

She tells her story in a report card on cancer, released by the Cancer Advocacy Coalition of Canada. The report also calls for more funding for cancer drugs, bans everywhere on smoking in cars with kids and more genetic testing so treatments can be targeted to those who will benefit.

Dr. Pierre Major, chair of the report card committee, said the electronic records system at Sunnybrook, known at MyChart, is the only one he’s aware of that’s available to cancer patients in Canada.

Physicians there have told him they’re happy with it, he said.

“It’s great because patients look up in their chart what the results are, and it saves phone calls. The patients are happy because they can access their results or even change their appointments.”

It’s something that Marlene Nicholson, who lives in Bedford, N.S., can only wish for as she helps her mother navigate the health-care system. She’s Hammill-Chalk’s sister, and has made the three-hour drive to Lower Freetown, P.E.I., on numerous occasions in recent months to support their 69-year-old mom, Margaret Hammill, during her medical appointments.

With one sister in Ontario, another in Bahrain, and a brother in California, she has to relay a lot of information, Nicholson said.

“When the siblings are at a distance, yes, it would be great to be able to just say ‘OK, go here’ or ‘Mom has a password’ or whatever it takes, or if we could send a file … everybody can have access to it.”

Lasers play key role in Medical Technology

medicaltechnologyontario — Fri, 19 Mar 2010 14:22:10 +0000

Mar 17, 2010

Stuttgart, Germany – Manufacturers of modern medical instruments and implants are faced with enormous challenges. Structures are becoming increasingly smaller, yet demands for the highest quality and accuracy are still expected to be met. This means flawless, smooth surfaces without any residue. “Laser micro processing is the best option here as it removes material without any contact. Furthermore, excellent beam quality and accurate control prevent the spreading of heat or the occurrence of material damage,” explains Mandy Gebhardt, head of marketing at 3D-Micromac.

A better way to evaluate health IT

medicaltechnologyontario — Mon, 15 Mar 2010 13:55:03 +0000

The folks at Medsphere, which licenses hospital software based on the VA’s open source VistA system, has launched aStimulus ROI Calculator, a handy way for evaluating its software based on that sweet, sweet stimulus cash, and of getting your hospital on its radar.

It’s a good thing.

But if you’re looking at health IT, especially if you’re a clinic, a stimulus calculator is not the first place you should be looking.

During the HIMSS show I got this clue in the Kryptiq booth, from Thomas Landholt (right), who runs a family clinic in Missouri and has been through the automation wars.

His advice? First write a business plan.

Whether you can afford an Electronic Medical Record (EMR) system is one thing. But if government money is going to be your sole motivator, your automation effort is going to fail.

Instead, he suggested, treat your EMR investment just as you would an investment in a new imaging system, or lab system, or any other major purchase you are making for your business. That’s what your clinic is, a business.

Doctors resist thinking of themselves as businessmen, but unless you’re drawing a paycheck that’s what you are. And the biggest mistake many doctors make is spending all their time working in their business, rather than on their business.

Writing a business plan is working on your business. Figure out how you’re going to profit from this investment. Add up all the costs, list all the benefits. Put numbers on them. Do research to make certain the numbers are accurate.

What Landholt found, in building out his own EMR system, was that it helped him re-engineer his business. He put his nursing station in sight of the reception desk. He put in secure messaging to reduce the cost of connecting with patients, and increase communication. He changed workflows.

These are some of the things EMR software is designed to enable, under the stimulus. But what the software really does is provide you the opportunity to get inside your business and make it work better, more efficiently. You can lower costs and provide better care once you have access to your own data.

The Apple iPad leap of faith

medicaltechnologyontario — Fri, 12 Mar 2010 18:12:35 +0000

By Larry Dignan

The questions of the day are really quite simple: Should you preorder a device you’ve never touched, played with or used in any fashion? And will gadget lust trump logic?

That’s what everyone is wondering. It’s the curse of the early adopter. The logic goes like this:

I have to preorder the iPad or I may not get one.
OK, so I’ve never tried it but man it looks good.
But I want to be the coolest geek on the block.
And it’s revolutionary.
No wait, do I really want to plunk down $499.
Oh why not I’ll order two.

More detailed EMR data may make comparisons difficult

medicaltechnologyontario — Fri, 12 Mar 2010 18:09:16 +0000

The unprecedented level of detail in EMR clinical data opens new possibilities for defining clinical quality measures in more clinically meaningful ways. However, more detailed data can cause difficulties in ensuring that data across institutions are comparable, according to an article in the online March edition of the Journal of Medical Informatics Association.

Michael G. Kahn, MD, department of pediatrics at the University of Colorado in Denver and Daksha Ranade from the department of clinical informatics at The Children’s Hospital in Aurora, Colo., sought to examine the impact of billing and clinical data extracted from an EMR system on the calculation of an adverse drug event (ADE) quality measure approved for use in The Joint Commission’s ORYX program, a mandatory national hospital quality reporting system.

http://www.healthimaging.com/index.php?option=com_articles&view=article&id=21163:jamia-more-detailed-emr-data-may-make-comparisons-difficult-XX

The Child Health Corporation of America‘s (CHCA) “Use of Rescue Agents—ADE Trigger” quality measure uses medication billing data from 48 nonprofit free-standing children’s hospitals in the U.S. contained in the Pediatric Health Information Systems (PHIS) data warehouse and was used to create The Joint Commission-approved quality measure, according to the authors.

“Using a similar query, we calculated the quality measure using PHIS plus four data sources extracted from our EMR system:…Four versions of the ‘Use of Rescue Agent – ADE Trigger’ quality measure’s numerator and denominator events were developed as SQL-based queries against the EPIC EMR system:

Ontario’s plan for electronic health records is at risk, official says

medicaltechnologyontario — Tue, 02 Mar 2010 15:01:42 +0000

Ontario must move faster with a series of legislative and regulatory measures in order to meet its commitment to create electronic health records for all residents by 2015, a senior official with eHealth Ontario says.

“It’s time the province decided if it’s really committed to this or not,” argues Doug Tessier, senior vice-president of development and implementation for the agency responsible for implementing the government’s multibillion-dollar electronic health records (EHR) strategy.

Progress on the province’s EHR file was hampered by the eHealth Ontario scandal surrounding compensation for consultants, Tessier says. The scandal triggered an audit, which concluded that the provincial government mismanaged over $1 billion and ultimately led to the resignations of former health minister David Caplan and former deputy minister of health Ron Sapsford.

“The swirl and scandal has hurt us,” says Tessier, considered the government’s expert on electronic health systems.

But Ontario’s EHR woes predate the scandal, Tessier says, arguing that there have consistently been delays in making key political decisions since the province first committed to implementation in 2000.

Deliberations on major decisions within the Ministry of Health and Long-Term Care have often taken two years, Tessier says. “If you are really committed to this, two years is too long. … To my mind, if the government is not committed to something, they hem and haw.”

Moreover, even the basic, legal framework for patient EHRs — which will require changes to laws governing patient record management and privacy — still isn’t in place, more than seven years after the province established the agency, Tessier says. Not only are “two or three pieces of new legislation” still required, “but we’ve also got to undo a number of pieces of [existing] legislation.”

The government must also do more persuade health regulatory colleges to overhaul policies that impact on EHRs, Tessier argues. “Let’s put our arm around them and gently bring them into the 21st century. … With the regulations, the legislation and the policy changes that government has to do, that’s not so gentle. That’s on the critical path. If they don’t do it, we’re blocked completely.”

Canada’s electronic health records initiative stalled by federal funding freeze

medicaltechnologyontario — Tue, 16 Feb 2010 21:59:27 +0000

The federal government’s failure to release $500 million in promised funding has slowed the next phase of the multibillion-dollar national effort to implement electronic health records (EHRs), says Canada Health Infoway President Richard Alvarez.

The year-long freeze on federal funding has compromised plans to rollout initiatives designed to improve physician uptake of electronic records, Alvarez says. This will do nothing to improve Canada’s status as an international EHR laggard, Alvarez says.

“The next very serious phase is basically in community physicians’ offices,” says Alvarez, head of the federal agency created in 2001 to promote provincial and territorial EHR programs. “The vast majority of the [new] money was earmarked for that. That’s an absolutely crucial step in this journey. We’ve been slowed down. If we don’t have money to invest in that area we obviously can’t do that until such time as the money is reinstated.”

The $500 million was promised in the 2009 federal budget, raising the government’s overall electronic health records investment to $2.1 billion. Since 2001, Ottawa has now paid $1.6-billion for an array of programs in which federal funds have been matched by provincial and territorial monies to build nationally compatible systems and platforms. Alvarez estimates that about $3 billion has been invested to date by various levels of government in the development of EHRs in Canada.

Google Health Canda? Your Health Records and EMR

medicaltechnologyontario — Tue, 20 May 2008 10:30:25 +0000

I always wondered what would happen if Google Health decided to launch in Canada. Would there be an effect on the Canadian Healthcare system? Or would PIPEDA (Personal Information Protection and Electronic Documents Act) get in the way?

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About a year ago Google announced that it would launch a service to allow users to store their own health records on a secure website. There was a lot of discussion about what it would look like but the wait is over. A free public “beta test” version of Google Heath is now operational at google.com/health.

The service allows users to create an online profile that includes information about any medical conditions, test results, procedures, immunizations and medications. You’re also asked to enter in your height, weight, blood type and race. With this information, the service, in theory, could offer you tailored medical information as well as serving as a central hub storing your medical records.

Eventually the goal is for users to be able to import their health information from the secure websites of care providers. To that end, Google already has arrangements with Beth Israel Deaconess Medical Center in Boston and the Cleveland Clinic as well the online pharmacies from Longs Drugs, Walgreens, RXAmerica and Medco. A relationship with Quest Diagnostics allows users of its services to import their lab tests. Google also has a link to the American Heart Association’s heart attack risk assessment site so that you can get your customized risk assessment without having to retype your height, weight, cholesterol and other into the Heart Association’s site.

One nice feature is the drug interaction alert that lets you know about potential conflicts between drugs you take. Of course, you have to remember to enter all your drugs for that to work.

Because none of my providers are among Google’s initial partners, I had to enter all the information myself. Fortunately, it was easy to find because the health clinic I use most of the time has its own online service that stores this information. I’m pretty happy with what my provider offers but it’s an island of information. If, for example, I were to have a blood test done elsewhere, that information would not be on my provider’s site nor is there a way I could even type it in. Google is trying to solve that problem by creating a health record keeping system that is controlled by the user, not the health care provider. This is especially important for those of us who don’t belong to a health maintenance organization (HMO) because we might visit different physicians who are not affiliated with each other.

Clearly privacy is the number one concern when it comes to any online medical information service. Google’s health privacy policy states that “You control who can access your personal health information. By default, you are the only user who can view and edit your information.” You can, however choose to share your information with others. The company also promises not to “sell, rent, or share your information” and will let you delete your account or any information in it at any time.

Can health care make voice interfaces viable?

medicaltechnologyontario — Tue, 06 May 2008 15:36:52 +0000

One of the big surprises in my career, watching technology develop, has been the failure of voice interfaces. Chalk it up to accents and the complexity of English. Listen to a Southerner or a Scotsman and the problem becomes obvious. Better yet try listening to your kids.

The only way to make it work is to make it work. And thanks to the immense growth in military medicine, you have a platform on which this forcing can happen.

Nuance Communications says its Dragon NaturallySpeaking is now being used by over 6,000 clinicians, because it was mandated by the military as the preferred way to document care with its AHLTA system.Whatever you think of AHLTA or the military, the bottom line is you now have a complete voice-to-text interface for medical diagnosis, with 6,000 users and growing.

AHLTA consultants say the system is saving clinicians time, and enabling the creation of more complete medical records.

Nuance has now begun the process of transferring this experience into civilian medicine, which I hope means that interfaces for McKesson, Cerner and Microsoft are coming soon.Once we have a beachhead for spoken interfaces in medicine, perhaps we can expand it into other areas, and speech will finally take its rightful space as the right way to talk to a computer.