Slightly blurry video of the Life Record EMR running on an iPhone:
New Zealand’s Orion Health growing rapidly:
Orion Health believes it has become New Zealand’s largest export-oriented software developer after growing revenues 40 per cent to $42 million in the year to March, over- hauling Christchurch’s Jade Software.
Chief executive and majority- owner Ian McCrae says the 270-strong firm, most of whose staff are employed in Auckland, has its largest ever pipeline of work ahead of it and may take on as many as 40 university graduates this year.
The company has just scored a deal worth $5.5 million over three years to supply medical records software and middleware to the Canadian province of New Brunswick, having previously won a similar contract in Alberta.
A larger win, believed to be with a hospital in the United States, may be two or three months away.
Orion Health’s flagship products are its clinical records system Concerto and software integration engine Rhapsody.
Hospitals and health authorities overseas are using electronic patient records to store all information about patients’ medical histories and treatment plans, so information can be easily accessed and updated by primary and secondary healthcare providers.
Orion Health achieves this by pulling patients’ medical information into a Java- based portal.
A different approach is being taken in New Zealand, where medical information tends to be shared between GPs and hospitals on a “needs be” basis.
This is possible in New Zealand, Mr McCrae says, because healthcare providers are better connected than in other countries, though he expects the adoption of centralised electronic patient records to happen here in time.
“New Zealand and Denmark lead the world in having a very good health information network across the country, so every GP would get their lab results electronically and receive discharge summaries from hospitals and reports from radiology clinics electronically. The amount of electronic communication between primary care providers and others is huge.”
Mr McCrae says future developments in the medical records market are likely to revolve around building more decision support tools into software, so clinicians can be better prompted about the actions they may need to take, and putting in place the technology that would let patients securely access their own medical records over the Internet.
“It is an area where a lot of countries are experimenting, and that seems to be the direction many regions of the world are heading toward.
For healthy patients there aren’t too many advantages, but if you have an ongoing chronic condition like diabetes you are probably tracking your lab results and medications quite closely and have a tight dialogue with your health providers.
For those patients in particular that sort of stuff is useful.”
If he wasn’t running Orion Health, Mr McCrae might be a spokesman for the Wiki movement. He says Orion has benefited greatly from maintaining its own internal Wiki – an online encyclopedia – which it uses as a knowledge base when developing and implementing software, providing customer support and for administration.
“We are ‘Wikiafying’ everything really, from human resources records to our board papers and all our project work. It is working really well.”
Mr McCrae says the secret to success in overseas markets is execution.
“It is a huge challenge to get offshore and it seems to me only a handful actually make it. We have been at it since 1999 when we opened an office in Los Angeles.”
Orion sold its software to smaller customers that for one reason or another were less attractive to rival vendors and worked hard to ensure the implementations succeeded.
The customers it is now winning are “the best you can have”, he says.
Information week is running a story about voice recognition in e-health records:
The emergency room (EMR) software has drop-down templates from which physicians can enter information about patients, such as during exams and in providing data about medical history. However, the voice recognition software provides the e-records an added boost by allowing doctors to add details that would otherwise be excluded from the data, or has to be type in.
“Doctors aren’t good typists,” said Gude. “I’m a hospitalist who works at night and does a heavy load of admissions,” he said. After about five months of using the voice recognition software with the EMR, “I couldn’t live without it,” he said.
Patient medical histories “can be hard to template because they can include complex problems” that can’t be detailed through drop-down lists featured in the E-health record system, he said. By speaking in those details via a USB microphone into the system at workstation at nursing stations, saves time while ensuring “a clear clinical picture of a patient,” he said.
Health IT News report on the talks between the various standards groups that took place recently in Brisbane, Australia:
BRISBANE, AUSTRALIA – The standards groups that met here at the end of August to work on developing health informatics standards that can be used around the world, are already preparing for their next work session in Dublin Oct. 2.
The Brisbane meeting was an inaugural one for the far-flung organizations, and it resulted in “significant and positive development towards the harmonization,” according to the newly established joint council.
CEN/TC251, ISO/TC215 and HL7 launched their Joint Initiative Council and Joint Working Group at the meeting and also agreed on a slate of projects.
CEN/TC251 is the European Committee for Standardization Technical Committee for Health Informatics; ISO/TC215 is the International Standards Organization Technical Committee for Health Informatics. HL7, or Health Level 7, is an American standards development organization.
Together, the groups agreed to work on standards for:
• EHR communications architecture
• Joint data types standard
• Care information model standards requirements
• Patient and medication safety standards.
Members of the Joint Initiative Council and the Joint Working Group said their work would build on existing agreements and recognize existing standards collaboration work already in place.
They formed the joint council and joint working group, they said, in response to a call for coordination and collaboration from governments, health providers and vendors around the world.
“The contribution of the many experts from each of the SDOs [standards development organizations], all working together, is
a huge strength of the Joint Working Group and we fully support this collaborative work that is so essential in delivering shared care through interoperability of our health information systems,” said HL7’s Ed Hammond, the newly elected chairman of the Joint Initiative Council.
The next meeting of the Joint Working Group is scheduled to coincide with the CEN/TC 251 meetings at Dublin on Oct. 2.
The BBC is running a story on MP critism of the NHS Connecting for Health Programme:
Fears over NHS e-records system
The NHS IT project is costing £6.8bn
A key plank of the £6.8bn NHS IT upgrade project in England has come under attack from MPs.The Health Committee said there was a “worrying lack of progress” and raised concerns about the security of electronic patients records.
But the MPs also said the system – an online database of 50 million medical records to be accessed across the NHS – had huge potential to improve care.
The government said the project was being implemented carefully.
But Liberal Democrat Health Spokesperson, Sandra Gidley MP said: “This ambitious project has suffered from a lack of consistent direction.
“Confidence in the system will not be boosted by the government’s woeful record at handling large scale IT projects.”
Meanwhile the Public Accounts Committee has criticised another aspect of the NHS.
Public and professional confidence in the programme is low and its credibility is at stake
Dr Vivienne Nathanson, of the BMA
It said the NHS was “paying lip service” to a government programme intended to boost quality and safety after high-profile scandals such as the Harold Shipman killings.
The MPs criticised PCTs, GPs and NHS contractors for poor communication and compliance with national systems for reporting clinical incidents.
For example, it found only 4% of GPs routinely reported incidents to the National Patient Safety Agency.
But the criticism of the NHS IT project – the biggest civilian programme of its kind in the world – is just the latest in a long line of negative reports.
The National Audit Office recently warned about delays and value for money.
The e-records system is part of a programme, run by a government agency called NHS Connecting for Health, aimed at linking more than 30,000 GPs to nearly 300 hospitals by 2014.
‘Lack of clarity’
The new systems include an online booking system, e-prescriptions and fast computer network links between NHS organisations as well as the centralised e-records system.
The e-records system consists of two parts – the summary care record (SCR) and the local detailed care record (DCR).
The SCR will contain basic information – such as current medication, allergies and long-term conditions – and will be shared by health professionals across England unless patients object.
Any details they want held back will remain on their full patient record – the DCR – in their local area.
The cross-party group of MPs said they found “it difficult to clarify exactly what information will be contained in the SCR and what the primary uses of the record will be”.
We still have some way to go before patients and the profession can see tangible benefits of the new system
Kevin Barron, of the Health Committee
They also said maintaining its security – with different members of staff having different access authority – presented a “significant challenge” despite the controls and audit systems put in place.
They said the project had been poorly communicated to patients and that delays to the system – some parts of it are two years behind schedule – meant progress had been slow.
The MPs said Connecting for Health and the government had to make more effort to get doctors and local NHS staff on board.
Committee chairman Kevin Barron, a Labour MP, said: “We still have some way to go before patients and the profession can see tangible benefits of the new system.”
And Joyce Robins, of the Patient Concern group, said e-records had been communicated to the public like a “sales pitch”.
Dr Vivienne Nathanson, of the British Medical Association, said: “Public and professional confidence in the programme is low and its credibility is at stake.”
A spokeswoman for the Department of Health, which was responding for NHS Connecting for Health, said e-records were about improving care and that it would consider the recommendations of the committee.
“NHS Connecting for Health is continuing with the careful and considered introduction of the summary care record in a small number of early adopter PCTs.”
CNET has a short peice about Microsoft’s new Common User Interface project and the work they are doing with the UK’s NHS. They also mention Intel’s Mobile Clinical Assistant project and quote Tim Smokoff, general manager of Microsoft’s health care unit saying we can expect more aquisitions in addition to recent the purchase of MedStory and Azyxxi.
Welcome to the new Health Informatics Blog! This blog will be covering news and developments in the field of Health Informatics.
I’m a Lecturer in Health Informatics at Otago University in New Zealand and am currently working on a PhD looking at EHR and e-Learning standards.