Featured Post

Hacking Health in Hamilton Ontario - Let's hear that pitch!

What compelled me to register for a weekend Health Hackathon? Anyway, I could soon be up to my ears in it. A pubmed search on Health Hack...

Showing posts with label HL7. Show all posts
Showing posts with label HL7. Show all posts

Friday, October 25, 2019

Axe the fax

From the Globe and Mail December 2018 Health reporter Andre Picard:
https://www.theglobeandmail.com/canada/article-the-british-are-axing-the-fax-will-canada-follow-suit/

It’s not often that a seemingly mundane ministerial announcement reduces one to jealous tears, but this one fits the bill.

On Sunday, Matt Hancock, the British health and social care secretary, banned the purchase of facsimile machines by the National Health Service effective Jan. 1, 2019. He also ordered that faxes be phased out completely in hospitals and physicians’ offices by April, 2020.

Oh, but how Canada – a country even more in the poisonous grip of the fax than Britain – could use this common sense initiative.

“We don’t underestimate the enormity of the challenge to remove all our machines in such a short time, but we cannot afford to continue living in the dark ages,” Mr. Hancock said in the release.

Amen.

In July, the Royal College of Surgeons released a report that revealed the NHS, the country’s publicly-funded national healthcare system, had more than 8,000 fax machines in service. A group of hospitals in Newcastle Upon Tyne had a mind-boggling 603 facsimile machines in use.

To cap it all off, the NHS had the dubious distinction of being the largest purchaser of fax machines in the world.

Richard Kerr, chair of the committee that prepared the report called the situation “farcical” and called on government to invest in 21st century technology.
The government actually listened.

In addition to the fax ban, there are two other important aspects of Sunday’s announcement. Come 2020, communication will be by secure e-mail or apps and, just as importantly, all communication technologies will have to meet a standard that ensure that they can talk to each other across organizational boundaries. 

There will also be some additional money for hospitals and physicians to replace their fax machines – £200-million (about $340-million) – in addition to what the NHS is already spending on IT. 

But we do know that the fax machine is still ubiquitous. A 2017 survey found that two-thirds of Canadian physicians use the fax as their primary means of communication with other health care professionals, such as doctors, pharmacists, and hospitals.

So why do we continue to use technology that is almost universally acknowledged to be absurdly outdated?

Some claim that the fax is more secure than alternatives like e-mail. Our privacy rules also consider the fax the safest form of communication. That’s simply not true, especially with readily available encryption. The continued use of fax machines is bad for privacy and bad for patient safety.

A principal reason the fax endures is habit. Change is always slow in the ultra-conservative health system, especially when it costs money.

But the single biggest impediment to banning the fax is that the computer systems and electronic health records that we have are rarely able to communicate with each other. Interoperability has not been a priority and that has left us beholden to largely paper-based technology.

Many will look at what is going on in Britain with envy. But, in true Canadian fashion, we will find countless excuses for not doing the same.

Expect to hear that, because Britain has a centralized national health-care system, ministerial directives are a lot easier to issue and implement. There is some truth to that; Canada’s 14 ministers of health can barely agree on the time of day, so an initiative to ban fax machines may be a stretch.

But we shouldn’t forget that Britain’s “axe the fax” campaign was a grassroots initiative. The College of Surgeons gave the initial push by providing data that generated a lot of media coverage and made it easy for government to act.
There were also hospitals that showed impressive initiative. For example, the Leeds Teaching Hospitals NHS Trust committed to eliminating its 340 fax machines within three months, sending a message to others that it was doable.
There is no doubt that fax machines can be eliminated, and they must be, sooner rather than later. The only question is who is going to show leadership? What health care organization, hospital, or politician is going to make axing the fax their legacy and drag Canada out of the dark ages?

Tuesday, December 22, 2015

Kaiser Survey Links Portal Use With Improved Perceptions of Health | Healthcare Informatics Magazine | Health IT | Information Technology

Kaiser Survey Links Portal Use With Improved Perceptions of Health | Healthcare Informatics Magazine | Health IT | Information Technology

I posted this link automatically after the story turned up in my google search RSS feed. The website with this Kaiser Survey story had over 280 reference (or Add This ) RSS icon links for sharing the story. I often share stories to my Twitter feed which also has an eHealth theme. My Facebook feed is mostly for personal stories. I can remember before Facebook when RSS was just developing, what a liberation it was from the inbox. Some email programs had a way to receive RSS feeds into a local folder or there was a browser navigation item where one could store the RSS links, kind of like bookmarks. These days I am told that the younger kids don't even read email - they are just message chatting on their smartphones or other social media sites. I still think RSS - Real Simple Syndication - is the greatest technological invention since newspaper publishing. In fact, I have "health informatics" set in a google search feed, which is just an RSS program.

RSS is programmed in XML. I took a course in XML once and started creating my own RSS feeds on the websites I had created. It was not that difficult. XML is also the basis for the HL7 standard for health records and interoperability. It is too bad that more personalized RSS "news" doesn't come into our google or other email accounts in terms of our own personal health records. I personally don't see the interoperable difficulty in doing that. Add to that developments in "web services", API, and inter-database sharing platforms like REST, and there are a lot of open doors for data sharing.

This eHealth enabled browser blog is dedicated to eHealth. Personal health records are a major interest that I like to share with others. After doing research for 5 years on PHR I still think they have many decades to go before they will be widely used. I could be mistaken here, but I just don't think the technology is ripe for wide spread PHR use. It is just not the technology, it is also the social awareness of health and wellness that is lacking.  Newer forms of technology might enable an evolution of this awareness - hard to say. A friend of mine who I follow on Facebook recalled the time in his university in 1990 when he and a colleague decide to get email accounts so they could stay in touch. They could not convince anyone else to use email because no one could see the reason for using a technology that no one else was using.

To get back to this story about the Kaiser Survey that showed that people thought that their health was improving because of using a PHR, I think that there is a need to find more evidence that PHRs can be a technological tool physicians may ultimately prescribe to help their patients. 

Wednesday, February 4, 2015

Personal Health Record Push to Apps

I sometimes follow the HL7 group on Personal Health Records. I received this email from a member of the group. I find it interesting that pushing medical records to a personal health record is becoming better:

NBB4C makes it easier for providers to share health information with their patients so that their patients can do what they want with it.





February 2015



Clearing the Way for Patients to Get Access to their Data
National Association for Trusted Exchange Unveils New Trust Community for Exchange with Consumers
WASHINGTON, D.C. (February 3, 2015) – The National Association for Trusted Exchange (NATE) today kicked off its new NATE Blue Button for Consumers (NBB4C) Trust Bundle at the 2015 ONC Annual Meeting with a surprise display of interoperability in patient-mediated exchange.  Shortly after NATE’s announcement, Greg Meyer, Director, Distinguished Engineer, Cerner Corporation, demonstrated how a provider using a Cerner electronic medical record (EMR) can simply push a patient record to the patient's personal health record (PHR), in this case to the Humetrix iBlueButton app running on the patient's smartphone.

The new NBB4C Trust Bundle helps relying parties to identify consumer facing applications (CFAs) that meet or exceed criteria considered to be the most important characteristics of a trustworthy steward of consumer health information, while still enabling patients to benefit from the value of having access to their health information.  Participation in the trust bundle will facilitate secure exchange of health information from provider-controlled applications to consumer-controlled applications such as PHRs using Direct secure messaging protocols.

“Thank you to my colleagues at Cerner and Humetrix for helping NATE demonstrate the capabilities of the new NATE Blue Button for Consumers Trust Bundle at the ONC Annual Meeting.  Greg’s demonstration today shows that the NBB4C is ready now to enable real world exchange between provider-facing applications and consumer-facing applications, empowering the consumer to get access to their data,” said NATE’s CEO Aaron Seib.  “Our industry achieved a major milestone today.  We studied the issues around securely sharing information from providers to patients and together we took a leap of faith.  Consumers across the country will now have more control over their care.  NBB4C gets the information flowing to where it should be: in the hands of the patient.  I look forward to the day when patients across the nation routinely download their health information into a consumer-facing application of their choice and use it to improve their lives and the lives of those they love.”

The NBB4C Trust Bundle is the result of the next generation of NATE’s ongoing PHR Ignite Project and incorporates lessons learned from NATE’s administration of the Blue Button Consumer Trust Bundles.  Over the past year, NATE and a task group made up of thought leaders in the patient-mediated exchange space worked together to develop a set of criteria and expectations that balances what is a ‘must have’ for today and what can wait until tomorrow, what is practical as a starting point and what is a showstopper that would kill consumer engagement if introduced.  In November 2014, NATE crowd sourced the trust framework, calling for and receiving comments from across the industry.  In January 2015, the NATE Board of Directors approved the workgroup’s recommendation for release into production.

“The NBB4C establishes a practical framework that will enable patients to securely exchange health information with their providers without burdening the patient with unnecessary steps to obtain their data and share it with whomever they choose,” said MaryAnne Sterling, Consumer Ombudsman for the NATE Board of Directors.  “As a long time caregiver for my aging parents, this work is important to all of us who manage healthcare on behalf of others.  I have confidence that applications participating in the NBB4C will meet or exceed my expectation that my family’s health information will be confidential and secure.”
Interested CFAs may begin onboarding to the NBB4C Trust Bundle now at http://nate-trust.org/trustbundles.  Stakeholders interested in participating in the next phase of NATE’s work in consumer-mediated exchange should consider NATE membership or subscribe to news from NATE’s PHR Community.
# # #
NBB4C makes it easier for providers to share health information with their patients so that their patients can do what they want with it.
About National Association for Trusted Exchange
The National Association for Trusted Exchange (NATE) brings the expertise of its membership and other stakeholders together to find common solutions that optimize the appropriate exchange of health information for greater gains in adoption and outcomes. Emerging from the Western States Consortium, a pilot project supported by the Office of the National Coordinator for Health Information Technology (ONC), NATE was established as a not-for-profit organization in May 2013. Consistent with NATE’s mission to address the legal, policy, and technical barriers that inhibit health information exchange between entities within a state and across states, NATE leads and participates in a number of ongoing and emerging projects in the HIE domain. NATE has been operating its own Trust Bundles in production since November 2012 and recently took over administration of the Blue Button Consumer Trust Bundles.  Working with a broad set of stakeholders through multiple task forces, crowdsourcing and a call for public comment, NATE is proud to make available the first release of NATE's Blue Button for Consumers (NBB4C) Trust Bundle beginning in 2015.

About Cerner 

Cerner’s health information technologies connect people, information and systems at more than 18,000 facilities worldwide. Recognized for innovation, Cerner solutions assist clinicians in making care decisions and enable organizations to manage the health of populations. The company also offers an integrated clinical and financial system to help health care organizations manage revenue, as well as a wide range of services to support clients’ clinical, financial and operational needs. Cerner’s mission is to contribute to the improvement of health care delivery and the health of communities. Nasdaq: CERN. For more information about Cerner, visit cerner.com, read our blog at cerner.com/blog, connect with us on Twitter at twitter.com/cerner and on Facebook at facebook.com/cerner.
As of February 2, 2015, Cerner Corporation acquired Siemens Health Services.  Certain trademarks, service marks and logos set forth herein are property of Cerner Corporation and/or its subsidiaries. All other non-Cerner marks are the property of their respective owners.
About Humetrix
Humetrix has pioneered the development of innovative consumer-centered IT solutions over the past 15 years, which have been deployed around the world.  The company’s award winning Blue Button enabled apps are the mobile embodiment of the U.S. Federal government Blue Button initiative available to more than 150 million Americans. Humetrix’s HHS award winning emergency and disaster preparedness mobile apps are now being advocated by EMS agencies across the US and were demonstrated at the White House Innovation for Disaster Response and Recovery Demo Day last summer. For more information, visit www.ibluebutton.com and www.humetrix.com


Copyright © 2015 National Association for Trusted Exchange. All rights reserved.
Contact email: meryt.mcgindley@nate-trust.org

You are receiving this message because you have an interest in health information exchange.

Thursday, July 19, 2012

HL7 Working Group on Personal Health Records

There is an HL7 Working Group on Personal Health Records.  They have weekly teleconferences. I have listened in for a few of them.  I just joined one of the HL7 listservs to get involved. It appears to be mostly a voluntary organization run by people in the industry, with oversight from the HL7 organization. Highly recommended for those who want to become more involved in this development.

Wednesday, May 2, 2012

The Power of Personal Health Records?

I have written and researched about Personal Health Records - and had a Google Health account until the project was closed - but I am not sure about the future for PHR anymore.  I joined a few teleconferences for the HL7 standards group on PHR and know how much work they are doing trying to define them in terms of HL7 and interoperability. Here is an article they recommend < HIMSS blog >.  The research has shown more doctors need to adopt EMR before PHR become viable.  And it just maybe more of us need to be chronically ill to speed up their adoption - healthy people don't need to use them!  Be that as it may, time will tell what the future has in store.  My hope will be that the PHR will gain more clinical efficacy and effectiveness for physicians to place them in the trust of their patients.  I have no doubt that a great many people will be using PHR or equivalents to track their wellness in novel ways, without their physicians.  

Thursday, April 19, 2012

Fitbit

Fitbit is quite a useful and potentially revolutionary device. When I was doing research for a computer science and software engineering paper, I was wondering how data from the fitbit could be wirelessly transmitted into personal health records, and stored in the HL7 standard. The problem is, there is a lot of data, so only certain trends need to be recorded. The other problem is how to program an XML or HL7 standard self-journalling area in the personal health record. I know the HL7 standards group is working on PHRs now, because I participated in one of their lunchtime teleconferences. I am not sure how this particular problem was addressed. This is one device the people in the self-tracking movement cannot afford to be without. In fact, they have latched on it, and the systems deployed with them and other similar devices they call "Health Mashups".

Tuesday, April 10, 2012

Integration Engines - the Cloverleaf on the Information Highway

I was looking at eHealth career postings on the COACH website and found one at Telus for an Integration Health Business Consultant. What caught my attention was one of the Responsibilities: "Develop HL7 interfaces to integrate disparate health care applications using a variety of commercial integration engines such as: Oracle’s Java CAPS; e*Gate (SRE); Datagate; OpenESB; SOA Suite; Quovadx Cloverleaf; webMethods; IBM WebSphere; and Microsoft BizTalk." I had heard of Biztalk and knew it was a web service, probably using Service Oriented Architecture, but the rest of them were all new to me. This is a veritable flotilla of integration engines for disparate systems. It was only minutes later when I found myself searching for information about Cloverleaf ("The Swiss Army Knife for Data Conversions"), that I landed on the MDI Solutions website. Here I found a grouping of HL7 Integration Engines like I have never seen before. Their webpage on HL7 Integration Expertise includes many of these same integration engines.

Sunday, March 11, 2012

HL7 and NCI collaborate on clinical trial link to EHR

The HL7 group is trying to do UML models for almost anything that has health related data. This new initiative is a hat tip to Big Data and Public Health. The patient, the little guy in the whole operation, might even benefit. Hopefully, there will no longer be a disconnect between the evidence collected through participation in clinical trials, and electronic medical records. That goes as well for Personal Health Records. Both record systems are potentially rich sources of evidence based medical data, if only there were more efficient ways to capture it, without jeopardizing the autonomy and consent of patients. http://www.fiercehealthit.com/story/hl7-and-nci-collaborate-clinical-trial-link-ehrs/2012-02-28