August 2008

NEWS REVIEW – WORLD

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CIGNA creating virtual health community

CIGNA, a leading health service company, has announced the development of a virtual health care community. This computer-simulated world is situated on a Second Life island, where seminars, interactive displays, educational games and virtual health consultations help foster real and sustainable behaviour change that improves health.

Developed by Method, a brand experience agency, CIGNA’s virtual community provides 3D video game-like interactivity that enables people to learn and interact anonymously with like-minded peers in order to positively change the way they live their lives.

For example, the newly-developed nutrition zone helps participants develop their nutrition knowledge, learn how to make healthier food choices, manage their weight and understand portion sizes and food labels – skills that will enable them to lead healthier, more energetic and productive lives.

To make the presentation come alive and increase audience involvement, the presenter uses a number of 3D props and graphics. For example, real-time voting about the fat content of particular food items encourages audience participation. Up until now, virtual worlds have been pegged as a niche phenomenon, but the work Method is doing with CIGNA illustrates how virtual worlds can be properly integrated with multiple channels and communication media to educate users and increase results on existing programs.

Technology can help older people who forget

New research has looked at how technology can be used to provide reminders to assist older people in decision making. These assistance technologies have significant potential to help older people and their carers in everyday life. The research investigated the reminder systems currently used by a small group of older people, their attitudes to technology, and, through some simple experiments, their reaction to certain reminders presented using a variety of simple technologies and formats.

The project developed a prototype ‘living room’ system featuring a wireless network connecting typical home devices, including a telephone (conventional and cordless), a remote control device, analog radio, TV and computer. The participants disliked impersonal services, such as those provided by call-centres, and preferred the interaction that accompanies a telephone conversation. The format and delivery of automated reminders needs to be straightforward and able to capture the attention of the individual without becoming bewildering to manage or irritating.

Spoken reminders worked well when someone was undertaking a quiet task such as reading, but less so when watching TV, for which, repeated on-screen messages worked best. Overall, it appears that to be effective, messages and messaging systems have to be tailored to the particular behaviours and routines of the individual.”

New telemedicine service to help care for sick babies

Tiny Tom is the latest development of the tele-paediatric service, a major research project run by The University of Queensland’s Centre for Online Health (COH), a research centre based in the Royal Children’s Hospital in Brisbane.

COH Deputy Director, Dr Anthony Smith said the new service linked clinicians at Mackay Base Hospital, by video, with the neonatal intensive care unit (NICU) at The Townsville Hospital.

“Tiny Tom also enables parents and family members, who are unable to travel to Townsville, to see their baby and talk to NICU specialists and nursing staff,” Dr Smith said.

The research will investigate the potential economic and clinical benefits of using telemedicine in neonatal intensive care.

This generous funding has allowed the Centre for Online Health to extend its tele-paediatric service into a number of regional areas, including Townsville and Mackay for neonatal continuity of care; Gympie and Nambour Hospital for general paediatric support; and Mount Isa and Emerald Hospitals for specialist paediatric support.

German insurer AOK requires doctors to digitise

The AOK Baden-W�rttemberg, a regional German health insurance company with three million members, has signed a direct primary care contract with up to 5,000 doctors in the state of Baden-W�rttemberg that requires them to digitise.

Media and health policy experts have hailed the new contract as a minor revolution, cutting through the layers of bureaucracy that currently exist.

The German healthcare system is organised in a collective fashion. Health insurance companies pay fixed budgets to regional doctor’s associations, the “Kassen�rztliche Vereinigungen”. These regional associations then give the money to usually several thousand doctors in the region.

How much money a doctor actually receives out of this budget depends on how many patients he sees, on the kind of diagnostics he performs and on the therapy he prescribes.

The new contract is also about paying them more. On average, what the doctor gets for an AOK patient is expected to increase 30%. AOK will have to refinance the increase in expenses, and this is where IT comes into play.

When making a prescription, the software will recommend a cheap vendor. The doctor does not necessarily have to follow the recommendation. But a refusal will reduce his payments, at least when it happens with regularity.

What is criticized, though, is that the software will be offered exclusively by the H�VG Software GmbH, a joint venture of doctors and the IT company ICW.

Agfa HealthCare launches nursing solution ORBIS Care

Agfa HealthCare, a leading provider of IT-enabled clinical workflow and diagnostic imaging solutions, and the Imelda Hospital in Bonheiden (Belgium) announced recently that more than 15,000 nursing documentation forms have been registered electronically in ORBIS(TM), after the initial go-live in November, 2007.

ORBIS’ capability to easily customise electronic forms based on best-practice standards now allows the nurses at Imelda Hospital document their main nursing activities within ORBIS Care. Successfully reaching this important milestone for an electronic nursing record with a stable interface to Imelda’s existing ADT System (“Admission, Discharge, Transfer”) underlines the close cooperation of Agfa HealthCare and the Hospital. ORBIS now transparently represents Imelda’s efficient nursing workflows electronically acknowledging individual needs and how the nurses prefer to work.

Since January 1, 1988, all Belgian general hospitals are required by law to collect data for a Nursing Minimum Data Set (NMDS) four times a year.

One of the next project steps at Imelda will be the implementation of Care Planning within ORBIS, where the captured data from the Nursing Documentation is immediately available for planning processes.

RFID may cause hospitals’ lifesaving equipment to malfunction: Study

Radio frequency identification devices (RFIDs), commonly used in hospitals for tracking supplies may prove potentially dangerous for the patients, a team of Dutch scientists claim. The radio waves generated by the wireless systems actually interfere in the working of certain lifesaving equipment like respirators, external pacemakers and kidney dialysis machines and simply switch them off, according to the news research.

The current study conducted by Vrije University in Amsterdam, the researchers evaluated the functioning of 41 lifesaving medical equipment – including pacemakers, ventilators, IV pumps and anaesthesia define machines.

Out of a total of 123 tests conducted, 34 electromagnetic interference (EMI) incidents were recorded – of which 24 were deemed as either “significant” or “hazardous” by an independent panel of intensive care doctors, the report published in the Journal of the American Medical Association reports.

In certain incidents reported, a distance of over 10 inches (between the RFID and the medical equipment) was sufficient to either switch off the devices or to change their settings.

Additionally, at times, the radio waves generated by the RFIDs were powerful enough to completely stop the working of syringe pumps, cause external pacemakers to malfunction and to halt dialysis machines besides often switching them off, researchers found.

Face to face with the future

Just like the iconic picture from the 1968 film 2001: A Space Odyssey, future ultrasounds will spring to life bringing the mother and her child closer than ever before.

One of the world’s leading medical technology companies, Philips Healthcare, is developing the ultrasound imagery. It is yet to set a release date but it could be within the next five years.

The amazing vision is created by using current 3D technology. Philips Healthcare business manager, ultrasound, Ian Schroen said it was an exciting time for parents.

But a leading obstetrician denied the company’s claims, saying the future images would be of no benefit for diagnostic purposes.

Relying on a belt that lies across the woman’s belly, ultrasonic waves are transmitted to create the image, which is bounced on to a wall giving the appearance of being inside the womb.

It will allow parents to watch the foetus develop in detail including the ability to view the chambers of the heart, spinal cord, fingers and toes.

While it won’t be every parents’ choice, Philips and doctors expect it will be in high demand, following the success of 3D/4D ultrasounds.

Teleradiology plus electronic health record

Klinikum Chemnitz GmbH has become one of the first hospitals in Germany to link its teleradiology service with the electronic health record (EHR). This means that, effective immediately, data obtained from a remote diagnosis, e.g. computed tomography images and the corresponding findings, can be stored in a shared health record and then used for information exchange between different facilities participating in the patient’s treatment.

Siemens supplied and implemented the overall technical solution. This included the software for the radiological image communication as well as the Soarian Integrated Care (Soarian IC) eHealth solution for the electronic health record. In cooperation with the regional county hospitals as well as numerous practising physicians and medical centres in its service area, Klinikum Chemnitz has thus assumed a leading role in integrated healthcare in Germany.

The advantages include, a high quality of healthcare and treatment that can be offered even outside of major centres, the cost effectiveness of clinics will be increased due to common utilisation of the available resources, and patient satisfaction will be enhanced, since waiting periods will decrease and unnecessary patient transports can thus be avoided.

Award for open source application for analysing health data

Health Atlas Ireland, an Open Source application to analyse health related datasets using geographical information systems (GIS) and statistical software, was one of twenty projects that were given the ‘Prime Minister Public Service Excellence Award’.

Health Atlas Ireland is based on the Open Source content management system Plone and the Open Source application server Zope. It was selected for the Award because of its capacity to innovate and its technical perfection, writes Zeapartners, a network of companies involved in Plone and Zope.

The Health Atlas Ireland application is easily transferable to other organisations. This project opens the way to international software collaboration. The development of such software sharing initiatives helps underpin the sustainability of public services and makes a real difference now and into the future.

The e-Government project Health Atlas Ireland is a joint Health Service Executive and academic initiative.

It integrates geographical information technologies, database software and statistical techniques. A user friendly interface supports web-enabled access across the Irish health sector and collaborating agencies. Health Atlas Ireland enables controlled access to maps, data and analyses for service planning and delivery, major incident response, epidemiology and research to improve the health of patients, their families and the population.

CIGNA Reaches across borders to improve healthcare

CIGNA is supporting a program that is searching the world for solutions to improving healthcare. The Global Knowledge Exchange Network (GKEN) was created through an unrestricted grant from the CIGNA Foundation to the Wye River Group on Healthcare (WRGH), a non-partisan group known as a catalyst for constructive health care change.

Through this work, the GKEN will explore health care systems around the world to discover what works well and why, and will examine how to replicate successful models that address healthcare challenges and improve healthcare quality. Issues to be considered include cost, delivery, administration, public health and the workforce.

Over the three-year period, the GKEN will identify better practices in healthcare, such as process changes, use of technology, and new roles for doctors and other members of the provider community. This information will be delivered through a robust internet site. The GKEN also will promote these better practices through speaking engagements, printed materials, events and other channels, including the development of an electronic newsletter.

“This initiative will build on the strength of existing international exchanges by partnering to promote cross-cultural knowledge exchange among the leadership of nations.

Pan-European health network planned

Smart Open Services (SOS) is a pan-European ehealth project facilitating cross-border healthcare. The project aims to develop services providing patients travelling across Europe with access to high-quality care.

The project involves 12 member states: Sweden, France, Germany, the Netherlands, Italy, Spain, the Czech Republic, Greece, Austria, Belgium, Denmark and Slovakia. It is supported by the European Competitiveness and Innovation Framework Programme (CIP). There are two services that will be developed in a first step: a patient summary, which contains basic medical information such as diagnoses or laboratory results, and an electronic prescription service with an electronic medication list. These will get basic, but important patient data to foreign doctors urgently when needed. The European Commission announced at the eHealth conference in Portoroz, Slovenia last week that the contract for the SOS project will be signed before the summer break. To achieve the new services, the participating countries will for the first time establish IT links between their healthcare systems.

The package’s key components include information on local rules, co-payments and other aspects of healthcare for citizens in their respective language at the point and time of treatment abroad, as well as instantaneous online verification of their insurance status for healthcare providers.

Cell phones to transmit medical images

People living in remote places away from the modern medical centres across the world can soon avail sophisticated radiological diagnoses and treatment. A Hebrew University researcher has developed a new process to transmit medical images via cellular phones.

Jointly patented and owned by the Hebrew University’s technology transfer company Yissum and by the University of California at Berkeley, the system provides an independent Data Acquisition Device (DAD) at a remote patient site, where users have no image display capabilities. The device is then connected via cellular phone technology to a hardware control multi-server unit at a central site with an advanced image reconstruction capability, with the processed data then returned to the DAD site.

The DAD can be made with off-the-shelf parts that somebody with basic technical training can operate. Around three-quarters of the world’s population has no access to ultrasounds, X-rays, magnetic resonance images and other medical imaging technology used for a wide range of applications.

The researchers further said that by simplifying the apparatus at the patient site, they have been able to reduces the cost of medical imaging devices in general. Besides, it also removes the need for advanced imaging training of the personnel at the patient site.

Health record microchip injected under skin

Healthcare RFID systems provider VeriChip Corporation has launched its first-ever direct-to-consumer marketing campaign for its personal health record microchip which is injected under the skin of patients.

As part of this campaign, VeriChip has renamed its patient identification system Health Link and created a new website. The site provides complete information about the product and how to enroll as a Health Link member.

The Health Link microchip stores only a unique 16-digit identification number and is injected just under the skin in the rear upper portion of the right arm.

When a Health Link member is  unconscious, unresponsive or confused, emergency medical personnel use the Health Link scanner to retrieve the member’s identification number to access his or her personal health record.

Scott R Silverman, Chairman and CEO of VeriChip, said: “Given our successful infrastructure build-out in South Florida, we are now ready to escalate our marketing efforts to increase consumer awareness and adoption through the first DTC launch of our product.”

Europe aims for interoperable EHRs by 2015

The European Commission has published new draft of interoperability guidelines setting out a roadmap to achieve interoperable electronic health records across the continent by the middle of the next decade.

“It would also make it possible for pharmacies to electronically process prescriptions from other member states, so that patients travelling within the EU or living in another member state can obtain a refill of essential medicine,” it adds. In order to achieve this, the EC is calling on member states to work on three main action points.
The recommendation calls on them to establish aspects of electronic health records that should be exchangeable between systems, such as patient summaries, emergency data sets, and medication records facilitating ePrescription.

It also says they should enable health data to be shared among different healthcare systems, based on a limited range of applications currently in use in different member states, and build appropriate networked systems and services covering all areas of healthcare, while fulfilling appropriate legal, operational and educational requirements.

Having records available would also help patients who need to refill prescriptions or replace lost medicines, and would ensure the continuity of care, facilitating unscheduled medical encounters and continued treatment afterwards.

Supercomputer helps predict risk of bone fracture

A research team from the Swiss Federal Institute of Technology (ETH Zurich) and IBM’s Zurich Research Laboratory have used the Blue Gene /L supercomputer to simulate the strain on a piece of bone to help determine the likely place of fracture.

The breakthrough method developed by the team combines density measurements with a large-scale mechanical analysis of the inner-bone microstructure.

Using large-scale, massively parallel simulations, the researchers were able to obtain a dynamic ‘heat map’ of strain, which changes with the load applied to the bone. This map shows the clinician exactly where and under what load a bone is likely to fracture.

The joint team utilised the massively large-scale capabilities of the 8-rack Blue Gene /L supercomputer to conduct the first simulations on a 5 by 5 mm specimen of real bone. Within 20 minutes, the supercomputer simulation generated 90 Gigabytes of output data.

ETH Zurich Professor Peter Arbenz, who initiated the collaboration of the involved groups, explains that what was first needed for large scale bone simulations were state-of-the-art numerical algorithms to solve extremely large problems in a short time.

Scientists in future aim to advance simulation techniques to go beyond the calculation of static bone strength to the simulation of the actual formation of the fractures for individual patients, in yet another step towards the fast, reliable and early detection of people at high-fracture risk.

iSoft introduces LabCentre in Netherlands

iSoft has announced that its LabCentre laboratory information system is to be introduced in the Netherlands.

An iSoft spokesperson said the system will be available immediately in the Netherlands and is to offer benefits including “extremely rapid implementation, ease of use, improved remote requesting, improved test turn around, embedded word processing and cancer dataset support”. LabCentre is a modern, scalable and full graphic laboratory information system for clinical chemical, bacteriological disciplines and blood bank and is used at laboratories in Germany, Switzerland, Austria and Russia. The system is also available in the UK, launched in April as i.Laboratory Enterprise.

The system meets traditional laboratory needs, as well as providing a more advanced database design for easier adoption of emerging and evolving standards and technologies.

It has been designed to support flexible workflows and improve efficiency and meets clinical safety and laboratory accreditation requirements.

iSoft’s new parent company, IBA Health, has been keen to promote LabCentre across Europe and help create integrated laboratory services across multiple sites.

iSoft said in a statement: “LabCentre currently runs some of the largest distributed, integrated laboratory services in Europe. It improves efficiency while ensuring that organisations adhere to the strictest safety and quality standards.” The system enables a wide range of processes to be automated including results validation, queue allocation, cascade requesting, report formatting, and electronic results notification.

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