Monday, February 22, 2010

1M'sia Clinics should be manned by docs: MMA | Daily Express Newspaper Online, Sabah, Malaysia.

Kuala Lumpur: The Malaysian Medical Association (MMA), the country's premier organisation representing doctors, lauds the Government's move in setting up 1Malaysia clinics for the urban poor, saying it is in line with the caring concept.

Its President, Dr David K L Quek, said while the MMA supported better, affordable and more accessible healthcare facilities for the public, the announcement that the 1Malaysia clinics were manned by medical assistants and nurses took many doctors by surprise.

Writing in his President's Column in the latest MMA bulletin, he said initially his personal opinion was that just 50 clinics around the country would have very little impact on any doctor's rice bowl but he was wrong as the Government's move had caused much anxiety and confusion among general practitioners.

"I have received, literally, hundreds of angry and condemning SMSs, and faxes and email demanding that the MMA address the issue which they felt had unfairly impacted their services. Almost every doctor who had complained believed this approach of using clinics to be run by medical assistants and nurses was wrong in law," he said.

He emphasised that the MMA strongly felt that all the 1Malaysia clinics should be manned by doctors, in line with the Medical Act, which dictates that all medical and health clinics be run only by registered doctors.

So far, the Government has set up 50 1Malaysia clinics in the urban areas to provide basic services like treating minor ailments and monitoring of diabetes and hypertension.

These clinics are manned by hospital assistants and nurses and periodically supervised by doctors.

Latest field reports indicate that these clinics are well received by the people and are becoming popular.

On the shortage of doctors, Dr Quek said the MMA believed that there was no real shortage but just a "misdistribution of resources".

He said the MMA understood that logistical problems resulting from the reluctance of doctors to be relocated to a more rural or remote location despite improved perks remained a challenge for the Ministry of Health.

Nevertheless, he added, it believed that a proper and fair deployment policy should be initiated to overcome the problem.

He said if the 1Malaysia clinics were now part of the expanded public healthcare system, then the MMA believed that even more public sector doctors would be willing to be deployed on rotation or as part of a training initiative for an enhanced family practice or general practice vocation.- Bernama

1M'sia Clinics should be manned by docs: MMA | Daily Express Newspaper Online, Sabah, Malaysia.

About ISO/TC215

Since 1998, ISO/TC215 Health Informatics has developed standards within the following scope:
  • Standardization in the field of information for health, and Health Information and Communications Technology (ICT) to achieve compatibility and interoperability between independent systems.
  • Ensures compatibility of data for comparative statistical purposes, (i.e. classifications) to reduce duplication of effort and redundancies.

The above diagram illustrates the current structure of the ISO/TC215, and its nine working groups.

ISO/TC215's current work program comprises over 130 items, which comprehensively cover the contemporary health information standards spectrum.


  • Hosts over 25 active participating (P-member) countries, including Canada, and a similar number of observing (O-member) countries.
  • Maintains an extensive array of liaisons through its standards efforts, including but not limited to: HL7, the International Health Terminology Standards Development Organization (IHTSDO), the European Committee for Standardization (CEN)/TC251 – Health Informatics, and Digital Imaging and Communications in Medicine Standards Committee (DICOM).
  • Provides leadership to the Joint Initiative on SDO Global Health Informatics Standardization, including the Joint Initiative Council (JIC).
    • The JIC consists of leaders from participating SDOs, including ISO/TC215, HL7, CEN, Clinical Data Interchange Standards Consortium (CDISC) and IHTSDO.
    • The JIC operates as a council of equals, and as liaison group under ISO/TC215.

ISO/TC215 and its working groups typically meet twice per year to develop standards and related guidance documents. This includes a Plenary Meeting in the spring and a Joint Working Group Meeting in the autumn. Additional out-of-cycle meetings are held as required; ad hoc meetings, in conjunction with ISO/TC215’s principal liaison SDO partners, HL7 and CEN/TC251, are also frequent.

For more information on the technical committee, ISO/TC215 – Health Informatics, please visit the ISO website.

Meaningful Use of EHRs - are hospitals ready? | Healthcare IT News

Ever since the release of the proposed final definition of Meaningful Use of Electronic Health Records, as well as specifications for what constitutes a Certified EHR, we have been blogging about how this impacts physician practices who are interested in qualifying for incentive payments beginning in 2011. Our focus has been on ambulatory practices, and EHR systems geared toward them. But what about hospitals? Hospitals are also eligible for bonus payments for implementing EHRs, and the kinds of systems applicable to an inpatient setting are the subject of their attention. Unlike ambulatory practices, where EHR adoption has historically be quite low and adoption of EHR technology will often represent a new investment in technology not previously used, hospitals are typically already invested in legacy IT systems (often separate systems within their walls, such as lab systems, imaging/radiology systems, billing systems, and medical records systems).

The task for hospitals is more often to migrate to an EHR from a legacy system (or set of systems), and show hospital-based Meaningful Use somehow. The expectation, especially for hospitals, is that several pieces will need to be fit together to achieve Meaningful Use – for example, Boston’s Beth Israel Deaconness Hospital will likely need to cobble together 6 different systems to achieve the 25 different measures, as noted on their CIO’s recent blog.

Recently, a survey of hospitals by CSC shows that hospitals are only 50% compliant with the new EHR requirements. Their press release is interesting enough to want to quote it here (with their permission):

FALLS CHURCH, Va., Jan 4 -- According to a survey released today by CSC (NYSE: CSC) titled "Are Hospitals Ready for Meaningful Use of EHRs?" U.S. hospitals are only halfway to qualifying for government incentive payments aimed at controlling healthcare costs while improving the quality and effective delivery of patient care. Under the American Recovery and Reinvestment Act of 2009 (ARRA), hospitals will receive payments from Medicare and Medicaid starting in October 2010 for the successful implementation and effective use of electronic health records (EHRs). The goal is for hospitals to increase use of comprehensive EHR systems from 10 percent in 2009 to 55 percent by 2014, and the incentive payments are substantial: a typical 275 bed hospital would be eligible for approximately $6 million. Hospitals that do not meet federal guidelines by 2015 face reductions in Medicare reimbursement.

The United States Department of Health and Human Services (HHS) released draft rules on the EHR incentive plan today that revealed broad gaps between government expectations and the healthcare industry's ability to meet those expectations. The CSC report shows only two-thirds of hospitals have even taken the first step: Identifying gaps in their current systems to meet the requirements for meaningful use. One quarter of hospitals meet at least 70 percent of the readiness criteria from the survey. Hospitals have the highest readiness scores for privacy and security protection, while the use of required EHR capabilities is furthest behind.

"The definition of ‘meaningful use' is a very important step in the process of transforming healthcare with better information for better decisions," said Deward Watts, president of CSC's Healthcare Group. "In addition to getting substantial monetary rewards, meaningful use criteria will enable our nation's hospitals to reap the full benefit of EHRs and provide the safest level of care while reducing costs of delivering, reporting and paying for care."

Hospitals do not necessarily need to purchase additional hardware or software to move forward. For instance, CSC's survey shows 70 percent of hospitals have systems capable of supporting Computerized Physician Order Entry (CPOE), but only eight percent have CPOE throughout the hospital with at least 75 percent of orders being entered by physicians. No hospital under 100 beds had CPOE up and running in even two units, and none of the midsized hospitals (100 - 300 beds) had the system up and running throughout the hospital.

Additional findings include:

  • Smaller hospitals have lower readiness scores especially for use of required applications and quality reporting;
  • 54 percent are using the latest software version of their EHR product, which indicates upgrading might be required to meet the criteria for meaningful use;
  • Although 89 percent report on core quality measures, only half capture the majority of the required data from their EHR system;
  • The majority (98 percent) have a policy in place to limit the disclosure of protected health information, but only 52 percent employ encryption technologies to render data unreadable or unusable in the case of unauthorized access;
  • Only 40 percent report that there is clear and broad awareness of the new civil and criminal penalties under the ARRA.

These findings came from a survey of executives from 58 hospitals and integrated health delivery networks of all sizes across the U.S. conducted by CSC. The respondents reported their readiness for HITECH incentives based on 50 indicators grouped into five general categories: Use of a certified product, current use of capabilities required for meaningful use, standards adoption, quality management and reporting, and privacy and security protection. To get a representative sample of hospitals, CSC collaborated with two state hospital associations and one hospital alliance to distribute the survey to their members. Additional surveys were obtained from CSC clients. All questions generated a "Yes" or "No" response and results were self-reported using a paper form or an online survey instrument. For complete results of the survey, visit

CSC's Healthcare Group, which serves healthcare providers, health plans, pharmaceutical and medical device manufacturers, and allied industries around the world, is a global leader in transforming the healthcare industry through the effective use of information to improve healthcare outcomes, decision-making and operating efficiency.

(This blog originally appeared at Practice Fusion's EHR Bloggers.)

(Source-Meaningful Use of EHRs - are hospitals ready? | Healthcare IT News)

Five healthcare IT decisions to avoid | Healthcare IT News

Providers eager to capitalize on incentives offered through the federal government's definition of 'meaningful use' of healthcare IT may find themselves evaluating their relationships with existing and new IT vendors

Modifying an agreement with a vendor during the contract phases can be a crucial step to aligning IT projects with federal incentive funds, said Jeffery Daigrepont, senior VP at Coker Group. "Many vendors offer a money back guarantee if their product does not comply with stimulus," Daigrepont said. "Every contract should have a warranty that requires a vendor to correct defects at their expenses and under NO circumstances should you ever sign a contract without being entitled to future upgrades and new releases."

Daigrepont, who has no financial ties with any vendors, provided Healthcare IT News with his list of five healthcare IT decisions to avoid:

1. Buying defective software - It may not be your fault, but it's your problem. Defects in software range from minor glitches to major liabilities. Most defects can be corrected, or workarounds developed. However, in cases where the defect creates a threat to security or patient safety, or a liability to the organization, the defect MUST be addressed immediately and/or use must be discontinued -- just as Toyota has had to do with their cars' sticking gas pedals.

2. Buying non-compliant software - Your entire organization is expecting the software to meet national standards or federal mandates, but the vendor fails to develop their product in accordance to these guidelines. In the case of stimulus incentives, being disqualified becomes a possibility. Moreover, penalties for not adopting could be enforced.

3. Not seeing the writing on the wall - Your system is installed, working and meeting the needs of the organization, but your vendor has commercially discontinued the product and is no longer creating enhancements. In short, you're on a sinking ship. Not acting or refusing to accept the obvious is only delaying the unavoidable reality of having to rip out and replace your system.

4. One-offs - A "one-off" occurs when you cave to pressure from a department or individual who needs a specific IT solution to fill gaps around the existing program. In some cases, you have no other option, but there can be some trap doors when doing this. It's always best to first see if there is a workflow workaround or if there can be a behavior change by those who feel they must have their own solution.

5. Going live with an incomplete system - The pressure to go live on a new system is often driven by a vendor who is trying to recognize revenue by burning through the hours in the budget so they can get to the next install. The system (in some cases) was not properly tested before going live. As a result, the users or physicians get first bitten by a bad experience or worse, backsliding starts to occur. This can be avoided by adopting a simple plan called "DBVT" (Design, Build, Validate, Test). For example, design your order form, build your order form, validate the build with end users, test the form with end users. This exercise will help you avoid proceeding with an incomplete system design.

(Source: Five healthcare IT decisions to avoid | Healthcare IT News)

Windows 7 RC's Shutdown Cycle Nearly Here

Free use of the Windows 7 Release Candidate's days are numbered.

Beginning Sunday, people who downloaded and installed the free test version of Microsoft Windows 7, known as the release candidate, were scheduled to start receiving messages warning of shutdowns. The bi-hourly shutdowns will start on March 1, and the release candidate will expire completely on June 1, 2010.

(Source : Windows 7 RC's Shutdown Cycle Nearly Here)

AHIMA Academy for ICD-10: Building Expert Trainers in Diagnosis and Procedure Coding | AHIMA

Experience a dynamic training program that uses various teaching methods to help coding professionals become proficient in coding with the ICD-10-CM/PCS coding systems while preparing them to train other coding professionals in these systems. The academy includes a combination of online courses (self-paced) and face-to-face training. The online courses provide basic training in ICD-10-CM and/or ICD-10-PCS and are required to be completed prior to the workshops.

Each workshop focuses on engaging the trainer with in-class intermediate and advanced ICD-10-CM/PCS coding exercises, while modeling training techniques.

(Source - AHIMA Academy for ICD-10: Building Expert Trainers in Diagnosis and Procedure Coding | AHIMA) IHE Integration Statements

Developers of commercial and open source healthcare IT systems can publish IHE Integration Statements to indicate their systems' conformance with specifications in the IHE Technical Frameworks. The Integration Statement specifies the IHE capabilities of a system in terms of the key concepts of IHE: Actors and Profiles.

New: IHE Product Registry

IHE has developed a new Web-based database of Integration Statements. The IHE Product Registry-- developers to create, manage and publish Integration Statements for their commercial and open source healthcare IT systems. It allows users to browse for these systems based on their conformance with specific IHE Actors and Profiles. The system is open for use by developers and users now!

The links below lead to IHE Integration Statements published by the companies listed. These links will be maintained until January 2010. Developers are strongly encouraged to migrate information for their Integration Statements into the Product Registry.

Contact with questions about IHE Integration Statements or the IHE Product Registry.

(Source : IHE Integration Statements)

IHTSDO: January 2010 International Release of SNOMED CT

Copenhagen, Denmark; January 2010 The first 2010 International Release of SNOMED Clinical Terms® (SNOMED CT®) will be available for use on January 29, 2010, incorporating enhancements that are part of on-going efforts directed towards facilitating the use of the terminology in electronic health records.

SNOMED CT is a standardized clinical terminology which facilitates the consistent capture, exchange and aggregation of health data. The International Health Terminology Standards Development Organisation (IHTSDO®) releases updates to the International Release of SNOMED CT twice per year to ensure that the terminology reflects the latest clinical knowledge and evolving user needs. The January 2010 release of SNOMED CT includes numerous content enhancements, including:

(a) Streamlined Documentation

The IHTSDO has begun to convert documentation for the SNOMED CT International Release into the DITA (Darwin Information Typing Architecture) standard. Once fully implemented, this will improve the process for maintaining and generating these documents, and make it possible to release SNOMED CT documentation in additional formats, such as HTML.

For the January 2010 International Release, three documents have been generated using DITA: one new document, the SNOMED CT Stated Relationships Guide, and two previously released documents, the SNOMED CT User Guide and the SNOMED CT Technical Reference Guide.

(b) New Content Additions

1,728 clinical concept codes were added for the January 2010 International Release. In addition, 134 SNOMED CT Model Component metadata concept codes were created and will be released as part of a Technology Preview, but are not included in the official International Release.

(c) Updated Content

Content in a number of areas of SNOMED CT has been updated to make use of the terminology more effective. Examples include:

  • Content additions as part of an operational trial of a division of labor in laboratory test terminology development being undertaken with LOINC and NPU;
  • Revision to the logical definitions of situation concept codes;
  • Updates to the Situation with explicit context hierarchy so that the logic definitions can be consistently used for both pre- and post-coordination;
  • Modeling of evaluations findings and evaluation procedures to review and sufficiently define content in these hierarchies, as well as to align logic definitions with new editorial policies;
  • Retirement of ambiguous codes related to severity in the Qualifier value hierarchy; and
  • Progress in populating the HAS DOSE FORM attribute for about 800 concept codes in the substance hierarchy.

(d) January 2010 Technology Preview

In preparation for adoption of the new “RF2” release format, it will be necessary to add a new concept hierarchy, consisting of metadata concept codes, to the Concepts table. These metadata concept codes are not part of the clinical content of SNOMED CT, but will be needed in order for the clinical content to be distributed using the RF2 format.

These changes do not affect the official January 2010 International Release, but are being included in the January 2010 Technology Previews. These previews provide versions of the January 2010 International Release content in both the current (RF1) and new (RF2) release formats. Based on feedback from the Community of Practice, the IHTSDO will determine the release date at which these changes will be incorporated into the official SNOMED CT International Release.

(Source: IHTSDO: January 2010 International Release of SNOMED CT)

Police finalising papers on Sekinchan rep accident

KUALA LUMPUR: Police are finalising their investigations into an accident involving Sekinchan assemblyman Ng Suee Lim and a Universiti Teknologi Mara (UiTM) student on Feb 7.

Selangor police chief Datuk Khalid Abu Bakar said the investigation papers on the case would be forwarded to the Attorney-General’s Chambers soon for further action.

“We are finalising the report,” he told reporters after opening the Taman Ampang Utama police beat base here on Wednesday.

He declined to elaborate but said that there were recommendations that Ng be charged for negligence.

In the incident at about 11.50pm, Ng, who was driving a Nissan X-Trail SUV, was said to have hit the student, Mohd Bakri Mohd Bazli, 23, who was riding a motorcycle at a traffic light junction in Section 7, Shah Alam.

The student has been admitted to the Tengku Ampuan Rahimah Hospital and remains in serious but stable condition.

(Source : Police finalising papers on Sekinchan rep accident)

UiTM berikrar penuhi hasrat PM

KUALA LUMPUR 13 Feb. - Universiti Teknologi Mara (UiTM) berikrar memastikan hasrat Datuk Seri Najib Tun Razak yang mahukan institusi berkenaan menyediakan 5,000 tempat untuk pelajar miskin dan anak yatim setiap tahun menjadi kenyataan.

Naib Canselor UiTM, Prof. Datuk Ir. Dr. Sahol Hamid Abu Bakar berkata, ia penting kerana idea Perdana Menteri itu jelas menunjukkan keprihatinan kerajaan terhadap nasib para pelajar miskin dan anak yatim.

"Melalui program ini kita dapat memberi peluang kepada anak-anak kaum bumiputera yang miskin untuk mendapat tempat di institusi pengajian tinggi awam (IPTA) serta berjaya dalam hidup mereka kelak," katanya ketika dihubungi Mingguan Malaysia di sini hari ini.

Perdana Menteri mencadangkan perkara tersebut semasa merasmikan Kampus UiTM Puncak Alam Fasa Satu di Shah Alam, semalam.

Menurut Najib, jika ia dapat dilakukan, 20,000 pelajar miskin terdiri daripada anak pekebun, anak yatim, nelayan dan anak kakitangan pembantu am rendah akan berpeluang belajar di IPTA.

Ketika ditanya apakah tindakan susulan UiTM, Sahol berkata, pihaknya akan mengadakan kempen di setiap negeri bagi mengenal pasti dan mencari calon yang bebar-benar layak.

"Kita sendiri akan mencari mereka (pelajar miskin) di seluruh pelosok negeri, manakala soal pengambilan dan penempatan di UiTM, kita tidak ada masalah," katanya.

Jelas beliau, jumlah pelajar yang dicadangkan oleh Perdana Menteri tersebut amat relevan dan tidak mendatangkan sebarang masalah terhadap UiTM untuk memenuhinya.

Tambah Sahol, UiTM sememangnya dalam usaha untuk meningkatkan pengambilan para pelajarnya daripada 130,000 sekarang kepada 200,000 pada tahun 2015.

"Kita mempunyai kakitangan yang cukup untuk kempen itu dan akan memastikan hanya yang benar-benar layak akan dipilih," katanya.

Katanya, kebanyakan pelajar miskin ini amat berpotensi jika diberikan peluang yang betul.

"Jika ada yang tidak cukup syarat kemasukan kita akan ambil juga tetapi akan diletakkan dalam program Kursus Peralihan selama enam bulan agar mereka berupaya meningkatkan syarat yang dikehendaki.

"Kita juga akan menumpukan kepada pelajar miskin lepasan Sijil Pelajaran Malaysia (SPM) yang tercicir ke dalam lulusan diploma dan setanding dengannya," katanya.

Menurut beliau, UiTM akan memberikan tumpuan secara individu terhadap setiap kes pelajar ini untuk memastikan mereka tidak tercicir.

Beliau turut mengingatkan orang ramai yang berkemampuan agar tidak mengambil kesempatan itu untuk 'menangguk di air yang keruh'.

"Kita ada cara dan sistem untuk mengenalpasti pelajar yang benar-benar miskin, tolong bagi peluang kepada golongan miskin untuk belajar tinggi seterusnya mengubah nasib keluarga mereka," katanya.

Utusan Malaysia Online - Kampus

195 Kematian Sepanjang Ops Sikap-21

KUALA LUMPUR 21 Feb. - Ops Sikap Ke-21 sempena Tahun Baru Cina yang akan berakhir esok menyaksikan 12 lagi kematian dicatatkan dalam tempoh 24 jam semalam.Ketua Trafik Pasukan Bukit Aman, Datuk Abdul Aziz Yusof berkata, ini menjadikan jumlah keseluruhan kematian yang dicatatkan kini meningkat kepada 195 orang.

Daripada jumlah itu, penunggang dan pembonceng motosikal masih mencatatkan angka kematian tertinggi iaitu sembilan orang.

Tiga lagi kematian, katanya, masing-masing membabitkan pengguna motokar, lori dan jip.

Beliau berkata, 847 kemalangan dilaporkan berlaku di seluruh negara semalam.

"Jalan bandaran mencatatkan jumlah kemalangan tertinggi iaitu sebanyak 393 kes, diikuti 207 kes di jalan Persekutuan, jalan negeri (146), lebuh raya (64) dan jalan-jalan lain (37)".

"Sepanjang tempoh 24 jam semalam, lapan kemalangan maut dicatatkan di jalan negeri dan masing-masing dua kematian berlaku di jalan Persekutuan dan bandaran," katanya dalam kenyataan yang dikeluarkan di sini hari ini.

Bagaimanapun, menurut Abdul Aziz, jumlah saman yang dikeluarkan pihaknya menunjukkan penurunan apabila hanya 5,586 saman yang dikeluarkan semalam. Ops Sikap ke-21 yang bermula pada 7 Februari lalu, berakhir hari ini.

(Sumber : Utusan Malaysia Online - Dalam Negeri)

Al Jazeera English - Middle East - Israel drones 'could target Iran'

Beranikah israel menyerang Iran...

Al Jazeera English - Middle East - Israel drones 'could target Iran'

Al Jazeera English - Middle East - Iranian scientists clone goat

Iranian scientists have cloned a goat and plan future experiments they hope will lead to a treatment for stroke patients.

The female goat, named Hana, was born early on Wednesday in the city of Isfahan in central Iran.

"With the birth of Hana, Iran is among five countries in the world cloning a baby goat," said Isfahani, an embryologist. Mohammed Hossein Nasr e-Isfahani, head of the Royan Research Institute, said.

He said his institute's main aim in cloning the goat is to produce medicine to be used to treat people who have had strokes.

In 2006 Iran became the first country in the Middle East to announce it had cloned a sheep.

The effort is part of Iran's quest to become a regional powerhouse in advanced science and technology by 2025. In particular, Iran is striving for achievements in medicine and in aerospace and nuclear technology.

Al Jazeera English - Middle East - Iranian scientists clone goat