Intergrated IQ,EQ dan SQ Menjana Intergrated Intelligence.

IQ, EQ dan SQ yang bersepadu akan menghasilkan kepintaran bersepadu dimana ia akan melahirkan manusia yang mempunyai hubungan yang baik dengan alam, hubungan yang baik sesama manusia dan hubungan yang akrab dengan Tuhan.

Segala Yang Hidup Memiliki Frekuensi.

Elektron mengelilingi proton
Proton mengelilingi neutron
Neutron menjadi pusat
Berpaksi suatu energi

Bulan mengelilingi bumi
Bumi mengelilingi Matahari
Matahari mengelilingi galaksi
Berpaksi suatu energi

Semua mengikuti orbit
Berjalan berulang-ulang
Tenggelam dan terbit
Menjadi frekuensi berulang

Minda mengelilingi Tubuh
Tubuh mengelilingi Jiwa
Jiwa mengelilingi hati
Hati yang tulusuci

Ahmad Rais Johari
Kolej Delima
UiTM

Hijrah - Suatu Perjuangan Jihad Menuju Kecemerlangan Abadi

Hari ini adalah hari terakhir seorang sahabat saya, saudara Afzal Haq berkerja di UiTM sebagai Penjaga Jentera Elektrik. Beliau meninggalkan UiTM kerana mendapat tawaran yang lebih baik menjawat jawatan sebagai eksekutif Fasiliti di UMW. Alasan yang beliau berikan ialah beliau ingin berhijrah dan menyambut seruan Tun Abdullah Badawi mantan Perdana Menteri Malaysia, yang pernah mencadangkan supaya orang kerajaan pergi ke sektor swasta dan sebaliknya. Beliau berazam untuk memberikan perkhidmatan terbaik di UMW dengan berbekalkan segala kemahiran, pengetahuan dan pengalaman yang beliau perolehi setelah 10 tahun berkhidmat di Pejabat Penyelenggaraan (kini Pejabat Fasiliti) UiTM.

Beliau berhijrah untuk mendapatkan kepuasan berkerja kearah kecemerlangan abadi dan kepuasan diri. Pada beliau, ia adalah suatu perjuangan untuk diri beliau dan keluarga beliau ke arah sesuatu yang lebih baik.

Demi Matahari

Demi Matahari
Dan Sinarnya Dipagi Hari
Dan Demi Bulan Apabila Ia Mengiringi

Demi Siang Hari
Bila Menampakan Diri
Demi Malam Apabila Ia Menutupi

Demi Langit Berserta Seluruh Binaannya
Demi Bumi Serta Yang Ada Dihamparannya
Demi Jiwa dan Seluruh Penyempurnaannya

Allah...Subhanallah

Allah Mengilhamkan
Sukma Kefasikan dan Ketaqwaan
Beruntung Bagi Yang Menyucikannya
Merugi Bagi Yang Mengotorinya

Lagu ini adalah diantara lagu yang saya nyanyikan semasa mengikuti ESQ Training Angkatan 30 Kuala Lumpur pada 17,18 dan 19 April 2009 baru-baru ini.

Al-Fatihah.....! Semoga Roh Beliau Sentiasa Dicucuri Rahmat Daripada Allah S.W.T

Saya menerima panggilan telefon daripada En. Ariffin Yusof memaklumkan En. Ahmad Nizar Abdul Karim, Timbalan Pengarah,PSMB telah kembali ke rahmatullah sekitar jam 5.30 petang. Pada jam 7.45 malam, saya, Fais dan Ariffin bergegas ke Hospital Besar Kuala Lumpur daripada Kolej Meranti, setibanya kami di Jabatan Forensik HKL, terdapat beberapa orang staf PSMB dan sanak saudara Allahyarham telah berada diruangan menunggu. Keadaan agak sayu dan sedih. Beliau yang saya kenali adalah orang cepat mesra dan senang didekati. Pemergian beliau amat dirasai oleh seluruh warga PSMB.

Sekitar jam lebih kurang 12.15 malam selepas bedah siasat, jenazah beliau telah dibawa rumah beliau di Rawang daripada HKL menggunakan van jenazah UiTM. Difahamkan polis mengkelasifikasikan kematian beliau sebagai mati mengejut. Menurut cerita daripada staf PSMB yang bersama beliau semasa Bengkel ICT anjuran Microsoft di KLCC petang tadi, beliau tidak bercakap banyak disepanjang bengkel tersebut. Beliau sempat bergambar dijabatan yang menghubungkan tower A dan tower B KLCC.

Semoga roh beliau ditempatkan bersama orang-orang yang beriman dan mendapat rahmat daripada Allah S.W.T.

Kematian adalah datangnya sebuah keadaan yang tidak bergerak dan kaku. Kematian merupakan pesanan dan peringatan terhadap kedatangan sebuah akhir kehidupan. Kematian merupakan sejenis makhluk yang unik dan bersifat rahsia. Ia merupakan makhluk berani yang tidak akan boleh ditahan dan dikalahkan, ia mampu meredah tembok yang tinggi dan melompati pagar yang kukuh.Tidak ada satu pun benteng yang mampu untuk melindungi dirinya daripada kematian. Ia menyapa semua yang bernyawa. Justeru itu, kita yang masih hidup perlu bersedia untuk menerima kematian pada bila-bila masa dan dimanapun jua.

Seorang Mahasiswa UiTM Shahid Di Seksyen 7

Saya baru selesai menguruskan jenazah seorang mahasiswa UiTM yang telah kembali ke rahmatullah sebentar tadi, menurut sumber polis, kematian beliau diklasifikasikan sebagai mati mengejut. Semoga roh arwah Mohamad Ashfar Bin Arshat sentiasa dicucuri rahmat oleh Allah S.W.T dan ditempatkan dalam kumpulan orang-orang yang beriman.

Jenazah Timbalan Dekan Fakulti Komunikasi & Pengajian Media Selamat Dikebumikan..

Sejak daripada semalam saya ternanti-nanti jenazah Allahyarham Shafie Ahmad daripada New Zealand, Alhamdulilah semuanya telah selesai pada sekitar jam 6.30 petang tadi. Jenazah beliau telah selamat dikebumikan di Memorial Park Seksyen 21 Shah Alam. Semasa di Surau Seksyen 8, Shah Alam pada petang tadi saya sempat menjadi jemaah solat jenazah Allahyarham. Beliau yang saya kenali adalah seorang sahabat yang komited dalam menjalankan tugas dan sentiasa bersikap positif dalam apa keadaan sekalipun. Semua urusan pengebumian berjalan lancar dan UiTM memberikan sepenuh komitmen untuk menyempurnakan majlis pengebumian tersebut. Semoga roh beliau dicucuri rahmat dan ditempat bersama orang-orang yang beriman.

UiTM Menjadi Juara Anugerah Kualiti Perdana Menteri 2008...!

Tahniah kepada semua warga UiTM daripada pentadbir, pensyarah, kakitangan sokongan dan pelajar di atas sokongan anda semua membawa kemenangan UiTM dinobatkan Johan Anugerah Kualiti Perdana Menteri 2008 (Sektor Awam). Tugas yang lebih berat selepas ini ialah mempertahankan kemenangan tersebut dan membudayakan kualiti dalam setiap aspek pekerjaan kita di UiTM.

Seruan Kepada Mahasiswa UiTM: Jadilah Mahasiswa Yang Berani !

Keberanian adalah asas kepada pembangunan jati diri. Mahasiswa wajar membebaskan diri mereka daripada mana-mana pengaruh fahaman tertentu untuk dibawa masuk ke dalam arena politik kampus. Mahasiswa perlu mempunyai jati diri sendiri yang bersifat idealistik. Berani kerana berilmu, menjunjung budaya ilmu dan berupaya berfikir secara rasional berdasarkan ilmu. Itu adalah asas kepada jati diri seorang mahasiswa.

Getaran.....Degupan Jantung Menghasilkan Tenaga.....?

" Setiap jisim mempunyai tenaga, tenaga itu terhasil daripada getaran, getaran itu menghasilkan bunyi, bunyi itu boleh didengari melalui degupan jantung dan gerakan nadi"

Nasihat Dato' Seri Harusani - Mufti Perak Kepada Kepimpinan Melayu Dulu, Kini dan Masa Depan...

Saya bertanya kepada Dato' Seri Harusani, Mufti Perak semasa Seminar Kepimpinan Melayu baru-baru ini, soalan saya kepada beliau berbunyi..."Kepimpinan semua negara islam pada hari ini kelihatan begitu lesu, kaku dan tidak bertenaga, kita berpecah dan tidak bersatu, walaupun negara islam kaya dengan hasil bumi seperti minyak tetapi kita miskin kerana ia tidak tahu pengurusan hasil bumi kita sendiri, semua fenomena ini berlaku kerana jiwa, tubuh dan pemikiran kita telah dirosakan oleh yahudi zionis. Persoalannya bagaimana caranya kita orang islam boleh melepaskan diri kita daripada belenggu Yahudi Zionis...?"

Beliau menjawab ringkas..."kita kena kembali kepada rukun iman dan rukun islam, itulah asas kita, kita kena faham, menghayati dan melaksanakan semua tuntutan dan kehendak rukun iman dan rukun islam, jika kita dapat menghayati dan mengamalkan semua kehendak rukun iman dan rukun islam, Insyaallah kita akan selamat daripada belenggu Yahudi Zionis". Beliau juga menyeru semua pemimpin melayu kembali kepada kehendak dan tuntutan rukun iman dan rukun islam untuk menjadi pemimpin melayu yang boleh membawa perubahan yang lebih baik kepada bangsa melayu kerana kekuatan bangsa melayu terletak kepada Islam.

Seminar Kepimpinan Melayu Anjuran InQKa, UiTM,Tajaan Sime Darby & UMW

Semalam dan hari ini saya menghadiri Seminar Kepimpinan Melayu di Sime Darby Convention Centre, Bukit Kiara anjuran InQKa. Saya menghadiri seminar tersebut di atas kapasiti saya sebagai Pegawai Pembangunan Pelajar NR (PPPNR). Sebanyak 4 kertas utama telah dibentangkan oleh cendikiawan, ulamak dan tokoh ekonomi manakala sebanyak 31 kertas kerja dibentangkan secara selari di dua bilik seminar yang berbeza selama 2 hari. Semua kertas kerja ini membicarakan dan mewacanakan soal kepimpinan melayu dulu, kini dan masa depan, semasa sesi penutup oleh Prof. Madya Dr. Shireen Haron, Penolong Naib Canselor, Institut Kualiti dan Pengembangan Ilmu (InQKA), UiTM mewakili Dato' Seri Naib Canselor membentangkan resolusi yang telah diputuskan oleh para ahli akademik di Malaysia dan Indonesia, ulamak, cendiakawan, NGO, Prowaris, Parti Politik dan lain-lain badan lagi yang mengambil bahagian dalam seminar tersebut.

Diantara resolusi tersebut ialah menuntut supaya kepimpinan melayu samada daripada Barisan Nasional atau Pakatan Rakyat untuk mempertahankan Sistem Raja Berpelembagaan sediada, Memahami, menghayati dan mendaulatkan Perlembagaan Persekutuan (undang-undang), menstruktur semula sistem pendidikan negara daripada peringkat rendah, menengah dan pengajian tinggi supaya menghasilkan rakyat yang memahami dan menghayati nilai sejarah dan rukun negara, mengamalkan budaya ilmu dalam kehidupan, memperkasakan diri dengan memahami, menghayati dan mengamalkan rukun iman dan rukun islam sebagai cara hidup.

Saya tertarik dengan kertas kerja utama yang dibentangkan oleh Prof. Dr. Nik Anuar Nik Mahmod mengenai usaha-usaha golongan tertentu yang cuba memutarbelitkan fakta sejarah dan diakhir pembentangan, beliau mempamirkan slide ungkapan kata-kata Tuan Guru Abdullah Fahim, ahli falak, ulamak dan juga datuk kepada Perdana Menteri Malaysia yang kita kasihi. Katanya "SEDARLAH, BERKERJALAH, BERGIATLAH, JANGAN DAKAP TUBUH SAHAJA, KALAU MASIH LAGI DENGAN KEADAAN-KEADAAN SEPERTI MASA LALU ITU, SAYA BERKEYAKINAN PENUH AKAN TENGGELAM SEKALI LAGI, TETAPI KALAU SEKIRANYA TENGGELAM PADA KALI YANG AKAN DATANG ITU, MAKA BANGSA MELAYU TIDAK AKAN TIMBUL DAN BANGUN MELAINKAN SUDAH KIAMAT, YANG MANA DUNIA TIDAK ADA LAGI MELAINKAN TUHAN YANG MAHA KUASA SAHAJA"

Saya tertanya-tanya apakah maksud "keadaan-keadaan seperti masa lalu itu" yang dimaksudkan oleh Kiai Abdullah Fahim. Soalan tersebut tidak sempat saya lontarkan kepada Prof. Dr. Nik Anuar kerana masa terlalu mencemburui saya dan saya terus tertanya-tanya sehingga disaat saya menulis post ini. Saya ingin mengucapkan syabas dan tahniah kepada InQKA kerana berjaya menganjurkan seminar tersebut dan seminar itu memberikan kesan yang mendalam kepada saya sebagai orang melayu.

What is Interoperability?

“Ability of two or more systems or components to exchange information and to use the information that has been exchanged.”

(Source: IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990)

Top Ten Mistakes in IT Decisions On Health Infomatic System..

1. Not Using a Structured Process - Many organizations plunge head first without a clear and structured plan.
   
2. Not Defining Needs Beforehand - The best way to determine which solution will work best for your organization is to identify your needs. To avoid overlooking important functionality, you may find it helpful to start with a good list of requirements.
3. Hiring a Consultant who is Really a Reseller - Many consulting firms not only provide help selecting computer systems, they also act as re-sellers and implementers of enterprise applications. You may not be exposed to all possible vendor solutions, just the ones with whom your consulting firm has an affiliation.
   
4. Paying Too Much Attention to Bells and Whistles - Innovative new product features may seem cutting edge and exciting don’t let it distract you. Concentrate on functionality you will use every day. Most sales reps are adept at dazzling you with fancy features.
   
5. Not Including Key Users in Selection Process - Do not select a solution without soliciting meaningful input from the users. At the beginning of your selection project, form a selection team with representatives from all affected departments. One of the biggest frustrations users face in selection decisions is being sidestepped by the IT department.
   
6. Buying More Than You Need - Without a clearly defined list of user requirements, you’ll tend to buy more functionality than you actually need. Select a system that allows for growth and enhancements--if and when you need them.
   
7. Allowing Vendors to Drive the Process - Vendors are highly skilled at showing you what they want to show you and answering questions the way they want to answer them. To level the playing field, you need a clearly designed and defined selection process that will ensure you receive responses in a standardized format.
   
8. Allowing the “Powers That Be”to Choose the System
9. Confusing the Salesperson with the Product
10. Not Using an RFP Process

Improving quality through effective implementation of information technology in healthcare

In 2003, two Stockholm hospitals 40 km apart merged to form the one Karolinksa University Hospital. Interviewees reported that there was a need to form a common EMR to increase integration and allow communication between the two sites, and, ultimately, other services.

Three independent appraisal studies were carried out. The reports were made to one session of heads of department: interviewees describe a ‘defining moment’ when the chief medical officer asked for a ‘show of hands’ from the group about which system should be adopted, and nearly all voted for one system. The meeting recommended that all departments at one site (Solna) would move from five different types of medical records to the one system used by the other site, and this was accepted by top management.

The new system would need to be installed in 40 clinics with 7000 users at the Solna site. Some new hardware had to be installed, as well as considerable changes to software. The new system contained patient administration, clinical medical records and referral- and replies to referral information, but it was not an entirely paperless record: there were still many documents such as EKG and ‘pictures’ (e.g. radiology).

Analysis of documents and interviews show four key choices, which were confronted and made before implementation, all related to making the key main change within 1 year using limited internal implementation capacity, and delaying other changes to later phases. The first choice was about the extent to which top-level management and the IT department should prescribe the system and its details, and how much and what type of independence the departments should have.

The preparation process involved the departments, and top leadership made the timetable and managed the project tightly, but departments could choose at what time during the year they would implement and some of the details of the screens which would be created by the hospital IT department.

The second key issue was whether to use an outside implementation service or use the limited in-house resources for implementation. The solution was to manage the project internally, phase-in the change over time, and to use external consultants for specific changed which needed to be made. This was possible because of a third choice and decision, which was not to attempt to implement computer physician order entry (CPOE) to order medications at the same time but to phase this in after the EMR and in the following year.

The disadvantage was that some departments would loose CPOE, which was functional in the current system. The fourth choice was not to implement functions which different departments needed for research during the EMR phase, but to modify the EMR in the second year to allow this.

Project process to introduce the EMR

Once the decision was made in 2004 about which system to introduce, interviewees reported that senior leadership made it clear that departments only had choice about small screen modifications and their date for implementation in 2005. Each department was required to nominate staff internally to form a department project group to work with the information technology department to fine-tune the system for the department and carry out implementation. During 2005, all clinics had the same interventions from the project members and the plan was almost exactly followed.

Effects of the system on personnel and work

An analysis of the interviews carried out half way through implementation (June, 2005) through to 3 months after implementation (March, 2006) identified common themes that are listed below and illustrated with typical quotes from informants. Approximately 95% of the comments were positive about the implementation process and the new system.

The relatively successful Karolinska implementation could be due to:

1. Consultation before implementation
2. Consensus about a need for the system and which system was best
3. Prioritzation and ‘driving’ by management team
4. Competent IT project leader and team
5. Tested, user-friendly and intuitive system needing little training
6. Potential for development of the system
   
7. Medication order entry not difficult to integrate after implementation
   

The evidence from this and other research is that an EMR designed to meet many different needs often does not meet local clinical work needs, is more difficult to implement, and can reduce productivity and access to information critical for patient care and safety.

A new system will need to have benefits which significantly outweigh these disadvantages and which are clearly communicated, if it is perceived to be less user-friendly and requires extra time for operation, which is often reported to be the case in previous research. Time and resources will be needed to develop the system.

Practical implications

In this study, the comparison with other research suggests general lessons for others implementing an EMR system in a hospital:

1. Choose a system which allows a range of needs to be met and is a tried and tested in a similar setting,
2. The overriding choice criteria should be a system that works for clinical personnel and saves time. Resistance is not always irrational. If personnel do not think it is easy to use and will save time then implementation will be significantly more difficult and possibly impossible.
3. The system should be intuitive, requiring little or no training,
4. The system should be easy to modify and develop, within limits, for different departments and uses.
5. The decision about the system should be participatory, but once made, implementation should be directed and driven.
6. Balance local control of selection, implementation and clinical participation with meeting higher-level requirements.
7. Involve each level in different ways, with clear and appropriate parameters about which decisions can be made locally and which require higher-level decision about common standards.
8. Assess and address the presence and absence of prior and concurrent factors, which have been repeatedly shown in research to help and hinder implementation.

Conclusions

Health services do not have a good history of cost effective implementation IT and especially of EMRs. The potential for increasing safety and productivity of this ‘quality intervention’ is largely unrealized. The study of EMR implementation presented in this paper was carried out using the same case study method of an implementation in the USA. After reviewing previous research, the research team expected the EMR planning and implementation in this study would follow the same problematic pattern of other implementation.

The findings of the research team, who were entirely independent from the hospital, were unexpected and contrary to most previously reported research: the Karolinska implementation was successful, on time and within budget.

Empirical data of respondent’s perception of what helped and hindered implementation show a consensus about the main ‘helping’ factors. These were the local hospital control of selection of the system, employee involvement in many different ways, leadership and support by a competent on site information technology department, and decisive and full leadership backing.

The Karolinska experience suggests that a tried and tested EMR, which is accepted by physicians can be implemented successfully in 1 year into a teaching hospital with some experience of computerization. It did not show whether such a system allowed the clinical work and process redesign, which some thought necessary and as a missed opportunity during the implementation

Other findings about what helped and hindered were derived by comparing interviewee data to a simple implementation theory developed from a review of previous research. The findings from this revealed the importance of organizational, leadership and cultural factors, as well as a user-friendly EMR, which assists clinical work, is easily modified and which saves time and increases productivity.

This theoretical model for successful implementation is based on a review of research and supported by the evidence of this study. It provides a theoretical basis for future research and a practical tool for implementing an EMR and realizing the potential of this method for improving safety and the quality of patient care.

(Source: International Journal for Quality in Health Care; Volume 19, Number 5: pp. 259–266, 23 August 2007)

Knowledge and Perception of the Staff of Pandan Hospital Regarding Total Hospital Information System

Pandan Hospital was the third hospital using Total Hospital Information System (THIS) in Malaysia after Selayang and Putrajaya Hospital. This 704 bedded hospital is located about 15 kilometers from the center of Johor Bahru City, It will be the first hospital in the southern using THIS.

THIS is designed to automate the care delivery process in hospital through the process of integrated clinical, imaging, financial and administrative system. A study of knowledge and perception regarding THIS among the staff posted to Pandan Hospital was held.

The objective of the study is to determine the knowledge and perception of the staff of Pandan Hospital regarding THIS. A total of 131 respondents with 55.7% of the respondents were staff nurse. Less than 50% of the respondents requested to work in this hospital.

Among those who requested, almost 60% said that they were interested with IT hospital. Almost 90% of the respondents had minimal computer knowledge and 96. % was very interested or interested with Information Technology (IT). Most of the respondents had superficial knowledge about THIS by saying that THIS was about computer and linkage, IT and paperless hospital.

The perceptions toward THIS were good, where 58% said it was a better, systematic and quality system, 16% said modern and advance and 5.3% said that the system had both good and bad effect. Majority of the respondent said that THIS would benefit to both patients and staff.

Interoperability challenges with imaging systems in John Paul II Hospital, Krakow, Poland

Among the main lessons learned during digital imaging implementation and system integration at John Paul II Hospital in Krakow, Poland, were interoperability issues. According to Zbigniew Les from the hospital, “only with closely integrated ICT systems throughout the hospital, the full imageenabled medical electronic patient record can become reality”. However, while extending the ICT network within the hospital and interconnecting it with the systems of other institutions, the hospital faced interoperability problems. Due to a lack of interoperability, John Paul II Hospital cannot take full advantage of the technology in place to extend its usage outside the campus.

On the one hand, “there are still too many versions of software that are not compatible within the sector causing difficulty to exchange data”, Mr. Les said. A lack of state regulation is a further reason: “The process of system integration within the hospital and with other institutions, for example the National Health Fund, is hampered by a lack of clear state regulation about electronic data storage and exchange as well as a lack of standards for exchanging medical information.” Consequently, beside technical solutions, “the involvement of policy makers is equally important to bring clarity and impose some common solutions for the healthcare sector”.

Currently, large institutions with competitive advantage such as John Paul II Hospital impose their solutions to others, Mr Les explained. This may lead to several competitive standards. Their coexistence may result in unnecessary complications for the users and may make the creation of interoperable solutions at the national level more difficult.

Source: European Commission, Enterprise and Industry DG (2007b), p. 116.

ICT standards consolidation to overcome interoperability problems

Standards are key to interoperability because they provide the specifications which are necessary for systems to communicate meaningfully with each other. From the perspective of the buyers and users of healthcare ICT – for example general practitioners or ICT managers in hospitals, community care centres and insurance funds – interoperability problems may arise because of various shortcomings of e-health standards and standardisation.

These may include a large number of conflicting standards on the one hand but too few or insufficiently developed standards for particular solutions on the other hand. From an ICT industry perspective, there is a lack of sufficiently specified and commonly used ICT standards that meet user needs.

Consequently, a solution for the ICT interoperability challenge in the health sector may be the common use of a more confined number of well-developed and harmonised standards. This may in short be considered as “standards consolidation”. Standards consolidation is easily stated as an objective but difficult to realise. Numerous standardisation organisations, governments, and enterprises with diverging interests are struggling to maintain or gain power in defining ICT standards for the health sector. The number of standards used and the number of organisations involved in defining standards is very high and almost impossible to overview.

The complexity of the area of ICT standardisation itself is an important barrier to reach the objective of standards consolidation and even to decide where and how best to tackle it. Structuring the area of e-health standardisation and thus reducing this complexity is a key objective of standardization.

Healthcare Interoperability: the big debate!

Are international standards the most important factor in healthcare interoperability?A reader poll ahead of the Healthcare Interoperability conference in Birmingham decided that they were. But what would expert debaters and their audience think on the day? Fiona Barr reports.

Are international standards the key to long-lasting success in healthcare interoperability - or are they sometimes doing more harm than good? That, essentially, was the question posed by those speaking in the debate at E-Health Insider’s Healthcare Interoperability conference in Birmingham.

For the motion

Paul Woolman, ehealth information architect in the ehealth directorate of the Scottish Government, proposed the motion that: “This House believes that international standards are the most important factor in achieving interoperability in healthcare.”

He argued that interoperability is not only about achieving the technical transfer of data, but also about ensuring that the clinical meaning is understood. To get that to work, successful international standards are essential, he said. “You can do things with local solutions but to do things that last for a long time you need international standards,” he added.

His view was backed up by Philip Scott, a board member of HL7 and head of IT projects and development for Portsmouth Hospitals NHS Trust.

Scott argued that standards were not a bar to life in the real world and standards such as those used in debit cards were proof that international standards could work. “Standards have to be international because vendors are operating in a global market,” he said.

And against

The case against the motion was put forward by Martin Strange, head of health IT at Lloyds Pharmacy. Strange said he believed that some standards were “the greatest impediment” to interoperability and that open, national standards were much more important. He said these could retain flexibility while delivering functionality and: “We need that flexibility.”

Strange was backed by Ian Herbert, an independent health informatician and vice-chair of the British Computer Society’s Health Informatics Forum.

Herbert argued that international standards are not developed in a coherent manner and not always developed by the most appropriate people to do the job. He also said features that were relevant to the US were not always relevant in the UK - and vice versa – while international standards were difficult to change and complex to maintain.

“What actually matters is reliable and consistent use of standards, and international standards don’t make this any easier,” he said.

Open for debate

The four debaters were questioned about the commercial impact of different standards on suppliers who want to market their software worldwide.

Woolman said there was evidence from the medical devices market of big companies being willing to work together on standards to try and defer some of the costs - which could then benefit smaller suppliers.

But Herbert argued that while international companies liked to work to international standards this could also be a bar to innovation among smaller companies. He said that, for example, the cost of getting products tested by NHS Connecting for Health, the agency that runs the National Programme for IT in the NHS, could be prohibitive. “Some of these complex standards are actually doing some harm as well as good,” he said.

Dr Mary Hawking, a GP in Bedfordshire, asked whether international standards should be introduced for information itself, given that healthcare interoperability was all about moving patient data around.

Scott responded that clinical practice differed across the globe and that achievement would have to be limited to some sort of summary, highlighting the proposals for a European health record summary.

Others in the audience suggested that introducing standards for clinical content was critical before anything else was tackled. The newly-published standards developed by the Royal College of Physicians were welcomed as a good first step. “Unless we address the clinical content we have nothing to convey,” one doctor said.

Summing up for those supporting the motion, Woolman said national standards were never going to be enough. “Medicine is an international business. Companies work internationally. They want to use international standards. International standards have to be used in the long term,” he said. However, the motion was lost by just one vote.

(Source : http://www.ehealtheurope.net)

Why Healthcare IT Projects “Go Bad”?

Dr. David More MB, PhD, has an excellent summary of the reasons why healthcare IT projects "go bad." It is clear this is an international phenomenon unrelated to the type of healthcare system (e.g., socialized vs. private sector model), and that the root causes are similar.

The reasons cited by Dr. More from his blog are as follows (emphases on the key phrases are mine):

1. Many believe a key point is that managerial and organisational instability is a major cause of failure. I agree this is really important and, indeed, when one reflects on the Public Health Sector it is really a relative rarity to have an Area Health Service CEO or CIO serve out their full five year contract. This flux is due, in part at least, to a combination of Government and Ministerial changes, changing policy priorities, some being perhaps promoted beyond their capabilities and the unexpected events that precipitate management change. Conducting any significant project in the absence of continuing stable senior management support is a recipe of disaster.

2. Especially in the public sector, there is often a disconnect between the managerial responsibility placed on a project manager and the freedom to act they are accorded. At times this leads to the “wrong” staff being retained in roles for which they are no longer suited, to the detriment of the project as a whole. The disconnect (and budget inflexibility) also often leads to difficulty in attracting and retaining suitably skilled staff as well as excessive delay in staff acquisition. The other problem that is almost universally encountered in Hospital projects in my experience is the “drip feed” of funds and the difficulties in getting suppliers paid. More than once I have seen competent project managers just resign in disgust when they realise they have neither the spending authority, money or the staff to deliver the project they are required to make happen.

3. Because executive health-care management are often uncomfortable regarding many aspects of Health IT, frequently associated with a fairly limited understanding of what is required, at an executive level, for project success, the quality of project sponsorship and support is less than is needed. Senior executives, like everyone else, prefer to stay within their “comfort zone” and, if the Health IT project is not within that zone, real difficulties are almost inevitable. The project manager has a difficult responsibility to carry the project sponsor along on the journey, and to make it clear what they must do for the project to be a success on their watch!

4. Clinicians inevitably see a new system as a very low priority in their “caring for their patients” activities. This will lead to all sorts of difficulties with change management, training and effective use of a new system, unless both executive management are fully committed and real “clinician” evangelists and enthusiasts are recruited to work with their peers.

5. Involvement of all relevant categories of clinicians in the selection and later configuration of systems is crucial. The clinicians really have to be confident the system will work for them and be convinced of its value and utility or the project will be at extreme risk before it even starts.

6. There is a real tendency to underestimate the complexity of and the effort required to implement say a new laboratory or patient management system – to say nothing of clinician facing systems such as Computerised Physician Order Entry or Computerised Nursing Documentation which involve virtually all key staff changing the way they work. Careful planning and an really adequate emphasis on education and change management are vital as is developing real clinician ownership of the project.

7. It is clear that all organisations need to develop organisational competence and teamwork with Health IT. I think the best way to do this is to choose one or two easily “doable” projects and get them done on time and within budget. Only once this capability is proven should an organisation try the larger and more complex implementations. Success, as they say, builds on success.

8. It is clear that when implementing systems in hospitals size really does matter. It is a relatively straightforward process to put basic systems in a 100 bed regional hospital in 3-6 months with very little difficulty. The 1000 bed tertiary teaching referral hospital is a horse of a totally different colour. The budget is likely to be in the millions, the complexity of what is needed much higher and the work practices more entrenched. All this means both risk and duration are much higher. Additionally these organisations cannot be fed a ‘one size fits all’ solution. The systems that are deployed must not only be flexible but be flexibly implemented in consultation with ALL involved.

9. It is vital to work hard to develop an open and frank relationship between the system vendor and the organisation which is implementing the new system. No contract will prevent a disaster but work on ensuring a constructive, frank and balanced relationship will make a huge difference.

I feel this is well said. Healthcare organizations should take heed of these observations.

(Reference : http://aushealthit.blogspot.com)