(CBC) The idea behind eHealth is to create electronic health records for Ontario, something the auditor says could save $6 billion if implemented in every province and territory.

Instead, Ontario "is near the back of the pack" when it comes to electronic health records, having wasted millions on underused computer systems and untendered contracts.

The report is damning in its criticism of the way governments have allowed eHealth and its predecessor, Smart Systems for Health, to let spending go out of control with few safeguards to protect tax dollars.

McCarter says the province was "lacking in strategic direction and relying too heavily on external consultations."

At one point, the auditor writes, the eHealth program branch had "fewer than 30 full-time employees but was engaging more than 300 consultants."

McCarter said charges that favouritism was shown toward certain companies "without giving other firms a chance to compete were largely true."

At the heart of the report are four recommendations aimed at putting an end to scandals like the one that enveloped the eHealth agency:

• Develop a strategic plan for implementation of electronic health records.
• Improve oversight by board of directors.
• Rely less on outside consultants.
• Ensure procurement policies are followed.

Ease of access to Internet means more and more consumers are getting online. In 1998, nearly 18 million people surfed the Internet for health-related products and services. Explosive growth in health care Internet connectivity is predicted for 2000. (Yes it's happening now!) It is estimated that by 2001, 30 million people will be using the Internet for a variety of health care needs.1 What does the explosive growth mean to this industry and to the health information management (HIM) professional?

Read Leveraging Internet Technologies

This is a weblog specifically for personal medical stories. Many interesting things happen in hospitals, clinics, schools, hospices, at ball games, recitals, and on planes and trains. Almost everyone that comes into contact with someone in some sort of medical situation has at least one good story, be it an RN, MD, LPN, nurse’s aide, unit clerk, unit support, manager, or volunteer. Principally authored by veteran nurse.

WSJ Health Blog – (WSJonline.com)

Wall Street Journal's dedicated blog on health. WSJ's Health Blog offers news and analysis on health and the business of health. The lead writers are Journal reporters Jacob Goldstein and Sarah Rubenstein. The blog also includes contributions from other staffers at the Journal, WSJ.com and Dow Jones Newswires.

Health Blog – Dr. Art Hister (www.HealthyCanada.com)

Dr. Art Hister is an award-winning physician, educator and media personality. A recipient of the Holobon Award from the Canadian Public Health Association as Canada's top public health educator, he practiced family medicine before devoting his efforts to healthcare education and information. He is the author of several health books, and is a widely respected doctor and health columnist on radio, as the health columnist on Global TV News in Vancouver and contributing to a variety of publications. Dr. Hister is the Chief Medical Editor for HealthyCanada.com where he is a regular writer, blogger, and podcaster.

Behind the Headlines – Dr. Simeon Margolis

Dr. Simeon Margolis, a professor of both medicine and biological chemistry at the Johns Hopkins School of Medicine. For many years, Dr. Margolis wrote a weekly medical column for the Baltimore Sun newspaper. Currently, he's the medical editor for a series of newsletters and reference books aimed at people over 50 years old.

The Health Care Blog - Multiple physicians & experts

The Health Care Blog (THCB) has acquired a reputation as one of the most respected independent voices in the healthcare industry. THCB prints original material from many contributors (some regular, some not so regular) and reprints (by permission) great posts from other bloggers. If you are interest in writing something for us, take a look at our writer's guidelines.

Running a hospital - Paul Levy, CEO, Beth Israel

This is a blog started by Paul Levy, CEO of a large Boston hospital “to share thoughts about hospitals, medicine, and health care issues.” Very candid, frank, thoughtful, and detailed in his posts, mixed with multimedia. One of the very best corporate blogs on the entire Internet.

SusanBiali.com – Dr. Susan Biali

Health blog of lifestyle coach, doctor, speaker and dancer, Susan Biali (MD). A blog on “all kinds of personal reflections, practical information, and tips, on a variety of topics: health & wellness; success & motivation; achieving your dreams; life balance; life coaching tips, and pretty much anything else that I think might be helpful to you.”

Technorati Profile

Canada's e-health journey and HIMSS Analytics' Canada Information and Communications Technology Study (2009 - Healthc Q.) NoFull Text
In spring 2007, HIMSS Analytics began developing its first Canada Information and Communications Technology (ICT) Study. Less than one year later, 38 RHAs, DHAs and HAs are already on board, with some 20 more scheduled to participate by year's end. Why are so many Canadian provincial healthcare delivery organizations now participating in HIMSS Analytics' Canada ICT Study? The answer is tied to the character of the HIMSS study, the value offered to all participants and specific Canadian healthcare issues that are addressed by the study.

US: Interoperable electronic prescribing in the United States: a progress report. (April 2009 - Health Affaires)
Although the vast majority of U.S. physicians still handwrite prescriptions, adoption of electronic prescribing is slowly growing. Major barriers to adoption remain, including the inability to electronically submit prescriptions for controlled substances and confusion about standards for data exchange. Federal and state governments and private insurers are using payment and policy incentives to boost e-prescribing because they still believe in its promise for improving the quality and efficiency of health care. However, additional efforts and further investments are needed to reap the benefits of e-prescribing on a national scale.

Health information technology: dispatches from the revolution. (April 2009 - Health Affairs)
Countries around the world are increasingly employing health information technology (IT). These tools hold the promise of powerful health system breakthroughs from Johannesburg to Jakarta. While implementers multiply, a global e-health consensus framework is beginning to take shape among donors, governments, industries, researchers, and policymakers. As plans are formulated in the United States for substantial new federal investments in health IT, this paper details common threads in national and global health IT discourse. Among them are the need for strong stakeholder engagement, workable policy solutions, funding and donor coordination, and the imperative for adequately addressing standards and interoperability.

Exploring antecedents of consumer satisfaction and repeated search behavior on e-health information (2009 - J Health Commun.)::
E-health information has become an important resource for people seeking health information. Even though many studies have been conducted to examine the quality of e-health information, only a few studies have explored the effects of the information seekers' motivations on the perceived quality of e-health information

User information seeking behaviour: Perceptions and reality. An evaluation of the WHO Labresources Internet portal (2009 - Inform Health Soc Care.)
This article discusses the evaluation of a WHO Internet portal: the Labresources website. The evaluation investigates user satisfaction with the resource, usability, demographic information about users and how well they could complete specific tasks using the website and compared this with the actual online behaviour revealing a number of discrepancies

Technorati Profile

NHS Direct (United Kingdom) has recently launched an online Contraception Checker to help take the agony out of what to do next. It is designed to deal with enquiries about emergency contraception, missed contraceptive pills, dislodged contraceptive devices, interactions with other medicines or failed contraceptives.

So far 34,700 have used the online checker and 409 have had web chats with others The new tool takes the protocols - used by NHS Direct call centre nurses to assess patients’ concerns over the telephone - and adapted them for the website.

A series of questions are asked and the advice given naturally depends on the information given.¹ At all times the user remains anonymous which enables NHS Direct to reach those who may be less comfortable using the telephone or talking face to face.

Depending on the data provided by the user, the system may suggest a number of options including: a conversation with a nurse advisor; a visit to the family planning service or GP to get a prescription for a contraceptive pill or a visit to the nearest pharmacy to buy over the counter emergency contraception.

An anonymous web chat service is also offered if further assessment is advised. Web chat advisors are available 8am to 8pm Monday to Friday and 9am to 5pm on Saturday and Sunday.

Anne Joshua, associate director of pharmacy at NHS Direct says: “Sexual health is one of the major public health challenges and unplanned pregnancy is the most problematic². The Contraception Checker is ideal for anyone in urgent need of information about what to do if they have had unprotected sex but who also wishes to remain anonymous. The user is advised about the next steps to take according to the tried and tested protocols NHS Direct has developed to support telephone calls. In some cases users may be advised to seek professional advice about taking the emergency hormonal contraceptive pill.

“The emergency hormonal contraceptive pill is most effective within 24 hours of sex and is recommended for use up to 72 hours after sex – the self assessment tool caters for this urgency. Emergency hormonal contraception however is not a replacement for regular contraception and it is important that women of child-bearing age seek professional advice to ensure they have the best form of contraception for them.”

To help users experience a seamless ‘journey’ NHS Direct is planning to introduce a call back from NHS Direct with the facility to arrange a specific call back from a nurse advisor at a time to suit. This is already in operation for the cold and flu Symptom Checker launched in December 08.

Useful facts about NHS Direct

• Medicine information enquiries are one of the top three reasons people phone the service and emergency contraception makes up the largest percentage of those calls.

• So far there have been 34,700 unique visits to the new online Contraception Checker and of those 409 engaged in anonymous web chats – 3% of those were from men.

• Emergency hormonal contraception is not intended to be used as a regular form of contraception. One dose of the Emergency Hormonal Contraceptive pill (Levonorgestrel 1500 micrograms, Levonelle®) doesn’t protect you against pregnancy during the rest of a menstrual cycle if you continue to have uprotected sex.

• Taking a dose of the emergency contraceptive pill does not protect you against sexually transmitted infections. A condom does.

• NHS Direct handles over 22,000 calls a day. That’s over 8 million calls a year.

• The NHS Direct Online website (www.nhsdirect.nhs.uk) receives around 21 million visits a year.

Notes:

• ¹The advice given is only suitable if you are aged 13 or over. If you are under the age of 13 orif this enquiry is for someone under the age of 13, call NHS Direct on 0845 4647.

• ² Bailey JV et al. Interactive computer-based interventions for sexual health promotion (Protocol). 1-12.2007

eHealth 2.0 is focused on “promoting conversation” and user-generated content via websites and intranets to promote community networks and collaboration:

• Promoting networks of relationships

• Transforming users into publishers

• Discussing, sharing & collaborating

• From one to many -> many to many

Web 2.0 collaboration is best categorized into seven over-arching categories of tools and technology:

• Conversation platforms

  • Blogs, podcasts, ePinions.com

• Collaboration platforms

  • Wikipedia, MyStarbucksIdea, CarePages

• Social networks

  • Facebook, LinkedIn, MySpace

• Social bookmarking

  • Delic.io.us, Digg, Reddit

• Micro-blogging or Presence

  • Twitter, YouAre, Yammer

• Content sharing sites

  • YouTube, Flickr,

• Virtual networking platforms

  • Second Life, There.com

(credit to Shel Holtz, www.Holtz.com, for the original version of the above list)

The new social media tools represented by eHealth 2.0 reveals an evolution from mainstream communication technology to new generation collaboration:

eHealth 1.0             > eHealth 2.0

Hospital news         > Care Pages

Executives speech   > Executive blog

Taxonomy              > Folksonomy

Quick poll               > Discussion forums

Generic report         > Regular podcasts

Wellness information > Patient sharing sites

Content management > Wikis

Directories (A-Z)      > Tagging

Sticky content         > RSS

Some leading eHealth 2.0 websites and tools include:

• MedHelp discussion forums

• Wiki Public Health

• WebMD Health Blogs

• Running A Hospital (blog)

• Codeblog: Tales of a Nurse (blog)

• National Institute of Health podcasts

• HealthyCanada.com – Health podcasts

• CarePages

• OrganizedWisdom

• PatientsLikeMe

• RateMDs.com

For more information on how to transform you website or intranet into the next generation eHealth 2.0 website or intranet, please contact Prescient Digital Media at (416.926.8800).