http://healthcare.zdnet.com/?p=2058
by Dana Blankenhorn
In practice, studies like this can easily be a political sop. They are easier to bury than your kids’ pet goldfish. Had the election turned out differently, that’s what likely would have happened, because the previous government was deeply attached to proprietary models.
http://govhealthit.com/articles/2009/03/25/ehr-adoption-abysmally-low-in-hospitals tiny percentage of U.S. hospitals use e-health records, according to a new survey by a team that includes the incoming national coordinator for health information technology. Fewer than 8 percent of hospitals have EHRs in even one clinical department, and only 1.5 percent have EHRs for all clinical departments, the researchers reported in today’s online edition of the New England Journal of Medicine.
http://fcw.com/articles/2009/03/27/dod-has-little-workforce-info.aspx
http://govhealthit.com/articles/2009/03/27/joint-lifetime-health-record.aspx
The Defense and Veterans Affairs departments have formed a working group to pursue a joint lifetime electronic heath and benefits record for service members, veterans, and their families. Rear Adm. Gregory Timberlake, director of the DOD/VA Interagency Program Office said yesterday the decision to form the group was made March 24 at a meeting of the Joint Executive Council, chaired by Defense Secretary Robert Gates and Veterans Affairs Secretary Eric Shinseki.
If you are interested in sharing medical information at the population or electronic health record level then you should be looking at how web services fit into the equation. A great resource for learning the basics and details is the W3 Schools.
Thinking about projects for implementing systems and then the portfolios of projects that result in a platform being put into place – standards, systems, processes et al. I enjoy the work that the Project Management Institute (PMI). I found this article helpful:
If you didn’t see this article in the New England Journal of Medicine (NEJM) on Electronic Health Records (EHR) then it is worth a look. Good baseline information but I can’t help but think – if we looked at computers this way in the 1970’s then…. well you know the rest……
I thought this was an interesting article on ZDnet – sounds like the iphone may be an interesting platform for some future medical applications. Sometimes I think we need to break our old ways of thinking that an applications or system needs to be the only way to look at medical systems. iPhone and twitter show interesting approaches to exposing platforms that let the world loose.
North Darfur camp hosting over 15,000 people uprooted by recent clashes – UN Source: United Nations News Service Date: 25 Feb 2009 Over 15,000 people have sought safety in the Zam Zam camp in North Darfur after fleeing the latest outburst of violence in the South Darfur region of Sudan, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reported today. OCHA is concerned that with more people arriving each day, the large influx of internally displaced persons (IDPs) is putting a strain on the provision of water to camp residents. The fighting which broke out last month around Muhajeria and Shearia in South Darfur between Government troops and other armed groups against the Justice and Equality Movement (JEM) exposed tens of thousands of civilians to violence. Earlier this month, the two sides signed an agreement of “goodwill and confidence-building,” which Secretary-General Ban Ki-moon welcomed as a “constructive step” in the ongoing efforts to negotiate a peaceful conclusion to their conflict. Meanwhile, the joint African Union-UN peacekeeping mission to Darfur, known as UNAMID, reported that an additional 150 Senegalese peacekeepers arrived today in El Fasher, capital of North Darfur and the mission’s headquarters, bringing the total to 834 in the Senegalese infantry battalion. The main duties of the battalion, which is based in El Geneina, West Darfur, include conducting escorts for humanitarian convoys, and conducting patrols to enhance security for civilians in the area and encourage confidence within the local population. One year after taking on the task of suppressing the violence, UNAMID has some 12,753 blue helmets – of the 19,555 authorized by the Security Council – across Darfur, where an estimated 300,000 people have been killed and another 2.7 million have been forced from their homes since fighting erupted in 2003
The Israeli military operation entered its eleventh day, with the civilian population of Gaza continuing to bear the brunt of the violence. Israeli air, sea and ground forces continue to surround Gazan populated areas. The Gaza and North Gaza governorates remain isolated from the rest of the Strip. Internal movement within the Strip is extremely difficult because of ongoing hostilities and the destruction of essential infrastructure. The humanitarian situation in the Gaza Strip continues to deteriorate.
VIOLENCE
According to the MoH, the total number of
casualties as of 1800 hours today has
risen to at least 640 Palestinians killed
and 2,850 injured. Ongoing hostilities and
the dangers involved in medical crews
accessing casualties make it increasingly
difficult to compile an accurate and
up-to-date account of casualties.
Among the main incidents reported:
Early reports suggest that at 15.45 on 6
January 08, three artillery shells landed
outside the UNRWA Jabalia Prep C Girls
School, resulting in at least 30
fatalities and 55 injuries, of which 15
are reported to be critical. The school is
currently being used as a shelter for
those fleeing hostilities.
At 2330 on 5 January, three Gazans were
killed in an UNRWA school in Gaza City.
They were among over four hundred people
who had earlier in the evening fled their
homes in Beit Lahiya in northern Gaza and
had been given refuge in the UNRWA school.
The school was clearly marked as a UN
installation. UNRWA has protested the
killings to the Israeli authorities and is
calling for an immediate and impartial
investigation.
Mid Morning 6 January, the UNRWA health
clinic in Bureij camp was damaged and ten
persons were injured when a missile hit an
adjacent building. Seven of the injured
were UNRWA staff, the other three being
patients. Three of the injuries are
reported to be serious.
On 4 January, approximately 100 members of
the extended Al Samuni family were
evacuated from their homes to a building
to the east of Gaza City. In the early
hours of 5 January, the house was
repeatedly shelled. Three children who
reached Shifa Hospital by civilian car
were pronounced dead on arrival. According
to survivors an unknown number of dead and
injured remain under the rubble, as
medical authorities have been unable to
reach them.
In the early hours of 5 January a shell
hit a house in Beach Camp killing at least
seven members of the Abu Aysha family.
Overnight shelling of residential houses
in the Bureij Camp have left at least five
dead and 16 injured. In another incident,
a pregnant Palestinian woman and her four
children were killed.
On 5 January, the al-Awda hospital in
northern Gaza was damaged by two shells
which landed in a busy car park close to
the emergency room. The entrance of the
emergency room was damaged, along with
some of their stores.
A WFP logistics contractor’s warehouse
holding 360 tonnes of food was hit as of 5
January, killing one person and critically
wounding two others.
Four Israeli soldiers were killed in two
separate incidents on 5 January. Over 40
Qassam and Grad rockets were reportedly
fired on Monday from Gaza at southern
Israel with no injuries reported.
SHELTER
Over 14,000 Palestinians are now staying
in 23 emergency shelters as of this
morning, with numbers quickly growing.
UNRWA’s aid stocks for the shelters are
depleting. UNRWA is in need of food and
non-food items (NFIs) for these shelters,
particularly blankets and mattresses, and
is requesting organizations to share NFIs
currently available. Local procurement of
these items is hampered by the supply
shortage on the local market due to the
18-month long blockade on the Strip.
Additionally, bringing in any new items is
difficult due to the bottle-neck at Kerem
Shalom crossing. Yesterday, ICRC provided
350 hygiene kits to UNRWA for people in
shelters. This is enough for 6,300 people
over 10 days
ELECTRICITY / TELECOMMUNICATIONS
The Gaza power plant is still not
functional. Following coordination with
the Israeli authorities, the 215,000
litres of industrial gasoline which
arrived yesterday have been transported
from Nahal Oz to the power plant: however,
this does not mean that all areas
depending on the power plant will receive
electricity immediately as most lines were
damaged.
Of the seven damaged electricity lines
coming from Israel and Rafah, two have
been repaired . GEDCO has received
approval from the Israelis to repair the
other lines from Israel. As of yesterday,
an additional electricity line located
east of Khan Yunis is no longer
functioning.
The Palestinian telephone company, Paltel,
warns that due to continued electricity
cuts, the shortage of fuel and other
constraints all land lines, cell phones
and the internet might be cut within one
to two days.
HEALTH
Hospitals continue to run on back-up
generators for the fourth consecutive day.
Only three out of 56 MoH primary health
care clinics are currently open.
Restrictions on movement and the
dissection of Gaza are the main reasons
for the closure of many clinics. Fuel
available for generators at primary health
care services and the central drug store,
including cold rooms for vaccine storage,
is estimated to be enough for five days.
According to the MoH, six medical staff
have been killed and 30 injured, while 11
ambulances have been hit.
Over the last 24 hours, the Palestinian
Red Crescent Society (PRCS) has not
received Israeli approval for any of its
coordination requests to reach those
killed or injured. Nonetheless they have
recovered 140 wounded and 22 dead.
The ICRC surgical team which entered on 5
January brought in 1000 units of tetanus
oxide for MoH hospitals.
WATER AND SANITATION
According to the Coastal Municipalities
Water Utility (CMWU), 800,000 people in
North Gaza, Gaza and the Middle Area have
no running water as of 6 January. Those
who still have running water face problems
in purifying water as well as risking the
additional danger of a contamination of
the water network due to waste water
leakage. Sanitation services (including
solid waste disposal) are not functioning
due to the fighting.
FOOD
Cooking gas is in short supply throughout
the Strip with people relying on wood
ovens or electricity, where available, or
are burning alternatives where available.
People continue to have problems obtaining
food, including basic items such as rice,
flour and oil. Bakeries have not received
wheat flour since the beginning of the
ground operation. As a result, only nine
bakeries remain operational with queues
lengthening for the allotted 50 small pita
bread piece allowance. Prices have nearly
doubled since the offensive began
compounding the cash shortage. The
Bakeries’ Owners’ Association has appealed
to UNRWA for wheat flour so they can
continue operating.
Prior to the current operation, 80 percent
of the Strip’s population was already
reliant on food distribution from UN and
international organizations. UNRWA food
distribution resumed under extremely
difficult circumstances after 13 days of
suspension on 1 January and is reaching
close to 20,000 a day with 2-3 months’ dry
food supplies. Neither UNRWA nor WFP were
able to distribute on 6 January due to the
prevailing security situation.
CROSSINGS
Kerem Shalom was open today with
approximately 50 truckloads expected to
arrive into Gaza. A total of 41.5
truckloads, including 40.5 from
humanitarian aid agencies, was allowed
entry through Kerem Shalom on 5 January.
These comprise 31 of flour for UN
agencies, 8 of food supplies from Arab
donors, and 1.5 of medical supplies for
ICRC.
The Nahal Oz fuel pipelines and Karni
conveyor belt used for grains were closed
today.
Rafah crossing was partially open today
for the transfer of medical supplies and
the evacuation of medical cases. On 5
January, 10 truckloads of medical supplies
were allowed entry and 18 medical cases
were allowed out. According to the MoH,
133 patients have been transferred through
Rafah for treatment outside of Gaza since
27 December.
PRIORITY NEEDS
Supply of fuel: Industrial fuel is needed
to power the Gaza Power Plant, which has
been shut down since 31 December. The
replacement of transformers which were
heavily damaged is also urgently needed,
as well as coordination to allow technical
teams to fix other damage. Nahal Oz
crossing must remain open as it is the
only crossing which can facilitate the
transfer of sufficient amounts of fuel to
restart and maintain operations of the
power plant, and restock other types of
fuel needed in the Strip. The continuous
switching off and on of the plant is
seriously damaging its machinery and could
lead to a collapse of some of its vital
components.
Distribution of cooking gas: Though
cooking gas was pumped from the Israeli
side of Nahal Oz to the Palestinian side,
it has not yet been picked up due to fears
of being targeted. Coordination is
urgently needed for the collection of
cooking gas from stores along the border
area and from Nahal Oz, and subsequently
for the distribution of the gas which is
essential for bakeries and home-cooking of
bread and other food.
Wheat grain, essential to provide flour
for local bakeries and humanitarian food
distribution to the population of Gaza.
The Karni Crossing conveyor belt is the
only mechanism which can facilitate the
import of the amount of grain required in
the Strip at this time. This crossing
remains closed.
Cash has still not entered the Gaza Strip
and is urgently needed, including for the
UNRWA cash distribution program to some
94,000 dependent beneficiaries, as well as
its “cash for work” programme, salaries
for its staff and payments to suppliers.
Internal movement within the Gaza Strip:
Movement within the Strip is restricted
and dangerous. It is essential that
patients and ambulances have access to
hospitals, that agencies access warehouses
to conduct distributions, and that damage
to public services can be repaired.
Bakeries also need access to cooking gas.
Promed Mail Google Maps of Emergency Services
