Tunnell Solutions Inc.

Most Reverend Archbishop Desmond Tutu Speaks on eHealth

2010-02-24T18:47:00.001-08:00

I was recently surprised and delighted to see the Most Reverend Archbishop Desmond Tutu speak about eHealth, and specifically reference the eHealth 2010 conference in Vancouver.

For the benefit of those internet users who cannot access the video, and so that his speech attracts more attention from the Google bots, we have decided to post the transcript of his speech here.

"It is with great pleasure that I invite you to join Canada's Health informatics and telehealth communities eHealth 2010 conference in Vancouver BC next May. The theme of the conference is 'from investment to impact'. This is a theme that will strike a chord with all delegates as there has been considerable human and intellectual investment not just in Canada but accross the world. Governments and health care providers recognize the potential of eHealth to help address health system challenges.

I truly believe that eHealth provides us the best means of providing the accessible and quality health care to the poorest and most vulnerable. To be sure, this holds true for the residents of Canada as much as it does for developing nations. I regard the term eHealth to include many different types of helpful tools. It encompasses all of the emergening applications of information and communication technology in eHealth ranging from the electronic health record to elearning and telemedicine applications to the use of mobile applications to bring health care into remote communities and into homes. I believe that eHealth is a great equalizer between the rich and poor, healthy and sick and as the ISfTeH ambassador for eHealth I have vowered to work for its implementation around the world.

I encourage all of you to use your power for the good of the eHealth revolution. The impact that you and your fellow delegates at the eHealth 2010 conference can have on the Canadian health care system can provide a model for other countries from around the world who are looking to you to lead by example. The organizers of eHealth 2010 inform me that the learning objectives for the conference include among other things gaining a better appreciation of the impact and outcomes achieved in terms of the interactions of patients providers and the health care system itself. This objective implies a system of evaluation. And so another objective is how to do benefits realization. These are lofty goals. But they relfect the keen desire of the Canadian health care system to ensure that the full range of investments have been and will continue to be aimed at improving the health care system through the application of information and communication technologies.

This conference has grown to the largest eHealth event and tradeshow in Canada and once again will showcase a set of models demonstrating interoperability which is so very important if the investments in hardware and software are to achvive their potential. The large audience that is expected ofers an unequaled opportunity for networking with your colleagues and for the very first time this conference will also include Canada's telehealth professionals. Thank you for givign me this opportunity to speak to you and I wish you a most successful and productive conference."

- Most Reverend Archbiship Desmond Tutu

Homesourcing

2009-11-15T18:37:00.000-08:00

The term homesourcing generally refers to the movement of jobs from the office to the home of the employees. Homesourcing can be thought of as telecommuting, but it is actually a bit more complicated. Telecommuting is really a personal activity by a worker, whereas homesourcing refers to the use of home based employees by an organization to save money on infrastructure and overhead.

In a typical homesourcing situation, and employee will spend the majority of their work time in their home. Ideally the employee will have their own office or private room at home, where they can work without distraction from their children or other activity. Some of the first home sourcing involved jobs that are already telephone based, such as telemarketing and telephone technical support. However, as more homes have access to higher bandwidth internet connections, other forms of work can move into the home.

Other technologies, such as virtualization and remote desktop allow users to actually use the computers in the office, thus allowing the worker to gain the advantages of an enterprise data architecture while at home.

An Example:

A systems administrator that works for a large enterprise sometimes needs to be available at all hours. It may be necessary for him to work at night, or over public holidays in order to perform necessary maintenance on critical systems while impacting as few users as possible. In addition, the systems administrator may need to immediately respond to emergency situations while at home. Therefore, he sets up secure remote connections to the servers at work, allowing him to connect immediately from home. This also allows him to work those evening or early morning hours while at home.

There are both advantages and disadvantages to homesourcing:

ADVANTAGES
Green The use of homesourcing greatly reduces the carbon footprint of a company. Every employee that is homesourced is one less workspace or office, including all of the emissions in the production and maintenance of that workspace. This includes water, electricity, internet usage etc.

Response Time Homesourced employees are better prepared to respond quickly to situations at work during off hours.

Greater Receptiveness to Odd Hours Homesourced employees are more receptive to odd hours of work. They may be more willing to work evenings or weekends, and will also be more likely to accept overtime work.

Employee Centric Many employees respond well to homesourcing. It allows employees to be at home with children or sick relatives while working (although that can be distracting).It also allows employees to better control their working conditions and their diet.

Improved Hiring Homesourcing makes a larger pool of potential employees available to a company, such as single mothers.

Reduced Costs One of the greatest benefits of homesourcing is reduced costs for the company. Depending on the location, a single office and support mechanisms for an employee can cost a company $20,000 per year or more.

DISADVANTAGES
Increased Overhead for Managers Managers will need to spend more time actively communicating with homesourced employees. This is required to overcome the lack of face to face and group communications. Video conferencing and other internet communication tools can mitigate this disadvantage.

Not for All Not all employees respond well to homesourcing. A company that changes to homesourcing may find it has difficulties keeping all of its employees.

Cultural Drift When using homesourcing, it is difficult to maintain a cohesive corporate culture. It may be necessary to schedule regular meetings or social activities so that employees can still interact fact to face.

Net Dependant For most professional positions, homesourcing will be internet dependant. The wider the geographic spread, the more likely it is that interruptions in internet traffic will disrupt work.

Tech Support Overhead Homesourcing can increase the expense of technical support within an organization. It may be necessary for technical support to visit homesourced employees, and the organization will need to maintain one or more servers to facilitate the homsourcing.

Homesourcing is not for every person, or company, or type of work. However it can bring immense savings to a company, and greatly reduce its carbon footprint. Homesourcing will appeal to younger generations as they come into the workplace. Already used to connecting virtually at all times with their peers, these new generations of employees will likely turn to companies that offer homesourcing as an option.

EHR vs EMR

2009-11-15T11:40:00.000-08:00

As electronic health systems become more prevalent, there has been a lot of discussion of both Electronic Medical Records (EMRs) and Electronic Health Records (EHRs). As interchangeable as these two may seem, the difference between them is critical in the development of an eHealth system.

According to the Auditor General of Canada, "The terms electronic health record and electronic medical record (EMR) are often interchanged. However, in the context of this audit, they must be clearly distinguished. An EHR refers to a person’s health record that can be accessed online from many separate, compatible systems within a network. An EMR refers to an electronic patient record that can be accessed from a single system in a doctor’s office and that may, or may not, be shared with other health care professionals."¹

"An electronic health record (EHR) is a secure and private lifetime record that describes a person’s health history and care. Such a record would be available electronically to authorized health care professionals anywhere and anytime to support the provision of high-quality care."²

Developing an EMR or EHR system is therefore very different. EHR systems are much more likely to be influenced by federal or regional regulations, and will tend to be large enterprise systems linking multiple organizations. They will need to satisfy or exceed any standards that have been established in a particular area. Any system linking multiple organizations in different geographic locations requires a much higher level of security, and becomes more subject to network disruptions.

While the Auditor General's states that an EHR would be available to authorized health care professionals, Tunnell Solutions believes that the EHR should also be available to the individual that it describes. A patient could then have access to their own health history, be able to update their address or phone number, setup an appointment with their doctor, renew a subscription, or submit an online query about a medical record in their health history.

While and EMR system could be as small as a single doctor's office, an EHR could be used by an entire state or province, or even an entire country. In fact if a country were to purchase a single EHR system they could acheive incredible economies of scale, and be able to quickly deploy future solutions or upgrades to the system. While it is recognized that countries such as Canada and the Unites States will likely adopt multiple EHR systems, it is important that such systems strive towards compatibility with one another. Use of technologies such as XML can make this possible.

There are many early adopters of EMR systems, including individual doctors who have purchased customized systems. EHR systems should also take into account these disparate systems and include tools for incorporating or importing EMR records into the EHR system.

While many Electronic Medical Records systems currently exist, the next few years will see the development and adoption of Electronic Health Records systems. Canada Health Infoway is a not-for-profit organization whose aim is to increase the use of electronic health records in Canada. They have already spent 1.2 billion dollars on this effort, and their aim is that "by 2010, 50 per cent of Canadians and by 2016, 100 per cent of Canadians will have their electronic health record available to their authorized professionals who provide their health care services.”³ This is a very lofy goal, but one that is achievable if entrepreneurs are up the challenge. Tunnell Solutions is.