Wednesday, October 01, 2014

Can We Ask The Same Important Question For Australia? I Think So.

This appeared a few days ago.

Where's the plan for interoperability?

Posted on Sep 22, 2014
By John Loonsk, MD, CGI Federal
It is a simple question: “Why doesn’t electronic health information flow after the nation spent $26 billion on electronic health records?" Suggesting a 10-year timeframe or arguing that there is progress if you look hard enough just doesn’t answer it.
Congress does not think so either. Despite the HITECH funds’ accomplishing a significant degree of EHR adoption there is still a large amount to do to achieve modest interoperability. And the question posed above is going to politically fester until something significant is done.
Part of the interoperability problem is that only a limited amount of the HITECH meaningful use leverage has been used to encourage data exchange. Interoperability took a back seat to adoption of EHRs and other things in meaningful use plans.
But another part of the problem is that there is no real technical plan. From a health IT perspective, the kind of “plan” that is needed would describe high-level functional needs, identify important technical elements, and show how they all fit together. It would be an architectural blueprint to guide technology in the very complex, loosely coupled system that is the health sector. And it would strategically articulate critical, but limited, pieces of the national health IT infrastructure. It would also show how what exists needs to be supplemented and changed to achieve the future state. It would be, in short, more of a high-level technical architecture than a roadmap.
A roadmap can help too but the nation needs to know where it wants to go in order to use a map for how to get there. Some, who not infrequently would rather go their own way, attack the word “architecture” as meaning “top down control.” So call it a “technical plan” or a “framework,” call it a “design pattern,” a “schematic” or whatever you want; interoperability will suffer until we have a picture that helps articulate and guide where we are going.
Without such a plan, the multiplicity of approaches makes for bad interoperability math. Each participant has too many variations with which they need to integrate. Software vendors can’t pick one approach and sell to the whole market – they need to pick them all or narrow their opportunities. Without a plan, we cannot communicate well about specific needs and how they fit together. Critical elements will be missing. Without a plan, funds and mindshare are invested in dead-ends that will take years, or decades, from which to escape. Without a plan, we will be highly susceptible to the whims of changing personalities, politics, and administrations. Without a technical plan, many of the health outcomes that assume information liquidity and on which HITECH was “sold” will be elusive.
External reports from notable experts including the President’s Council of Advisors on Science and Technology, or PCAST, and the JASON group have said that a technical plan is necessary. PCAST was ignored. The more recent JASON report is now being picked apart for flaws in its sample architecture. But the plea both reports share is to develop an architectural plan not necessarily their specific one.
So, to substantiate the need for a technical plan, here are six barriers to interoperability that are the result of not having one. It is our hope that discussing these issues will help us constructively move forward to having a technical plan that resolves these issues now and prevents similar issues in the future.
Lots more here with some salutary warnings and insights.
In Australia we have this document:

eHealth Interoperability Framework - Framework v1.1

Size: 0.84 MB
Type: PDF
Name
NEHTA-1024:2012 eHealth Interoperability Framework - Framework v1.1
Identifier
NEHTA-1024:2012
Version
1.1
Published Date
30-04-2012
Type
End Product
"This document describes a standards-based set of concepts, structuring rules and approaches for use in specifying and building interoperable eHealth systems. It includes guidelines for:
  • structuring specifications
  • recommended document components for an eHealth specification
  • defining the capability of healthcare organisations to interoperate.
The framework and specifications identified in this document are intended primarily for use in cross-organisational contexts but some of the core principles and approaches may be applicable in an individual organisation or unit. Interoperability is one of the key factors that should guide the specification, development, acquisition, implementation and use of eHealth systems.
This document is intended to be read in conjunction with the eHealth Architecture Principles."
This is found here:
According to the release note it is no longer supported:
Support
eHealth Interoperability Framework v1.0 is retired and will be supported through to 2 December 2013.
As a minor release to v1.0, eHealth Interoperability Framework v1.1 will be supported through to 2 December 2013.
To obtain support please contact eao@nehta.gov.au.
A planned review of the Framework in April 2014 does not seem to have happened so I have no idea where we are.
As for what the actual plan is - no idea? Does anyone else?
David.

Tuesday, September 30, 2014

It Looks Like National Standards Setting (Including E-Health) Is Getting More Messy.

This appeared late last week.

Standards Australia quick off mark in review of royalties on SAI Global contract

Simon Evans
The 74-member Standards Australia organisation that made a last-ditch effort to try and be part of a buyout process for SAI Global has revealed a review of royalties for a key contract with SAI has already begun, and that its chairman is stepping down.
SAI’s former parent Standards Australia has just released its 2014 annual review which is the last presided over by chairman Alan Morrison. In it the firm outlines that it expects larger amounts will be due to the organisation from a revised royalties deal with SAI, but it doesn’t specify how much.
SAI last week revealed that after a protracted sale process which began in May with an indicative $1.1 billion proposal, it ended up without any whole-of-company bids.
Uncertainty over the key contract with Standards Australia for the publishing and sale of 6900 standards was one of the main reasons.
Private equity firms Pacific Equity Partners, which later brought in Kohlberg Kravis Roberts as a partner, made an original indicative buyout proposal in May for SAI which valued the company at up to $1.1 billion.
Standards Australia wrote to SAI just before the deadline for bids expired, saying it was interested in submitting a bid, but required more time. SAI and its advisers spurned that request.
The Standards Australia annual review for 2014 outlines that it receives royalties primarily based on net revenue from publishing sales under the contract with SAI, known as the Publishing Licence Agreement (PLA).
“A review of the calculation of royalties is being undertaken and it is expected that an additional amount will be due to the company,’’ the annual review states.
But it warns that currently there is no reasonable basis for estimating the amount receivable.
More details are here:
What this means is that the price of printed Standards are very much likely to rise from their already hardly cheap levels and the chances of DoH continuing to fund e-Health Standards in the longer term would appear to be dropping.
Given this it would make sense to download all the documents you might need reasonably soon!
All that are presently available can be downloaded free from here (for now - sponsored by DoH):
I also thought I would see if I could find the NEHTA Standards Catalogue which we were told would soon be available in Feb 2013:
Here is the blog of the time:

Wednesday, February 27, 2013

Can This Be Seen As Acceptable In Any Way? Can’t See How.

Checked this link today.

Standards Catalogue

The National E-Health Standards Catalogue (Standards Catalogue) consists of a collection of standards and specifications that are essential guidance for those who develop, sell, support, buy and implement e-health software in Australia. The catalogue provides a list of the standards recommended by, and specifications sourced or developed by, NEHTA, and is updated regularly.
What does the Standards Catalogue provide?
  • advice on when and where the use of a standard is appropriate.
  • can be navigated via  content classifications
  • links to both de facto and de jure standards from national and international standards bodies including proprietary, business, and more openly developed standards.
Open Standards
We support the adoption of open standards where appropriate. These standards should require no royalty payments, be openly published, allow extension, promote reusability, and reduce the risk of technical lock-in and high switching costs. However, where open standards are not appropriate due to significant market or technical issues, we will adopt the standards deemed most fit-for-purpose, relevant and useful to the community.
Importance of Standards
Standards are relevant to all areas of our work, and provide rigour as well as a means of validation with external expert groups. The lack of clear standards makes it difficult for vendors to develop software applications that can support a broad range of communication within the health community. Vendors face developing their own solutions and accepting the risk of industry adopting a different approach. Where widely supported standards are available to vendors, the lack of agreement at a national level about their use can preclude their adoption.
Standards also benefit those who purchase and implement health software applications. Knowing which software products conform to agreed standards can greatly simplify the purchasing process, and increase purchaser confidence that the selected product will be fit-for-purpose. Standards also offer the potential to avoid vendor 'lock-in'.
The PCEHR Standards Catalogue currently being updated and will be available soon.
For any inquiries regarding Standards, please contact us at standards@nehta.gov.au
----- End extract.
The link above now goes below here and we still don’t have a catalogue of recommended Standards but we have a huge number of NEHTA Resources of unproven quality as far as I can tell in terms of clinical impact and value.
So bottom line grab what you need soon and wonder when we will ever see some better managed co-ordination and progress in E-Health Standards setting. I am sure not holding my breath.
David.

Monday, September 29, 2014

Weekly Australian Health IT Links – 29th September, 2014.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Another very quiet week with the biggest news being the new Health IT being implemented in the Defence domain and some movement from Apple in the Health IT Space.
Minister Dutton seems to have gone to ground on the PCEHR. Wonder when we will hear something?
-----

Australian Medical Association to scrutinise Apple’s HealthKit app over privacy concerns

Chris Griffith

HARNESSING Apple’s new HealthKit system for patient care may have benefits but there are also big issues involving privacy and the accuracy of data, healthcare professionals said.
The Australian Medical Association said it would welcome the opportunity to meet with Apple to discuss how its HealthKit system and Health app could assist patients.
Apple’s new Health app can amass almost 70 types of health and fitness data on a phone, including blood glucose, blood pressure, body temperature, caffeine level, cycling distance, heart rate, potassium levels, sleep analysis and even falls.
The app can gather data such as steps walked from the phone’s sensors, let users add health information manually, and store data passed to it by devices such as wristband monitors and medical equipment.
-----

Gearing up for the wearables revolution

The recent announcement of Apple’s watch defined the next must-have gadget for tech-hungry consumers.
But with smartwatches, fitness trackers, head-mounted displays and other wearable devices forming the latest craze in consumer electronics, some business leaders are already asking how they will manage and utilise them for their workforce and customers.
Australians have demonstrated a mania for personal technology. Australia ranks sixth globally for smartphone usage, according to Google, with 64.6 per cent penetration, just seven years after the release of the first iPhone.
The rapid uptake of smartphones caught many organisations by surprise, both in terms of the strong desire of employees to bring them to work, and customer demands to use them as a means of interaction.
There are signs the adoption of wearable technology could happen faster still. Deloitte has estimated the global market for wearables at $US3 billion, and according to the analyst firm Telsyte, there were already 380,000 smartwatches in Australia at the end of June this year.
-----

Clinical communication, interruption and the design of e-health

September 23, 2014
The different ways clinicians interact does not just shape the success of the communication act. Our propensity to interrupt each other, and multitask as we handle communication tasks alongside other duties, has a direct effect on how well we carry out everything we do. Interruption for example has the capacity to distort human memory processes, and lead to memory lapses as well as memory distortions.
Earlier this year I was interviewed by Dr. Robert Wachter, the Editor of the Agency for Healthcare Research and Quality (AHRQ) WebM&M. In that interview we covered the roles that interruption and multitasking play in patient safety, discussing both their risks, as well as strategies for minimising their effects. The interview also looked at the implications these communication and task management styles have for the design of information technologies.
-----

Telstra pays millions for stake in US electronic signatures firm DocuSign

Fran Foo

TELSTRA has expanded its investment tentacles in Silicon Valley, pumping millions of dollars for a stake in electronic signatures firm DocuSign, which counts blue chip brands Google, Visa and SAP as investors.
The telco joins the likes of Japan’s telecommunications provider NTT and Korean electronics giant Samsung in DocuSign’s latest funding round.
DocuSign, reportedly valued at $US1.6 billion ($1.8bn), offers an online service that allows people to electronically sign documents and return them without the need for printing or scanning.
The news comes weeks after Telstra splashed $US270 million on Ooyala, increasing its stake from 23 per cent to 98 per cent in the Valley-based online video service provider.
-----

Telstra pays millions for stake in US electronic signatures firm DocuSign

Fran Foo

TELSTRA has expanded its investment tentacles in Silicon Valley, pumping millions of dollars for a stake in electronic signatures firm DocuSign, which counts blue chip brands Google, Visa and SAP as investors.
The telco joins the likes of Japan’s telecommunications provider NTT and Korean electronics giant Samsung in DocuSign’s latest funding round.
DocuSign, reportedly valued at $US1.6 billion ($1.8bn), offers an online service that allows people to electronically sign documents and return them without the need for printing or scanning.
The news comes weeks after Telstra splashed $US270 million on Ooyala, increasing its stake from 23 per cent to 98 per cent in the Valley-based online video service provider.
-----

Telstra buys into US startup DocuSign

Telstra has made an undisclosed investment in DocuSign, a US technology startup that lets people use digital signatures in documents and financial transactions, as part of its push into Silicon Valley.
Telstra spent millions of dollars to buy the stake as part of a funding round, news reports suggested, but it refused to specify the exact amount. It will adopt the system as part of the move.
It comes as global technology giant Apple enters the game of authenticating payments and documents via the fingerprint recognition system on its hugely popular Apple iPhone 6 and iPhone 6 Plus devices in the US.
-----

Telstra takes stake in DocuSign

Telco will roll out digital signature technology internally and then offer to customers later this year
Byron Connolly (CIO) on 23 September, 2014 12:28
Telstra has invested in US-based electronic signature and digital transaction management firm, DocuSign.
The online DocuSign platform lets users upload documents; add names and email addresses of the signers; places tags in the document where the signature, initial and dates are required; and hit send – within a secure, online environment. It is used by more than 40 million people in 188 countries.
Telstra will use the platform internally to speed up its paper-based processes before offering the technology to its customer base later this year.
-----

In iOS 8, Medical ID could be a life-saver

The Medical ID record in the new Health app in Apple's iOS 8 hasn't gotten a lot of attention. But it should, says columnist Ryan Faas.
Ryan Faas (Computerworld (US)) on 22 September, 2014 20:32
Of all the new features in iOS 8, one hasn't gotten a lot of attention -- and it's the one feature that all iOS 8 users should at least consider.
I'm talking about the Medical ID record in the new Health app. Even if you aren't tracking fitness, diet or sleep -- and fortunate enough not to be managing or monitoring a chronic condition like diabetes, COPD or heart disease -- this is one aspect of the health app worth understanding. Although all other HealthKit-related functions are on hold for now, Medical ID is fully baked and ready to use.
The Medical ID pane of the Health app is a pretty generic medical information and history form. It contains much of the data that you'd see requested on a form when you visit a new doctor or an urgent care center -- birthdate, existing medical conditions, notes about those conditions or your medical history, allergies (to drugs, foods and environmental factors), medications you're taking, emergency contact (including relationship to you), blood type, whether you're an organ donor and your height and weight. The app automatically pulls your name and photo from the iOS Contacts app.
-----

"I buy up to 500 pseudo tablets a day for drug cooks"

Date September 25, 2014 - 4:15PM

Nicole Cox

Reporter

An anonymous talkback radio caller has confessed to "pseudo-shopping" around Perth pharmacies, buying up to 500 cold and flu tablets a day to on-sell to illicit drug cooks.
The man, known only as "Bob", told 6PR Radio on Thursday morning that he managed to avoid strict controls on the sale of pseudoephedrine-based drugs, including having his personal details recorded on a database set up by the Pharmacy Guild to stop such activity.
If he spent half a day shopping around chemists, he could sell the tablets to drug cooks for $1 each, he said.
"I live on the other side of the fence, mate. I buy them for illegal activity," Bob told 6PR's breakfast show hosts Steve Mills and Basil Zempilas.
-----

openEHR 2014 Roadmap Meeting, Sep 16/17, Oslo

Last week saw the first major face-to-face international openEHR community meeting, which took place in Lilletstrom, near Oslo, at premises kindly organised by DIPS asa, openEHR Industry Partner and major EHR supplier in Norway.
We had 32 participants from vendors including DIPS asa, Cambio Healthcare Systems, Code24Marand, Ocean Informatics, Raysearch Labs, as well as Erik Sundvall (Linkoping University, Sweden), Gunnar Klein (Professor of eHealth, Informatics Section, Örebro University School of Business), attendees from Oslo University Hospital, Furst Medical Laboratories, Helse-Bergen (Bergen regional health org), as well as Shinji Kobayashi (Kyoto University), David Moner (Polytech University, Valencia), and Luis Marco-Ruiz, who organised the great Tromso openEHR conference earlier this year. I know Koray Atalag (University of Auckland) and some others were listening in.
-----

Sale of SAI’s assurance unit most likely: CIMB

Edited by Sarah Thompson, Anthony Macdonald and Jake Mitchell
While an offer for the whole of SAI Global has failed to materialise, CIMB analyst Julian Guido thinks the sale of its assurance division should be the “easiest” to achieve.
“Our scenario analysis indicates a potential sale price of $372 million to $483 million,” Guido writes in a research note to clients on Tuesday. “Unfortunately, (SAI’s) valuation still doesn’t appeal to us … with our price target reverting to our passive valuation of $4.20 per share.”
Guido says the sale of the assurance division would be the most likely transaction to proceed given “cleaner operating performance relative to the other two divisions, and identifiable potential offshore buyers such as Intertek, SGS and Bureau Veritas.”
Guido also reckons a weaker Australian dollar does not hurt for offshore buyers.
-----

Pollen app will track hayfever in the ACT

Date September 26, 2014 - 9:01AM

Fleta Page

A mobile app tracking and forecasting pollen levels has been issued by the Australian National University, designed to help hayfever and asthma sufferers, who can  in turn contribute to national research. 
The free Canberra Pollen app  has been developed by the ANU's Department of Archaeology and Natural History, which has used its expertise in pre-historic pollen to  study pollen in the modern atmosphere.
Department head Simon Haberle said it had the "biggest pollen collection in the southern hemisphere pretty much".
-----

Online CBT for an anxious FIFO worker

23 September, 2014 Dr Jan Orman
A FIFO worker is steered towards online CBT resources after admitting to feelings of panic and anxiety.
History
Gary, 38, has been a patient for many years. He experimented with drugs and alcohol during his younger years, but has since returned to the 'straight and narrow' to finish his apprenticeship, get married and start a family.
He is now a qualified electrician. Gary has recently struggled to find locally based employment. For the past nine months, he has been working in a fly-in fly-out role for a mining company.
-----

HL7 Australia #FHIR Forum and Connectathon

Posted on September 23, 2014 by Grahame Grieve
On Thursday & Friday 6-7 November 2014 Hl7 Australia is holding a FHIR Forum and Connectathon in Melbourne.
Day 1 is focused on education:
Keynote: FHIR in context … a step forward for patients  Andrew Yap, Alfred Hospital Melbourne
-----

Profile: Snioch takes global role at GS1

The use of GS1 standards in healthcare isn’t just about improving the efficiency of supply chains, and therefore organisations’ bottom lines. Instead, says Tania Snioch, industry manager for healthcare at GS1 Australia, it’s all about improving patient safety and healthcare outcomes.
“If a patient is in hospital, they have to be delivered the right healthcare product at the right time,” she says. “If the healthcare product has to be correctly identified in case there is a recall,  this demonstrates another clear example of how the GS1 standards come into play.
“The GS1 standards are the foundations that enable a product to be related to the patient. GS1 Barcodes can be scanned at the bedside or in the theatre, thereby reducing risk of the wrong product being provided to the patient, and creating records of what has been administered.”
-----

The AMT v20140930 September release is now available for download

Created on Friday, 26 September 2014
The AMT v20140930 September release is now available for download from the NEHTA website.
-----

eHealth Guide for General Practice

Getting Started with eHealth – A guide for General Practice is designed for practices or organisations using the eHealth record system through their clinical software.
Getting Started with eHealth – A guide for General Practice
This guide will show you how to:
  • How to link local patient records with their Individual Healthcare Identifier
  • Patient consent and patient privacy controls
  • Clinical documents
  • Assisting patients to register for an eHealth record
  • Becoming familiar with the system
  • Help and support contacts
-----

E-health system for soldiers launched

19th Sep 2014
A $133 MILLION electronic record system for Australian military personnel launched today in Canberra will not actually follow Australian soldiers to war. But it is likely to be free of the troubles plaguing Australia’s civilian e-health system.
Launched today by the assistant minister for defence, Stuart Robert, the Defence eHealth System will reduce red tape and provide up-to-date health data on Australian Defence Force personnel to treating clinicians and healthcare providers, Mr Roberts said. 
“Importantly, it will also allow health information to be easily and accurately passed to the Department of Veterans’ Affairs as well as to civilian health providers,” the minister said.  
-----

Return of JeHDI makes Defence Australia’s eHealth leader

The military’s long march to get its nascent eHealth system out of triage and into the hands of Australian Defence Force members and medical staff has managed to leap-frog similar civilian efforts.
The massive department said on Friday said the new ADF eHealth system has been “successfully rolled out in Defence health facilities in Queensland, the Northern Territory and Western Australia” with facilities across the rest of Australia to be up and running by “the end of 2014.”
It’s a feat likely to produce a concerned pang or two at the office of Health Minister Peter Dutton who is still contemplating the best way forward for the frequently troubled civilian eHealth counterpart, the Personally Controlled Electronic Health Record (PCEHR).
-----

Why Australian defence invested in a US$118 million eHealth system

The Australian Defence Force has just bought a new A$133 million (US$118 million) eHealth system to provide health providers accurate, up-to-date health data on their personnel.
The eHealth System will be made available to all stakeholders responsible for providing health services and benefits to defence staff, including clinicians, the Department of Veterans’ Affairs, and civilian health providers.
The members’ health data, from recruitment to discharge, will be centrally stored and updated in the system. This will help simplify internal work processes and reduce duplication of data, said Stuart Robert, Assistant Minister for Defence.
“The demands of service life can at times lead to physical injury or mental illness. It is therefore essential that Defence’s health services are at the cutting edge to ensure the provision of the best possible health care for our people,” he added.
-----

A better alternative to “Dr Google”

24 September, 2014
Over 80% of Australians are now searching for health information online, and the majority of these people are looking for information about medical conditions and symptoms*. 
With more and more patients turning to “Dr Google”, it’s important that credible health information is available online and by phone to support those who are making important health decisions at home.
Healthdirect Australia was established by the Australian Government to provide all Australians with access to trusted health information online and over the phone.
-----
Orion Health has appointed Andrew Ferrier as its new Chairman, succeeding Andrew Clements who announced his leave at the company’s annual general meeting.
-----
  • 22 September 2014 15:03

Ignia sharing industry insights at the 2014 Health Information and Technology WA conference

Ignia sharing industry insights at the 2014 Health Information and Technology WA conference
Western Australia’s only e-health conference, HITWA 2014 brings together a diverse range of industry professionals and academics to share their knowledge and stories. International, national and state-wide leaders and thinkers will use HITWA as a forum.
This year's conference theme, 'Leadership and education: Encouraging innovative technologies for improving healthcare' aims to inform attendees about leading, encouraging, educating and engaging with health workforce colleagues in collaboratively designing and building better healthcare services by incorporating innovative technologies into service delivery models.
-----

Enough already? The rise of home internet data limits—and what we do with all those gigs

  • September 24 2014
  • Finding No. 5286
  • Topic: Press Release
Source: Roy Morgan Single Source, July 2013-June 2014, sample = 20,022 Australians 14+ with a home internet connection.
Are our bandwidths getting bigger than our eyes when it comes to gobbling gigabytes? With an increasing number of Australians signing up for over 300GB per month of internet data, Roy Morgan Research looks at whether people with higher (or no) limits are actually doing more with them.
In the year to June 2014, of the 15.7 million Australians (14+) with a home internet connection 9% downloaded TV programs by computer in an average four week period, 7% downloaded feature-length movies, 9% streamed TV and 4% streamed movies.
-----

Beyond the internet: moves to set up a 'third network'

Date September 25, 2014

Stuart Corner

The public internet is ubiquitous, you can connect from anywhere to anywhere but it's a decentralised, best-effort service, with poor security.
Private data networks, on the other hand, provide guaranteed bandwidth and guaranteed quality and security, but must be preconfigured.
Now the communications industry has come up with a vision for a "third network" that will combine the flexibility of the internet with the quality and reliability of private, ethernet-based, networks.
It's the brainchild of the Metro Ethernet Forum, an industry body charged with progressing data networks based on the ethernet protocol.
-----

Microsoft offers first look at new Windows - and gives it a name

Date September 27, 2014 - 4:48PM

Bill Rigby

Microsoft will unveil a new name for its best-known product early next week when it offers the first official glimpse of its latest Windows operating system.
The project, known for the past few years as "Threshold" inside the software company and "Windows 9" outside it, will likely get an entirely new brand, or just be called Windows, analysts said, ahead of its full release early next year.
The name change is symbolic of a new direction and style for Microsoft, which is veering away from an aggressive focus on Windows and PCs, the hallmark of previous chief executive officer Steve Ballmer. The new, quieter emphasis is on selling services across all devices and is championed by new boss Satya Nadella.
-----
Enjoy!
David.

Sunday, September 28, 2014

NEHTA Produces A Guide For GPs Using The PCEHR - Very Interesting Indeed And Not Good.

This appeared just a few days ago - Document created 23/09/2014:

eHealth Guide for General Practice

Getting Started with eHealth – A guide for General Practice is designed for practices or organisations using the eHealth record system through their clinical software.
Getting Started with eHealth – A guide for General Practice
This guide will show you how to:
  • How to link local patient records with their Individual Healthcare Identifier
  • Patient consent and patient privacy controls
  • Clinical documents
  • Assisting patients to register for an eHealth record
  • Becoming familiar with the system
  • Help and support contacts
How to order brochures and factsheets
If you are interested in ordering printed brochures from us, please provide the following information within an email to ask@nehta.gov.au
  • Organisation
  • Name
  • Street Address
  • Email Address (if different from the email address you have used to request brochures)
  • Phone Number
  • Quantity (minimum is 50)
NOTE: Orders will be received within 5 working days.
-----
Here is the direct link:
Looks like having a GP as the NEHTA new chair has reminded NEHTA that writing obscure 100+ page documents for GPs just guarantees no one will ever read then and makes sure they continue not to make a difference.
In January we had this wonderful document released - and it was Version 2.0:

eHealth Clinicians User Guide

This eHealth Clinicians User Guide includes material that is relevant to both general practices and private specialist practices, however other healthcare professionals, e.g. allied health and in aged and community care, may also find this guide useful.
The eHealth Clinicians User Guide supports medical practices in navigating the complexities of eHealth (including the national eHealth record system) from planning, preparation, registration and implementation through to meaningful use. It covers key eHealth topics of interest to medical practices (including quality improvement) and focuses on the foundation products (e.g. Healthcare Identifiers, NASH, Secure Message Delivery), the national eHealth record system and other functionality currently available and being released by software vendors. Importantly it includes practical step-by-step implementation advice.
Through use of this guide you should reasonably expect to understand the benefits to your practice associated with adopting eHealth as well as some of the Organisational and Governance changes required. It also outlines some of the prerequisites for implementation and use of the eHealth features. It includes practical quick reference checklists for practice staff and links to additional education and support resources.
The eHealth Clinicians User Guide is also available in a web version at: http://www.nehta.gov.au/for-providers/about-ehealth-guidance
This was a wonderfully brief 157 pages long and as I said at the time:
“My guess is that this fiasco will be the end of any GP co-operation with the NEHRS / PCEHR.
DoHA has always wanted to reduce the cost of PIP and this will certainly do it!”
The real gem in the new document is the 54 step roadmap found in the document from page 16 and for the next few.
The rest of the 157 page document is just non-clinical jargon laid on non-clinical jargon.
That pages 125 to 134 are a Glossary shows just how clinician friendly this is!
There a links galore that one presumes are meant to be followed and so it just goes on.
The author is - not unexpectedly - a consultant hired by NEHTA.”
Here is my link to the blog where I described it and made these and other comments.
The new guide is just 9 pages and clearly written. This actually results in a useful document that is readable and allows a reader to grasp just what is going on with the PCEHR and, very probably, why one should not be involved.
This quote make it clear to me:
Page 4:

Viewing an eHealth record

 Who can view an eHealth record?

·         Any person involved in an individual’s care, who is authorised by the healthcare organisation can access an eHealth record. For example, reception staff, registered nurses, doctors. Your organisation may choose to limit access to clinical staff. Check with your organisation’s eHealth champion
·         Access is not limited to healthcare providers with a Healthcare Provider Identifier-Individual (HPI-I). Your organisation may authorise other staff who need to access the eHealth record system as part of their role in healthcare delivery (for example, an Aboriginal health worker who does not have a HPI-I). However, only providers with an HPI-I can author and upload clinical documents.
·         Organisations can authorise their staff by writing their details in the organisation’s eHealth record system security policy. Sample policies can be found on NEHTA’s website.
To me having even the possibility of non-clinicians accessing my PCEHR (see first paragraph)  - where another provider may have uploaded any information over which I might not have control (e.g. the intern uploading a discharge summary) means I would advise any sensible person to just say away!
I also have to say this rather surprised me… (Page 7)
Who can create a Shared Health Summary?
  • a registered medical practitioner
  • a registered nurse
  • an Aboriginal and Torres Strait Islander health practitioner registered with AHPRA
I had thought that it was doctors who created Shared Health Summaries (And the Aboriginal care providers) rather than nurses. To me having nurse created shared summaries further invalidates the utility of the record. How long before receptionists are adding and updating shared summaries?
The document then goes on to say that a nurse uploading a Shared Summary becomes the patient’s Nominated Healthcare Provider! Just how does that work?
At the least all shared summaries need to be created by doctors if other doctors are to be expected to trust them which I understand was the intent of the PCEHR. Nurse shared summaries just invalidate the whole thing in my view. I must have just missed this point in older documents!
My advice is for everyone to share their clinical information with their doctor and not with the PCEHR! Even better still don’t create one of these records until the controls are such that you are totally comfortable with what information may wind up in it - now and in the future.
It just seems to be getting worse…
David.